PAEDIATRICS WORKBOOK – NUC304

SUMMER 2021
Dear Student & Preceptor,

This workbook, intended for 3rd year, 2nd semester, Al-Riyada College nursing students,
presents Paediatric objectives in the context of modern student nursing practice.

When completed, it provides the nursing student with ready, self-directed information which is
needed to prepare her for exams and also to help her organize clinical approaches to the client
in the Paediatric setting.

This Paediatric workbook, tries to ensure that the chosen objectives (cognitive, psychomotor,
affective) reflect the needs and realities of day-to-day nursing student practices.

This workbook is to be used in conjunction with the Handbook of Clinical Assessment that the
student will use during the Paediatric rotation.

Student Name:
Formative Assessment Date: ________________________

Summative Assessment Date: _______________________

Clinical Instructor: _______________________

NB: All sources (text and pictures) to be referenced using Harvard referencing

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Part 1. Multiple Choice Questions: (5 points)
Direction: Read the following questions carefully, and then circle the one best answer for each
question, unless the question explicitly states “select all that apply”.

Q1. What is the normal oxygen saturation that the nurse should expect as a priority assessment
of a baby after 5 minutes of birth?
A. 80% - 85%
B. 70% - 75%
C. 60% - 65%
D. 90% - 95%

Q2. The nurse is administering IV fluids to a dehydrated infant. Which intervention is

necessary?
A. Ensuring the sterility of equipment
B. Calculating the total necessary intake
C. Continuing the prescribed rate of flow
D. Maintaining the fluid at baby temperature

Q3. During observing a toddler and other children in the playroom, the nurse should expect the
toddler to engage in:
A. Parallel play
B. Solitary play
C. Competitive play
D. Cooperative play

Q4. Regarding primary enuresis, which of the following is true:

A. It is a voluntary discharge of urine
B. It is a voluntary discharge of faces
C. Usually wet during day
D. Familial inheritance

Q5. When an infant’s vomiting is uncontrolled, which of following is the most important
complication the nurse should assess?
A. Alkalosis
B. Acidosis
C. Hyperkalemia
D. Hypernatremia

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Preceptor signature____________________________________

Q6. Which of the following childhood immunizations is contraindicated in a child with an

undiagnosed evolving neurological disease:
A. Tetanus
B. Measles
C. Pertussis
D. Rubella

Q7. Which behavior should the nurse recognize as the Moro reflex response?
A. Extension of the arms
B. Adduction of the arms
C. Abduction and then adduction of the arms
D. Extension of the legs and fanning of the toes.

Q8. In a newborn baby, what is a risk factor for Respiratory Distress Syndrome?
A. Prematurity
B. Cesarean Section
C. Male gender
D. Infection

Q9. A 2 year- old -girl is diagnosed with acute otitis media (AOM). The most common cause of
AOM at this age
A. Streptococcus pneumonia
B. E. coli
C. Staphylococcus aureus
D. Streptococcus group A

Q10. A 9-year-old child has a fractured tibia and a full leg cast has been applied. Which of the
following should the nurse immediately report to the doctor? Select all that apply
A. An increased urinary output
B. An inability to move the toes
C. A pedal pulse of 90 b/min
D. A tingling sensation in the foot
E. A fiberglass cast that is damp after 4 hr.

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Preceptor signature_____________________________________

Part 2. Fill in the Blank Questions: (12 points)

Q11. An infant is receiving parenteral therapy. The IV order is 400 ml of D 5 0.45 NS to run over
8 hrs. At what rate should the nurse maintain the hourly rate?
0.45÷ 8= 0.056
400× 0.056/60= 22.4/60 =0.37 ml/min
Q12. A newborn is admitted to the neonatal intensive care unit (NICU) with the diagnosis of
choanal atresia. The nurse is aware that choanal atresia is an anomaly located in the
nasal cavity by bone, soft tissue or both .
Q13. What are the most serious complications of meningitis in young children?
seizures , brain damage, hearing loss and disability
Q14. What is the definition of failure to thrive (FTT)? Mention the classification of FTT
failure to thrive (FTT): term used to describe inadequate growth or the inability to maintain
growth, usually in early childhood.
Organic FTT : Growth failure is due to an acute or chronic disorder that interferes with nutrient
intake, absorption, metabolism, or excretion or that increases energy requirements, Illness of any
organ system can be a cause
Nonorganic FTT : due to insufficient calorie intake. It usually manifests as failure to gain
weight. Growth in length and head circumference remain normal for a period of time until they
too become impacted by poor calorie intake. This is the most common pattern of nonorganic
FTT. .
Q15. What are the cardiac defects that associated with tetralogy of Fallot?
 Ventricular Septal Defect
 Pulmonary Stenosis
 Right Ventricular Hypertrophy
 Overriding Aorta
Q16. The nurse is caring for child with Sickle cell anemia. What is the priority of nursing
interventions to prevent thrombus formation in capillaries that occurs in the sickling process?
Encourage the fluids .
Q17. A 3 year old with nephrotic syndrome is being treated with corticosteroid therapy. The
nurse evaluates that treatment has been successful when the child has decreased ……………(fill in
the blank)

