SAMPLE TEST

1. Which of the following should the nurse do next after noting that an 8-month-old’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 
2. When discussing a 7-month-old’s motor skill development with the mother, the nurse should explain
that by 7 months, an infant most likely be able to do the following
A. Walk with one hand held 
B. Eat successfully with a spoon 
C. Stand while holding on to furniture 
D. Sit alone using hands for support 
3. A toddler is given an epinephrine inhalant (Vaponefrin) because of increasing respiratory distress.
The nurse evaluates the treatment as being effective when the child’s:
A. Color is normal 
B. Retractions are less severe 
C. Heart rate is 100 beats per minute 
D. Pulse oximeter reads 90 
4. Which assessment finding would the nurse consider normal for a 3-month-old infant?
A. Able to hold a bottle 
B. Able to lift head and shoulders 
C. Able to roll from back to abdomen 
D. Able to sit with support 
5.  Which clinical observation would lead the nurse to suspect epiglottitis?
A. Decreased secretions 
B. Drooling 
C. Low-grade fever 
D. Barking cough 
6. A 2-year-old child with status asthmaticus is admitted to the pediatric unit and begins to receive
continuous treatment with albuterol (Proventil), given by nebulizer. The nurse should observe for which
adverse reaction?
A. Bradycardia 
B. Lethargy 
C. Tachycardia 
D. Tachypnea 
7. Which nursing intervention is appropriate to correct dehydration for a 2-year-old client with asthma?
A. Give warm liquids 
B. Give cold juice or ice pops 
C. Provide three meals and three snacks 
D. Provide small, frequent meals and snacks 
8. Which suggestions should the nurse include when teaching the parents of a child who has viral
tonsillitis?
A. Administering aspirin for fever control 
B. Gargling with warm salt water 
C. Offering cough medicine every 4 hours 
D. Giving acetaminophen for sore throat 
E. Offering lots of fluids 
9. Which clinical feature would be found in a child with cystic fibrosis?
A. Increase in pancreatic secretions of bicarbonate and chloride 
B. Decrease in sodium and chloride in both saliva and sweat 
C. Increased viscosity of mucous gland secretions 
D. Decreased viscosity of mucous gland secretions 
10. Which definition best describes the form of clubfoot called talipes varus?
A. Inversion of the foot 
B. Eversion of the foot 
C. Plantar flexion 
D. Dorsiflexion 
11. A child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions
for avoiding future crises should the nurse provide to the child and his family? (Select all that apply.)
A. Avoid foods high in folic acid. 
B. Drink plenty of fluids. 
C. Use cold packs to relieve joint pain. 
D. Report a sore throat to an adult immediately. 
E. Restrict activity to quiet board games. 
F. Wash hands before meals and after playing 
12. A 6-year-old child has a cast applied for a fractured radius. The nurse completes an orthopedic
assessment on this child. Which of the following symptoms requires immediate attention and should
be reported to the physician?
A. Capillary refill of 3 seconds in the affected hand 
B. Edema in the affected fingers that improves with elevation 
C. Child describing feeling of the affected hand being "asleep
D. Skin surrounding the cast is warm 
13. Which of the following instructions would the nurse provide to the parent whose child has sprained
her ankle? (Select all that apply.)
A. Immobilize the ankle for 24 to 36 hours 
B. Avoid compression to the ankle 
C. Apply ice to the area 
D. Begin range-of-motion exercises within 12 hours of injury 
E. Apply heat to the area 
F. Elevate the extremity on two pillows 
14. When a child is suspected of having muscular dystrophy, a nurse should expect which muscles to
be affected first?
A. Muscles of the hip 
B. Muscles of the arm 
C. Muscles of the hand 
D. Muscles of respiration 
15. Discharge planning for a child with Duchenne’s muscular dystrophy should include teaching about
which diet?
