1.

A nurse is teaching a parent of a child with hemophilia how to control a minor bleeding
episode. Which of the following statements by the parents is inappropriate?

a.
b.
I will elevate the affected extremity
I will apply heat neat
c.
d.
I will have my child rest
I will compress the site Mmffigatapply
iontrol
2. The nurse caring for a patient with osteogenesis imperfecta understands that the goal of
treatment is to?

a.
b.
Utilize serial casting
Treat the bone infection OI 4 bone density
c. Maintain spica cast
d. Increased bone density

3. The nurse is caring for a toddler who present with a honey-colored crusted oral lesion to
the urgent care cause of the lesion could be. What is the nurse best response?

a.
b.
A common viral infection
A common allergic response honey
colored staph
crust oral infect
c. A bacterial staphylococcal infection
d. A parasitic infection

4. A nurse is caring for a school-age child with a suspected diagnosis of bacterial

meningitis. Which of the following actions is the nurse’s priority?

a.
b.
Suction nasal secretions to minimize intracranial pressure
Encourage play activities in the facility’s public playroom antibio
c. Encourage completion of schoolwork bathing
d. Administer prescribed antibiotics

5. A nurse is providing teaching to an adolescent on measures to prevent urinary tract

infection (UTIs). Which of the following statements indicates teaching has been
effective?

a.
b.
I will need to restrict my fluid intake
I will need to decrease my fiber intake UTI's 4 Fiber
c. I will need to increase my fiber intake
d. I will need to perform vaginal douching daily
6. A child is seen in the clinic for his 6 months well child visit. The nurse is providing
education to the parents on the recommended immunization schedule. Which of the
following statements is appropriate?

a. The child will receive the MMR vaccine today 6m hep B

b. The child will receive the Hepatitis A vaccine today
c. The child will receive the Hepatitis B vaccine today
d. The child will receive the Varicella vaccine today

7. The nurse is caring for a child who is about to undergo a lumbar puncture. Which of the
following positions would be appropriate placement during the procedure? SATA

a. Positioning the child prone during the procedure Nfdxed

b. Positioning the head flexed inward towards the chest lumbar
c.
d.
Positioning the knee drawn up towards the chest
Positioning the child in a Trendelenburg position Kneedrawn
e. Position the child side lying

8. At hemophilia camp, several children with injuries arrive at the clinic at the same time.
sidetying
When prioritizing care for the children, the child who requires the most immediate care
from the nurse is the child with which of the following symptoms?

a. A slight head injury

b.
c.
Abrasions on both arms
A swollen knee
Immediate head injure
d. A sprained wrist

9. A nurse is caring for a child who is having a tonic-clonic seizure and vomiting, which of
the following actions is the nurse’s priority?

a. Position the child side-lying

b.
c.
Loosen restrictive clothing (belt)
Intubate patient tonic clonic sidetying
d. Clear the area of hazards
e. Place a pillow under the child’s head

10. A parent calls the pediatric clinic to report that her child has a bloody nose. The nurse
should give the parent which of the following instructions to stop the bleeding?

a. Place the child in a supine position with a pillow under her back
b. Have the child sit with the head titled slightly forward while holding
pressure on the nose
c. Place the child in a sitting position with the head titled back
d. Apply heat at the base of the nose for 5 minutes to minimize bleeding
11. The nurse is preparing discharge teaching to a client who was admitted for trauma,
secondary to a bicycle injury. Which of the following is important to include in the
discharge teaching? SATA

a. Teach the child to ride their bicycle with flow of traffic

b. Teach the child that both balls of their feet should touch the ground when
standing on the bike
c. Teach the child to wear dark colors with no fluorescent lights while riding their
bike
d. Teach the child to ride their bicycle against flow of traffic
e. Teach the child to wear a helmet and pads while riding a bike

12. A parent is concerned that her 5-year-old child may be exhibiting regression behaviors.
The nurse knows the behavior that indicates regression is:

a. Bedwetting several times a day

b. Crying when mother leaves Regression bedwetting
c. Eating only food from home several
d. Cuddling a threadbare blanket at bedtime
times
13. The nurse is caring for a 2-month-old infant in the emergency room with projectile
vomiting and an olive shaped mass in the right upper quadrant. Which of the following
intervention should the nurse do next?

a.
Epiglottis IV
Offer the infant small amounts of rehydrating oral electrolyte solution
b. Thicken the infant formula with rice cereal
c. Place the infant supine
d. Initiate prescribed intravenous fluids

14. The nurse in the pediatric emergency room is caring for a 3-year-old unvaccinated. The
child is anxious, drooling, and in the tripod. The parent states the child has become
progressively ill within the past 2 hours. Which of the following intervention is most
appropriate?

a.
tripod upright position
Complete throat culture to rule out bacterial infection
b. Inspect the child’s throat with a tongue blade
c. Maintain the child in an upright position while the nurse assesses the child
d. Maintain the child in a prone position to assist with drainage

15. The nurse is caring for a child with fever, headache, and running nose that begin 3 days
ago. Now the child has a rash which is prevalent in the face and has a slapped cheek
appearance. Which communicable disease would the nurse suspect for the patient?

a. Fifth disease (Erythema infectiosum)

b. Rubella (German measles)

Slapped check
c. Measles (Rubeola)

Fifth disease
 d. Varicella (chickenpox)

16. The nurse is caring for a toddler in the emergency department with an abdominal mass.
The patient blood pressure is elevated hematuria is noted on Urinalysis. The most likely
cause of these symptoms is likely to be which of the following?

a. Ewing sarcoma

Wilmsabdominal MBP hematuri

b. Osteosarcoma
c. Neuroblastoma
d. Wilm’s tumor
mass
17. The nurse is preparing to administer maintenance IV to a patient who weight 42 kg.
Calculate the daily maintenance total fluid requirement to determine the hourly IV fluid
rate. Fill in the blank with mL/hr. Record your answer in a whole number.

____81__mL/hr

100 x10 = 1000

50 x 10 = 500
20 x 22 = 440
------------------
= 1940 / 24 = 81

18. The nurse is caring for a newborn with a new diagnosis of phenylketonuria (PKU). The
mother asks the nurse about dietary restrictions. Which of the following is the nurse best
response?

a. There are no dietary restrictions with your child’s diagnosis

b. Formula that is high in phenylalanine is recommended for your child
c. Exclusively breastfeeding is the recommended dietary intake for your child
d. Exclusively breastfeeding is not possible

19. A child with Tylenol overdose has been admitted into the pediatric intensive care unit.
Which of the following intervention should the nurse anticipate?

a. Administration of phytonadione
b. The administration of protamine sulfate Tylenolacetylcastei ne
c. Gastric lavage
d. The administration of N-acetylcysteine

20. A nurse is caring for an adolescent who is scheduled to receive a transfusion of packed
red blood cells. The patient type patient’s blood is type B+. Which of the following donor
blood would be most appropriate to administer?

a. Blood type AB-

b. Blood type O-

Bt O
 c. Blood type AB+
d. Blood type A+

21. A 16-year-old boy with sickle cell anemia is admitted with severe pain in his abdomen
and legs. He asks why the doctor has ordered fluids intravenously. The nurse will be most
accurate in stating that the main therapeutic benefit of fluids in this child is to do with
which of them following?

a.
sickle all 402 carrying
Prevent further clumping of red blood cells
b.
c.
Decreased the potential for infection during the crisis
Increased the oxygen carrying capacity of red blood cells
capacity RBC
d. Prevent respiratory complications

22. A nurse is caring for an infant who has a congenital heart defect associated with
decreased pulmonary blood flow. Which of the following would the nurse expect the
infant to be diagnosed with?

a. Tetralogy of Fallot (decrease) (cyanotic)

b. Coarctation of the aorta (Obstructive) (acyanotic)
c. Patent ductus arteriosus (Increase) (acyanotic)
d. Ventricular septal defect (increase) (acyanotic)

23. The nurse is caring for a 5-month-old infant with a diagnosis of intussusception. The
infant has periods of irritability during which the knees are brought to chest and the infant
cries, altering with periods of lethargy. Vital signs are stable and within age-appropriate
limits. The physician elects to give an air enema. The parents ask the purpose of the air
enema. Select the nurses most appropriate response?

a. The enema will help confirm the diagnosis and has a good chance of
correcting the intussusception
b. The enema will confirm the diagnosis. If the test result is positive, your child
will need to have surgery to correct the intussusception
c. The enema will help confirm the diagnosis while the patient is prepared for
colonoscopy
d. The enema will confirm the diagnosis by visualization of an intestinal
megacolon
e. The enema will help confirm the diagnosis and may temporarily fix the
intussusception. If the bowel returns to normal, there is a strong likelihood that
the intussusception will recur.
f. The enema will confirm the diagnosis. Although very unlikely, the enema may
also help fix the intussusception so that your child will not immediately need
surgery”
24. A nurse is caring for a child with nephrotic syndrome. The child’s albumin level is 2.5 g.
Which of the following complications should the nurse assess for?

a. Fractures

hygiene
b. Steatorrhea
c. Increased intracranial pressure
d. Embolism

25. The nurse is caring for a child who is being treated for extensive bleeding in the
emergency department. The soured and extent of bleeding are being determined as the
nurse is trying to control the bleeding. The nurse places highest priority on which of the
following activities?

a. Talk with the family regarding the risk of HIV and hepatitis C with blood
transfusions
b. Obtain the clients history Replace
c. Provide psychosocial support to the family
gotra
d. Replace blood volume
189m
26. The nurse is caring for a child with Kawasaki Disease (KD). A student nurse who is on
the unit asks what the most common medication are to treat this disease. The nurse’s
response to the student nurse is:

a. Immunoglobulin G and antibiotics

Aspire
Imgt
b. Immunoglobulin G and aspirin
c.
d.
Immunoglobulin G and Tylenol
Immunoglobulin G and Ace inhibitors
Kawasaki
e. Immunoglobulin E and heparin
f. Immunoglobulin E and ibuprofen

27. A school-age child is admitted in Vaso-occlusive sickle cell crisis. Being well versed in
the management of Vaso-occlusive crisis in the patient with sickle cell anemia, the nurse
determines which of the following can be therapeutic intervention for the patient? SATA

a. Intramuscular phytonadione
b. Oral desmopressin (DDAVP)

Migliphinerasooans
c. Intravenous fluids
d. Intravenous morphine
e. Oxygen therapy
f. Oral ferrous sulfate

