Peds Exam 1 NCLEX style questions
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 - ANS 3. 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. - ANS 3. 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 - ANS 3. 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 - ANS 3. 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 - ANS 2. 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." - ANS 2. "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
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 - ANS 3. 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. - ANS 3. 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 - ANS 3. 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 - ANS 3. 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 - ANS 2. 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." - ANS 2. "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
