Peds In-Class Questions

A father calls in the evening of his son's first MMR vaccination with concerns that he has a fever of 102.3F, measured from a temporal thermometer. He has no other symptoms of illness such as a rash, cough or runny nose. The nurse's best response is: A) "Fevers can happen after vaccines and are usually not serious, give him a dose of Tylenol and recheck the temperature in 30 minutes." B) The fever concerns me after his vaccination, let's have you bring him back to clinic tomorrow." C) That high of a fever after his MMR shot needs immediate evaluation. Can you drive him to the emergency room?"

A) "Fevers can happen after vaccines and are usually not serious, give him a dose of Tylenol and recheck the temperature in 30 minutes."

The mother of a 2-month old infant tells the nurse at the well child visit "I am concerned that my son will get sick from all of these shots. I got a cold after my flu shot last year." What is the nurse's best response? A) "It is common to have symptoms such as mild congestion after some vaccines as our immune system is making antibodies to protect against the actual disease." B) "Children must develop a mild form of each disease after vaccinations in order for the shots to work." C) "Since you had that reaction to the vaccination, we should avoid immunizing your baby until he is older." D) "Don't worry, your baby will not get sick after his shots today."

A) "It is common to have symptoms such as mild congestion after some vaccination as our immune system is making antibodies to protect against the actual disease."

The nurse's best description regarding the Human Papilloma Virus (HPV) vaccine when providing education to a 10-year old girl and her family is: A) "This vaccine will protect your child from cancer." B) "This vaccine will protect your child from STIs." C) "This vaccine should be given after you are sexually active."

A) "This vaccine will protect your child from cancer."

A child, age 4 years, tells the nurse that she "needs a Band-Aid" where she had an injection. Which of the following is the best nursing action? A) Apply a Band-Aid B) Ask her why she wants a Band-Aid C) Explain why a Band-Aid is not needed D) Show her that the bleeding has already stopped

A) Apply a Band-Aid

Which of the following scenarios concerns the nurse? A 6 month old who is not yet: A) Cooing (ooo/ahh) B) Sitting independently C) Lifting chest when prone D) Stacking 2-3 blocks E) Using pincer grasp

A) Cooing (ooo/ahh) C) Lifting chest when prone

The mother of a 7-month old infant newly diagnosed with cystic fibrosis is rooming in with her infant. She is breast-feeding and provides all the care except for the medication administration. The nurse includes in the care plan: A) Ensuring that the mother has time away from her infant. B) Making sure the mother is providing all of the infant's care. C) Determining whether other family members can provide the necessary care so the mother can rest. D) Contacting the social worker because of the mother's interference with the nursing care.

A) Ensuring that the mother has time away from her infant.

An 8-year old girl is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which of the following will help her most in her adjustment to the hospital? A) Explain hospital schedules to her, such as mealtimes. B) Use terms such as "honey" and "dear" to show a caring attitude. C) Explain when parents can visit and why siblings cannot come to see her. D) Orient her parents, since she is too young, to her room and hospital facility.

A) Explain hospital schedules to her, such as mealtimes.

Susan is 15-years-old and a single mom of a 1-month-old son Ryan. Ryan is experiencing health problems and is requiring surgery. Who can sign the consent form? A) Susan, Ryan's mom B) One of Susan's parents (Ryan's grandparents) C) Both Susan and one of her parents have to sign

A) Susan, Ryan's mom

After numerous research trials in several countries, there is NO clinical evidence suggesting a link between Autism Spectrum Disorder (ASD) and vaccine administration. A) True B) False

A) True

The parents of a 4-month old infant cannot visit except on weekends. Which action by the nurse indicates an understanding of the emotional needs of a young infant? A) Place her in a room away from other children. B) Assign her to the same nurse as much as possible. C) Tell the parents that frequent visiting is unnecessary. C) Assign her to different nurses so she will have varied contacts.

B) Assign her to the same nurse as much as possible.

Which would be the priority nursing action on finding the varicella vaccine at room temperature on the shelf in the medication room? A) Ensure that the varicella vaccine integrity is intact. If intact, follow the five rights of medication administration. B) Do not administer this batch of the vaccine. C) Check the vaccine expiration date and lot number and administer per protocol. D) Ask the father if the child has had any prior reactions to varicella.

B) Do not administer this batch of the vaccine.

A mother is worried about her three children developing an inherited medical condition because many members of her family have died from this disease. To start an assessment of this family, which tool should the nurse choose? A) Ecomap B) Genogram C) Problem List D) Quantitative Tool

B) Genogram

The transfer of immunity in-utero from mother to fetus is considered: A) Active Immunity B) Passive Immunity C) Herd Immunity

B) Passive Immunity

Which nursing intervention should take place prior to all vaccination administrations? A) Document the vaccination to be administered on the immunization record and medical record. B) Provide vaccine information statement handout and answer all questions. C) Administer the most painful vaccination first, and then alternate injection sites. D) Refer to the vaccination as "baby shots" so the parent understands that the baby will be receiving an injection.

B) Provide vaccine information statement handout and answer all questions.