28. The school nurse is attempting to decrease transmission of the flu during the flu season in
an elementary school which infection control strategy would be appropriate for the school
nurse to implement? SATA
 a. Sanitize toys, telephone and/or doorknobs within the school
b. Educate student how to properly wash their hands
c. Inform parents to keep children with the flu at home until the child is at least
24 hours afebrile
d. Inform parents to withhold the inactivated influenza vaccine if their child has a
chronic condition
e. Educate teachers how to properly wash their hands
f. Educate students to cover their mouth with their pal when coughing or
sneezing

29. The nurse is taking care of child who is about to receive an intramuscular shot, which of
the following is appropriate when EMLA cream?

a. Apply EMLA cream to the site of injection 15 minutes prior to the injection
b. It is ok to give intramuscular shot without wiping off the EMLA cream
c. Apply the EMLA cream over open cuts and burns
d. Apply EMLA cream to the site of injection 60 minutes prior to the injection

30. A nurse is caring for a pre-school age child with high fever and difficulty breathing who
is drooling, agitated and on a tripod position. Which of the following is an appropriate
nursing action?
a. Encourage coughing
b. Administer prescribed oral antipyretic
c. Attempt to obtain a throat culture
d. Initiate intravenous access
nothing by mouth
31. The nurse is caring for an infant diagnosed with pertussis. The parent asks if there is any
way that pertussis can be prevented. What is the nurses best response?

a. Pertussis can be prevented with administration of the DTap vaccine

b. Pertussis can be prevented with administration of the Rotavirus vaccine
c. Pertussis can be prevented with administration of the MMR vaccine
d. Pertussis cannot be prevented but may treated with acyclovir

32. A nurse is performing a developmental screening on 2-year-old child. Which of the

following skills should the toddler be able to perform?

a. Jump across the floor using both feet

b. Rides a tricycle
c. Alternated feet when climbing up the stairs
d. Build a tower of six blocks (Fine Motor)
33. A child who has leukemia is being admitted. Several rooms are available on the pediatric
floor. Which of the following clients should the nurse place in the same room with this
child?
hemophilia
a.
b.
A child who has hemophilia
A child recovering from a varicella leukemia
c. A child who has cystic fibrosis
d. A child who has rheumatic fever

34. A nurse is providing teaching to the parents of a child who has been recently diagnosed
with rheumatic fever. Which of the following statements by the parent indicated the cause
of rheumatic fever?

a. My child has a recent UTI Rhumatic recentettifoat

b. My child is unvaccinated
c. My child has a recent throat infection (Group A beta-hemolytic
streptococcus)
d. My child has a recent GI infection

35. A nurse is caring for a pediatric client who is about to receive chemotherapy. The nurse
reviewing the client’s laboratory results notes that her platelet count is 80,000. Which of
the following precautions should the nurse add to the clients care plan?

a.
b.
Droplet precautions
Bleeding precautions (normal 150-400) Chemo Bleed
c.
d.
Seizures precautions
Airborne precautions
precautions
36. The nurse is providing discharge teaching for a client with Syndrome of inappropriate
antidiuretic hormone secretion (SIADH). Which of the following is most important to
include in the client’s discharge teaching?

a. The client should drink at least 3 gallons of water a day

SIAD HE N Cramps
 b. The client should increase their sodium intake
c. The client should decrease their sodium intake
d. Inform the client that nausea and muscle cramps is normal (s/s of SIADH)

37. When caring for adolescents, the nurse is aware that which of the following interventions
helps to reduce stress due to hospitalization?

a. Discuss with adolescent patients fears of anxiety about altered body image
b. Discourage any communication with peers during hospitalization to reduce
distractions
c. Adolescent patients enjoy dependency on parents
d. Explain procedures to the parents and not adolescent patients

38. The nurse is caring for a school-age child with sick cell anemia. The child’s condition
worsened due to hypoxia and dehydration. Which of the following assessment findings is
the nurse most likely to assess?

a.
b.
c.
Lordosis
Epistaxis
Petechia Ehh Pain
d. Pain (s/s)
anemia
39. The nurse is caring for a toddler with mild fever, a seal-like cough and inspiratory stridor
on auscultation. The respiratory pathogen panel is positive for parainfluenza. Which of
the following is a priority intervention?

a.
b.
Initiation of airborne precautions
Cool midst humidification coolmidst
c.
d.
Ibuprofen
Intubation
seglign humidification
40. An 11-year-old child and his family were given instructions on use of the peak expiratory
flow meter (PEFM) to measure peak expiratory flow rate (PEFR). The child shows a
PEFR of 55% of his personal best. Which of the following actions if taken by the family
would indicate and understanding of the instructions?

a. Increase the daily prescribed dose of the inhaled corticosteroid

b. Encourage the child to participate in physical activity SABA
c. No change of treatment
d. Administer the patients prescribed quick-relief medication

41. An adolescent female is prescribed amoxicillin (Amoxil) for an ear infection. The nurse
should teach the adolescent about risks associated with her concurrent use of:

a. Antacids
b. Multiple vitamins

Amoxicillin or a l contraup
 c. Protein shakes
d. Oral contraceptives

42. The nurse is administering a liquid iron preparation to a 3-year-old with iron deficiency
anemia. It will be most appropriate to do which of the following?

a. Give medication with an antacid to prevent dark-tarry stools

b. Give medication with a spoonful of yogurt
c. Give the medication in a small cup with a straw
d. Mix the medication with the child’s milk and give it at lunch
e. Allow the child to decide whether to take the medicine with breakfast or dinner
f. Give the medication after lunch with a sweet dessert to disguise the taste

43. The parents of a child with cystic fibrosis (CF) is excited about the possibility of the child
receiving a double lung transplant. What should the parent understand?

a. The transplant will not cure the child of CF but will allow the child to have
a longer life
b. The transplant will cure the child of CD and allow the child to lead a long and
healthy life
c. The transplant will be the only chance at surviving long enough to graduate
college
d. The transplant will help to reverse the multisystem damage that has been cause

CF double longer longerlife

by CF

44. Which assessment findings should lead the nurse to suspect that a toddler is experiencing
an emergent respiratory distress? SATA

a. Restlessness

distressBattering
b. Nasal flaring
c. Respiratory rate of 35 breaths/min
d. Heart rate of 95 beats/min
e.
f.
Fever
Respiratory rate of 65 breaths/min
i
resp 65
45. The nurse is caring for a patient with type 1 diabetes who has a blood sugar reading of
40. The child is awake and alert. What intervention would be most appropriate for the
nurse to provide?
a. Administer 2 oz of whole milk by mouth
b. Administer 4 oz of juice by mouth
c. Administer glucagon IM
d. Initiate and infusion of dextrose 50%
46. The nurse is caring for an infant who has inadequate mortality of part of the intestine due
to absence of ganglion cells. On assessment, the infant has abdominal distention with
decreased appetite and chronic constipation with occasional ribbon-like stools. The nurse
should identify these findings as a manifestation of which of the following disorders?
I
a. Hirschsprung’s disease (megacolon Disease)
b. Pyloric stenosis
c. Celiac disease
d. Encopresis Hirschsprung ganglion
47. What activity should the school nurse recommend for a child with hemophilia A?

no conta
a. Golf
hemophilia
G Rugby swim
b. Lacrosse
c. Football
d.
e.
Jogging
Swimming
no contact
f. Rugby

48. The nurse is assessing a 3-year-old child who has an intreated congenital heart defect.
Which of following findings would the nurse expect the child to exhibit? SATA

a. Tachycardia
b. Normal heart rhythm congenital
c. Delayed cap refill of the nail beds Tacky
d.
e.
Weak pulses
Murmur Heart I delaycaprefit
f. Hypotension
detect weakpus
murmur
49. The nurse is caring for a 5-year-old experiencing gross hematuria, edema, blood pressure
of 130/89, and slight proteinuria. The nurse expects which of the following as the most
likely diagnosis?

a. Rheumatic fever
Gomer hematuria
b. Hemolytic uremic syndrome

glomsproteinuria
c. Nephrotic syndrome
d. Glomerulonephritis

50. The nurse in a family clinic receives a call from the mother of a 2-year-old child. The
mother states the child has a barky cough with a low-grade fever. She denies any
respiratory distress symptoms. Which of the following should the nurse recommend?

a. Recommend the nurse for antibiotic therapy

b. Provide fluids that the child likes and use a cool mist humidification
c. Control fever with aspirin and call if cough gets worse tonight
d. Admit to the hospital and observe for impending epiglottis

mist
barry cough cool
humidification
 I ds

51. A child sustains a traumatic brain injury and is monitored in the pediatric intensive care
unit (PICU). The nurse is using a Glasgow Come Scale to assess the child. Which items
will the nurse assess when using this tool? SATA

a. Deep tendon reflexes

b. Pupil response
c. Motor response
d. Eye opening
e. Verbal response

52. A nurse is discharging a child with sickle cell anemia after an acute crisis episode. Which
of the following should the nurse teach the child’s parents to do to prevent future Vaso-
occlusive episodes?
prevent future Vasoocclusive drinkplenty
a. Encourage the child to drink plenty of fluids
ofwater
b. Encourage increased moderate to high intensity aerobic exercise for 90 min
daily
c. Have the child eat a high protein diet
d. Monitor the child’s temperature only

53. The nurse is administering Prilosec (omeprazole) to a 3-month-old with a

gastroesophageal reflux (GER). The child’s parents ask the nurse how the medication

decrease stomachacid
works. Select the nurse’s best response.

a.
PPI
Prilosec helps food move through the stomach quicker, so there will be less
chance for reflux
b. Prilosec decreases stomach acid, so it will not be as irritating when your
child spits up
c. Prilosec us commonly prescribed for reflux in infant
d. Prilosec relaxes the pressure of the lower esophageal sphincter

54. A nurse is admitting a 9-year-old with a bacterial pneumonia to a room on a semi-private

medical-surgical unit. Which of the following room assignments should the nurse make
for the client?

a. A private negative pressure room

b. A room with another child with bacterial pneumonia
c. A room with a child with an appendectomy
d. A room with an oncology patient
55. The nurse is caring for a patient with recently diagnosed diabetes insipidus. The nurse
should expect which of the following laboratory findings? SATA

a. Hyponatremia
b. Decreased specific gravity
c. Polyuria
d. Oliguria
e. Hypernatremia
f. Elevated specific gravity

56. The nurse is caring for a child with potential conjunction. Which of the following
symptoms are indicative of bacterial conjunctivitis?

