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WorksheetsPediatric Nursing Quiz
Total questions: 83
Worksheet time: 42mins
A 4-year-old child is admitted with Kawasaki disease. Which nursing intervention is the priority?
Administer IV immunoglobulin (IVIG) as prescribed
Monitor intake and output
Apply lotion to dry skin
Encourage fluid intake
Which assessment finding in an infant with a ventricular septal defect (VSD) requires immediate action?
Harsh systolic murmur
Poor feeding and weight gain
Respiratory rate of 68 breaths/min
Capillary refill of 2 seconds
The nurse is caring for a child post-cardiac catheterization. Which is the priority nursing assessment?
Monitor for fever
Assess peripheral pulses
Check oral intake
Administer pain medication
Which teaching point is most important for parents of a child with rheumatic fever?
Avoid all physical activity
Administer antibiotics as prescribed
Provide a low-sodium diet
Maintain isolation precautions
What is the primary pathophysiological cause of cyanosis in Tetralogy of Fallot?
Decreased pulmonary blood flow
Increased pulmonary vascular resistance
Atrial septal defect
Left ventricular hypertrophy
A nurse notes that a child with heart failure is irritable and has a respiratory rate of 65/min. What is the next best action?
Reposition the child
Notify the provider immediately
Offer a pacifier
Administer morphine sulfate
What is the priority assessment in a child receiving digoxin?
Respiratory rate
Apical pulse
Capillary refill
Pupillary reaction
Which condition is commonly associated with Kawasaki disease?
Coronary artery aneurysms
Ventricular hypertrophy
Valvular stenosis
Bacterial endocarditis
The nurse should withhold digoxin if a child’s apical pulse is:
Below 100 bpm in an infant
Below 80 bpm in a toddler
Below 90 bpm in a preschooler
Below 70 bpm in a school-age child
Which finding would be expected in a child with left-sided heart failure?
Hepatomegaly
Dependent edema
Crackles in the lungs
Jugular vein distention
Which of the following is the most appropriate activity restriction post-cardiac surgery?
Avoid lifting for 6-8 weeks
Restrict all physical activity for 2 months
Avoid walking for the first 2 weeks
Return to sports within 1 week
What is a priority nursing intervention for a child in skeletal traction?
Encourage fluid intake
Provide age-appropriate play
Assess neurovascular status of the affected limb
Turn every 4 hours
The nurse is caring for an infant with developmental dysplasia of the hip (DDH). Which device is commonly used?
Pavlik harness
Milwaukee brace
Halo traction
Boston brace
What is an early sign of compartment syndrome in a child with a cast?
Decreased temperature
Absence of pulse
Paresthesia
Cyanosis
Teaching for parents of a child in a hip spica cast should include:
Place the child prone for feeding
Use a bar between legs for lifting
Elevate head of bed during feeding
Do not use car seats
Which intervention best prevents complications in a child with scoliosis wearing a brace?
Remove brace during exercise
Wear brace 23 hours/day
Apply lotion under the brace
Use heat therapy for discomfort
What should the nurse include in discharge teaching for a child with a femur fracture in a cast?
Use a hairdryer on high heat to relieve itching
Keep the cast clean and dry
Insert a pencil to relieve itching
Stand up every 2 hours
Which action should the nurse take when assessing a toddler with clubfoot?
Observe gait while walking
Evaluate hip range of motion
Inspect the alignment of the foot
Encourage daily exercise
What is the priority concern during cast application?
Allergic reaction to cast material
Skin irritation
Circulatory compromise
Odor from the cast
Which dietary instruction should the nurse give the parent of a child with iron-deficiency anemia?
Provide milk with every meal
Administer iron with orange juice
Avoid meat products
Administer iron with dairy
A child with sickle cell disease reports severe pain. What is the nurse's priority intervention?
Apply ice to painful joints
Administer prescribed opioid analgesic
Restrict fluids
Encourage physical activity
Which lab result is expected in a child with iron-deficiency anemia?
Elevated hemoglobin
Low hematocrit
High platelet count
Elevated reticulocyte count
What is the primary nursing goal during a vaso-occlusive crisis?
Promote weight gain
Maintain adequate hydration
Encourage ambulation
Restrict protein intake
Which statement by a parent of a child with hemophilia indicates understanding?
My child should take aspirin for pain.
I will apply heat to injuries.
I should avoid giving my child intramuscular injections.
