NCLEX Prep: Pediatrics

NCLEX Prep: Pediatrics!

Multiple Choice

1.) The nurse is monitoring a child with burns during treatment for burn shock. Which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation?

• Skin turgor

• Level of edema at burn site

• Adequacy of capillary filling

• Amount of fluid tolerated in 24 hours

Multiple Choice

2.) The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child’s skin?

• Fine grayish red lines

• Purple-colored lesions

• Thick, honey-colored crusts

• Clusters of fluid-filled vesicles

Multiple Choice

3.) The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child?

• Platelet count

• Hematocrit level

• Hemoglobin level

• Partial thromboplastin time

Multiple Choice

4.) The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by parents as a precipitating factor, indicates the need for further instruction?

• Stress

• Trauma

• Infection

• Fluid overload

Multiple Choice

5.) A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed because acute lymphocytic leukemia is suspected. The nurse determines that which laboratory result confirms the diagnosis?

• Lumbar puncture showing no blast cells

• Bone marrow biopsy showing blast cells

• Platelet count of 350,000 mm^3 (350 x 10^9/L)

• White blood cell count 4500 mm^3 (4.5x10^9/L)

Multiple Choice

6.) A diagnosis of Hodgkin's disease is suspected in a 12-year-old child. Several diagnostic studies are performed to determine the presence of this disease. Which diagnostic test result will confirm the diagnosis of Hodgkin’s disease?

• Elevated vanillylmandelic acid urinary levels

• The presence of blast cells in the bone marrow

• The presence of Epstein-Barr virus in the blood

• The presence of Reed-Sternberg cells in the lymph nodes

Open Ended

7.) Alternative Style Q: What nursing interventions can be implemented in the care of a child with leukemia who is at risk for infection? (Think neutropenic precautions!)

Multiple Choice

8.) An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note?

• Sweating and tremors

• Hunger and hypertension

• Cold, clammy skin and irritability

• Fruity breath odor and decreasing level of consciousness

Multiple Choice

9.) A child has a fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted?

• The child has no tears

• Urine specific gravity is 1.035

• Capillary refill is less than 2 seconds

• Urine output is less than 1 mL/kg/hour

Open Ended

10.) Alternative Style Q: A school-aged child with type 1 diabetes mellitus has soccer practice and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do?

Multiple Choice

11.) A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem?

• Diarrhea

• Metabolic acidosis

• Metabolic alkalosis

• Hyperactive bowel sounds

Multiple Choice

12.) The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?

• Bile-stained fecal emesis

• The passage of current jelly-like stools

• Failure to pass meconium stool in the first 24 hours after birth

• Sausage-shaped mass palpated in the upper right abdominal quadrant

Multiple Choice

13.) The nurse is reviewing the laboratory results for a child scheduled for a tonsillectomy. The nurse determines that which laboratory value is most significant to review?

• Creatinine level

• Prothrombin time

• Sedimentation rate

• Blood urea nitrogen level

Multiple Select

14.) A child has been diagnosed with acute otitis media of the right ear. Which interventions should the nurse include in the plan of care? Select all that apply.

• Provide a soft diet

• Administer an antihistamine twice daily

• Irrigate the right ear with normal saline every 8 hours

• Administer ibuprofen for fever every 4 hours as prescribed and as needed

• Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy

Multiple Choice

15.) A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor which sign, knowing that is indicates a worsening of the condition?

• Warm, dry skin

• Decreased wheezing

• Pulse rate of 90 beats/minute

• Respirations of 18 breaths/minute

Multiple Select

16.) A home health nurse is managing care for an adolescent client with cystic fibrosis. Which of the following potential complications should the nurse consider when developing a nursing care plan? Select all that apply.

• Chronic hypoxemia

• Diabetes insipidus

• Frequent respiratory infections

• Obesity

• Vitamin deficiencies

Open Ended

17.) Alternative Style Q: The nurse is teaching a 9-year-old child with asthma how to use a metered-dose inhaler (MDI). Place the instructions in the appropriate order. All options must be used.

1. Exhale completely

2. Deliver one puff of medication into spacer

3. Place lips tightly around the mouth piece

4. Rinse mouth with water

5. Shake MDI and attach it to spacer

6. Take a slow deep breath and hold for 10 seconds

Multiple Choice

18.) The nurse is reviewing discharge instructions with the parents of a child who just had a tracheostomy. Which statement made by the parents indicates teaching has been effective?