a.
b.
Increased tearing of the eyelid
Crusty eyelids upon awakening
backer Innit'anitatpura
c. Unilateral mucopurulent eye discharge conjunctivitis
d. Bilateral watery eye discharge (viral) redness
e. Redness of the conjunctiva
f. Unilateral watery discharge
unilateralpurvu
eyelid
crusty
57. A nurse is teaching a client about the side effects of chemotherapy medication. Which of
the following nursing statements should the nurse include in the teaching?

a. “Nutritional supplementation is often needed to maintain nutritional

status”
b. “Most clients start to gain weight during their treatment”
c. “Most clients do not experience nausea”
d. “Clients lose their hair, but it usually grows back nice and thick”

58. In preparing a pediatric client for an appendectomy, the nurse should question which
doctors’ orders?

a. Administer ceftriaxone (Rocephin) 100mg, IVBP, now.

b. Witness legal guardian sign the contest form Appendectomy
c. Initiate intravenous fluids
d. Administer a normal saline enema prior to surgery enema
e. Obtain signed consent form from parents
f. Administer an enema prior
g. Administer 500 mL ringer lactate solution at 50mL/hr
surgery
59. The hydration status of an infant can be estimated by assessing which of the following?
SATA

a. Weight
b. Urine output hydrationIweightoutput
status urine
reflex
Skin turgor
 I bid I a

c. Skin turgor
d. Reflexes
e. Fluid intake
f. Stool output

60. A nurse is caring for a child who has acute gastroenteritis with frequent episodes but is
able to retain oral fluids. The child’s vital signs are within normal limits. The nurse
should anticipate providing which of the following therapeutic interventions?

a. Pedialyte
b. Cow’s milk
c. Isotonic intravenous solution
d. Diluted juice

61. The nurse is planning care for an adolescent with acquired immunodeficiency syndrome.
What is the priority nursing goal?

a. Identify source of infection Pffreention

b. Prevent infection Immunodeficiency
c. Prevent secondary cancers
d. Restore immunologic defenses

62. It is important that a child with acute streptococcal pharyngitis be treated with antibiotics,
to prevent what condition?

a. Nephrotic syndrome
b. Kawasaki disease acutestrep
c.
d.
Acute rheumatic fever
Diabetes insipidus
Affmatic pharyngitis
63. A school-aged child with diabetes gets 10 units of regular insulin at noon. According to
when this insulin peaks, the child should be at greatest risk for a hypoglycemic episode
between when?

a.
b.
Lunch and afternoon snacks
Dinner and bedtime snack Insulin lunch G
c.
d.
Bedtime and breakfast in the morning
At the hour of sleep
afternoon
snacks
64. The nurse is assessing an 8-month-old infant at a wellness clinic. The infant has a history
of myelomeningocele. The nurse expects which of the following assessment findings?

a. Negative extrusion reflex

b. decreased sensation to the lower extremities
c. Sits unsupported
 d. Absence of head lag

65. The nurse is caring for a child with newly diagnosed mononucleosis. The child hepatic
panel showed elevation in liver enzymes (ALT/AST). Which of the following
recommendations should the nurse provide the caregivers of the child?

a. Minimization of rest is recommended Mononucle Avoid intact

68 W
b. Avoidance of contact sports for 6-8 weeks is recommended
c. Intake of citrus drinks is recommended
d. Antibiotic therapy is recommended

66. The nurse is providing teaching to a child and her parents about the child’s new diagnosis
of moderate persistent asthma. The parents ask the nurse if the child will have to take any
daily medications. What is the nurses best response?
Asthma inhaled iorticosteroid
a. “Management with a daily dose of an inhaled corticosteroid is necessary”
b. “There is no daily treatment medication available for asthma.”
c. “Management with a daily dose of oral steroids is necessary.”
d. “Management with a daily dose of an inhaled bronchodilator is necessary”

67. A nurse is caring for a group of patients with COVID-19. The nurse recognizes most
cases of the disease presents with symptoms about 5 days after exposure. The nurse
determines the stage in which the patient is exposed to the virus and the virus replicates is
consistent with what stage of the infectious process?

a. Communicability period
b.
c.
Incubation period
Prodromal period
Incubation replicates
d. Convalescent period

68. The nurse is caring for a patient who arrived in the urgent care with cough, runny nose,
and conjunctivitis. On further assessment, the nurse notices tiny white spots on the oral
cavity. Which communicable disease should the nurse suspect?

a. Rubella (german measles)

white Measu
b.
c.
Varicella (chickenpox)
Measles (rubeola) tiny spots
d. Pertussis (whooping cough)

69. The nurse would expect to find the greatest cyanosis in a child with which cardiovascular
condition?

a. A mixed defect transposition of the great vessels (TGV) with a large patent
ductus arteriosus (PDA)
b. An obstructive defect like coarctation of the aorta
 c. A defect of decreased pulmonary flow like tricuspid atresia
d. Ventricular Septal Defect
e. A defect of increased pulmonary blood flow like atrioventricular canal defect

70. The nurse is assessing a child with rheumatic fever. The child has involuntary muscle
movements which make it hard to coordinate purposeful movements. The parent is highly
concerned with these symptoms. What is the nurses best response?

a. “The symptoms are self-limiting, in nature and key focus is on injury

prevention”
b. “These symptoms are unrelated to rheumatic fever and other causes must be
investigated
c. “These symptoms are progressive in nature and eventually lead to total loss
of purposeful movement”
d. “These symptoms indicate the disease is worsening

71. The nurse is planning care of a child with hemolytic uremic syndrome who has been
anuric for over 24 hours and will be initiated on peritoneal dialysis treatment. The nurse
should plan to implement which important measure?

a. Restrict fluids as prescribed

tags
b. Administer spironolactone 25 mg by mouth
c. Encourage foods high in potassium
d. Care for the arteriovenous fistula Paralegal
e. Administer analgesics as prescribed

72. A nurse if caring for a 4-year-old patient who has a fracture of the tibia involving the
growth plate the child will require casting of the extremity. As the cast dries which of the
following should the nurse recommend?

a. Utilize the fingertips of the hands to palpate the cast as it dries

b. Utilize heat lamps to assist with cast drying
c. Turn and reposition the extremity frequently
d. Maintain the extremity in a dependent position as it dries

73. On assessment the nurse notes the child has bounding upper extremity pulses but thready,
faint pulses on the lower extremities. Which congenital heart defect does the nurse most
likely suspect?

a. Aortic stenosis (AS)

b. Tetralogy of Fallot (TOF)
c. Transposition of the great vessels
d. Coarctation of the aorta (COA)
74. The elementary school nurse is assessing and giving initial care to a client with
hemophilia who has significant pain in his knee. The nurse suspects hemarthrosis. As the
nurse waits for his caregiver to arrive, the nurse would take which action?

a. Elevate the leg above his heart

b. Apply warm soaks to reduce the swelling
c. Maintain joint mobility with passive range of motion of motion exercises
d. Administer children’s aspirin for pain

hemophilia Ekuggtfleg
75. A toddler has been hospitalized to have bilateral myringotomy tubes inserted. When
discussing age-appropriate activities for the child, which of the following should the
nurse recommend?

a. “Separating from your child for long periods of time will prevent regressive
behavior.”
b. “Playing chess with your child will encourage development and prevent
boredom”
c. “Bring your child’s favorite blanket or toy from home when she will be
staying the hospital”
d. “Avoid allowing the child to make any decision for themselves as this will
increase stress levels”

76. A newborn is suspected of having cystic fibrosis. As the newborn is being prepared for
transfer to a pediatric hospital, the mother asks the nurse which symptoms made the
practitioner suspect cystic fibrosis. Which response by the nurse is the most appropriate?

meconiumillus
a. Rectal prolapse

Cystic fibrosis
b. Black stools
c. Constipation
d. Meconium ileus

77. Which of the following is most descriptive of the pathophysiology of leukemia?

Ieremia
a. Unrestricted proliferation of immature white blood cells (WBC) occurs
b. Unrestricted proliferation of immature red blood cells (RBC) occurs imm
c. Lack of erythropoietin has led to a decrease in red blood cells production
causing anemia WBU
d. Thrombocytopenia (excessive destruction of platelets) occurs

78. In a child with leukemia, which presenting lab value would the nurse expect?

a. Hemoglobin of 13 mg/dl
b. RBC count of 5.0 million cells/mcl
c. Platelet count of 80,000 per microliter of blood

IWKEE86,000
 d. Platelet count of 6000,000 per microliter of blood

79. The clinic nurse has organized a class for several parents of children newly diagnosed
with sickle cell disease. The nurse explains that problems with the disease can include
which of the following? SATA

a. Sequestration of blood
b. Hemarthrosis
c. Hemochromatosis
d. Aplastic crisis
e. Vaso-occlusive crisis
f. Hyperhemolytic crisis

80. A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of
the following strategies should the nurse use to elicit the child’s cooperation?

a. Tell the child it is candy

b. Offer the child the choice of taking the medication with juice or water
c. Hide the medication in a bowl of ice cream
d. Offer the child if he’d like to take the medication now or after playtime
e. Tell the child he will have to have a shot instead

81. The nurse is caring for a newborn with a spinal sac protrusion at the lumbar spine. The
nurse prioritizes which of the following interventions to complete first?

a. Apply a moist sterile gauze to the spinal sac

b. Administer intravenous antibiotics as prescribed
c. Encourage infant parent attachment
d. Complete a rectal temperature

82. A 4-year-old child was admitted to the ER. He was recently diagnosed with rubella. The
nurse should anticipate which of the following to be correct?

a. The disease can be transmitted via droplet 3 days before and 5 days after
the rash appears
b. Patient can have a fever of 104
c. Incubation period lasts 21 days
d. If pregnant, rubella can cause the fetus to develop PDA
e. Rash begins in the trunk
f. Patients may appear to have whooping cough (pertussis)
83. Which would be a nursing priority intervention for a child with suspected of having
varicella?

a. Call another nurse for assistance

b. Initiate universal precautions and standard precautions
c. Initiate airborne precautions
d. Initiate respiratory precautions

84. The health care provider prescribes ceftazidime (fortaz) 75 mg per intravenous piggyback
(IVPB) every 8 hours for a child with cystic fibrosis. The pharmacy sends the medication
to the unit in a 100-ml bag with directions to run the medication over 30 minutes. What
milliliters per hours will the nurse set the intravenous pump to run the medication over 30
minutes? Fill in the blank and record your answer in a whole number

