Pediatrics Practice Questions
What is the best response to a 12-year old child who asks about rheumatic fever? A."You have an infection in your heart" B."Your heart is having trouble handling an infection that is in your bloodstream" C."Your immune system has mistaken your heart valves as bacteria and is attacking your own heart" D."This is a condition that can easily be treated with antibiotics"
A."You have an infection in your heart"
A nurse is assisting with the admission of a child who has measles. Which of the following isolation precautions should the nurse initiate? A.Airborne B.Contact C.Protective environment D.Droplet
A.Airborne
Which of the following are priority assessments for a 10-year old receiving digoxin? A.Apical pulse prior to administration B.Blood pressure prior to administration C.Temperature prior to administration D.Ensure adequate hydration prior to administration
A.Apical pulse prior to administration
Which of the following is expected growth and development of a 4 month old? Select all that apply A.Babble B.Sit with support C.Roll over both ways D.Hold a bottle E.Hold head steadily
A.Babble B.Sit with support E.Hold head steadily
Which of the following assessment findings would be considered normal when assessing the circulation of a child's toes following the application of a long leg cast? A.Capillary refill of < 2 seconds B.Child complaining of numbness in their toes C.Child only slightly able to wiggle toes D.Toes are cool and slightly swollen
A.Capillary refill of < 2 seconds - Other choices are s/s decreased circulation and impaired neurovascular assessment. These findings may indicate the cast is too tight and the provider needs to be notified immediately to come assess the patient.
A nurse is providing teaching to the parents of a 4 year old about fine motor development. Which of the following tasks should the nurse include in the teaching as an expected finding for this age group? A.Copies a circle B.Cuts foods using a table knife C.Begins writing in cursive D.Prints first and last name clearly
A.Copies a circle
A 3-year old is hospitalized for treatment of Kawasaki disease. During the acute phase of this disease, the nurse must assess the child for: A.Desquamation of the hands and feet B.Level of consciousness C.Kidney failure D.Hepatitis
A.Desquamation of the hands and feet
A 16 year old female has been admitted to the hospital because of a serious respiratory infection with a diagnosis of possible tuberculosis. She has been placed on respiratory isolation in a private room. Knowing that peers are important, what would the nurse suggest? A.Maintaining contact her friends by telephone B.Drawing pictures of her feelings to give to her peers C.Placing the adolescent in a room with a roommate of the same age D.Having friends visit her often
A.Maintaining contact her friends by telephone
A 16 year old female has been admitted to the hospital because of a serious respiratory infection with a diagnosis of possible tuberculosis. She has been placed on respiratory isolation in a private room. Knowing that peers are important, what would the nurse suggest? A.Maintaining contact her friends by telephone A.Drawing pictures of her feelings to give to her peers B.Placing the adolescent in a room with a roommate of the same age C.Having friends visit her often
A.Maintaining contact her friends by telephone - Telephone contact with friends should be encouraged for the hospitalized adolescent. Disposable equipment is contaminated and should be discarded. In this situation, peer visitation would not be encouraged because the client is in respiratory isolation for possible tuberculosis. She would not want to expose her friends to the disease. Drawing pictures symbolizing her feelings to give to her friends is not age appropriate.
A 5 year old reports a pain level of 3 using the FACES scale. The nurse knows the best methods to relieve pain include: (SELECT ALL THAT APPLY) A.Offer the child a distraction B.Administer acetaminophen according to the PRN order C.Ask the parent to leave the room D.Enlist assistance from Child Life E.Request a PRN order for morphine
A.Offer the child a distraction B.Administer acetaminophen according to the PRN order D.Enlist assistance from Child Life
A nurse is planning care for a 4 year old child who requires airborne precautions. Which of the following activities should the nurse plan for the child? A.Putting a large piece puzzle together B.Watching a video game in the playroom C.Pulling a wagon with toys in the hallway D.Constructing a model airplane
A.Putting a large piece puzzle together
The treatment for clubfoot is: A.Serial casting followed by nighttime splinting B.Surgical stabilization of the femoral head C.Corticosteroids D.Watch for progression, no treatment necessary unless the condition worsens
A.Serial casting followed by nighttime splinting - B is the option for SCFE C is the option for JIA D is for scoliosis with < 25% curvature
A nurse on a pediatric unit is admitting a 4 year old. Which of the following toys should the nurse plan to provide for the child to engage in independent play? A.Brightly colored mobile B.Plastic stethoscope C.Small piece jigsaw puzzle D.A book of short stories
B.Plastic stethoscope
You are caring for a 6 -week old male with suspected diagnosis of pyloric stenosis. As the nurse caring for this patient you know that this patient may present with which of the following? A.Nausea B.Projectile vomiting C.Weight gain D.Bilious vomiting
B.Projectile vomiting
