Peds Exam 1 NCLEX style questions and answers
A 10-year-old girl is being treated for rheumatic fever. Which would be an appropriate activity while she is on
bed rest?
1. Stringing large wooden beads
2. Engaging in a pillow fight
3. Making craft items from felt
4. Watching television - ans3. Craft work allows her to accomplish something while meeting her needs for rest.
Industry is the developmental task for school-age children. The joint pains with rheumatic fever tend to be in
the large joints, not the small ones, so craft work using finger activity would probably not be painful. Stringing
large wooden beads is appropriate for younger children. Pillow fighting requires too much energy for a child on
bed rest and is not appropriate for a hospital environment. Watching television is a solitary activity with no
sense of accomplishment
A 2-year-old child is hospitalized for a fractured femur. During his first two days in the hospital, he lies quietly,
sucks his thumb, and does not cry. Which is the best interpretation of his behavior?
1. He has made a good adjustment to being in the hospital.
2. He is comfortable with the nurses caring for him.
3. He is experiencing anxiety.
4. He does not have a good relationship with his parents. - ans3. The child's behavior is typical of the despair
phase of toddler responses to anxiety. The child should cry. Lying quietly, sucking his thumb, and saying
nothing are suggestive of severe anxiety, a bad adjustment to the hospital, and no comfort with the nurses.
This anxiety response does not suggest a poor relationship with his parents. In fact, his severe separation
anxiety may be because he is so close to his parents.
A 3-year-old child has all of the following abilities. Which did he acquire most recently?
1. Walking
2. Throwing a large ball
3. Riding a tricycle
4. Stating his name - ans3. Riding a tricycle is 3-year-old behavior. Remember, "three years, three wheels."
Children start to walk at about 1 year of age. Throwing a large ball and stating his name are 2-year-old
behaviors. Remember to use developmental trends when determining the most recently acquired behavior—
head to tail and simple to complex. Look for a complex lower body behavior.
,A 5-year-old child had major surgery several days ago and is allowed to be up. When planning diversional
activity, which action by the nurse is most appropriate?
1. Give the child a book to read.
2. Play a board game with the child.
3. Encourage the child to play house with other children.
4. Turn on the television so the child can watch cartoons - ans3. Five-year-old children like cooperative play,
such as playing house. The other activities are solitary activities. Note that the child is several days postsurgery.
Most 5-year-olds are not able to read a book by themselves. Playing a board game with a child is not wrong,
but it is a solitary activity. Most 5-year-olds would prefer to play with other children. There is almost always a
better alternative than turning on the television. This child is several days postsurgery and is able to be up and
play with others.
A child has just been admitted to the facility and is displaying fear related to separation from his parents, the
room being too dark, being hurt while in the hospital, and having many different staff members come into the
room. Based on the nurse's knowledge of growth and development, the child is likely:
1. 7 to 12 months old (an infant).
2. 1 to 3 years old (a toddler).
3. 6 to 12 years old (a school-age child).
4. 12 to 18 years old (an adolescent - ans2. 1 to 3 years old (a toddler).
RATIONALE: Toddlers show fear of separation from their parents, the dark, loud or sudden noises, injury,
strangers, certain persons, certain situations, animals, large objects or machines, and change in environment.
Infants show fear of strangers, the sudden appearance of unexpected and looming objects (including people),
animals, and heights. School-age children show fear of supernatural beings, injury, storms, the dark, staying
alone, separation from parents, things seen on television and in the movies, injury, tests and failure in school,
consequences related to unattractive physical appearance, and death. Adolescents show fear of inept social
performance, social isolation, sexuality, drugs, war, divorce, crowds, gossip, public speaking, plane and car
crashes, and death.
A child, age 3, is admitted to the pediatric unit with dehydration after 2 days of nausea and vomiting. The
mother tells the nurse that her child's illness "is all my fault." How should the nurse respond?
, 1. "Maybe next time you'll bring the child in sooner."
2. "Tell me why you think this is your fault."
3. "Try not to cry in front of the child. It'll only upset her."
4. "Don't be so upset. Your child will be fine." - ans2. "Tell me why you think this is your fault."
RATIONALE: Having the mother explain why she feels the illness is her fault is appropriate because many
parents feel responsible for their child's illness and may need instruction about the actual cause of the illness.
Pointing out that the mother could have brought the child in sooner could increase the mother's feelings of
guilt. Telling the mother not to cry or be upset ignores her feelings
A chronically ill school-age child is most vulnerable to which stressor?
1. Mutilation anxiety
2. Anticipatory grief
3. Anxiety over school absences
4. Fear of hospital procedures - ans3. Anxiety over school absences
RATIONALE: The school-age child is becoming industrious and attempts to master school-related activities.
Therefore, school absences are likely to cause extreme anxiety for a school-age child who's chronically ill.
Mutilation anxiety is more common in adolescents. Anticipatory grief is rare in a school-age child. Fear of
hospital procedures is most pronounced in preschool-age children.
A hospitalized 2.5-year-old child has a temper tantrum while her mother is bathing her. Her mother asks the
nurse how she should handle this behavior. Which information should be included in the nurse's reply?
1. Temper tantrums in a hospitalized child indicate regression.
2. Tantrums suggest a poorly developed sense of trust.
3. Discipline is necessary when a child has a temper tantrum.
4. This behavior is a normal response to limit setting in a child of this age. - ans4. Temper tantrums are a normal
response to limit setting in a 2-year-old child. Answer 1 might be correct if the child were older. However,
A 10-year-old girl is being treated for rheumatic fever. Which would be an appropriate activity while she is on
bed rest?