Answer: 100/30= 3.3 = 3

85. The mother of a 20-month-old boy tells the nurse that he has a barking cough at night.
His temperature is 37 C (98.6 F). The nurse suspects mild croup and should recommend
which intervention?

a. Control fever with aspirin and call if cough gets worse tonight
b. Try over-the-counter cough medicine and come to the clinic tomorrow if no
improvement
c. Admit to the hospital and observe for impending epiglottitis
d. Provide fluids that the child likes and use comfort measures

86. The practitioner changes the medication for the child with asthma to albuterol (Proventil).
The mother asks the nurse what this drug will do. The nurse explains that albuterol
(Proventil) is used to treat asthma because the drug produces which characteristic?

a. Dilates the bronchioles

b. Decreases inflammation
c. Decreases mucous production
d. Controls allergic rhinitis

87. Which of the following medications would the nurse teach a 10-year-old with asthma to
use as a rescue medication for a mild asthma attack at recess?

a. The child needs to use his/her inhaler cromolyn sodium (intal)

b. The child’s asthma is under good control, so the routine treatment plan
should continue
c. The child needs to use his/her short-acting inhaler beta2-agonist
medication
 d. This is a medical emergency requiring a trip to the emergency department for
treatment

88. A nurse has received a physician order to give 20mL of Mylanta every 12 hours. The
nurse knows that 20mL equal how many teaspoons? (Round to the nearest whole
numbers)

1teaspoons= 5mL

20/5=4
Answer in teaspoons: 4 tsp

89. A nurse is teaching assistive personnel to measure a newborn’s respiratory rate. Which of
the following statements indicates an understanding of why the respiratory rate should be
counted for a complete minute?

a. “The rate and rhythm of breath can become irregular in newborns”

b. “Activity will increase the respiratory rate”
c. “Newborns do not expand their lungs fully with each respiration”
d. “Newborns are abdominal breathers”

90. The nurse is providing homecare instructions to the parents of a child with cystic fibrosis.
Which statement by the parents indicates that they do not understand the treatment
regimen? (Select all that apply)

a. “We will perform chest physiotherapy and postural drainage after

meals”
b. “If her bowel movements are normal and her appetite is good, she does
not need her pancreas enzymes”
c. “The swimming sessions at our Sunday school picnic next week will be good
exercise for her as long as she is capable”
d. “My child will not need any special dietary intake”
e. “We will keep her away from the church nursery if any of the children are
coughing and have fever or runny noses.”

91. A 6-year-old with a fever is prescribed amoxicillin clavulanate 250mg/5 cc three times
daily by mouth x 10 days for otitis media. Which teaching point will guard against
antibiotic resistance to the disease process?
a. Measure the prescribed dose in a household teaspoon
b. Administer a loading dose for the first dose
c. Give the antibiotic for the full 10 days
d. Stop the antibiotic if the child is afebrile

Giahtibiotic
resist
graval Antibiotic ForIOfull
against days
92. A nurse is monitoring the flow rate of an IV solution prescribed to infuse 100 mL/hr
using a drop factor of 15 gtt/mL. The nurse should measure the flow rate is set to infuse
how many gtt/min? (Round the answer to the nearest whole number)

III YI
100 mL x 15 gtt / 60min (1hr) = 25ml

Answer: 25 mL
mint
93. A nurse is providing care to a child who has an allergy to eggs. The nurse should question
a prescription for which of the following immunizations?

a. Influenza, live attenuated (LAIV)

b. Hepatitis B (HepB)
c. Hemophilus influenza type b (Hib)
d. Inactivated poliovirus (IPV)

94. The nurse is reviewing infant care with a mother of a 5-day-old patient in a pediatric unit
with a diagnosis of “rule out sepsis”. Under which circumstances should the nurse
emphasize, that parents should call their healthcare provider immediately? (SATA)

a. Child difficult to awaken and has a pulsing fontanel

b. Child has a stiff neck and has been irritable for three days
c. Child 4 months old, received a DTaP immunization yesterday, and has a
temperature of 38.0 C (100.4 F)
d. Child under 3 months old and has a temperature over 40.1 C (104.2 F)
e. Child has purple spots on the skin and is lethargic

95. A 12-year-old patient is being treated in the hospital for pneumonia. The primary care
provider is calling in a telephone order for ampicillin. The nurse should do which of the
following? (SATA)

a. Ask the nursing supervisor to cosign the telephone order as transcribed by the
nurse
b. Ask the primary care provider to confirm that the order is correct as
understood by the nurse
c. Ask the unit clerk to listen on the speaker phone with the nurse and write
down the order
d. Ask the primary care provider to come to the hospital and write the order on
the chart
e. Repeat the order to the primary care provider

96. An infant with a diagnosis of pyloric stenosis is admitted to the pediatric unit. Shortly
after admission, the infant begins to vomit. What is an appropriate nursing action?

a. Evaluate the infant for dehydration

b. Place the infant on his or her back
 c. Offer the infant small amounts of rehydrating solution
d. Place the infant in isolation

97. A newborn is noted to have an increasing head circumference upon physical examination.
Which finding should the nurse anticipate?

a. Bulging fontanels
b. A soft, low-pitched cry
c. Response to comforting
d. “On time” developmental milestones

98. Which question should the nurse ask the parents of a child suspected of having
glomerulonephritis?

a. “Did your child fall off of a bike onto the handlebars?”

b. “Has the child been itching or had a rash anytime in the last week?”
c. “Has the child had persistent nausea and vomiting?”
d. “Has the child had a sore throat or a throat infection in the last few
weeks?”

99. A 2-year-old child had a tonsillectomy yesterday. The nurse would be least concerned
about:
a. Increased swallowing
b. Increased pulse
c. Halitosis
d. Nausea and vomiting

100. When caring for a child with probable appendicitis, the nurse should be alerted to
recognize which of the following as a sign of perforation?

a. Bradycardia
b. Sudden relief from pain
c. Anorexia
d. Decreased abdominal distention

101. A nurse is preparing to administer morphine 6 mg via IV bolus. Available is

morphine 4mg/mL. how many mL should the nurse administer? (Round the answer to the
nearest tenths place)

6mg / 4mg = 1.5 x1 = 1.5

Answer: 1.5 mL

102. Which should the nurse administer to provide quick relief to a child with asthma
who is coughing, wheezing, and having difficulty catching her breath?
 a. Singulair (Montelukast) (decrease in airway resistance)
b. Prednisone (steroids)
c. Albuterol (acute exacerbation)
d. Flovent (fluticasone) (steroids)

103. A nurse is providing discharge instructions to the parent of a 11-yeard-old child

following a cardiac catheterization. Which of the following instructions should the nurse
include?
a. Offer the child clear liquids for the first 24 hr
b. Assist the child to take a tub bath for the first 3 days
c. Give the child acetaminophen for discomfort
d. Keep the child home for 1 week

104. A nurse is caring for a pre-school age child who has epiglottitis with a barking
cough. Which of the following is an appropriate nursing action?

a. Encourage coughing
b. Attempt to obtain a throat culture
c. Visualize the back of the throat
d. Apply oxygen

105. Which of the following is the most common malignant renal and intra-abdominal
tumor of childhood?

a. Wilm’s tumor
b. Osteosarcoma
c. Neuroblastoma
d. Ewing sarcoma

106. A school-age child is admitted in vaso-occlusive sickle cell crisis. The child’s
care should include which therapeutic interventions?

a. Correction of alkalosis and reduction of energy expenditure

b. Hydration of pain management
c. Electrolyte replacement and administration of heparin
d. Oxygenation and factor VII replacement

107. Which statement should the nurse include when teaching parents of a 7-month-old
infant about preventing anemia?

a. “Anemia is unusual in infancy as infants use fetal iron stores until 18 months
of age”
b. “Anemia can easily occur during infancy, and all infants should receive iron
supplements.”
c. “Cow’s milk is an excellent source of iron, and infants should be changed
from formula to milk as soon as possible after 6 months of age.”
 d. “Milk is a poor source of iron, and infants should be given solid foods
high in iron such as cereal, vegetables, and meats.”

108. A 3-year-old child is brough into the emergency department in her mother’s arms.
The child’s mouth is open, and she is drooling and lethargic. Her mother states that she
became ill suddenly within the past 2 hours. What should the nurse do first?

a. Draw blood cultures for complete blood count

b. Maintain the child in an undisturbed, upright position while the nurse
assesses the child.
c. Start a medication infusion
d. Inspect the child’s throat with a tongue blade

109. A nurse is caring for an infant who weighs 12 lbs. and is prescribed cefuroxime
sodium 15mg/kg PO every 12-hr. available is cefuroxime sodium oral solution
125mg/5mL. how many mL should the nurse administer per dose? (Round the answer to
the nearest tenth)

Answer in mL: 3.27 = 3.3 mL

110. A nurse is calculating the intake of a client during the past 9 hr. the client’s intake
includes lactated ringer’s IV at 150mL/hr. cefazolin 2 g IV intermittent bolus in 100 mL
of 0.9% sodium chloride. Two units of packed RBCs of 275 mL and 250 mL; two IV
bolus infusions of 250 mL of 0.9% sodium chloride, ranitidine 50 mg IV intermittent
bolus in 50 mL of dextrose 5% in water. How many mL of intake should the nurse
record? (Round to the nearest whole number)

Answer in mL: 2, 525mL

111. The nurse must evaluate the intake of a 17-year-old client for a total of 8 hours for
the following consumed items. What is the total milliters that will be recorded for the
total intake? (Round to the nearest whole number) 2 cups of water, 750 mL of 0.9%
normal saline IV infusion, 8 oz of chicken broth, 4 oz of milk, 16 oz of hot tea.