A nurse is caring for a patient with Tetralogy of Fallot. The nurse expects to see fatigue and poor activity tolerance related to: A.Poor muscle tone B.Restricted blood flow leaving the heart C.Inadequate oxygenation of tissues D.Inadequate intake of food
B.Restricted blood flow leaving the heart
A nurse is caring for a child who has pertussis. The child's parent asks the nurse what the common name for this disease is. The nurse should respond with which of the following common names? A.Chicken pox B.Whooping cough C.Mumps D.Fifth disease
B.Whooping cough
You are educating a parent of a child who just had a cast placed for a fracture of the radius and ulna. Which of the following statements by the parent indicates the need for further education? A."When my child is sitting, I should keep the arm elevated to help decrease swelling" B."I should assess my child's cast for any foul-smelling drainage" C."If my child complains of itching, I can use baby powder inside the cast to help relive the itching" D."I should keep the cast clean and dry. I can cover the cast with a trash bag and tape to the skin of their arm to allow them to shower"
C."If my child complains of itching, I can use baby powder inside the cast to help relive the itching" - Powder should never be used near the cast as it is a medium for bacteria
A nurse is weighing a 12 month old who weighed 8 lb at birth. What does the nurse anticipate his weigh will be? A.12 lb B.16 lb C.24 lb D.32 lb
C.24 lb
At what age can a child ascend stairs with alternating feet? A.1 year B.2 years C.3 years D. 4 years
C.3 years
Justin is a 3-year old with both parents as carriers of cystic fibrosis. His mother wants to know Justin's status on cystic fibrosis. What genetic counseling can you give regarding Justin's chances as a carrier of cystic fibrosis? A.100% B.66% C.50% D.25%
C.50%
While providing care for a child with constipation, the nurse knows that: A.Most constipation is organic in nature B.The fiber content in the diet is sufficient C.A common cause is stool withholding D.Increasing the fluid intake will increase liquid stool
C.A common cause is stool withholding
The nurse is preparing education for the parents of an infant with a diagnosis of gastroesophageal reflux (GER). What information regarding the best time to administer ranitidine (Zantac) should be included? A.Administer right before feeding B.Administer after a feeding C.Administer 30 minutes before a feeding D.Administer at night before bedtime
C.Administer 30 minutes before a feeding
The nurse is preparing to administer a Hepatitis B vaccine to a 1 month old. In order to reduce the pain of the injection, the nurse A.Administers the injection as quickly as possible B.Asks the parent to assist in holding the infant in the correct position C.Administers sucrose on a pacifier 2 minutes before the procedure D.Swaddles the baby prior to the procedure
C.Administers sucrose on a pacifier 2 minutes before the procedure - Sucrose works best when given 2 minutes prior to a procedure. None of the other options reduce pain.
You are reviewing diet teaching with a mother of a teenager with cystic fibrosis. Which of the following best describes the child's dietary requirements? u A.Low sodium diet B.Multivitamins (Vitamin B and C) supplement C.High protein, high calorie D.Supplemental fruits and vegetables
C.High protein, high calorie
A nurse is planning care for a child who has mumps. Which of the following instructions should the nurse include in the plan? A.Initiate standard precautions B.Initiate airborne precautions C.Initiate droplet precautions D.Initiate contact precautions
C.Initiate droplet precautions
A nurse prioritizing care for an infant post-op cleft palate repair includes which of the following? A.Monitor for adequate circulation B.Ensure infant can breath through the mouth C.Monitor for airway edema and cyanosis D.Cluster care to protect the surgical site
C.Monitor for airway edema and cyanosis
A nurse is examining a 9 month old during a well-child visit. Which of the following findings would the nurse report to the practitioner? A.Pulls to a standing position B.Transfers objects hand to hand C.Sits with support D.Uses crude pincer grasp
C.Sits with support
Which of the following assessment findings would the nurse expect to find in a child with a developmental dysplasia of the right hip that has not yet been treated? A.Full passive range of motion of the right and left hip joints B.The left side has more skin folds than the right side when the child is supine with the knees bent C.The right buttock has a flattened appearance when lying prone D.With knees bent, both legs from the knee to the hip are the same length
C.The right buttock has a flattened appearance when lying prone - A- ROM is limited B- skinfolds on the affected side are increased D- there will be a length discrepancy
A 17 year old male reports a pain level of 6 using the numbers scale. His PRN pain orders include ibuprofen for mild, moderate, or severe pain, and morphine for moderate and severe pain. Knowing that a pain level of 6 falls in the moderate level range, the BEST action of the nurse is to: A.Administer the morphine B.Administer ibuprofen and re-check in 60 minutes C.Administer ibuprofen but be prepared to give morphine if the pain does not improve in 30 minutes D.Ask the patient which medication gives him the best relief
D.Ask the patient which medication gives him the best relief - The PRN med orders overlap the reported pain level. The nurse should include the child (or caregiver) in choosing the pain medication that will work most effectively.
