Pediatric NCLEX Questions

Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin should include which information? Select all that apply. a. give the medication at regular intervals b. mix the medication with a small volume of breast milk or formula c. mix the dose in orange juice if the patient will not take it d. notify the healthcare provider of poor feeding or vomiting e. make up any missed doses as soon as realized

Answer: a. give the medication at regular intervals d. notify the healthcare provider of poor feeding or vomiting

When explaining to parents how to reduce the risk of sudden infant death syndrome (SIDS), the nurse should teach about which measures? Select all that apply. a. maintain a smoke-free environment b. use a wedge for side-lying positions c. breast-feed the baby d. place the baby on his or her back to sleep e. use bumper pads over the bed rails f. have the baby sleep in the parent's bed

Answer: a. maintain a smoke-free environment c. breast-feed the baby d. place the baby on his or her back to sleep

An infant is being treated at home for bronchiolitis. What should the nurse teach the parent about home care? Select all that apply. a. offering small amounts of fluids frequently b. allowing the infant to sleep prone c. calling the clinic if the infant vomits d. writing down how much the infant drinks e. performing chest physiotherapy every 4 hours f. watching for difficulty breathing

Answer: a. offering small amounts of fluids frequently f. watching for difficulty breathing

A 12-year-old with rheumatic fever has a history of long-term aspirin use. Which client statement MOST indicates that the client is experiencing a serious adverse reaction to aspiration? a. "I hear ringing in my ears" b. "I put lotion on my itchy skin" c. "My stomach hurts after I take that medicine" d. "These pills make me cough"

Answer: a. "I hear ringing in my ears"

The nurse is proving postoperative care for an infant who had a ventriculoperitoneal shunt placed to correct hydrocephalus. Which clinical finding warrants immediate intervention? a. abdominal distention b. lethargy c. facial edema d. headache

Answer: a. abdominal distention Rationale: abdominal distention in a pediatric client with a ventriculoperitoneal shunt can be an indication of peritonitis and requires intervention

The mother of an infant with myelomeningocele asks if her baby is likely to have any other defects. The nurse responds based on the understanding that myelomeningocele is commonly associated with which disorder? a. excessive CSF within the cranial cavity b. abnormally small head c. congenital absence of the cranial vault d. overriding of the cranial sutures

Answer: a. excessive CSF within the cranial cavity

Which sign should lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation (DIC)? a. hemorrhagic skin rash b. edema c. cyanosis d. dyspnea on exertion

Answer: a. hemorrhagic skin rash

Which medication prescription to help relieve pain in a child with leukemia should the nurse question? a. hydromorphone b. acetaminophen with codeine c. ibuprofen d. acetaminophen with hydrocodone

Answer: c. ibuprofen Rationale: ibuprofen prolongs bleeding time and is contraindicated in clients with leukemia

A 16-month-old child diagnosed with Kawasaki disease is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. What should the nurse do FIRST? a. apply lotion to the hands and feet b. offer foods the toddler likes c. place the toddler in a quiet environment d. encourage the parents to get some rest

Answer: c. place the toddler in a quiet environment

What type of diet should the nurse teach the parents to give an older infant with cystic fibrosis? a. low-protein diet b. high-fat diet c. low-carbohydrate diet d. high-calorie diet

Answer: d. high-calorie diet

A child with cerebral palsy is to begin botulinum toxic type A injections. Which treatment goals should the healthcare team set for the child related to botulinum toxin? Select all that apply. a. improved nutritional status b. decreased pain from spasticity c. improved motor function d. enhanced self-esteem e. reduced caregiver strain and improved self-care f. decreased speech impediments

Answers: b. decreased pain from spasticity c. improved motor function d. enhanced self-esteem e. reduced caregiver strain and improved self-care

Which signs and symptoms of leukemia would lead the nurse to suspect the client has thrombocytopenia? Select all that apply. a. fever b. petechiae c. epistaxis d. anorexia e. shortness of breath

Answers: b. petechiae c. epistaxis

Which clinical manifestations would lead the nurse to suspect an infant has hydrocephalus? Select all that apply. a. depressed fontanelle b. diarrhea c. vomiting d. low-pitched cry e. irritability f. pupillary changes g. bulging fontanelle

Answers: c. vomiting e. irritability f. pupillary changes Rationale: hydrocephalus is a block in the flow of cerebrospinal fluid

A child has viral pharyngitis. What should the nurse advise the parents to do? Select all that apply. a. use a cool mist vaporizer b. offer a soft-to-liquid diet c. administer amoxicillin d. administer acetaminophen e. place the child on secretion precautions

Answer: a. use a cool mist vaporizer b. offer a soft-to-liquid diet d. administer acetaminophen

