Pedia Questions.pdf

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PEDIATRIC NURSING

“Our greatest glory is not in never falling, but in rising every time wefall…”

Name: ______________________________________________ Score: _________

QUESTIONS

1. A nurse from the surgical department is reassigned to the pediatric unit. Thecharge nurse should recognize that the child at highest risk for cardiac arrestand is the least likely to be assigned to this nurse is which child?A) Congenital cardiac defectsB) An acute febrile illnessC) Prolonged hypoxemiaD) Severe multiple trauma

2. The nurse is assessing a 2 year-old client with a possible diagnosis of

congenital heart disease. Which of these is most likely to be seen with thisdiagnosis?A) Several otitis media episodes in the last yearB) Weight and height in 10th percentile since birthC) Takes frequent rest periods while playingD) Changing food preferences and dislikes

3. The nurse is reassigned to work at the Poison Control Center telephone hotline.In which of these cases of childhood poisoning would the nurse suggest thatparents have the child drink orange juice?A) An 18 month-old who ate an undetermined amount of crystal drain cleanerB) A 14 month-old who chewed 2 leaves of a philodendron plantC) A 20 month-old who is found sitting on the bathroom floor beside an empty

bottle of diazepam (Valium)D) A 30 month-old who has swallowed a mouthful of charcoal lighter fluid

4. Upon examining the mouth of a 3 year-old child, the nurse discovers that theteeth have chalky white-to-yellowish staining with pitting of the enamel. Which ofthe following conditions would most likely explain these findings?A) Ingestion of tetracyclineB) Excessive fluoride intakeC) Oral iron therapyD) Poor dental hygiene

5. The nurse is discussing dietary intake with an adolescent who has acne. The most

appropriate statement for the nurse isA) "Eat a balanced diet for your age."B) "Increase your intake of protein and Vitamin A."C) "Decrease fatty foods from your diet."D) "Do not use caffeine in any form, including chocolate."

6. The nurse is caring for a child who has just returned from surgery following atonsillectomy and adenoidectomy. Which action by the nurse is appropriate?A) Offer ice cream every 2 hoursB) Place the child in a supine positionC) Allow the child to drink through a strawD) Observe swallowing patterns

7. The nurse in a well-child clinic examines many children on a daily basis. Whichof the following toddlers requires further follow up?A) A 13 month-old unable to walkB) A 20 month-old only using 2 and 3 word sentencesC) A 24 month-old who cries during examinationD) A 30 month-old only drinking from a sippy cup

8. A 15 year-old client with a lengthy confining illness is at risk for alteredgrowth and development of which task?A) Loss of control

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B) InsecurityC) DependenceD) Lack of trust

9. In providing care to a 14-year-old adolescent with scoliosis, which of thefollowing will be most difficult for this client?A) Compliance with treatment regimensB) Looking different from their peers

C) Lacking independence in activitiesD) Reliance on family for their social support

10. The nurse is preparing to perform a physical examination on an 8 month-old whois sitting contentedly on his mother's lap. Which of the following should thenurse do first?A) Elicit reflexesB) Measure height and weightC) Auscultate heart and lungsD) Examine the ears

11. Which of these principles should the nurse apply when performing a nutritional

assessment on a 2 year-old client?A) An accurate measurement of intake is not reliableB) The food pyramid is not used in this age groupC) A serving size at this age is about 2 tablespoonsD) Total intake varies greatly each day

12. The nurse measures the head and chest circumferences of a 20-month-old infant.After comparing the measurements, the nurse finds that they are approximately thesame. What action should the nurse take?A) Notify the health care providerB) Palpate the anterior fontanelC) Feel the posterior fontanelD) Record these normal findings

13. At a routine clinic visit, parents express concern that their 4-year-old iswetting the bed several times a month. What is the nurse's best response?A) "This is normal at this time of day."B) "How long has this been occurring?"C) "Do you offer fluids at night?"D) "Have you tried waking her to urinate?"

