Wong’s Nursing Care of Infants and Children, 12th Edition —
Chapter 1: Perspectives of Pediatric Nursing.
1. Chapter 1 – Perspectives of Pediatric Nursing, Health
Promotion
Key Concept: Leading cause of death in 1- to 4-year-olds
Question Stem
A 2-year-old is brought to the clinic for a health-maintenance
visit. Which topic should the nurse prioritize to reduce the
child’s greatest risk of death?
A. Sun-safe behaviors
B. Proper use of rear-facing car seat
C. Water-safety and pool fencing
D. Anticipatory guidance on firearm storage
Correct Answer: C
Rationale Correct: Unintentional drowning is the single leading
cause of injury death in 1- to 4-year-olds in the U.S. (CDC, 2023).
Wong 12e Ch 1 identifies water-safety counseling as the
highest-yield injury-prevention message for this age.
Rationale Incorrect: A—Skin-cancer risk rises later; not an
immediate mortality threat. B—Important, but motor-vehicle
deaths peak 15–24 months later. D—Firearm injuries rank
below drowning in toddlers.
Teaching Point: Drowning prevention counseling saves the most
toddler lives.
, 2. Chapter 1 – Infant Mortality & Morbidity
Question Stem
Which maternal factor is the strongest predictor of infant
mortality in the United States today?
A. Advanced maternal age ≥35 years
B. Unmarried marital status
C. Preterm birth <37 weeks’ gestation
D. History of two prior cesarean births
Correct Answer: C
Rationale Correct: Preterm birth/low-birth-weight accounts for
≈65 % of all infant deaths (CDC 2022); Wong 12e Ch 1 stresses
gestational age as the pivotal variable.
Rationale Incorrect: A—Increases chromosomal risk but not the
leading direct mortality driver. B—Social correlate, weaker than
biologic maturity. D—Raises morbidity, not mortality, and is
modifiable by care practices.
Teaching Point: Gestational age is the prime biologic
determinant of infant survival.
3. Chapter 1 – Childhood Obesity & Type 2 Diabetes
Question Stem
A 10-year-old BMI >95th percentile has acanthosis nigricans.
Which laboratory result best confirms early type 2 diabetes?
,A. Fasting plasma glucose 100 mg/dL
B. HbA1c 6.7 %
C. 2-h OGTT 125 mg/dL
D. Random glucose 140 mg/dL
Correct Answer: B
Rationale Correct: ADA 2023 and Wong 12e Ch 1 define
pediatric T2DM as HbA1c ≥6.5 %; 6.7 % meets criterion with
minimal fasting burden.
Rationale Incorrect: A—Indicates impaired fasting glucose, not
diabetes. C—Value is below 200 mg/dL cutoff. D—Random
glucose ≥200 mg/dL plus symptoms is diagnostic; 140 mg/dL is
nondiagnostic.
Teaching Point: HbA1c ≥6.5 % is the preferred non-fasting
screen for obese youth.
4. Chapter 1 – Adolescent Vaping Epidemic
Question Stem
A 15-year-old who vapes 8–10 hits daily reports chest tightness.
Which assessment finding most strongly suggests e-cigarette–
associated lung injury (EVALI)?
A. Oxygen saturation 97 % on room air
B. Chest x-ray showing bilateral ground-glass opacities
C. WBC 7 000/mm³
D. Temperature 37 °C
, Correct Answer: B
Rationale Correct: CDC 2020 case definition and Wong 12e Ch 1
list bilateral infiltrates on imaging in the absence of infection as
the hallmark of EVALI.
Rationale Incorrect: A—Hypoxemia is common; 97 % saturation
argues against significant injury. C—Mild leukocytosis is
nonspecific. D—Low-grade fever may occur, but normal temp
does not rule EVALI in or out.
Teaching Point: Bilateral ground-glass opacities are the
radiologic signature of EVALI.
5. Chapter 1 – COVID-19 & Multisystem Inflammatory
Syndrome (MIS-C)
Question Stem
Two weeks after mild COVID-19, a 7-year-old presents with 5-
day fever, rash, conjunctivitis, and left ventricular dysfunction.
Which nursing action is most urgent?
A. Obtain throat culture for group A strep
B. Administer IV immune globulin per protocol
C. Schedule outpatient echocardiogram in 1 week
D. Teach hand hygiene to prevent transmission
Correct Answer: B
Rationale Correct: Current AAP/WHO and Wong 12e Ch 1
guidelines recommend immediate IVIG ± steroids to reduce
Chapter 1: Perspectives of Pediatric Nursing.
