12.
The nurse notices that the infant is wearing a plastic coated
Pediatric Nursing
SITUATION: Still in your self-managed Child Health Nursing Clinic,
you encounter these cases pertaining to the CARE OF CHILDREN
WITH PULMONARY AFFECTIONS
1. The nurse instructs the caregivers of a newborn to notch the
diapers or fold them in such a way as to expose the cord. The major
purpose of exposing the cord is to:
A. Remind the caregivers to do cord care
B. Keep the diaper from rubbing the cord
C. Provide air circulation for the cord
D. Allow visualization at all times
2. Josie brought her 3 month old child to your clinic because of
cough and colds. Which of the following is your primary action?
A. Give Co-trimoxazole tablet or syrup
B. Assess the patient using the chart on management of children
with cough
C. Refer to the Doctor
D. Teach the mother how to count her child’s breathing
3. In responding to the care concerns of children with severe
disease, referral to the hospital is of the essence especially if the
child manifests which of the following?
A. Wheezing C. Fast breathing
B. Stopped feeding well D. Difficulty to awaken
4. Which of the following is the most important responsibility of a
nurse in the prevention of unnecessary deaths from pneumonia and
other severe diseases?
A. Giving of antibiotics
B. Taking of the temperature of the sick child
C. Provision of Careful Assessment
D. Weighing of the sick child
5. You were able to identify factors that lead to respiratory problems
in the community where your health facility serves. Your primary
role therefore in order to reduce morbidity due to pneumonia is to:
A. Teach mothers how to recognize early signs and symptoms of
pneumonia
B. Make home visits to sick children
C. Refer cases to hospitals
D. Seek assistance and mobilize the BHWs to have a meeting with
mothers
6. Which of the following is the principal focus of the CARI program
of the Department of Health?
A. Enhancement of health team capabilities
B. Teach mothers how to detect signs and where to refer
C. Mortality reduction through early detection
D. Teach other community health workers how to assess patients
7. Evidence-based care started in medicine as a way to:
A. Promote technological advances in medicine
B. Incorporate collaboration within all health care disciplines
C. Integrate individual experience with clinical research
D. Teach medical students the art and science of medicine
8. Tertiary care by the home health nurse is directed toward children
with:
A. Problems in mobility C. Short-term needs
B. Minor problems D. Clinically apparent disease
9. If a newborn does not pass a meconium stool by 24 to 48 hours
after birth the following should be expected except?
A. Meconium Ileus
B. Imperforate anus
C. Volvolus
D. Hypospadia
10. The nurse assessing newborn babies and infants during their
hospital stay after birth will notice which of the following symptoms
as a primary manifestation of Hirschsprung’s disease?
A. A line rash over the trunk
B. Failure to pass meconium during the first 24 to 48 hours after
birth
C. The skin turns yellow and then brown over the first 48 hours of
life
D. High-grade fever
11. When assessing the weight of a 6-month old, which of the
following indicates healthy growth?
A. Doubling of birth weight
B. Tripling of birth weight
C. Quadrupling of birth weight
D. Stabilizing of birth weight
diaper. If topical medications were to be prescribed and it were to
go on the stomach or buttocks, the nurse would teach the caregivers
to:
A. Avoid covering the area of the topical medication with the diaper
B. Avoid the use of clothing on the top of the diaper
C. Put the diaper on as usual
D. Apply an icepack for 5 minutes to the outside of the diaper
13. The nurse is teaching a group of expectant mothers about the
prevention of diaper dermatitis. The nurse explains that one of the
preventive measures is the use of:
A. Absorbent disposable diapers
B. Plastic panties over diapers
C. Baby powder or cornstarch
D. Cloth diaper
SITUATION: You are working as a Pediatric Nurse in your own Child
Health Nursing Clinic. The following cases pertain to ASSESSMENT
AND CARE OF THE CHILDREN
14. Adopting New Policies and Protocol on Newborn Care prioritizes
which of the following aspects the most?
A. Establishment of patent airway
B. Promoting proper breathing pattern
C. Maintenance of blood circulation
D. Stabilizing normal body temperature
15. A nurse is caring for a newborn and observes that the newborn
extrudes any substance that is placed on the anterior portion of the
tongue and understands that this protective reflex prevents the
swallowing of inedible substances. This reflex is called?
A. Rooting reflex
B. Extrusion reflex
C. Tonic neck reflex
D. Palmar grasp reflex
16. The nurse instructs the mother that when over stimulated the
infant will:
A. Show increased alertness and eye contact
B. Respond with coordinated, synchronous body movement
C. Look away to reduce the intensity of the interaction
D. Drift off to deep sleep to shut out the interaction
17. Infant head control is judged by the:
A. Ability to hold head without support
B. Presence or absence of head lag
C. Rigidity of the neck and head
D. Amount of neck wrinkling
18. The nurse is assessing an 8-month old infant for head lag, pulling
the infant by the hands from a supine to a sitting position. The head
does not stay in line with the body when being pulled forward.
Which of the following statements best represents the significance
of this finding?
A. Head lag should not be tested until the child is over 1 year of age.
B. Significant head lag after the age of 6 months may indicate brain
injury and needs further investigation.