1. Stringing large wooden beads
2. Engaging in a pillow fight
3. Making craft items from felt
4. Watching television - ans3. Craft work allows her to accomplish something while meeting her needs for rest.
Industry is the developmental task for school-age children. The joint pains with rheumatic fever tend to be in
the large joints, not the small ones, so craft work using finger activity would probably not be painful. Stringing
large wooden beads is appropriate for younger children. Pillow fighting requires too much energy for a child on
bed rest and is not appropriate for a hospital environment. Watching television is a solitary activity with no
sense of accomplishment
A 2-year-old child is hospitalized for a fractured femur. During his first two days in the hospital, he lies quietly,
sucks his thumb, and does not cry. Which is the best interpretation of his behavior?
1. He has made a good adjustment to being in the hospital.
2. He is comfortable with the nurses caring for him.
3. He is experiencing anxiety.
4. He does not have a good relationship with his parents. - ans3. The child's behavior is typical of the despair
phase of toddler responses to anxiety. The child should cry. Lying quietly, sucking his thumb, and saying
nothing are suggestive of severe anxiety, a bad adjustment to the hospital, and no comfort with the nurses.
This anxiety response does not suggest a poor relationship with his parents. In fact, his severe separation
anxiety may be because he is so close to his parents.
A 3-year-old child has all of the following abilities. Which did he acquire most recently?
1. Walking
2. Throwing a large ball
3. Riding a tricycle
4. Stating his name - ans3. Riding a tricycle is 3-year-old behavior. Remember, "three years, three wheels."
Children start to walk at about 1 year of age. Throwing a large ball and stating his name are 2-year-old
behaviors. Remember to use developmental trends when determining the most recently acquired behavior—
head to tail and simple to complex. Look for a complex lower body behavior.
,A 5-year-old child had major surgery several days ago and is allowed to be up. When planning diversional
activity, which action by the nurse is most appropriate?
1. Give the child a book to read.
2. Play a board game with the child.
3. Encourage the child to play house with other children.
4. Turn on the television so the child can watch cartoons - ans3. Five-year-old children like cooperative play,
such as playing house. The other activities are solitary activities. Note that the child is several days postsurgery.
Most 5-year-olds are not able to read a book by themselves. Playing a board game with a child is not wrong,
but it is a solitary activity. Most 5-year-olds would prefer to play with other children. There is almost always a
better alternative than turning on the television. This child is several days postsurgery and is able to be up and
play with others.
A child has just been admitted to the facility and is displaying fear related to separation from his parents, the
room being too dark, being hurt while in the hospital, and having many different staff members come into the
room. Based on the nurse's knowledge of growth and development, the child is likely:
1. 7 to 12 months old (an infant).
2. 1 to 3 years old (a toddler).
3. 6 to 12 years old (a school-age child).
4. 12 to 18 years old (an adolescent - ans2. 1 to 3 years old (a toddler).
RATIONALE: Toddlers show fear of separation from their parents, the dark, loud or sudden noises, injury,
strangers, certain persons, certain situations, animals, large objects or machines, and change in environment.
Infants show fear of strangers, the sudden appearance of unexpected and looming objects (including people),
animals, and heights. School-age children show fear of supernatural beings, injury, storms, the dark, staying
alone, separation from parents, things seen on television and in the movies, injury, tests and failure in school,
consequences related to unattractive physical appearance, and death. Adolescents show fear of inept social
performance, social isolation, sexuality, drugs, war, divorce, crowds, gossip, public speaking, plane and car
crashes, and death.
A child, age 3, is admitted to the pediatric unit with dehydration after 2 days of nausea and vomiting. The
mother tells the nurse that her child's illness "is all my fault." How should the nurse respond?
, 1. "Maybe next time you'll bring the child in sooner."
2. "Tell me why you think this is your fault."
3. "Try not to cry in front of the child. It'll only upset her."
4. "Don't be so upset. Your child will be fine." - ans2. "Tell me why you think this is your fault."
RATIONALE: Having the mother explain why she feels the illness is her fault is appropriate because many
parents feel responsible for their child's illness and may need instruction about the actual cause of the illness.
Pointing out that the mother could have brought the child in sooner could increase the mother's feelings of
guilt. Telling the mother not to cry or be upset ignores her feelings
A chronically ill school-age child is most vulnerable to which stressor?
1. Mutilation anxiety
2. Anticipatory grief
3. Anxiety over school absences
4. Fear of hospital procedures - ans3. Anxiety over school absences
RATIONALE: The school-age child is becoming industrious and attempts to master school-related activities.
Therefore, school absences are likely to cause extreme anxiety for a school-age child who's chronically ill.
Mutilation anxiety is more common in adolescents. Anticipatory grief is rare in a school-age child. Fear of
hospital procedures is most pronounced in preschool-age children.
A hospitalized 2.5-year-old child has a temper tantrum while her mother is bathing her. Her mother asks the
nurse how she should handle this behavior. Which information should be included in the nurse's reply?
1. Temper tantrums in a hospitalized child indicate regression.
2. Tantrums suggest a poorly developed sense of trust.
3. Discipline is necessary when a child has a temper tantrum.
4. This behavior is a normal response to limit setting in a child of this age. - ans4. Temper tantrums are a normal
response to limit setting in a 2-year-old child. Answer 1 might be correct if the child were older. However,