A. Low calorie, high protein, and high fiber
B. Low calorie, high protein, and low fiber” 
C. High calorie, high protein, and restricted fluids
D. High calorie, high protein, and high fiber
16. A nurse is caring for a child with leukemia. On what should the nurse place priority?
A. Preventing injury 
B. Monitoring the child’s platelet count 
C. Monitoring the child’s temperature 
D. Encouraging increased fluid intake 
17. A 2-year-old child is admitted to the pediatric unit with the diagnosis of bacterial meningitis. Which
measure would be appropriate for the nurse to perform first?
A. Obtain a urine specimen 
B. Draw ordered laboratory tests 
C. Place the toddler in respiratory isolation 
D. Explain the treatment plan to the parents 
18. Which statement about cerebral palsy would be accurate?
A. Cerebral palsy is a condition that runs in families 
B. Cerebral palsy means there will be many disabilities 
C. Cerebral palsy is a condition that does not get worse 
D. Cerebral palsy occurs because of too much oxygen in the brain 
 19. A child is admitted with possible Reye syndrome. The nurse should recognize that which of the
following factors in the child’s health history supports this diagnosis?
A. Recent history of urinary tract infection 
B. Recent history of bacterial otitis media 
C. Recent episode of gastroenteritis 
D. Recent episode of Haemophilus influenzae meningitis 
20. The nurse assigned to a patient with Kawasaki disease reviews the medication orders expecting to
find orders for:
A. Aspirin and immune globulin 
B. Ampicillin and furosemide 
C. Glucagon and Phenobarbital 
D. Digoxin and cisplatin 
21. Which cardiovascular disorder is considered acyanotic?
A. Patent ductus arteriosus 
B. Tetralogy of Fallot 
C. Tricuspid atresia 
D. Truncus arteriosus 
22. A 10-year-old has hemophilia A and is admitted to the hospital for hemarthrosis of the right knee.
He is in a great deal of pain. Which of the following interventions would aggravate his condition?
A. Applying an ice bag to the affected knee. 
B. Administering children’s aspirin for pain relief. 
C. Elevating the right leg above the level of his heart. 
D. Keeping the right leg immobilized. 
23. Which statement best describes transposition of the great arteries?
A. The body only receives only saturated blood 
B. It is classified as an acyanotic defect with increased with increased pulmonary blood flow 
C. The pulmonary artery leaves the left ventricle and the aorta exits from the right ventricle
D. The right atrium and the left atrium empty into one ventricular chamber 
24. The nurse has been assigned to care for a child with suspected rheumatic fever. The lab reports
have just come back and the nurse reviews them. Which lab report would be helpful in confirming this
diagnosis?
A. Antistreptolysin O titer 
B. Erythrocyte sedimentation rate 
C. Glucose tolerance test 
D. Red blood cell count 
25. Which test would the nurse expect to be performed on a client with leukemia before initiation of
therapy to evaluate his ability to metabolize chemotherapeutic agents?
A. Lumbar puncture 
B. Liver function studies 
C. Complete blood count 
D. Peripheral blood smear 
26. A 15-year-old female has recently been diagnosed with leukemia and is undergoing chemotherapy.
Select the nursing interventions that apply:
A. Monitor white blood cell count 
B. Encourage frequent mouth care 
C. Teach good hand washing habits 
D. Avoid large crowds 
E. Monitor potassium level 
27. A nurse is caring for an infant with a diagnosis of tetralogy of Fallot (TOF). The nurse knows that
there are four defects associated with TOF. They are:
A. Left ventricular hypertrophy, atrial septal defect, aortic stenosis, and overriding aorta  
B. Right ventricular hypertrophy, pulmonary stenosis, atrial septal defect, and overriding pulmonary
artery
C. Right ventricular hypertrophy, pulmonary stenosis, ventricular septal defect, and overriding aorta.  
D. Left ventricular hypertrophy, pulmonary stenosis, atrial septal defect, and overriding aorta.  
28. A client is seen in the pediatrician’s office for complaints of bone and joint pain. Which other signs
and symptoms may suggest leukemia?
A. Abdominal pain 
B. Increased activity level 
C. Increased appetite 
D. Petechiae