The triage nurse in the emergency department must prioritize the children waiting to be seen. Which child is in the GREATEST need of emergency medical treatment? a. a 6-year-old with a fever of 104 F (40 C), a muffled voice, no spontaneous cough, and drooling b. a 3-year-old with a fever of 100 F (37.8 C), a barky cough, and mild intercostal retractions c. a 4-year-old with a fever of 101 F (38.3 C), a hoarse cough, inspiratory stridor, and restlessness d. a 12-year-old with a fever of 104 F (40 C), chills, and a cough with thick yellow secretions

Answer: a. a 6-year-old with a fever of 104 F (40 C), a muffled voice, no spontaneous cough, and drooling Rationale: this child is exhibiting signs and symptoms of epiglottitis, which is a medical emergency

After a tonsillectomy and adenoidectomy, which finding should alert the nurse to suspect early hemorrhage in a 5-year-old child? a. drooling of bright red secretions b. pulse rate of 95 bpm c. vomiting of 25 mL of dark brown emesis d. BP of 95/56 mm HG

Answer: a. drooling of bright red secretions

A 3-month-old infant with meningococcal meningitis has just been admitted to the pediatric unit. Which nursing intervention has the HIGHEST priority? a. instituting droplet precautions b. administering acetaminophen c. obtaining history information from the parents d. orienting the parents to the pediatric unit

Answer: a. instituting droplet precautions

A child with cystic fibrosis is receiving gentamicin. Which nursing action is most appropriate? a. monitoring intake and output b. obtaining daily weights c. monitoring the client for indications of constipation d. obtaining stool samples for hemoccult testing

Answer: a. monitoring intake and output

The parent of a 16-month-old child calls the clinic because the child has a low-grade fever, cold symptoms, and a hoarse cough. What should the nurse suggest that the parent do? a. offer extra fluids frequently b. bring the child to the clinic immediately c. count the child's respiratory rate d. use a hot air vaporizer

Answer: a. offer extra fluids frequently

A child is admitted with a fracture of the femur and is placed in skeletal traction. What should the nurse assess FIRST? a. the pull of traction on the pin b. the Ace bandage c. the pin sites for signs of infection d. the dressings for tightness

Answer: a. the pull of traction on the pin

The nurse reports to the healthcare provider signs of increased ICP in an infant with myelomeningocele who has which finding? a. minimal lower extremity movement b. a high-pitched cry c. overflow voiding only d. a fontanelle that bulges with crying

Answer: b. a high-pitched cry

What should be part of the nurse's teaching plan for a child with epilepsy being discharged on a regimen of phenytoin? a. drink plenty of fluids b. brush teeth after each meal c. have someone be with the child during waking hours d. report signs of infection

Answer: b. brush teeth after each meal Rationale: phenytoin can cause gingival hyperplasia

A 15-year-old has been admitted to the hospital with the diagnosis of acute lymphocytic leukemia. Which signs and symptoms require the most immediate nursing interventions? a. fatigue and anorexia b. fever and petechiae c. swollen neck lymph glands and lethargy d. enlarged liver and spleen

Answer: b. fever and petechiae Rationale: fever and petechiae associated with acute lymphocytic leukemia indicate a suppression of normal WBC's and thrombocytes by the bone marrow an put the client at risk for other infections and bleeding

During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which intervention would be MOST appropriate to institute? a. limiting conversation with the child b. keeping extraneous noise to a minimum c. allowing the child to play in the bathtub d. performing treatments quickly

Answer: b. keeping extraneous noise to a minimum

At a follow-up appointment after being hospitalized, an adolescent with a history of cystic fibrosis describes his stool to the nurse. Which description should the nurse interpret as indicative of continued problems with malabsorption? a. soft with little odor b. large and foul-smelling c. loose with bits of food d. hard with streaks of blood

Answer: b. large and foul-smelling

A 10-year-old with leukemia is taking immunosuppressive drugs. To maintain health, the nurse should instruct the child and parents to: a. continue with immunizations b. not receive any live attenuated vaccines c. receive vitamin and mineral supplements d. stay away from peers

Answer: b. not receive any live attenuated vaccines

Which outcome indicates that the activity restriction necessary for a 7-year-old with RF during the acute phase has been effective? a. joints demonstrate absence of permanent injury b. the resting HR is between 60 and 100 bpm c. the child exhibits a decrease in chorea movements d. the subcutaneous nodules over the joints are no longer palpable

Answer: b. the resting HR is between 60 and 100 bpm

A preschooler with a history of repaired lumbar myelomeningocele is in the ED with wheezing and a skin rash. Which questions should the nurse ask the parent FIRST? a. "Is your child taking any medications?" b. "Who brought your child to the ED?" c. "Does your child have any allergies?" d. "What are you doing to treat your child's skin rash?"