A 10-year old girl needs to have another IV started. She keeps telling the nurse, "wait a minute," and "I'm not ready." The nurse should recognize that" A) IV insertions are viewed as punishments B) This is expected behavior for a school aged child C) Protesting like this is usually not seen past the preschool years D) The child has successfully manipulated the nurse in the past

B) This is expected behavior for a school aged child

On development assessment the nurse notes a 4 month old who coos (ooo/ahh), grasps objects and lifts chest when prone. The most appropriate best action is: A) No nursing interventions needed B) Anticipatory guidance for infancy C) Re-assess development in 1 month D) Referral to primary care provider (PCP) for evaluation

B) Anticipatory guidance for infancy

The nurse notes mild right occipital cranial flattening with no bossing or ear displacement, normal fontanel and cranial sutures on physical assessment of a 4 month old. Which of the following is the most appropriate next step? A) Expected normal findings, no additional intervention B) Ask parents about infant's typical activity preference C) Referral to specialist for further evaluation and treatment

B) Ask parents about infant's typical activity preference

Parents are frustrated with toilet training their 2-year old. Both parents work full time and claim that they do not have time to spend on toilet training. What is the best response that the nurse can tell the parents? A) "You will have to invest some time if the child is to become potty trained." B) "A child needs to be both physically and psychologically ready to learn the skills needed to become continent." C) "Do you think your child is stubborn? Many times kids with persistent personalities have a harder time toilet training." D) "Have the child sit on the toilet until the child voids. Consistency is key."

B) "A child needs to be both physically and psychologically ready to learn skills needed to become continent."

The mother of a 2-month old brings her baby in for her well child visit. The older brother, Gavin, was diagnosed with Autism Spectrum Disorder (ASD) 6 months ago. The mother states "I am worried about giving my baby vaccines since learning about Gavin's autism." What is the nurse's best response? A) "I will let the provider know, and we will not administer vaccinations today." B) "Would you mind if we discussed your concerns?" C) "Every parent is worried about their baby getting autism, and your child will still get her shots today." D) "I will let the provider know that you refuse immunizations today."

B) "Would you mind if we discusses your concerns?"

Which of the following findings warrants further nursing assessment? A) 7 month old who is sitting independently B) 12 month old with a right hand preference C) 4 month old who voluntarily grasps a rattle D) 6 month old who rolls over E) 2 month old with a social smile

B) 12 month old with a right hand preference

You are notified that a 9-year old boy with nephrotic syndrome is being admitted. Nephrotic syndrome is a noninfectious kidney disorder that puts the child at risk for renal failure. Only semi-private room are available. The best roommate would be: A) 10-year old girl with pneumonia B) 8-year old boy with fractured femur C) 10-year old boy with a ruptured appendix D) 9-year old girl with congenital heart disease

B) 8-year boy with fractured femur

Which of the following scenarios is an absolute contraindication for a child to receive the diphtheria, tetanus, and pertussis (DTaP) vaccine? A) 6-month old who is exhibiting cold symptoms but no fever B) 4-month old with a temperature of 101.9F, who is breastfeeding normally C) 5-year old who developed hives and wheezing after his 12-month dose of DTaP D) 12-month old with a strong family history of seizures

C) 5-year old who developed hives and wheezing after his 12-month dose of DTaP

A nurse is working with family members who have been striving to improve their functioning as a family unit. What behavior would suggest to the nurse that the family is meeting its goals? A) The children are in multiple activities to develop talents. B) The desire to be understood guides most communication. C) Family members gave up some activities in order to eat dinner together on most nights. D) The parents have a strong desire for the children to succeed.

C) Family members gave up some activities in order to eat dinner together on most nights.

A 17 month old is brought into the clinic and the nurse notes the toddler has tooth decay on the maxillary upper incisors. Which tactic is NOT an appropriate tactic for the nurse to suggest regarding weaning the toddler from the bottle? A) Hide the bottle and tell the toddler that it is not needed anymore. B) Put only tap water in the bottle. C) Give the bottle only at night. D) Do not give any bottles before bed.

C) Give the bottle only at night.

A 2-year old presents to the ED with fever, cough, hoarse voice. Throat assessment showed erythema and frothy gray patches on the tonsils. Which of the following is the best initial action? A) Request order for antibiotics B) Place child on 2L oxygen per NC C) Institute droplet isolation D) Place an IV for access and hydration

C) Institute droplet isolation

A major premise of family-centered care is that: A) The child is the focus of all interventions B) Nurses are the authorities in the child's care C) Parents are the experts in caring for their child D) Decisions are made for the family to reduce stress

C) Parents are the experts in caring for their child

Which is the nurse's best response to the mother of a 2-month old who is going to get IPV immunization when the mother tells the nurse the older brother is immunocompromised? A) "Your baby should not be immunized because your immunocompromised son could develop polio." B) "Your baby should receive the oral poliovirus vaccine instead so your immunocompromised son does not get sick." C) "You should separate your 2-month old child from the immunocompromised son for 7 days after the IPV injection." D) "Your baby can be immunized with the IPV, he will not be contagious."

D) "Your baby can be immunized with the IPV, he will not be contagious."

A spinal tap must be done on a 9-year old boy. While he is waiting in the treatment room, the nurse observes that he seems composed. When the nurse asks him if he wants his mother to stay with him, he says, "I am fine." Which of the following is the best interpretation of this situation? A) The child is unusually brave. B) He has learned that support doesn't help. C) Nine year old boys do not usually want a parent present during the procedure. D) Children in this age group often do not request support, even though the need and want it.

D) Children in this age group often do not request support, even though they need and want it.

Which of the following motor milestones are infants expected to demonstrate by 9 months of age? A) Cruising B) Walking C) Raking Grasp D) Pincer Grasp

D) Pincer Grasp