the risk of serious infection

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Q18. A child diagnosed with a severe asthma attack.
a) What are the clinical findings the nurse should expect when performing physical
examination? b) What is the priority nursing intervention for patients on Prednisone 15 mg PO
twice daily?
a) clinical findings : wheezing or whistling that could mean inflammation .
b) Preventing exposure of the child to infection Rationale: Prednisone reduces the child's
resistance to certain infectious processes and, as an anti-inflammatory drug, masks infection.
The child will self-limit activity depending on respiratory status. The eosinophil count is often
consistently increased in children with asthma. The child will need adequate hydration to help
loosen and expel mucus
Part 3. True/False Questions: (14 points)
Directions: Read the following items carefully, and then mark the item true (T) if the statement
is true and false (F) if the statement is false and then, correct the false statement
Q19. Sudden infant death syndrome (SIDS) is one of the most common causes of death in
infants, so it is diagnosed at 6 months to 1 year of age, peaking at 10 months ( F )
between 1 and 4 months old
Q20. Glucose-6-phosphate dehydrogenase deficiency (G6PD) is an inborn error of metabolism
that causes premature destruction of RBC ( T )
Q21. The median age of children for walking well is 10 months ( T )
Q22. A building set is one of the play materials the nurse should offer for two 6 year old
children in the playroom ( F )
for toddlers (about 24 months)
Q23. The nurse should expect to administer fresh frozen plasma to control bleeding in a child
with hemophilia A ( T )
Q24. A nurse instructs a new parent about their infant's nutrition; she said breast milk is the most
complete diet for 4 months and then solid food can be introduced ( F )
at around 6 months but not before 4 months.
Q25. Heart rate, blood pressure, and respiratory rate decrease with increased age, so when the
nurse assesses an infant, the normal rate of HR is 80 to 95 beat/min; RR is 20 to 30 breath/min;
and BP 100-110/55-70 mmHg ( F )
HR is 80 to 160 beat/min , RR is 30 to 60 breath/min , BP 70-90/50-65 mmHg
Q26. Brain reaches 90% of its total size by 2 years of age. ( F )

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By age 2, the brain is 80 percent of its adult size.
Q27. A child is admitted to the pediatric unit with suspected rheumatic fever. While obtaining
the child's history, the most important information the nurse should consider is a recent episode
of pharyngitis ( T )
Preceptor signature____________________________________

Part 4. (14 points)

Pediatric Equipment Mention the name /correct size Write the procedure, some tips
for pedia patients about this procedure

A/ A = is an instrument for
Esophageal/Stethoscope measuring and
monitoring heart sound
Size
or respiratory sound
a 6 French : 1 day to 4 years old, a 9 during operation
French : 4 to 12 years old, and an 18
A B French : 12 years of age or older.

B / Laryngoscope B= are designed for

Size: visualizing deep
Very preterm: 00 miller structures of the throat
and trachea
Preterm :0 miller

Neonate/small infant: 0 miller

Infant to 2 years of age : 1

miller

2-8 years of age : 2 miller

A/ tracheostomy tube A=Most pediatric

Size patients, on the other
hand, use a single cannula
2.5-5.5 mm
tracheostomy tube, cuffed
B/ suctioning catheter or uncuffed, without the
A B inner cannula
Pediatrics 8 – 12 Fr
B=Adjust wall suction.
Recommended pressures
should not exceed 80 –
120 mmHg for pediatrics
and 80 - 100 mmHg for
neonates. Cleanse hands
and put on sterile gloves.
A Long peripheral cannulas
represent a valid option
IV cannula
for medium-term
A Size : intravenous access in
children undergoing
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 Use of 8-cm 22G-long surgery
A Nasal cannulas A nasal cannula consists
of a flexible tube that is
placed under the nose , A
B face mask face mask covers the nose
A B and mouth .
A IV cannula IV cannulas consist of
short, flexible tubing
Yellow =24G
doctors place into a vein.
Blue=22G
A
Purple = 26G
A These masks help people
who can still breathe on
non-Rebreathing Oxygen
their own but need a lot
Mask
A of extra oxygen , used to
treat several conditions .
A passed through a nostril
of the nose into the throat
Pediatric nasogastric tube
and down into the
A stomach to feed the child
if they are unable to take
enough food by mouth or
they are not safely able to
take food by mouth.

Preceptor signature_____________________________________

EXTRA NOTES Extra notes/other information/pieces of work/aspects of learning that

you wish to record

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 References

https://www.msdmanuals.com/professional/pediatrics/miscellaneous-disorders-in-infants-and-
children/failure-to-thrive-ftt

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https://www.cochrane.org/CD001533/RENAL_corticosteroid-therapy-children-nephrotic-
syndrome

https://www.childrenshospital.org/conditions-and-treatments/conditions/s/sudden-infant-death-
syndrome-sids/symptoms-and-causes

https://www.pregnancybirthbaby.org.au/introducing-solid-food

https://www.aboutkidshealth.ca/article?contentid=984&language=english

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