14. The nurse is teaching parents of an infant about introduction of solid food totheir baby. What is the first food they can add to the diet?A) VegetablesB) CerealC) FruitD) Meats

15. When counseling parents of a child who has recently been diagnosed withhemophilia, what must the nurse know about the offspring of a normal father and acarrier mother?A) It is likely that all sons are affectedB) There is a 50% probability that sons will have the diseaseC) Every daughter is likely to be a carrierD) There is a 25% chance a daughter will be a carrier

16. A 7 year-old child is hospitalized following a major burn to the lowerextremities. A diet high in protein and carbohydrates is recommended. The nurseinforms the child and family that the most important reason for this diet is toA) Promote healing and strengthen the immune systemB) Provide a well balanced nutritional intakeC) Stimulate increased peristalsis absorptionD) Spare protein catabolism to meet metabolic needs

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17. The parents of a 7 year-old tell the nurse their child has started to "tattle"on siblings. In interpreting this new behavior, how should the nurse explain thechild's actions to the parents?A) The ethical sense and feelings of justice are developingB) Attempts to control the family use new coping stylesC) Insecurity and attention getting are common motivesD) Complex thought processes help to resolve conflicts

18. The nurse is caring for a 7 year-old child who is being discharged following atonsillectomy. Which of the following instructions is appropriate for the nurse toteach the parents?A) Report a persistent cough to the health care providerB) The child can return to school in 4 daysC) Administer chewable aspirin for painD) The child may gargle with saline as necessary for discomfort

19. The nurse is caring for a 14 month-old just diagnosed with Cystic Fibrosis. Theparents state this is the first child in either family with this disease, and askabout the risk to future children. What is the best response by the nurse?

A) 1 in 4 chance for each child to carry that traitB) 1 in 4 risk for each child to have the diseaseC) 1 in 2 chance of avoiding the trait and diseaseD) 1 in 2 chance that each child will have the disease

20. Which of the following statements describes what the nurse must know in orderto provide anticipatory guidance to parents of a toddler about readiness fortoilet training?A) The child learns voluntary sphincter control through repetitionB) Myelination of the spinal cord is completed by this ageC) Neuronal impulses are interrupted at the base of the gangliaD) The toddler can understand cause and effect

21. An anxious parent of a 4-year-old consults the nurse for guidance in how toanswer the child's question, "Where do babies come from?" What is the nurse's bestresponse to the parent?A) "When a child asks a question, give a simple answer."B) "Children ask many questions, but are not looking for answers."C) "This question indicates interest in sex beyond this age."D) "Full and detailed answers should be given to all questions."

22. A 3-year-old child is treated in the emergency department after ingestion of 1ounce of a liquid narcotic. What action should the nurse do first?

A) Provide the ordered humidified oxygen via maskB) Suction the mouth and the noseC) Check the mouth and radial pulseD) Start the ordered intravenous fluids

23. In teaching parents to associate prevention with the lifestyle of their childwith sickle cell disease, the nurse should emphasize that a priority for theirchild is toA) Avoid overheating during physical activitiesB) Maintain normal activity with some restrictionsC) Be cautious of others with viruses or temperaturesD) Maintain routine immunizations

24. A parent has numerous questions regarding normal growth and development of a 10month-old infant. Which of the following parameters is of most concern to thenurse?A) 50% increase in birth weightB) Head circumference greater than chestC) Crying when the parents leaveD) Able to stand up briefly in play pen

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25. The nurse is assessing a 4 year-old for possible developmental dysplasia of theright hip. Which finding would the nurse expect?A) Pelvic tip downwardB) Right leg lengtheningC) Ortolani signD) Characteristic limp

26. A 2 year-old child has recently been diagnosed with cystic fibrosis. The nurseis teaching the parents about home care for the child. Which of the followinginformation is appropriate for the nurse to include?A) Allow the child to continue normal activitiesB) Schedule frequent rest periodsC) Limit exposure to other childrenD) Restrict activities to inside the house

27. Parents of a 7 year-old child call the clinic nurse because their daughter wassent home from school because of a rash. The child had been seen the day before bythe health care provider and diagnosed with Fifth Disease (erythema infectiosum).What is the most appropriate action by the nurse?

A) Tell the parents to bring the child to the clinic for further evaluationB) Refer the school officials to printed materials about this viral illnessC) Inform the teacher that the child is receiving antibiotics for the rashD) Explain that this rash is not contagious and does not require isolation

28. The nurse is caring for a 12 year-old with an acute illness. Which of thefollowing indicates the nurse understands common sibling reactions tohospitalization?A) Younger siblings adapt very wellB) Visitation is helpful for bothC) The siblings may enjoy privacyD) Those cared for at home cope better

29. What is the best way for the nurse to accomplish a health history on a 14-year-old client?A) Have the mother present to verify informationB) Allow an opportunity for the teen to express feelingsC) Use the same type of language as the adolescentD) Focus the discussion of risk factors in the peer group