• “I will always travel with two tracheostomy tubes, one of the same size and one a smaller size.”

• “I will immediately change the tracheostomy tube if my child has difficulty breathing.”

• “I will provide deep suctioning frequently to prevent any airway obstruction.”

• “I will remove the humidifier if my child starts developing more secretions”

Open Ended

19.) Our Question: You’re caring for a pediatric infant with suspected Patent Ductus Arteriosus (PDA). Where does the pathophysiology of this condition occur?

Multiple Choice

20.) A nurse is assisting a new mother as she is breastfeeding her infant. The infant has been diagnosed with Tetralogy of Fallot. During feeding, the infant becomes cyanotic and is having difficulty breathing. What should be the nurse’s first action?

• Administer morphine to the infant

• Administer oxygen via mask

• Assess infant’s vital signs and pulse oximetry

• Place the infant in the knee-chest position

Multiple Choice

21.) The nurse is providing discharge instructions to the parent of a child with Kawasaki disease. The nurse informs the parent that the presence of which symptom should be immediately reported to the health care provider?

• Fever

• Irritability

• Knee pain

• Skin peeling

Multiple Select

22.) A nurse is assisting with an education conference for graduate nurses about infant CPR. Which of the following statements are appropriate to include in the teaching? Select all that apply.

• “A single rescuer responding to an unwitnessed infant arrest should perform 2 minutes of CPR before retrieving a defibrillator.”

• “Depth of chest compressions for infants should be half the depth of the anterior-posterior chest diameter.”

• “Rescuers should place the heel of one hand on the lower sternum when delivering chest compressions to infants.”

• “The ratio of chest compressions to breaths during CPR by a single rescuer for infants is 15:2 for infants.”

• “You should assess the infant’s brachial pulse for no longer than 10 seconds.”

Multiple Choice

23.) The nurse is caring for a 7-year-old client diagnosed with nephrotic syndrome who will be discharged soon. Which statement by the parent indicates the need for further teaching?

• “I’ll provide a healthy diet without added salt for my child.”

• “I’ll organize playdates to keep my child’s spirits up during relapses.”

• “I’ll restrict my child’s fluids if I notice swelling or rapid weight gain.”

• “I’ll test for protein in my child’s urine every day.”

Open Ended

24. Alternative Style Q: Label the following posturing images. Write in your answers!

Multiple Choice

25. A child is diagnosed with Reye’s syndrome. The nurse creates a nursing care plan for the child and should include which intervention in the plan?

• Assessing hearing loss.

• Monitoring urine output.

• Changing body position q2h.

• Providing a quiet atmosphere with dimmed lighting.

Multiple Choice

26. A child has undergone spinal fusion for scoliosis and complains of abdominal discomfort. The patient begins having episodes of vomiting. On further assessment, the nurse notes abdominal distention. Based on these findings, which action should the nurse take?

• Administer an antiemetic.

• Increase the intravenous fluids.

• Place the child in a Sims’ position.

• Notify the PCP.

Multiple Choice

27. The nurse is assisting a primary care provider examine a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the provider to assess?

• Babinski’s sign

• The Moro reflex

• Ortolani’s maneuver

• The palmar-plantar grasp

Multiple Choice

28. An infant of a mother infected with HIV is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children with HIV, the nurse assess the infant for which sign?

• Cough

• Liver failure

• Watery stool

• Nuchal rigidity

Multiple Choice

29. A 6-year-old child with HIV has been admitted to the hospital for pain management. The child asks the nurse if the pain will ever go away. The nurse should make which best response to the child?

• “The pain will go away if you lie still and let the medicine work.”

• “Try not to think about it. The more you think it hurts, the more it will hurt.”

• “I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less.”

• “Every time it hurts, press on the call button and I will give you something to make the pain go all away.”

Open Ended

30. Alternative Style Q: A pediatrician’s prescription reads “ampicillin sodium 125mg IV q6h.” the medication label reads “when reconstituted with 7.4 mL of bacteriostatic water, the final concentration is 1g/7.4 mL.” The nurse prepares to draw up how many milliliters for 1 dose?