A nurse is caring for a 2 year old child who has cystic fibrosis. The nurse is planning to take the child to the playroom. Which of the following activities would be appropriate for the child? A.Cutting figures from colored paper B.Drawing stick figures using crayons C.Riding a tricycle D.Building towers of blocks
D.Building towers of blocks
A newborn has been admitted to your unit after surgical repair of a myelomeningocele. Which postoperative findings would the nurse recognize as an early sign of increased ICP? A.Decreased urine output B.Tachycardia C.Bradycardia D.Bulging anterior fontanel
D.Bulging anterior fontanel - A bulging fontanel (anterior or posterior) may be an early sign of increased ICP. Urine output may be affected by the level of the myelomeningocele on the spine causing a neurogenic bladder response. Tachycardia and bradycardia are not the earliest signs of increased ICP.
The nurse is caring for a toddler who yells, "NO!" whenever vital signs need to be assessed. Which of the following is the best method to gain cooperation from this child? A.Defer vital signs until the child is in a more cooperative mood B.Explain to the child the importance of cooperating with assessment C.Ask the family to hold the child still while obtaining vital signs D.Offer a choice of starting with the temperature or blood pressure
D.Offer a choice of starting with the temperature or blood pressure
The nurse is caring for a toddler who yells, "NO!" whenever vital signs need to be assessed. Which of the following is the best method to gain cooperation from this child? A.Defer vital signs until the child is in a more cooperative mood B.Explain to the child the importance of cooperating with assessment C.Ask the family to hold the child still while obtaining vital signs D.Offer a choice of starting with the temperature or blood pressure
D.Offer a choice of starting with the temperature or blood pressure - Choices promote autonomy, the primary stage of psychosocial development for toddlers.
The nurse is teaching a parenting group about patterns of growth & development. What is the best example to use to explain cephalocaudal development? A.After sitting independently, the baby will begin to reach for objects B.First the baby will play with sounds, like babbling, then say simple words C.Learning to run and jump comes after mastering walking D.The baby gets control of their head before their arms and hands
D.The baby gets control of their head before their arms and hands
A nurse is providing education to a 16-year-old female who is sexually active and is being placed on Accutane for acne. Which of the following is vital information for the patient to know? a.Avoid using sunscreen b.Use two forms of birth control c.Take erythromycin daily d.Wash face twice a day with mild soap
b.Use two forms of birth control - Accutane is associated with birth defects
A nurse is observing an infant who can walk with support, throw a ball, and use a pincer grasp. The nurse estimates that this child is how old? A.9 month B.12 months C.18 months D.24 months
B.12 months
You are preparing to measure the length of 12 month old William. His mother tells you he was 20 inches at birth. Based on your knowledge of normal growth parameters, you would expect his length to be approximately: A.25% greater than his birth length B.50% greater than his birth length C.75% greater than his birth length D.Double his birth length
B.50% greater than his birth length
A nurse is caring for a child with suspected rheumatic fever. When obtaining a history, the nurse considers which information to be most important? A.A fever that started 3 days ago B.A recent episode of pharyngitis C.Lack of appetite D.Vomiting for 2 days
B.A recent episode of pharyngitis -A recent episode of pharyngitis is the most important factor in establishing the diagnosis of rheumatic fever. Although the child may have a history of fever or vomiting or lack interest in food, these findings are not specific to rheumatic fever.
The nurse is working with a preschooler admitted to a pediatric hospital for an upcoming complex surgery. Which of the following therapeutic play techniques would be most appropriate for this age child? u A.Allowing the child to watch child-focused programming on the television in the child's room B.Asking the child to draw a picture about being in the hospital C.Playing with a puzzle available in the pediatric unit D.Playing with a toy that the child brought from home
B.Asking the child to draw a picture about being in the hospital - Play that presents an opportunity to deal with the fears, concerns, and stressors of health experiences is called therapeutic play. The only option listed that is therapeutic is asking the child to draw a picture about being in the hospital. The nurse would talk with the child about the drawing, allowing the child to verbalize any fears or concerns that developmentally the child might not be able to ask directly. The other options are definitely possible ways for the child to pass time while in the hospital, but do not fit the definition of therapeutic play.