30. A 2 year-old child is being treated with Amoxicillin suspension, 200 milligramsper dose, for acute otitis media. The child weighs 30 lb. (15 kg) and the dailydose range is 20-40 mg/kg of body weight, in three divided doses every 8 hours.Using principles of safe drug administration, what should the nurse do next?A) Give the medication as ordered

B) Call the health care provider to clarify the doseC) Recognize that antibiotics are over-prescribedD) Hold the medication as the dosage is too low

31. The nurse is performing a developmental assessment on an 8-month-old. Whichfinding should be reported to the health care provider?A) Lifts head from the prone positionB) Rolls from abdomen to backC) Responds to parents' voicesD) Falls forward when sitting

32. The nurse caring for a 14 year-old boy with severe Hemophilia A, who wasadmitted after a fall while playing basketball. In understanding his behavior andin planning care for this client, what must the nurse understand about adolescentswith hemophilia?A) Must have structured activitiesB) Often take part in active sportsC) Explain limitations to peer groupsD) Avoid risks after bleeding episodes

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33. The nurse is caring for a newborn who has just been diagnosed with hypospadias.After discussing the defect with the parents, the nurse should expect thatA) Circumcision can be performed at any timeB) Initial repair is delayed until ages 6-8C) Post-operative appearance will be normalD) Surgery will be performed in stages

34. A neonate born 12 hours ago to a methadone maintained woman is exhibiting a

hyperactive MORO reflex and slight tremors. The newborn passed one loose, waterystool. Which of these is a nursing priority?A) Hold the infant at frequent intervals.B) Assess for neonatal withdrawal syndromeC) Offer fluids to prevent dehydrationD) Administer paregoric to stop diarrhea

35. While planning care for a preschool aged child, the nurse understandsdevelopmental needs. Which of the following would be of the most concern to thenurse?A) Playing imaginativelyB) Expressing shameC) Identifying with familyD) Exploring the playroom

36. The nurse is caring for 2 children who have had surgical repair of congenitalheart defects. For which defect is it a priority to assess for findings of heartconduction disturbance?A) Artrial septal defectB) Patent ductus arteriosusC) Aortic stenosisD) Ventricular septal defect

37. In a child with suspected coarctation of the aorta, the nurse would expect tofind:

A) Strong pedal pulsesB) Diminishing carotid pulsesC) Normal femoral pulsesD) Bounding pulses in the arms

38. The nurse is caring for a child receiving chest physiotherapy (CPT). Which ofthe following actions by the nurse would be appropriate?A) Schedule the therapy thirty minutes after mealsB) Teach the child not to cough during the treatmentC) Confine the percussion to the rib cage areaD) Place the child in a prone position for the therapy

39. The nurse is talking to parents about nutrition in school aged children. Whichof the following is the most common nutritional disorder in this age group?A) BulimiaB) AnorexiaC) ObesityD) Malnutrition

40. At a well baby clinic the nurse is assigned to assess an 8 month-old child.Which of these developmental achievements would the nurse anticipate that thechild would be able to perform?A) Say 2 wordsB) Pull up to standC) Sit without support

D) Drink from a cup

41. First-time parents bring their 5 day-old infant to the pediatrician's officebecause they are extremely concerned about its breathing pattern. The nurseassesses the baby and finds that the breath sounds are clear with equal chestexpansion. The respiratory rate is 38-42 breaths per minute with occasionalperiods of apnea lasting 10 seconds in length. What is the correct analysis ofthese findings?A) The pediatrician must examine the baby

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B) Emergency equipment should be availableC) This breathing pattern is normalD) A future referral may be indicated

42. A 30 month-old child is admitted to the hospital unit. Which of the followingtoys would be appropriate for the nurse to select from the toy room for thischild?A) Cartoon stickers

B) Large wooden puzzleC) Blunt scissors and paperD) Beach ball

43. A 2 year-old child has just been diagnosed with cystic fibrosis. The child'sfather asks the nurse "What is our major concern now, and what will we have todeal with in the future?" Which of the following is the best response?A) "There is a probability of life-long complications."B) "Cystic fibrosis results in nutritional concerns that can be dealt with."C) "Thin, tenacious secretions from the lungs are a constant struggle in cysticfibrosis."D) "You will work with a team of experts and also have access to a support groupthat the family can attend."

44. A mother asks the nurse if she should be concerned about the tendency of herchild to stutter. What assessment data will be most useful in counseling theparent?A) Age of the childB) Sibling position in familyC) Stressful family eventsD) Parental discipline strategies

45. During an examination of a 2 year-old child with a tentative diagnosis ofWilm's tumor, the nurse would be most concerned about which statement by themother?