2 cup 480 mL
8 x 30= 240
4 x 30= 120
16 oz = 480
-----------------
= 1320 + 750 = 2,070

Answer in mL: 2,070 mL

112. A nurse is teaching about neural tube defects to a group of females who are
pregnant and the nutritional implications. Which of the following disease processes
should the nurse include as an example of a neural tube defect?

a.
b.
Muscular dystrophy
Hydrocephalus Naral
c.
d.
Cerebral palsy
Spina bifida tugged'Pingitiinda
113. When educating a patient with a new diagnosis of phenylketonuria about food
choices that they should avoid, which should the nurse include?

core
a. Oatmeal
b.
c.
Diet coke
Wheat dinner roll PKU Diet
d. Cereal

QUIZ 3
1. The nurse is reviewing risk factors for the development of congenital heart defects with a
client that wants to conceive. Which of the following conditions should the nurse include
as a maternal risk factor?

a. Placenta Previa
b. Late prenatal care
c. Preeclampsia
d. Maternal infection with Rubella

2. The nurse is caring for a patient with Rheumatic Fever. The nurse anticipates which of
the following laboratory values?

a. Decreased Erythrocyte Sedimentation Rate

b. Decreased C - reactive protein level
c. Elevated Antistreptolysin O titer
d. Elevated Red Blood Cell Count

3. The nurse is providing discharge instructions to a child with a central venous catheter.
Which of the following instructions should the nurse include?
 a. Implement good oral hygiene
b. Keep the child on bed rest for 72 hours
c. Elevated body temperature is a common characteristic with a central venous
catheter.
d. Implement home seizure precautions

4. The nurse is assessing an 8-month-old infant for coarctation of the aorta. Which of the
following findings is a manifestation of the condition?

a. Clubbing of the fingers

b. A continuous “machinery murmur”
c. Skin warm to touch in the lower extremities
d. Lower blood pressure in the legs compared to the arms

5. The nurse is assessing a patient in the community with suspected aortic stenosis. Which
statement, made by the caregiver, is a symptom of the suspected diagnosis?

a. “I’ve been told my child has a higher blood pressure in her arms thank her
legs”
b. “My child had a recent throat infection”
c. “My child squats often when playing”
d. My child has had several syncopal episodes recently”
6. The nurse is providing teaching to parents for a newborn with suspected Tetralogy of
Fallot. What should the nurses include are the pathological defects seen in Tetralogy of
Fallot? SATA

a. Overriding aorta
b. Aortic stenosis
c. Pulmonary stenosis
d. Right ventricular hypertrophy
e. Ventricular septal defect
f. Foramen Ovale

7. The nurse is caring for an infant 48 hours post heart surgery to correct Tetralogy of
Fallot. Which of the following is the nurses greatest concern?

a. Capillary refill 2 seconds

b. Decreased appetite
c. Respiratory rate of 48 bpm
 d. Decreased level of consciousness

8. The nurse is providing anticipatory guidance to the parents of a school – aged child with
Pulmonary Arterial Hypertension. The parents ask the nurse what after- School activity
would be most appropriate for their child. What is the nurses best response?

a. Soccer
b. Chess
c. Cross- Country running
d. Football

9. A nurse is providing teaching to the mother of an infant who has a prescription for
digoxin. Which of the following statements indicated a need for further teaching?

a. “My baby can have digoxin with or without food”

b. “Digoxin will slow my baby’s heart rate”
c. “I should give my baby Digoxin at regularly scheduled times”
d. Digoxin will increase my baby heart rate

10. A nurse in the cardiac medical- surgical unit is caring for an infant with a continuous
machine- like murmur. Which of the following interventions should the nurse
anticipate?

a. Administration of Nitroglycerin
b. Administration of Prostaglandin
c. Administration of Indomethacin
d. Administration of Pulmozyme

11. The nurse is providing education to an adolescent with dyslipidemia. The nurses
emphasize the recommended levels for the tested lipids would include which of the
following ranges? SATA

a. Triglycerides less than 90mg/dL

b. Triglycerides less than 75 mg/dL
c. Total Cholesterol less than 170 mg/dL
d. HDL greater than 45 mg/dL
e. HDL less than 45mg/ dL
f. LDL less than 170 md/dL
12. A nurse is reviewing data for four children. Which of the following children should the
nurse assess first?

a. A 10- day old with central cyanosis during feeding

b. A 10-year-old child with a ventricular septal defect
c. A 2-year-old child with a patent ductus arteriosus
d. A 7-year-old child with a higher blood pressure in the upper extremities when
compared to the lower extremities

13. The nurse is educating a group of patients on the potential risk factors for Pulmonary
Arterial Hypertension. Which risk factors should the nurse include? SATA

a. Increased Pulmonary Blood Flow Defects

b. Inflammatory Bowel Disease
c. Bronchiolitis
d. Right Ventricular Hypertrophy
e. Genetics

14. A nurse is preparing to administer digoxin 8 mcg/kg/day PO to divide equally every 12hr
for a preschool who weighs 33lb. Available is digoxin elixir 0.05mg/mL. How many mL
should the nurse administer per dose?

___1.2____mL

15. The nurse is caring for an infant post Cardiac catherization who has experienced
hemorrhage with severe blood loss. Which of the following clinical manifestations would
the nurse be most concerned with?

a. 2 second capillary refill

b. Decreased pain response
c. Respiratory rate of 40 bpm
d. Heart rate of 115 bpm

16. Which of the following symptoms should the nurse recognized is typically the first
indication of a congenital heart defect in an infant?

a. Bradypenia
b. Heart murmur
 c. Acrocyanosis
d. polycythemia

17. The nurse is caring for the child 1-week post-surgical repair of a ventricular septal defect.
The child has a central venous catheter and is presenting with fever, myalgia, chest pain,
and diaphoresis. The nurse should anticipate which of the following diagnostic procedure
to be ordered by the provider?

a. Cardiac catherization
b. Blood culture
c. Throat culture
d. Urine culture

18. The infant with Tetralogy of Fallot becomes dysgenic while crying, which intervention is
most appropriate for the nurse to perform

a. Position child knee to chest

b. Position child prone
c. Position child in reverse Trendelenburg
d. Position child Supine

19. The nurse for a 3-month-old infant receiving Digoxin. Which of the following clinical
manifestation would require the nurse to hold the dose of the scheduled digoxin?

a. Potassium level of 2.5

b. Heart Rate is 180
c. Heart rate is 95 bpm
d. Never hold a dose of schedule Digoxin

20. The infant admitted with cyanosis has a history of Trisomy 18, Edwards Syndrome.
Which do the following congenital heart defects would the nurse most likely expect in the
patient?

a. Tetralogy of Fallot
b. Trancus Ateriouosis
c. Transposition of the Great Arteries
d. Hypoplastic Left Heart Syndrome
21. The nurse is caring for a patient with suspected aortic stenosis. Which of the following
should the nurse expect?

a. Machine-like murmur
b. Hypertension
c. Hyper cyanotic Tet-spells
d. dizziness

22. The nurse is caring for a patient on furosemide. Which of the following nursing
intervention is appropriate?
a. encourage a diet high in sodium
b. encourage a diet high in potassium
c. Encourage a diet and calcium
d. encourage a diet in low potassium

23. the nurse is reviewing a risk factor for the development of congenital heart defects with a
client who wants to conceive. Which of the following condition should the nurse include
as a maternal risk factor?

a. preeclampsia
b. placenta previa
c. rubella infection
d. late prenatal care

24. a nurse is providing care instructions to the parent of a 10-year-old child following a
cardiac catherization. Which of the following intervention should the nurse include?

a. Remove pressure dressing

b. Maintain extremity elevated
c. Maintain serenity dependent
d. Increase fluid intake

25. A nurse is caring for a child who has Kawasaki disease. Which of the following
complication should the nurse assess?

a. Mitral Valve regurgitation

b. Coronary Aneurysm
c. Respiratory Infection
d. D Gastrointestinal Malabsorption
26. Which of the following manifestation should the nurse recognize as being characteristic
of Kawasaki Disease? SATA

a. Elevated ASO Titer

b. Elevated erythrocytes sedimentation (ESR)
c. Subcutaneous nodules
d. Edema
e. High fever
f. Strawberry Tongue

27. After receiving change of shift report, which patient should the nurse see first?

a. 5-yro with endocarditis who has crackles audible throughout both lungs
b. 3-year-old with rheumatic fever who reports severe knee pain
c. 18-month-old with coarction of the aorta who has diminished pedal pulse
d. 8-year-old with Kawasaki disease who has a temperature of 102.2 degrees
Fahrenheit

28. The nurse is caring for a child with a congenital heart defect. The nursing assessment
revealed clubbing of the fingernails and toenails what congenital heart defect should the
nurse anticipate?

a. Call auction of the aorta

b. patent ductus arteriosus
c. atrial septal defect
d. tricuspid artresia

29. A nurse is assessing a child with untreated aortic stenosis. Which of the following
findings should the nurse expect?

a. Ascitis
b. jugular venous distention
c. dependent edema
d. cough
30. the nurse is caring for an infant with tricuspid atresia. Which of the following
interventions would be most appropriate for the nurse to implement?

a. Prostaglandin administration
b. antibiotic administration
c. indomethacin administration
 d. cardiac catheterization
31. a nurse is providing preoperative education for an 8-year-old who will be undergoing
cardiac surgery. Which of the following action should the nurse take?

a. Minimize exposure of medical equipment

b. plan a teaching session that will last at least 60 minutes
c. use a medical doll with tools and decisions to explain the surgery
d. discuss methods to hide the scar once healing has occurred

Quiz 4
1. Which is the best position for an 8yr old who has just returned to the pediatric unit after
an appendectomy for a ruptured appendix?

a. High-Fowler
b. Prone
c. Right side lying
d. Left side lying

2. The nurse is providing education to the parents of a child who is prolonged steroid
therapy for a pre-existing condition. The parents share with the nurse that the child wants
to participate in sport like most of his friends. Which of the following activities should
the nurse recommend?

a. Hockey
b. Lacrosse
c. Football
d. Tennis

3. The nurse is providing education to the caregiver of an infant with cleft lip and palate.
The parents ask the nurse what future healthcare resources the infant will require. What is
the nurse’s best response?

a. The infant will require orthodontic care

b. The infant will require physical therapy
c. The infant will require neurological follow up
d. The infant will require cardiology follow up

4. What is the daily fluid maintenance requirement of a pediatric patient that weights 27kg?
__1640___

10+10+7= 27kg

100x 10 = 1000
500x10 = 500
20x7= 140
---------------= 1640 mL

5. A nurse is caring for an infant who has gastroesophageal reflex. The nurse should
recognize that which of the following findings are associated with this conditions SATA

a. Arching of back
b. Frequent spit ups
c. Irritability
d. Abdominal pain at mcburners point (appendix related)
e. Fever
f. (Pyloric stenosis) Olive-shaped mass in the right upper quadrant

6. The nurse is caring for 4-month-old infant in the family health clinic who is being seen
for their 4-month well child checkup. The parent reports when the infant cries or strains
that a bulge at the umbilicus forms and that she has been banding the abdomen in order to
prevent the protrusion. Which of the following is the nurse’s best response?