Which of the following would be the lowest priority when caring for a child with a seizure disorder? A.Teaching the family about anticonvulsant therapy B.Assessing for signs and symptoms of increased intracranial pressure C.Ensuring safety and protection from injury D.Observing and recording all seizures
B.Assessing for signs and symptoms of increased intracranial pressure - Signs and symptoms or increased ICP are not associated with seizure activity and therefore would be the lowest priority
A nurse is performing a physical assessment on a 6 month old. Which of the following reflexes should the nurse expect to find? A.Stepping B.Babinski C.Extrusion D.Moro
B.Babinski
The nurse is caring a 15 year old who rates their pain at a 4 out of 10 on the numeric pain scale. Which of the following non-pharmacologic pain interventions would be most developmentally appropriate for an adolescent? A.Completing homework sent from school B.Connecting with friends on social media C.Medical play with dolls and equipment D.Playing with other patients on the unit
B.Connecting with friends on social media
The nurse is caring for a pediatric patient admitted to the hospital. Which of the following best promotes family centered care for this patient? A.Allowing the child sleep through vital signs B.Delaying interdisciplinary rounds until the family is available C.Encouraging the family to bring the child's comfort items from home D.Re-timing medication to match the patient's home routine
B.Delaying interdisciplinary rounds until the family is available
Which of the following would not be a focus of a teaching plan for an adolescent with a seizure disorder? A.Ability to obtain a driver's license B.Increased risk of infections C.Drug and alcohol use D.Peer pressure
B.Increased risk of infections - Adolescents with seizure disorders are at no greater risk for infections than other adolescents. The ability to obtain a driver's license may be influenced by the adolescent's seizure history. Drug and alcohol use may interfere with or cause adverse reactions form anticonvulsants. Peer pressure may put the child at risk for increased risk-taking behaviors that my exacerbate seizure activity.
A mother of a school age child with moderate persistent asthma demonstrates understanding of medication administration by which of the following statements? u A."I will administer the anti-inflammatory medication during the night when he wakes up with consistent cough and it looks like he needs it" B."I will administer montelukast (Singulair) when he starts to have an asthma attack" C."I will stop the oral corticosteroids as soon as his cold symptoms resolve" D."I will administer the albuterol when the results of the peak flow fall into the yellow and red zone"
D."I will administer the albuterol when the results of the peak flow fall into the yellow and red zone"
A nurse is teaching the parent of a 12 month old about nutrition. Which of the following statements by the parent indicates a need for further teaching? A."I can give my baby 4 ounces of juice to drink each day." B."I will offer my baby dry cereal and chilled banana slices as snacks." C."I am introducing my baby to the same foods the family eats." D."My infant drinks at least 2 quarts of skim milk each day."
D."My infant drinks at least 2 quarts of skim milk each day."
Which factor does not contribute to hydrocephalus? A.A decrease in the reabsorption of cerebral spinal fluid B.An increase in the production of cerebral spinal fluid C.Interventricular bleed, meningitis, or trauma to the head D.A decreased amount of cerebral spinal fluid in the subarachnoid space of the brain
D.A decreased amount of cerebral spinal fluid in the subarachnoid space of the brain - Hydrocephalus is caused by increased production or decreased absorption of cerebral spinal fluid (CSF). IVH in premature infants, meningitis and head trauma may cause acquired hydrocephalus.
A common site for impetigo in children is: a.The face b.The trunk c.The upper arms d.The perineal area
a.The face
A nurse is providing education to the mother of a 3-month-old who has diaper dermatitis. What information must the nurse include? a.Add additional layers of barrier products with each diaper change b.Use baby wipes that contain a high concentration of alcohol c.Change the diaper as soon as it is soiled and at least every 2 hours d.Use hot water to clean the perineal area each diaper change
c.Change the diaper as soon as it is soiled and at least every 2 hours
When planning care for a child with burns on the upper torso, which nursing diagnosis takes highest priority? a.Disturbed sleep pattern related to hospital environment b.Impaired physical mobility related to the disease process c.Ineffective airway clearance related to edema of the respiratory passages d.Risk for infection related to skin breakdown
c.Ineffective airway clearance related to edema of the respiratory passages - When caring for a client with upper torso burns, the nurse's primary goal is to maintain respiratory integrity. Therefore, option A should take the highest priority. Option B isn't appropriate because burns aren't a disease. Option C and D may be appropriate, but don't command a higher priority than option A because they don't reflect immediately life-threatening problems.