C. The nurse has not conducted the test correctly and must do it
again using proper technique
D. This is a normal finding, as the infant’s head will not stay in line
after 8 months of age.
19. The extent of burns in children are normally assessed and
expressed in terms of:
A. The amount of body surface that is unburned
B. Percentage of total body surface area (TBSA)
C. How deep the deepest burns are
D. The severity of the burns on a 1 to 5 burn scale
20. Theresa, a mother with a 2 y/o daughter asks, “at what age can I
be able to take the BP of my daughter as a routine procedure since
hypertension is common in the family”? Your answer to this is:
A. At 2 years you may C. When she’s 3 yrs old
B. As early as 1 y/o D. When she’s 6 yrsol
21. As a nurse, you reviewed infant safety procedures. What are two
of the most common types of accidents among infants?
A. Aspiration and falls C. Poisoning and burns
B. Falls and auto accidents D. Drowning and homicide
22. Which of the following approaches would work best when the
nurse is communicating with an infant?
A. Use an adult voice just as you would for anyone
B. Communication through the caregivers
C. Allow the child time to warm up to the nurse
D. Respond only after the child cries for a little while.
23. Which of the following fears would the nurse typically associate
with toddlerhood?
A. Mutilation
B. The dark
C. Separation anxiety
D. Separation from peers
SITUATION: Nurse Michelle works with a Family Nursing Team in
Calbayog Province specifically handling a UNICEF Project for
Children. The following conditions pertain to CARE OF THE FAMILIES
WITH PRESCHOOLERS.
24. Ronnie asks constant questions. How many does a typical 3 y/o
ask in a day’s time?
A. 1,200 or more C. 100 – 200
B. Less than 50 D. 300 - 400
25. Ronnie will need to change to a new bed because his baby sister
will need Ronnie’s old crib. What measure would you suggest that
his parents take to help decrease sibling rivalry between Ronnie and
his new sister?
A. Move him to the new bed before the baby arrives
B. Explain that new sisters grow up to become best friends
C. Tell him he will have to share with the new baby
D. Ask him to get his crib ready for the new baby
26. Ronnie’s parents want to know how to react to him when he
begins to masturbate while watching television. What would you
suggest?
A. They refuse to allow him to watch television
B. They schedule a health check-up for sex-related disease
C. They remind him that some activities are private
D. They give her “timeout” when this begins
27. Ronnie’s mother is concerned about her child’s masturbating.
When responding to the mother, which of the following would the
nurse need to keep in mind?
A. The child needs counseling for the abnormal behavior
B. Masturbation is normal in children of this age
C. The child is expressing some unmet needs
D. Masturbation at this age provides sexual release
28. If the parent of a 4-year-old child tells the nurse about concerns
that the child frequently talks about a make believe playmate, which
response by the nurse is best?
A. “This type of behavior is normal for a preschooler.”
B. “Can you identify any stressors that may be causing this
regression?”
C. “You may need a referral to see a child psychologist
D. “Give a time-out when this behavior occurs.”
29. The American Academy of Pediatrics suggests that caregivers do
which of the following things in regard to physical activities for
preschoolers?
A. Push the child to practice sports activities while they are more
flexible
B. Encourage a variety of physical activities in a noncompetitive
environment
C. Have the child engage in competitive sports to see where they
excel
D. Keep physical activities to a minimum until the child is in grade
school
30. The school nurse notices a child who is wearing old, dirty, poor-
fitting clothes; is always hungry, has no lunch money; and is always
tired. When the nurse asks the boy his tiredness, he talks of playing
outside until midnight. The nurse will suspect that this child is:
A. Being raised by a parent of low intelligence quotient (IQ)
B. An orphan
C. A victim of child neglect
D. The victim of poverty
31. The mother of a 9-month-old infant is concerned that the head
circumference of her baby is greater that the chest circumference.
The BEST response by the nurse is:
A. “These circumferences normally are the same, but in some babies
this just differs.”
B. “Perhaps you baby was small for gestational age or premature.”
C. “This is normal until the age of 1 year, when the chest will be
greater.”
D. “Let me ask you a few questions, and perhaps we can figure out
the cause of this difference.”
32. Which of the following should the nurse do next after noting that
an 8-month-old child's posterior fontanel is slightly open?
A. Check the child's head circumference.
B. Document this as a normal finding.
C. Question the mother about the child's delivery.
D. Schedule an x-ray of the child's head.
33. An infant is diagnosed as having communicating hydrocephalus.
When helping the parents understand the physician’s explanation of
the baby’s problem , the nurse should state:
A. “Too much cerebrospinal fluid is produced within the ventricles of
the brain.”
B. “The cerebrospinal fluid is prevented from proper absorption by a
blockage in the ventricles of the brains.”
C. “The part of the brain surface that normally absorbs CSF after its
production is not functioning adequately.”
D. “There is a flow of CSF between brain cells and the ventricles,
which do not empty properly into the spinal cord.”
34. An infant has returned to the unit after revision of a
malfunctioning VP shunt. Which of the following would indicate to
the nurse that a problem could be developing with the shunt?