a. This protrusion rarely resolves on its own and surgery will be necessary
b. Application of abdominal banding is appropriate in reducing the protrusion
c. This protrusion is probable a tumor and must be evaluated immediately
d. Application of abdominal banding can lead to constriction of the intestine

7. A nurse is caring for a 2-month-old infant who is postoperative following surgical repair
of a cleft palate. Which of the following actions is most important for the nurse to take?

a. Offer the infant a pacifier for comfort

b. Position the infant upright
c. Administer aspirin as needed for pain
d. Assess placement of elbow restraints

8. A nurse is caring for a pre-school aged child who has suspected appendicitis. What
clinical manifestation can be seen in the patient suspected appendicitis?

a. Leukocytosis (high WBC)

b. Abdominal pain in left lower quadrant
c. Positive ASO titer
d. Heart rate of 105 bpm

9. The nurse is education the parent of a child with gastroenteritis on health promotion
activities. What health promotion activities should the nurse recommend? SATA

a. Encourage raw fruits and vegetables

b. Immunizations
c. Use of prophylactic antibiotics
 d. Short, clipped nails
e. Frequent hand washing
f. Sanitations of toys

10. The nurse is teaching a student nurse about the presenting clinical manifestation of type 1
diabetes mellitus. Which of the following statements by the student indicates an
understanding of the teaching? (clinical manifestation: polyuria, polydipsia, weight loss,
polyphagia, ketoacidosis)

a. Weight loss is a common presenting clinical manifestation of type 1 diabetes mellitus

b. Weight gain is a common presenting clinical manifestation of type 1 diabetes mellitus
c. Decreased urine output is a presenting clinical manifestation of type 1 diabetes
mellitus
d. A decreased appetite is a presenting clinical manifestation of type 1 diabetes mellitus

11. A nurse is providing teaching to a 12yr old patient who has diabetes mellitus type 1.
Which statement indicates understanding of diabetes mellitus management?

a. I will need to check my blood glucose levels more often when I’m sick
b. I should drink diet cola if I feel shaky
c. I will only need to check my blood sugar twice a day
d. I will always need to avoid snacks between meals

12. The nurse is preparing discharge teaching for an infant with acute gastroenteritis. Which
of the following recommendation would be appropriate for the nurse to include in the
teaching?

a. Utilize a soft washcloth with warm water with each diaper change
b. Utilize baby-powder with each diaper change to prevent skin breakdown
c. Avoid breast milk until diarrhea has resolved
d. Administer antidiarrheals to prevent dehydration

13. The nurse is caring for a set of patients during her shift. Which patient should the nurses
assess first?

a. 4-month-old infant who is post-op pyloric stenosis repair and crying

b. 3-year-old patient with acute gastroenteritis and a temperature of 101.2 F
c. 3-month-old infant who is post-op cleft lip repair and has respiratory rate of 40
d. 13-year-old male patient in pain with appendicitis who reports a sudden absence of
pain

14. A school nurse is assessing an adolescent who reports feeling shaky and is having
difficulty speaking and concentrating on the questions the nurse is asking. The nurse
checks the adolescents blood glucose level and identifies a value of 55 mg/dL. What
priority nursing intervention should the nurse implement?
 a. Administer 4oz of diet coke
b. Administer 2 units of rapid-acting insulin
c. Administer 15g of fasting acting carbohydrate
d. Administer 4oz of chicken broth

15. The nurse is caring for an infant weighing 8 kilograms with diarrhea due to acute
gastroenteritis. On assessment, the infants heart rate is 190 bpm with sunken fontanels
and oliguria. Which of the following medical orders should the nurse anticipate?

a. Initiate D5% NS with 20 meQ of potassium chloride IV fluid replacement

b. Encourage 2oz of Pedialyte after every diarrheal episode
c. Initiate 0.9% sodium chloride IV fluid replacement
d. Give infant one more ounce of formula every feed

16. The nurse is caring for an infant in the emergency room who was brought in by the parent
for rectal bleeding and suspected abdominal pain. Which of the following laboratory
results would the nurse suspect for this patient?

a. Anemia
b. Thrombocytopenia
c. Leukopenia
d. Elevated eosinophils

17. The nurse is providing teaching about hypoglycemia symptoms to a group of adolescents
with diabetes mellitus. Which of the following symptoms should the nurse include in the
teaching?

a. Flushed skin
b. Kussmaui breathing
c. Fruity breath odor
d. Pallor

18. The nurse is providing education to parents of a child with encopresis. The parents ask
how they can prevent this from recurring. What is the nurses best response?

a. A high-fiber diet encouraged

b. A gluten free diet is encouraged
c. Treatment of the vital infection is necessary
d. A low-fiber diet is encouraged

19. The nurse is caring for an adolescent patient post appendectomy. Which of the following
should the nurse report to the provider?

a. Pain of 5 out of 10 on a numeric pain scale

b. Absent bowel sounds on auscultation
 c. Oral temperature of 99.0 F
d. Respiratory rate of 16 breath per minute

20. The nurse is educating a group of parents on non-pharmacological methods of treating

gastrointestinal reflux in infants. Which statement by the parents indicates teaching has
been effective?

a. Use of ranitidine is the only means to decrease symptoms (can treat other things)
b. Smaller, more frequent feeding can decrease symptoms
c. Placing baby in the car seat following feeds will decrease symptoms
d. Burping the baby at the end of the feeding will decrease symptoms

21. A nurse is caring for a client with diabetes mellitus who is prescribed rapid acting insulin
(Humalog) via a sliding scale. After administering the correct dose, a 1230 with lunch,
when should the nurse recognize that patient is at highest risk for hypoglycemia?
- Humalog peak effect is 30-90min, onset action is 0-15

a. Between 1330 and 1400

b. Between 1245 and 1300
c. Between 1830 and 1900
d. Between 1230 and 1245

22. The pediatric nurse is completing the history on a new administration. The parent states
the infant is always constipated has a large rounding abdomen and he appears smaller
than the rest of the children at daycare. On abdominal X-ray the descending colon is
found to be enlarged. What nursing education should the nurse anticipate providing?

a. Education parent on manual fecal disimpaction

b. Education parent on need for air enema to solve constipation
c. Education parent on temporary colostomy care (674 GI)
d. Education parent on the infectious process causing the constipation

23. The nurse is caring for a child with ulcerative colitis. What complications should the
nurse aware of this patient? SATA

a. Dehydration
b. Failure to thrive
c. Nutritional deficiencies
d. Oral ulcers
e. Anemia

24. The nurse is caring for a child on the ED with celiac disease who has been experiencing
diarrhea for the past 3 days. The medical provider orders an arterial blood gas draw on
the patient. Results are as follows pH 7.30, PaCo2 40, HCO3 18. Which acid base
imbalance should the nurse expect?
 a. Respiratory acidosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Metabolic alkalosis

25. The nurse is providing dietary teaching to the parent of a newly diagnosed child with
celiac disease (intolerance of gluten). What should the nurse include in the teaching?
SATA

a. Avoid use of excess salt

b. Substitute gluten product with corn, rice, and other flour alternative
c. Avoid products with gluten
d. Avoid saturated fat and sugar
e. Avoid foods with rye wheat and barley

26. The nurse in the ED is assessing an infant brought due to diarrhea for the past 2 days and
a significant decreased in oral intake? Which of the following findings should the nurse
expect? SATA

a. Elevated hematocrit
b. Decreased hematocrit
c. Specified gravity 1.005
d. Heat rate of 70 bpm
e. Heart rate of 195 bpm
f. Specific gravity 1.050

27. A nurse is providing teaching to a parent of a 6yr old who was recently diagnosed with
DM type 1 about the prescribed rapid acting insulin (lispro). Which of the following
options demonstrate the parents understood the teaching?

a. Give insulin 15 min before meals

b. Lispro has an onset of 15-30 min
c. Lispro has no peak
d. Lispro has a duration of 3-6hr
e. Lispro has a peak of 20min
f. Lispro has a peak of 1hr

28. The nurse is caring for an infant who is constantly hungry after feeds due to projectile
vomiting. On assessment, the nurse notices (pyloric stenosis) olive-shaped mass to the
right upper quadrant. Which of the following nursing intervention is most important?

a. Prepare infant for air enema

b. Initiate antibiotics therapy
c. Thicken formula with rice cereal
d. Initiate intravenous access
 Quiz 5
1) A nurse is conducting a postoperative assessment on an infant who has just had a
ventriculoperitoneal shunt placed for hydrocephalus. Which assessment finding would
indicate malfunction in the shunt?

a. Negative Brudzinski sign

b. Incisional pain
c. Positive Babinski sign
d. Bulging fontanel

2) The nurse is proving care for her child post chemotherapy infusion three days earlier. Child is
oliguric with a 3 kg weight gain in the past 2 days. Which assessment finding should the
nurse anticipate?

a. Potassium level of 3.6

b. Decreased heart rate
c. Decreased blood pressure
d. Crackles on auscultation

3) The nurse is providing education to the parents of a patient with hemolytic uremic syndrome.
What statement by the parent indicates an understanding of the etiology of the syndrome?

a. Consuming raw meat is a risk factor for the syndrome

b. This syndrome usually occurs following a strep throat infection
c. Consuming items containing rye, wheat and barley predisposes children to the syndrome
d. The influenza vaccine is usually a risk factor for the syndrome

4) The nurse is preparing a discharge teaching for the caregivers for an adolescent post-
concussion injury. Which of the following is most important to include In the teaching?

a. Your child’s access to screen time should be limited during the immediate recovery
period
b. Your child should be able to resume normal sport activities within 24 hrs.
c. Your child’s friends should bring missed homework to complete during the immediate
recovery period.
d. Your child should sleep uninterrupted in the immediate recovery period.