Answer: c. "Does your child have any allergies?" Rationale: children with myelomeningocele are at high risk for development of latex allergy because of repeated exposure to latex products during surgery and bladder catheterizations

The nurse is caring for a 7-year-old who has undergone a cardiac catheterization 2 hours ago finds the dressing and bed saturated with blood. The nurse should FIRST: a. assess the vital signs b. reinforce the dressing c. apply pressure just above the catheter insertion site d. notify the healthcare provider

Answer: c. apply pressure just above the catheter insertion site

Which intervention is the GREATEST priority for the therapeutic management of a child with CHF caused by pulmonary stenosis? a. educating the family about the signs and symptoms of infection b. administering enoxaparin to improve left ventricular contractibility c. assessing HR and BP every 2 hours d. administering furosemide to decrease systemic venous congestion

Answer: d. administering furosemide to decrease systemic venous congestion

A child who limps and has pain has been found to have Legg-Calve-Perthes disease. What should the nurse expect to include in the child's plan of care? a. initiation of pain control measures, especially at night when acute b. promotion of ambulation despite the child's discomfort in the affected hip c. prevention of flexion in the affected hip and knee d. avoidance of weight bearing on the head of the affected femur

Answer: d. avoidance of weight bearing on the head of the affected femur

An 8-week-old infant with congenital heart disease is being discharged. What is the MOST important information for the nurse to convey regarding feeding? a. allow the infant 1 hour to complete each feeding b. position the infant in an upright position after each feeding c. give feedings per nasogastric tube to conserve energy d. provide a higher calorie formula or fortified breast milk

Answer: d. provide a higher calorie formula or fortified breast milk Rationale: fortified breast milk or a high-calorie formula will help the infant gain weight and conserve energy

Which statement obtained from the nursing history of a toddler should alert the nurse to suspect that the child has had a febrile seizure? a. the child has had a low-grade fever for several weeks b. the family history is negative for convulsions c. the seizure resulted in respiratory arrest d. the seizure occurred when the child had a respiratory infection

Answer: d. the seizure occurred when the child had a respiratory infection Rationale: Most febrile seizures occur in the presence of an upper respiratory infection, otitis media, or tonsillitis. Febrile seizures typically occur during a temperature rise rather than after prolonged fever.

A child with Tetralogy of Fallot becomes upset, cries, and thrashes around when a blood specimen is obtained. The child becomes cyanotic, and the respiratory rate increases to 44 breaths/min. Which action should the nurse do FIRST? a. obtain a prescription for sedation for the child b. assess for an irregular heart rate and rhythm c. explain to the child that it will only hurt for a short time d. place the child in a knee-to-chest position

Answer: d.place the child in a knee-to-chest position Rationale: the child is experiencing a "tet" or cyanotic episode

Nursing care management of the child with bacterial meningitis includes which interventions? Select all that apply. a. administration of IV antibiotics b. intravenous fluids at 1.5 times maintenance c. decreasing environmental stimuli d. neurologic checks every 4 hours e. administration of IV anticonvulsants

Answers: a. administration of IV antibiotics c. decreasing environmental stimuli d. neurologic checks every 4 hours

Which assessment findings should lead the nurse to suspect that a toddler is experiencing respiratory distress? Select all that apply. a. coughing b. respiratory rate of 45 breaths/min c. heart rate of 95 beats/min d. restlessness e. muscle aches f. diaphoresis

Answers: a. coughing b. respiratory rate of 45 breaths/min d. restlessness f. diaphoresis

Parents bring a 10-month-old boy with myelomeningocele and hydrocephalus with a ventriculoperitoneal shunt to the ED. His symptoms include vomiting, poor feeding, lethargy, and irritability. What interventions by the nurse are appropriate? Select all that apply. a. weigh the child b. listen to bowel sounds c. palpate the anterior fontanelle d. obtain vital signs e. assess pitch and quality of the child's cry

Answers: a. weigh the child c. palpate the anterior fontanelle d. obtain vital signs e. assess pitch and quality of the child's cry

A 10-year-old has a 5 lb. of Buck's extension traction on his left leg. What finding should the nurse assess the child for? Select all that apply. a. dryness of the skin, by removing the foam wraps and boot b. alignment of the shoulder, hips, and knees c. frayed rope near pulleys d. correct amount of traction weight on fracture e. pressure on the coccyx

Answers: b. alignment of the shoulder, hips, and knees c. frayed rope near pulleys d. correct amount of traction weight on fracture e. pressure on the coccyx