A. Irritability C. Sunken fontanel
B. Bradycardia D. Increased urine output
B. Bradycardia
35. Which of the following arrangements is generally considered to
be best for the parents of a hospitalized infant or young child?
A. Rooming-in
B. Separate caregiver sleeping room on the unit
C. Day visits and sleeping at home
D. Staying at a nearby hotel or motel
36.When teaching parents of a neonate the proper position for the
neonate's sleep, a nurse stresses the importance of placing the
neonate on his back to reduce the risk of:
A.aspiration.
B.sudden infant death syndrome (SIDS)
C.suffocation.
D.gastroesophageal reflux (GER)
37.A client plans to breast-feed her healthy, full-term neonate. The
nurse encourages her to start breast-feeding within 30 minutes of
the neonate's birth because:
A.the neonate will be responsive and eager to suck at this time.
B.breast-feeding will inhibit prolactin production.
C.her breasts will be firm and filled with colostrum at this time
D.breast-feeding will help the neonate fall asleep.
38.A nurse is performing a neurologic assessment on a neonate.
Which sign is considered a normal finding in a neonate?
A.Doll's eyes
B.Sunset "eyes"
C.Positive Babinski's reflex
D.Pupils that don't react to light
39.A client is concerned that her 2-day-old, breast-feeding neonate
isn't getting enough to eat. The nurse should teach the client that
breast-feeding is effective if:
A.the neonate voids once or twice every 24 hours.
B.the neonate breast-feeds four times in 24 hours.
C.the neonate loses 10% to 15% of the birth weight within the first 2
days after birth.
D.the neonate latches onto the areola and swallows audibly.
40.A nurse is assessing a neonate born 1 day ago to a client who
smoked one pack of cigarettes daily during pregnancy. Which finding
is most common in neonates whose mothers smoked during
pregnancy?
A.Post-term birth
B.Large size for gestational age
C.Small size for gestational age
D.Appropriate size for gestational age
41.A nurse assesses a 1-day-old neonate. Which finding indicates
respiratory distress?
A.Respiratory rate of 54 breaths/minute
B.Abdominal breathing
C.Nasal flaring
D.Acrocyanosis
42.A nurse in a newborn nursery is monitoring a preterm newborn
for respiratory distress syndrome. Which assessment signs noted in
the newborn would alert the nurse to the possibility of this
syndrome?
A.Tachypnea and retractions
B.Acrocyanosis and grunting
C.Hypotension and bradycardia
D.Presence of a barrel chest with acrocyanosis
43.A neonate begins to gag and turns a dusky color. What should the
nurse do first?
A.Calm the neonate.
B.Notify the physician.
C.Provide oxygen via a face mask as ordered.
D.Aspirate the neonate's nose and mouth with a bulb syringe.
44.Which of the following would be the priority nursing diagnosis for
a 4-week-old infant with a diagnosis of pyloric stenosis?
A.Constipation
B.Deficient fluid volume
C.Imbalanced nutrition: Less than body requirements
D.Impaired swallowing
45.When assessing a toddler's growth and development, the nurse
understands that a child in this age-group displays behavior that
fosters which developmental task?
A.Initiative
B.Autonomy
C.Trust
D.Industry
46.When assessing a toddler, age 18 months, the nurse should
interpret which reflex as a sign of a neurologic dysfunction?
A.Positive gag reflex
B.Positive tonic neck reflex
C.Positive Babinski's reflex
D.Positive corneal reflex
SITUATION: Graciela 1 ½ y/o is admitted in the hospital from the ER
with a fracture of the left femur due to a fall down a flight of stairs.
Graciela is placed on Bryant’s traction.
47.While on Bryant’s traction, which of these observations of
Graciela and her traction apparatus would indicate a decrease in the
effectiveness of her traction?
A.Graciela’s legs are suspended at a 90-degree angle to her trunk
B.The traction weights are hanging 10 inches above the floor
C.Graciela’s buttocks are resting on the bed
D.The traction ropes move freely through the pulley

48.Graciela is assessed to have no head injury. The Bryant’s traction

is removed. A plaster of Paris hip spica is applied. Which of these
findings is a concern of immediate attention that must be reported
to the physician immediately?
A.The nurse is unable to insert a finger under the edge of Graciela’s
cast on her left foot
B.Graciela is scratching the cast over her abdomen
C.The toes of Graciela’s left foot blanch when the nurse applies
pressure on them
D.Graciela’s cast is still damp
49.Part of discharge plan is for the nurse to give instructions about
the care of Graciela’s cast to the mother. Which of these statements
indicate that the mother understood an important aspect of cast
care?
A.I will place plastic sheeting around the perineal area of the cast
B.I will reinforce cracked areas on the cast with adhesive tape
C.I will use cool water to wash the cast
D.I will use white shoe polish to keep the cast neat
50.Which desired outcome demonstrates effective parent teaching
about disciplining a toddler?
A.The parents will set flexible rules.
B.The parents will verbalize requests for behavior in negative terms.
C.The parents will raise their voices when reprimanding the child.
D.The parents will call immediate attention to undesirable behavior.