5) The nurse is caring for an infant with meningitis. The nurse is monitoring for signs of
increased intracranial pressure. The nurse should assess the infant for which ICP?

a. Double vision
b. Headache
c. Bulging fontanel
d. High pitched cry
e. Sunset eyes
 f. Irritability

6) The nurse is providing the parents of a child with phenylketonuria discharge education.
Which of the following instructions should the nurse include?

a. Encourage consumption of milk and other dairy products

b. Most fruits and vegetables will be appropriate for your child to consume
c. There is no safe amount of phenylaline your child may consume
d. You should substitute your child’s sugar intake with artificial sugars such as Splenda

7) The nurse is caring for a child with hemolytic uremic syndrome who has abdominal pain and
fever. The patients basic metabolic panel shows pH at 7.3 calcium at 8.0, sodium at 135,
phosphorus at 4.9 and potassium at 6.0. which of the following medications should the nurse
recommend to the health care provider as part of the SBAR report?

a. Phosphorus binder
b. Sodium polystyrene sulfate
c. Spironolactone
d. Aspirin

8) The nurse is caring for an infant with meningitis who is admitted to the medical surgical
floor. The nurse is assessing the parents understanding of the care for the child. Which of the
following statements by the parents indicates teaching has been effective?

a. We will make sure to keep the child lying flat

b. We will dim the lights in the room
c. We will give aspirin to the child for fever or pain
d. We will make sure to take the child to the playroom
e. We will ensure our child’s immunizations are up to date

9) A nurse is caring for a client who is experiencing an active-tonic clonic seizure. Which of the
following actions should the nurse take?

a. Loosen restrictive clothing

b. Administer prescribed intravenous benzodiazepine
c. Place the client into the supine position
d. Place the client side lying
e. Administer prescribed oral daily anticonvulsant
f. Time the seizure activity.

10) The nurse is caring for an adolescent with acute glomerulonephritis with peripheral edema,
hyperventilation, blood pressure of 190/92 and is producing an average of 10 mL of urine per
hour. The medical provider orders an arterial blood gas be performed on the patient,
measurement of ABG shows 7.25 paCO2, 30mm hg, and HCO3 18. How would you
interpret this?
 a. Respiratory acidosis, uncompensated
b. Metabolic acidosis, uncompensated
c. Metabolic acidosis, partial compensation
d. Metabolic alkalosis, partial compensation

11) The charge nurse is making appropriate assignments for the medical surgical unit. Which of
the following tasks should the charge nurse assign to the LPN, working under the supervision
of the RN?

a. Monitor hemodialysis catheter insertion site for bleeding

b. Administer prescribed oral antibiotics for the child with a urinary tract infection
c. Educate the adolescent with a urinary tract infection on preventative measures for UTI
d. Assess the child for pyelonephritis who has severe acute flank pain

12) The nurse has admitted a child with nuchal rigidity, photophobia, and headache. Which of
the following procedures would be contraindicated for this child?

a. Iv insertion
b. Position patient with the head of the bed elevated 30 degrees
c. Chest physiotherapy
d. Magnetic resonance therapy

13) A nurse is preparing to administer amoxicillin 200 mg PO 8hr to a toddler who weighs 20 kg.
the drug handbook recommended dosage range is 20-25 mg/kg/day. Which of the following
is the nurses next step?

a. The nurse determines the prescription is insufficient to achieve the desired effect and
contacts
b. The nurse administers the prescribed dosage as it has been prescribed by the provider
c. The nurse contacts the pharmacist to request a different dosage of the prescribed
medication
d. The nurse determines the prescription above is the recommended dosage range and
contacts the provider

14) The nurse is caring for a patient with glomerulonephritis. Which laboratory results should the
nurse anticipate?

a. Elevated erythrocyte sedimentation rate

b. Hematuria on urinalysis
c. Low hemoglobin
d. Elevated ASO titer
e. Decreased c-reactive protein (CRP)
f. Elevated lipids
15) The nurse is caring for a child with chronic renal failure who has been admitted to the
medical surgical floor due to potential fracture of the tibia. The child’s mother asks the nurse
how this might have happened since the child did not suffer from a fall. What is the nurse’s
best response?

a. Your child’s diet is deficient in calcium, and this can lead to spontaneous fractures.
b. Your child’s bones are depleted of calcium by the body to compensate low serum
calcium
c. You child may have congenital bone disease, osteogenesis imperfecta, which can lead to
spontaneous fractures.
d. Your child’s bones are depleted of calcium by the body to compensate the decreased in
erythropoietin

16) The nurse is caring for a 2-day old infant with newly diagnosed hyperbilirubinemia on
phototherapy in the medical surgical floor. The infant’s caregiver asks the nurse what she can
do to help the bilirubin levels decrease. What is the nurse best response?

a. You can keep most of the infant’s skin exposed to the light by only using a diaper and
light shirt
b. You can donate blood as the infant will require a blood transfusion
c. You can enhance UV light absorption of bilirubin by applying baby powder to the
infant’s skin
d. You can supplement intake with breast milk or formula to improve hydration

17) The nurse is caring for an adolescent with chronic renal failure who is on peritoneal dialysis.
On assessment the patient has a fever, abdominal pain, cloudy dialysate, and rigid abdomen.
The nurse suspects these symptoms are most concerning for which of the following?

a. Hypovolemic shock
b. Leakage of dialysate
c. Peritonitis
d. Hypotension

18) The nurse is providing education to the parents of an infant with a urinary tract infection. The
parent asks if they give aspirin for infant’s fever. Which is the following responses would be
most appropriate for the nurse to provide?

a. Aspirin is contraindicated in children as it has been associated with cerebral edema

b. You can give aspirin to reduce fever, but it must be taken with food
c. Aspirin is contraindicated in children as it has been associated with glomerulonephritis
d. Aspirin is the only acceptable medication to reduce your child’s fever

19) The nurse in a medical surgical floor is caring for a 6-year-old male with enuresis. At the
beginning of the shift, the nurse delegates several tasks to the unlicensed assistive personnel.
Which of the following tasks would be appropriate for the nurse to delegate to the unlicensed
assistive personnel?
 a. Discuss family dynamic and family stressors
b. Wake the child in the middle of the night to use the bathroom
c. Diaper the child before bed to prevent bed wetting
d. Reinforce teaching to the mother about the use of moisture alarm devices during the night

20) The nurse is caring for an adolescent who weighs 60 kg. the patient is receiving tobramycin
for treatment of a severe urinary tract infection. The patient’s urine output has been 480 mL
for the past twenty-four hrs. and the patient has had a weight gain of 3 kg in 2 days. The
nurse suspects what to be the most likely cause of the symptoms?

a. Acute glomerulonephritis.
b. Chronic renal failure
c. Acute kidney injury
d. Nephrotic syndrome

21) A 4-year-old child presented to the ER with a traumatic head injury after a motor vehicle
accident. Upon assessment, which of the following findings indicate the child is experiencing
an increase in intracranial pressure?

a. Increased head circumference

b. Bulging fontanels
c. Projectile vomiting
d. High pitched shrill cry
e. ICP range of 20
f. Decreased response to painful stimuli

22) The nurse is caring for a 3-year-old patient in the pediatric care clinic with a history of
nephrotic syndrome. The parents ask the nurse if they can help prevent the disease from
recurring. what is the nurse best response?

a. Your child is most likely to get sick if sodium is avoided In the diet
b. It is very rare for a child to have a relapse after fully recovering
c. Preventing strep throat is the only way to prevent a relapse from occurring
d. Keep your child away from other sick children as relapses have been associated with
infectious illness

23) The nurse is caring for a child with acute glomerulonephritis. The child’s blood pressure is
190/90 and urine output for the past 24 hours has been 200 mL. which of the following
nursing action is priority?

a. Encourage the child to have low sodium meals

b. Assess the child neurological status
c. Encourage the child to drink more water
d. Assist the child with ambulation
24) The nurse is caring for a child with ureterovesicular junction obstruction. Which of the
following laboratory test should the nurse anticipates be ordered by the physician?

a. Urine culture
b. Gastrointestinal panel
c. Throat culture
d. Antistreptolysin (ASO)

25) The nurse is caring for a child in the medical surgical floor. This child is presented with
massive proteinuria, hyperlipidemia, hyperalbuminemia ascites. Which of the following
causes should the nurse suspect?

a. Glomerulonephritis
b. Rheumatic fever
c. Pyelonephritis
d. Nephrotic syndrome

26) The nurse is caring for a female adolescent patient with a urinary tract infection. The nurse
instructs the student nurse to provide patient instructions on how to prevent UTI’s. which
statements by the student nurse is inappropriate?

a. You should void before and after sexual activity

b. Ensure you empty your bladder regularly, even if you do not feel the urge to urinate
c. You should utilize tub baths for hygiene to prevent future UTI’s
d. You should increase your fiber consumption to help prevent urinary infections.
27) The nurse is caring for an infant with newly diagnoses hyperbilirubinemia on photo therapy
in the medical surgical floor. The infant’s caregiver asks the nurse what she can do to help
the bilirubin levels decrease. What is the nurse best response?

a. You can donate blood as the infant will require a blood transfusion
b. You can keep most of the infant’s skin exposed to the light by using a light shirt and
diapers
c. You can supplement intake with breast milk or formula to improve hydration
d. You can enhance UV light absorption of bilirubin by applying a baby powder to the
infant’s skin.

28) An infant brought to the emergency department by their parent due to fever and increased
irritability. A lumbar puncture is performed. What results would the nurse expect from the
LP in the infant with bacterial meningitis?

a. Decreased glucose in the cerebrospinal fluid

b. Clear cerebrospinal fluid
c. Decreased protein in the cerebrospinal fluid
d. Elevated blood cell count in the cerebrospinal fluid
e. Elevated protein in the cerebrospinal fluid
29) The nurse is educating a group of nursing students on the risk factors associated with
seizures. Which of the following would be inappropriate for the future nurse to include in the
teaching?

a. Hypothermia
b. Brain tumor
c. Meningitis
d. Increased blood lead levels

30) The nurse is caring for a 4-month-old suspected with west syndrome (infantile spasms).
Which of the following findings is expected?

a. Acrocyanosis
b. Fever of at least 102.2
c. Poor head control
d. Skin that tastes salty

31) The nurse is caring for a patient diagnosed with renal failure. Which of the following
electrolyte imbalances support the diagnosis?

a. Hypermagnesemia
b. Hyperkalemia
c. Hyponatremia
d. Hypercalcemia
e. Hypophosphatemia
f. Hypocalcemia
QUIZ 6
1. A nurse is caring for an 8-year-old child who recently has a cast placed on their right leg
and is now complaining of intense pain. Which of the following actions should the nurse
do next?

A) Elevate the extremity

B) Call the provider
C) Perform a neuro-vascular assessment
D) Administer analgesics

2. The nurse is assessing the healthcare needs of a child with a chronic condition. The child
lives in a secluded rural form with his parents and two infant siblings. Which of the
following resources should the nurse prioritize?

A) Include the family and siblings in all decision making

B) Assist the family in its accessibility to care
 C) Recognize and respect the cultural practices of the child and family
D) Encourage the family in assuming the role of care coordinator

3. The nurse is caring for a child with suspected growth hormone deficiency. Which of the
following findings would the nurse expect in her assessment of the child? Select all that
apply.