A) My child has lost 3 pounds in the last month.B) Urinary output seemed to be less over the past 2 days.C) All the pants have become tight around the waist.D) The child prefers some salty foods more than others.

46. Which type of accidental poisoning would the nurse expect to occur in childrenunder age 6?A) Oral ingestionB) Topical contactC) InhalationD) Eye splashes

47. A mother wants to switch her 9 month-old infant from an iron-fortified formula

to whole milk because of the expense. Upon further assessment, the nurse findsthat the baby eats table foods well, but drinks less milk than before. What is thebest advice by the nurse?A) Change the baby to whole milkB) Add chocolate syrup to the bottleC) Continue with the present formulaD) Offer fruit juice frequently

48. A nurse is conducting a community wide seminar on childhood safety issues.Which of these children is at the highest risk for poisoning?A) 9 month-old who stays with a sitter 5 days a weekB) 20 month-old who has just learned to climb stairsC) 10 year-old who occasionally stays at home unattendedD) 15 year-old who likes to repair bicycles

49. The nurse assesses delayed gross motor development in a 3 year-old child. Theinability of the child to do which action confirms this finding?A) Stand on one footB) Catch a ballC) Skip on alternate feet

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D) Ride a bicycle

50. A pre-term newborn is to be fed breast milk through nasogastric tube. Why isbreast milk preferred over formula for premature infants?A) Contains less lactoseB) Is higher in calories/ounceC) Provides antibodiesD) Has less fatty acid

51. Which of the following nursing assessments in an infant is most valuable inidentifying serious visual defects?A) Red reflex testB) Visual acuityC) Pupil response to lightD) Cover test

52. Which nursing action is a priority as the plan of care is developed for a 7year-old child hospitalized for acute glomerulonephritis?A) Assess for generalized edemaB) Monitor for increased urinary outputC) Encourage rest during hyperactive periodsD) Note patterns of increased blood pressure

53. The nurse is preparing a 5 year-old for a scheduled tonsillectomy andadenoidectomy. The parents are anxious and concerned about the child's reaction toimpending surgery. Which nursing intervention would be best to prepare the child?A) Introduce the child to all staff the day before surgeryB) Explain the surgery 1 week prior to the procedureC) Arrange a tour of the operating and recovery roomsD) Encourage the child to bring a favorite toy to the hospital

54. The nurse is assessing a child for clinical manifestations of iron deficiencyanemia. Which factor would the nurse recognize as cause for the findings?

A) Decreased cardiac outputB) Tissue hypoxiaC) Cerebral edemaD) Reduced oxygen saturation

55. In planning care for a child diagnosed with minimal change nephrotic syndrome,the nurse should understand the relationship between edema formation andA) Increased retention of albumin in the vascular systemB) Decreased colloidal osmotic pressure in the capillariesC) Fluid shift from interstitial spaces into the vascular spaceD) Reduced tubular reabsorption of sodium and water

56.Which of the actions suggested to the RN by the PN during a planning conferencefor a 10 month-old infant admitted 2 hours ago with bacterial meningitis would be

acceptable to add to the plan of care?A) Measure head circumferenceB) Place in airborne isolationC) Provide passive range of motionD) Provide an over-the-crib protective top

57. The nurse would expect the cystic fibrosis client to receive supplementalpancreatic enzymes along with a dietA) High in carbohydrates and proteinsB) Low in carbohydrates and proteinsC) High in carbohydrates, low in proteins

D) Low in carbohydrates, high in proteins

58. The nurse is discussing nutritional requirements with the parents of an 18month-old child. Which of these statements about milk consumption is correct?A) May drink as much milk as desiredB) Can have milk mixed with other foodsC) Will benefit from fat-free cow's milkD) Should be limited to 3-4 cups of milk daily

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59. An eighteen month-old has been brought to the emergency room with irritability,lethargy over 2 days, dry skin and increased pulse. Based upon the evaluation ofthese initial findings, the nurse would assess the child for additional findingsofA) SepticemiaB) DehydrationC) HypokalemiaD) Hypercalcemia

60. The nurse is performing an assessment on a child with severe airwayobstruction. Which finding would the nurse anticipate finding?A) Retractions in the intercostal tissues of the thoraxB) Chest pain aggravated by respiratory movementC) Cyanosis and mottling of the skinD) Rapid, shallow respirations

61. The father of an 8 month-old infant asks the nurse if his infant'svocalizations are normal for his age. Which of the following would the nurseexpect at this age?A) CooingB) Imitation of soundsC) Throaty soundsD) Laughter

62. The nurse is planning to give a 3 year-old child oral digoxin. Which of thefollowing is the best approach by the nurse?A) "Do you want to take this pretty red medicine?"B) "You will feel better if you take your medicine."C) "This is your medicine, and you must take it all right now."D) "Would you like to take your medicine from a spoon or a cup?"