1. Chapter 1 – Perspectives of Pediatric Nursing, Health
Promotion
Key Concept: Leading cause of death in 1- to 4-year-olds
Question Stem
A 2-year-old is brought to the clinic for a health-maintenance
visit. Which topic should the nurse prioritize to reduce the
child’s greatest risk of death?
A. Sun-safe behaviors
B. Proper use of rear-facing car seat
C. Water-safety and pool fencing
D. Anticipatory guidance on firearm storage
Correct Answer: C
Rationale Correct: Unintentional drowning is the single leading
cause of injury death in 1- to 4-year-olds in the U.S. (CDC, 2023).
Wong 12e Ch 1 identifies water-safety counseling as the
highest-yield injury-prevention message for this age.
Rationale Incorrect: A—Skin-cancer risk rises later; not an
immediate mortality threat. B—Important, but motor-vehicle
deaths peak 15–24 months later. D—Firearm injuries rank
below drowning in toddlers.
Teaching Point: Drowning prevention counseling saves the most
toddler lives.
, 2. Chapter 1 – Infant Mortality & Morbidity
Question Stem
Which maternal factor is the strongest predictor of infant
mortality in the United States today?
A. Advanced maternal age ≥35 years
B. Unmarried marital status
C. Preterm birth <37 weeks’ gestation
D. History of two prior cesarean births
Correct Answer: C
Rationale Correct: Preterm birth/low-birth-weight accounts for
≈65 % of all infant deaths (CDC 2022); Wong 12e Ch 1 stresses
gestational age as the pivotal variable.
Rationale Incorrect: A—Increases chromosomal risk but not the
leading direct mortality driver. B—Social correlate, weaker than
biologic maturity. D—Raises morbidity, not mortality, and is
modifiable by care practices.
Teaching Point: Gestational age is the prime biologic
determinant of infant survival.
3. Chapter 1 – Childhood Obesity & Type 2 Diabetes
Question Stem
A 10-year-old BMI >95th percentile has acanthosis nigricans.
Which laboratory result best confirms early type 2 diabetes?
,A. Fasting plasma glucose 100 mg/dL
B. HbA1c 6.7 %
C. 2-h OGTT 125 mg/dL
D. Random glucose 140 mg/dL
Correct Answer: B
Rationale Correct: ADA 2023 and Wong 12e Ch 1 define
pediatric T2DM as HbA1c ≥6.5 %; 6.7 % meets criterion with
minimal fasting burden.
Rationale Incorrect: A—Indicates impaired fasting glucose, not
diabetes. C—Value is below 200 mg/dL cutoff. D—Random
glucose ≥200 mg/dL plus symptoms is diagnostic; 140 mg/dL is
nondiagnostic.
Teaching Point: HbA1c ≥6.5 % is the preferred non-fasting
screen for obese youth.
4. Chapter 1 – Adolescent Vaping Epidemic
Question Stem
A 15-year-old who vapes 8–10 hits daily reports chest tightness.
Which assessment finding most strongly suggests e-cigarette–
associated lung injury (EVALI)?
A. Oxygen saturation 97 % on room air
B. Chest x-ray showing bilateral ground-glass opacities
C. WBC 7 000/mm³
D. Temperature 37 °C
, Correct Answer: B
Rationale Correct: CDC 2020 case definition and Wong 12e Ch 1
list bilateral infiltrates on imaging in the absence of infection as
the hallmark of EVALI.
Rationale Incorrect: A—Hypoxemia is common; 97 % saturation
argues against significant injury. C—Mild leukocytosis is
nonspecific. D—Low-grade fever may occur, but normal temp
does not rule EVALI in or out.
Teaching Point: Bilateral ground-glass opacities are the
radiologic signature of EVALI.
5. Chapter 1 – COVID-19 & Multisystem Inflammatory
Syndrome (MIS-C)
Question Stem
Two weeks after mild COVID-19, a 7-year-old presents with 5-
day fever, rash, conjunctivitis, and left ventricular dysfunction.
Which nursing action is most urgent?
A. Obtain throat culture for group A strep
B. Administer IV immune globulin per protocol
C. Schedule outpatient echocardiogram in 1 week
D. Teach hand hygiene to prevent transmission
Correct Answer: B
Rationale Correct: Current AAP/WHO and Wong 12e Ch 1
guidelines recommend immediate IVIG ± steroids to reduce