A) Precocious puberty
B) Hypoglycemia
C) Hyperglycemia
D) Muscular hypertrophy
E) Delayed dentition
F) Delayed sexual maturation

4. The nurse receives an order for a patient following spinal fusion to infuse 250 mL of
packed red blood cells over 4 hours. The drip factor is 15 gtt/mL. How many gtt/mon
should the nurse set the manual infusion (round to the nearest whole number).
- 15.6 = 16

5. The nurse is caring for a patient with spastic cerebral palsy who is immobile. When
developing the patient’s plan of care, the nurse determines which of the following
potential complication is most important to prevent.

A) Pressure ulcer
B) Constipation
C) Aspiration
D) Contractures

6. The nurse is performing an assessment on a 12-year-old girl. Which of the following

assessment findings should the nurse suspect correlate with a suspicion of scoliosis?

A) Asymmetry of the hips

B) Visible hunchback
C) Prominent scapula
D) Asymmetry of the shoulders
E) Pectus excavatum
F) One-sided rib hump

7. The nurse is admitting a child who was previously discharged home following an open
femoral fracture repair one week ago. The child is now experiencing fever, night sweats,
irritability, and restrictive movement of the previously fractured leg. Which of the
following interventions is the nurse’s priority?
 A) Application of topical antibiotics to the affected area
B) Abduction bracing of the affected area
C) Prepare the patient for surgery
D) Initiation of an intravenous catheter

8. The nurse is providing education to a group of caregivers of children with spastic cerebral
palsy. The caregivers ask the nurse what some non-pharmacological interventions are to
assist in the rigid muscles of their children. What is the nurse’s best response?

A) Utilize diazepam in order to decrease muscle rigidity

B) Maintain child in singular position to decrease muscle rigidity
C) Utilize baclofen in order to decrease muscle rigidity
D) Utilize range of motion exercise to maintain flexibly

9. The nurse is providing teaching to the parents of an adolescent with newly diagnosed
juvenile idiopathic arthritis (JIA). Which of the following statements by the parent
indicates has been effective?

A) I will call my child’ school to make sure he can have two schoolbooks for class in
order to keep one home
B) My child’s pain will be alleviated with cool compression applied to the inflamed
joints
C) My child will not be able to attend school because of the side effects of the
medications
D) I should restrict my child’s socialization with peers to decrease the potential for
injury

10. The nurse is assessing a 7-year-old male child who is admitted with a new onset of
limping and hip pain that is exacerbated by activity. Which of the following history
questions is most appropriate for the nurse to ask the caregiver based on the child’s
symptoms?

A) Is there a positive family history of developmental dysplasia of the hip?

B) Did your child have delayed achievement of walking or crawling?
C) Is there a positive family history of legg-clave- perthes disease?
D) Has your child had a recent strep throat?

11. A nurse in a clinic is talking with the caregivers of a child who has a new diagnosis of
osteogenesis imperfect. The nurse should anticipate that caregiver would require teaching
about which of the following medications?

A) Prostaglandins
B) Disease-modifying anti-rheumatic drugs (DMARDS)
 C) Nonsteroidal anti-inflammatory drugs (NSAIDS)
D) Pamidronate

12. The nurse is preparing for discharge the caregivers of a child with newly diagnosed
chronic condition. The caregiver upset, overwhelmed and tearful. Which of the following
responses by the nurse is best?

A) If you stop crying, we can calmly discuss how you are feeling.
B) There is nothing to be upset about; we will work with you to provide your child
with the best care
C) I have a child with a chronic illness too. It gets better, trust me
D) When something is worrying you, what do you do?

13. The nurse is caring for an infant with myelomeningocele in the newborn nursery. The
nurse determines care for this child should include which of the following?

A) Position patient supine

B) Assess head circumference
C) Swaddle infant for maximum comfort
D) Keep the sac open to air

14. The nurse is providing education to the mother of a child with spinal bifida. The mother
asks the nurse “How can i prevent this from happening with my future pregnancies?”
What is the nurse best response?

A) Spinal bifida is multifactorial in cause but there are certain environmental factors
that have been implicated.
B) Spinal bifida is multifactorial in cause but there is no increased incidence of the
condition in families.
C) Spinal bifida is only cause by maternal nutritional deficiencies, particularly folic
acid
D) Spinal bifida is transmitted via an X-linked recessive inheritance pattern

15. The nurse is caring for a 6-year-old with suspected developmental dysplasia of the hip.
Which of the following clinical manifestations would the nurse expect this child to
exhibit? Select all that apply.

A) Walking with a limp

B) Shortened leg
C) Positive Barlow and ortolani test
D) Positive Trendelenburg sign
E) Talipes varus
F) Toe walking
16. The nurse is caring for a child immediately post plaster cast application for a fractured
ulna. Which of the following is an appropriate handling technique of the casts?

A) Utilize heat to promote drying of the wet plaster cast

B) Keep affected extremity in dependent position
C) Lightly use fingertips when handling the wet plaster cast
D) Lightly use palms when handling the wet plaster cast

17. The nurse is providing education to the parents of a newborn with newly diagnosed
osteogenesis imperfecta (OI). Which of the following statements should the nurse be sure
to include in the teaching?

A) OI is temporary condition that can resolve with surgery

B) It is important to lift the baby with OI by the buttocks when diapering
C) Range of motion exercises should be eliminated in the child with OI
D) Hypertonicity is the main presence of OI

18. The nurse has provided discharge education to a group of parents. The caregivers are
providing return demonstrations to the nurse on how to appropriately care for their child
with a Pavlik harness. Which of the following actions indicate teaching has been
effective?

A) The caregiver removes the harness when changing the diaper

B) The caregiver adjusts the straps of the harness
C) The caregiver applies powder underneath the straps
D) The caregiver uses a light shirt underneath the harness

19. The nurse is caring for a group of children with ataxic cerebral palsy. The nurse
recognizes these children have difficulty with which of the following?

A) Social interaction
B) Balance
C) Cognitive development
D) Language development

20. The nurse in a family clinic is completing the nursing history for a child with a history of
osteogenesis imperfect who has recently been discharged from the hospital. The nurse
asks the parent how transitioning to home care has been for the family. The parents
begins to cry states “ It has been very difficult and I feel overwhelmed.” Which of the
following resources would be appropriate for the nurse to discuss with the parent at this
time? Select all that apply.
 A) Support groups
B) Home health care
C) Hospice care
D) Respite care

21. The nurse is providing teaching to the parents of a child with a new diagnosis of
Duchenne muscular dystrophy. The parents ask the nurse what some complications of the
disease are. What is the nurse’s best response?

A) Progressive curvature of the lumbar spine leads to shoulder symmetry

B) Progressive joint deformity leads to functional disability
C) Progressive weakening of respiratory muscles leads to respiratory compromises
D) Progressive weakening of cerebellar motor function leads to immobility

22. The nurse is caring for an 8-year-old male with painless limp admission to the medical
surgical floor. During assessment, the nurse notes decreased range of motion of the
affected limb, a positive history for recent hip injury and radiological evidence of hip
dysplasia. Which of the following nursing interventions should the nurse anticipate?

A) Prepare patients for Pavlik harness

B) Prepare patient for abduction brace
C) Initiate administration of methotrexate
D) Prepare patient for immediate surgery

23. The nurse is assessing the family’s ability to cope with the child’s diagnosis of cerebral
palsy. Which action by the family is an example of appropriate coping with the disease
process?

A) The family does not share the child’s disease to close to family and friends
B) The family states the child’s specific physically needs will not change their day to
day life
C) The family is learning measures to meet the child’s physical needs
D) The family is limiting interaction with extended family friends

24. The nurse is evaluation a caregiver understanding of her child’s new diagnosis of
Duchenne muscular dystrophy. Which of the following statements made by the caregiver
indicates a need for further teaching?

A) I should encourage my child to continue to social interactions with friends

B) As long as my child is on steroids, the symptoms of the disease will not worsen
C) As the disease progresses my child may lose their ability to walk
D) Physical therapy will assist in maintaining function unaffected muscles.
25. A nurse is teaching the parents of a 5-year-old child about cast care. Which of the
following shows parents understood the teaching? Select all that apply.

A) Elevate the extremity above the level of the heart

B) Plaster cast takes up to 10 hours to dry
C) Avoid cast from getting wet during baths and showers
D) Rough edged may be alleviated by petaling or mole skin
E) Use a hair dryer with heat to help cast dry
F) If itchy, allow child to scratch inside the cast with a pencil

26. The nurse is assessing a child with muscular dystrophy raise to a standing position. The
child maneuvers to a position supported the art.. Legs in order to push off the floor. The
maneuvering is indicative of which of the following?

A) Positive Gower’s sign

B) Positive Allis sign
C) Positive Barlow sign
D) Positive Trendelenburg sign

27. The nurse is providing information to the caregiver of a child with a new diagnosis of
clubfoot. The caregiver asks the nurse about treatment options. Which statement should
the nurse include?

A) A spica-cast will be required to correct alignment

B) There will be a need for a Pavilk harness for proper alignment
C) Corrective shoes are required immediately after birth
D) Serial casting is initiated soon after birth

28. The nurse is providing teaching to an adolescent girl scheduled for spinal fusion surgery
to treat scoliosis. Which of the following should the nurse include?

A) You will experience minimal pain immediately following surgery

B) Administration of a blood transfusion may be necessary with surgery
C) Ambulation is discouraged for the first week following surgery
D) You will be place prone immediately following surgery

29. The nurse is evaluating a caregiver understanding of the child’s new diagnosis of
Duchenne Muscular Dystrophy. Which of the following statement made by the caregiver
indicate teaching has been effective?

A) This condition will only affect females

B) This condition can be prevented
C) Physical therapy should be avoided as it can progress degeneration of muscles
 D) This condition will only affect males

30. The nurse is caring for an adolescent female with scoliosis. The provider has
recommended the use of a brace. Which of the following education instruction should the
nurse provide?

A) The brace should be worn with a light shirt underneath

B) The brace must be worn at least half of the day
C) The brace with correct the spinal curvature
D) The brace can be removed during sleep

31. The nurse is caring of a preschool aged child who has suffered a fracture due to twisting
force applied to the extremity. The nurse suggests this likely type of fracture the paitent
has suffered in which of the following?

A) Greenstick fracture
B) Comminuted fracture
C) Buckle fracture
D) Spiral fracture