Saunders Comprehensive Review for the NCLEX-PN®
Examination
9th Edition
Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1
A 15-month-old toddler is admitted with suspected iron-
deficiency anemia. Which nursing action is the most
appropriate when teaching the parents about iron
supplementation?
A. Give iron with whole cow’s milk to increase absorption.
B. Mix the iron with formula or breast milk to mask taste.
C. Give iron with orange juice or another vitamin C source.
D. Administer iron at bedtime to decrease GI upset.
Answer: C
Rationale:
• Correct (C): Vitamin C increases nonheme iron absorption;
giving iron with juice improves bioavailability and is a
recommended safety/practice principle for pediatric iron
therapy. Developmentally, parents should be taught
practical measures that are safe and effective.
,• Incorrect (A): Cow’s milk interferes with iron absorption
and may worsen iron deficiency; it can also risk
constipation/iron loss.
• Incorrect (B): Mixing iron with formula or breast milk may
be acceptable in some cases, but repeated mixing with
milk can decrease absorption (because milk inhibits iron
absorption). Masking taste is secondary to ensuring
adequate absorption.
• Incorrect (D): Giving iron at bedtime may decrease visible
GI upset but is not best practice if it reduces absorption
(timing relative to meals/juice matters more); also
preventing vomiting/choking is important but absorption
optimization is priority.
2
A 4-year-old in the emergency department has inspiratory
stridor, a barking cough, and low-grade fever that worsened
overnight. The nurse suspects viral croup. Which of the
following is the priority action?
A. Administer humidified cool mist and calm the child.
B. Immediately prepare for endotracheal intubation.
C. Give oral corticosteroids and discharge home.
D. Begin intravenous broad-spectrum antibiotics.
Answer: A
Rationale:
,• Correct (A): For mild to moderate viral croup, calming the
child and providing humidified air or cool mist can reduce
upper airway edema; keeping the child calm maintains
airway patency (developmental principle: reduce
fear/crying in preschoolers). This is the immediate,
noninvasive priority.
• Incorrect (B): Intubation is reserved for severe airway
compromise (e.g., severe retractions, stridor at rest with
cyanosis). Not the first action for typical croup.
• Incorrect (C): Oral corticosteroids can be appropriate
(dexamethasone), but immediate calming and mist
therapy are first; also one shouldn't discharge until
response to therapy and assessment are satisfactory.
• Incorrect (D): Viral croup is usually viral; antibiotics are not
indicated unless bacterial superinfection is suspected.
3
A 2-year-old with bronchiolitis is receiving supplemental
oxygen. The child’s pulse oximeter reading is 90% on room air
and 95% with oxygen. The parent asks why the child needs
oxygen when he is sleeping and seems comfortable. Which
nursing response is best?
A. “Oxygen is only for severe cases; we’ll discontinue as soon
as possible.”
B. “Oxygen helps keep your child’s tissues healthy by
, improving oxygen levels.”
C. “Oxygen makes children sleepy — that’s why we give it.”
D. “It’s required by hospital policy even if it’s not necessary.”
Answer: B
Rationale:
• Correct (B): Explains purpose in family-centered,
developmentally appropriate language: oxygen improves
arterial oxygenation and tissue perfusion. This educates
the parent and supports family involvement.
• Incorrect (A): Minimizes current need and is inaccurate;
oxygen is indicated when SpO₂ is below target (often <92%
— individual policies vary).
• Incorrect (C): Incorrect and potentially harmful
misinformation. Oxygen does not cause children to
become sleepy in the therapeutic context.
• Incorrect (D): Not an honest/accurate explanation and
undermines trust.
4
A newborn has a harsh, continuous murmur best heard at the
left infraclavicular area and signs of feeding intolerance. The
nurse suspects a patent ductus arteriosus (PDA). Which
statement about PDA is most accurate for the nurse to
include in parent teaching?
Examination
9th Edition
Author(s)Linda Anne Silvestri; Angela Silvestri
TEST BANK
1
A 15-month-old toddler is admitted with suspected iron-
deficiency anemia. Which nursing action is the most
appropriate when teaching the parents about iron
supplementation?
A. Give iron with whole cow’s milk to increase absorption.
B. Mix the iron with formula or breast milk to mask taste.
C. Give iron with orange juice or another vitamin C source.
D. Administer iron at bedtime to decrease GI upset.
Answer: C
Rationale:
• Correct (C): Vitamin C increases nonheme iron absorption;
giving iron with juice improves bioavailability and is a
recommended safety/practice principle for pediatric iron
therapy. Developmentally, parents should be taught
practical measures that are safe and effective.
,• Incorrect (A): Cow’s milk interferes with iron absorption
and may worsen iron deficiency; it can also risk
constipation/iron loss.
• Incorrect (B): Mixing iron with formula or breast milk may
be acceptable in some cases, but repeated mixing with
milk can decrease absorption (because milk inhibits iron
absorption). Masking taste is secondary to ensuring
adequate absorption.
• Incorrect (D): Giving iron at bedtime may decrease visible
GI upset but is not best practice if it reduces absorption
(timing relative to meals/juice matters more); also
preventing vomiting/choking is important but absorption
optimization is priority.
2
A 4-year-old in the emergency department has inspiratory
stridor, a barking cough, and low-grade fever that worsened
overnight. The nurse suspects viral croup. Which of the
following is the priority action?
A. Administer humidified cool mist and calm the child.
B. Immediately prepare for endotracheal intubation.
C. Give oral corticosteroids and discharge home.
D. Begin intravenous broad-spectrum antibiotics.
Answer: A
Rationale:
,• Correct (A): For mild to moderate viral croup, calming the
child and providing humidified air or cool mist can reduce
upper airway edema; keeping the child calm maintains
airway patency (developmental principle: reduce
fear/crying in preschoolers). This is the immediate,
noninvasive priority.
• Incorrect (B): Intubation is reserved for severe airway
compromise (e.g., severe retractions, stridor at rest with
cyanosis). Not the first action for typical croup.
• Incorrect (C): Oral corticosteroids can be appropriate
(dexamethasone), but immediate calming and mist
therapy are first; also one shouldn't discharge until
response to therapy and assessment are satisfactory.
• Incorrect (D): Viral croup is usually viral; antibiotics are not
indicated unless bacterial superinfection is suspected.
3
A 2-year-old with bronchiolitis is receiving supplemental
oxygen. The child’s pulse oximeter reading is 90% on room air
and 95% with oxygen. The parent asks why the child needs
oxygen when he is sleeping and seems comfortable. Which
nursing response is best?
A. “Oxygen is only for severe cases; we’ll discontinue as soon
as possible.”
B. “Oxygen helps keep your child’s tissues healthy by
, improving oxygen levels.”
C. “Oxygen makes children sleepy — that’s why we give it.”
D. “It’s required by hospital policy even if it’s not necessary.”
Answer: B
Rationale:
• Correct (B): Explains purpose in family-centered,
developmentally appropriate language: oxygen improves
arterial oxygenation and tissue perfusion. This educates
the parent and supports family involvement.
• Incorrect (A): Minimizes current need and is inaccurate;
oxygen is indicated when SpO₂ is below target (often <92%
— individual policies vary).
• Incorrect (C): Incorrect and potentially harmful
misinformation. Oxygen does not cause children to
become sleepy in the therapeutic context.
• Incorrect (D): Not an honest/accurate explanation and
undermines trust.
4
A newborn has a harsh, continuous murmur best heard at the
left infraclavicular area and signs of feeding intolerance. The
nurse suspects a patent ductus arteriosus (PDA). Which
statement about PDA is most accurate for the nurse to
include in parent teaching?