63. Which of these parents’ comment for a newborn would most likely reveal aninitial finding of a suspected pyloric stenosis?

A) I noticed a little lump a little above the belly button.B) The baby seems hungry all the time.C) Mild vomiting that progressed to vomiting shooting across the room.D) Irritation and spitting up immediately after feedings.

64. The nurse prepares for a Denver Screening test with a 3 year-old child in theclinic. The mother asks the nurse to explain the purpose of the test. What is thenurse’s best response about the purpose of the Denver?A) It measures a child’s intelligence.B) It assesses a child's development.C) It evaluates psychological responses.D) It helps to determine problems.

65. The nurse is caring for a toddler with atopic dermatitis. The nurse shouldinstruct the parents toA) Dress the child warmly to avoid chillingB) Keep the child away from other children for the duration of the rashC) Clean the affected areas with tepid water and detergentD) Wrap the child's hand in mittens or socks to prevent scratching

66. In evaluating the growth of a 12 month-old child, which of these findings wouldthe nurse expect to be present in the infant?A) Increased 10% in heightB) 2 deciduous teethC) Tripled the birth weight

D) Head > chest circumference

67. The nurse enters a 2 year-old child's hospital room in order to administer anoral medication. When the child is asked if he is ready to take his medicine, heimmediately says, "No!". What would be the most appropriate next action?A) Leave the room and return five minutes later and give the medicineB) Explain to the child that the medicine must be taken nowC) Give the medication to the father and ask him to give itD) Mix the medication with ice cream or applesauce

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68. A mother asks about expected motor skills for a 3 year-old child. Which of thefollowing would the nurse emphasize as normal at this age?A) Jumping ropeB) Tying shoelacesC) Riding a tricycleD) Playing hopscotch

69. A 4 year-old child is recovering from chicken pox (varicella). The parents

would like to have the child return to day care as soon as possible. In order toensure that the illness is no longer communicable, what should the nurse assessfor in this child?A) All lesions crustedB) Elevated temperatureC) Rhinorrhea and coryzaD) Presence of vesicles

70. The nurse is planning care for a 2 year-old hospitalized child. Which of thefollowing will produces the most stress at this age?A) Separation anxietyB) Fear of painC) Loss of controlD) Bodily injury

71. A 9 year-old is taken to the emergency room with right lower quadrant pain andvomiting. When preparing the child for an emergency appendectomy, what must thenurse expect to be the child's greatest fear?A) Change in body imageB) An unfamiliar environmentC) Perceived loss of controlD) Guilt over being hospitalized

72. A nurse aide is taking care of a 2 year-old child with Wilm's tumor. The nurseaide asks the nurse why there is a sign above the bed that says DO NOT PALPATE THE

ABDOMEN? The best response by the nurse would be which of these statements?A) "Touching the abdomen could cause cancer cells to spread."B) "Examining the area would cause difficulty to the child."C) "Pushing on the stomach might lead to the spread of infection."D) "Placing any pressure on the abdomen may cause an abnormal experience."

73. The nurse will administer liquid medicine to a 9 month-old child. Which of thefollowing methods is appropriate?A) Allow the infant to drink the liquid from a medicine cupB) Administer the medication with a syringe next to the tongueC) Mix the medication with the infant's formula in the bottleD) Hold the child upright and administer the medicine by spoon

74. The most common reason for an Apgar score of 8 and 9 in a newborn is anabnormality of what parameter?A) Heart rateB) Muscle toneC) CryD) Color

75. A newborn’s failure to pass meconium within 24 hours after birth mayindicate which of the following?a. Aganglionic Mega colonb. Celiac diseasec. Intussusception

d. Abdominal wall defect

“The PESSIMIST will see the glass filled to the halfway mark with wateras being half EMPTY, the OPTIMIST is being half FULL.”

I WILL PASS THE BOARD EXAM...A promise to yourself...

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Prepared by:

Robert C. Reña, BSN

10 (11/16/2009)

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