My child can participate in all sports.
What is a common sign of bleeding in a hemophilic joint?
Pain and swelling
Redness and warmth
Muscle spasm
Decreased range of motion only
A child with sickle cell disease has a fever of 102°F (38.9°C). What is the nurse's next action?
Administer ibuprofen and reassess
Provide a tepid sponge bath
Restrict fluid intake
Encourage physical activity
A nurse is caring for an infant with a ventricular septal defect (VSD). Which clinical finding should the nurse expect?
Cyanosis at rest
Bounding pulses
Loud, harsh murmur at the left sternal border
Bradycardia
Which is the priority nursing action post–cardiac catheterization in a 4-year-old?
Monitor intake and output
Check the insertion site for bleeding
Offer a snack
Encourage ambulation
A child with Kawasaki disease is receiving IVIG. The nurse knows that:
Aspirin should be avoided
Immunizations can be given the same day
IVIG should be administered slowly
The child should be isolated
Which symptom would the nurse expect in a child with congestive heart failure?
Diaphoresis with feeding
Decreased urine output
Tachypnea
All of the above
In rheumatic fever, which lab value supports the diagnosis?
Platelet count
Antistreptolysin O (ASO) titer
Hematocrit
Troponin
Teaching for a child post-cardiac surgery includes:
Encourage active play immediately
No need to restrict visitors
Use pillows when coughing
Resume normal activities within 24 hours
Which finding requires immediate action post–cardiac cath?
Mild bruising at the site
Absent pedal pulse on affected leg
Mild pain at site
Slight oozing of blood
A 3-month-old with a congenital heart defect has poor feeding. Which intervention is appropriate?
Allow infant to breastfeed as long as needed
Use a firm nipple and limit feeding to 30 minutes
Offer feeding every 6 hours
Delay feeding until symptoms resolve
What is a nursing diagnosis for a child with heart failure?
Ineffective airway clearance
Risk for infection
Decreased cardiac output
Risk for impaired skin integrity
Which medication improves cardiac output in pediatric heart failure?
Furosemide
Digoxin
Captopril
Propranolol
Parent teaching for Kawasaki disease includes:
Continue aspirin until symptoms subside
Follow up with cardiologist for ECHO
Return to school immediately
Immunizations are up-to-date
A child in a cast for a fractured femur complains of tingling and severe pain. What should the nurse do first?
Elevate the leg
Notify the provider
Administer analgesics
Apply cold compress
Which is a sign of developmental dysplasia of the hip in an infant?
Equal leg length
Negative Ortolani test
Asymmetrical thigh folds
Normal gait
Which intervention is most important when caring for a child in skeletal traction?
Encourage repositioning every 8 hours
Remove traction weights every shift
Assess neurovascular status frequently
Use heat to relieve muscle spasms
Education for a child with scoliosis wearing a brace includes:
Remove brace at bedtime
Wear the brace 18-23 hours/day
Apply lotion under the brace
Wear loose, cotton clothing over brace
Which is a nursing priority for a child with a cast?
Pain level every 8 hours
Skin integrity around the cast
Range of motion exercises
Dietary intake
What is the best play activity for a 6-year-old in a leg cast?
Soccer ball
Reading books
Board games
Climbing activities
A toddler with clubfoot is being discharged. What teaching is most important?
Pain medication for 3 weeks
Cast care and signs of swelling
Brace wear instructions
Avoid weight-bearing
Which musculoskeletal condition most often requires surgical correction?
Clubfoot
Osgood-Schlatter
Juvenile arthritis
Nursemaid’s elbow
Which instruction is correct for administering oral iron to a toddler?
Mix with milk
Give with citrus juice
Administer with antacids
Take on a full stomach
A child with sickle cell disease presents with chest pain and fever. What is the priority action?
Administer IV fluids
Start oxygen
Administer morphine
Obtain a chest x-ray
In sickle cell crisis, the child is receiving morphine and fluids. What else should the nurse monitor?
Potassium levels
Signs of dehydration
Pain relief and perfusion
White blood cell count
Hemophilia patient education includes:
Routine aspirin use for pain
Avoid contact sports
Apply heat to joint bleeds
Factor replacement is rarely needed
Which lab finding is expected in iron-deficiency anemia?
High MCV
High ferritin
Low hemoglobin
High reticulocyte count
A 10-year-old with hemophilia is bleeding after a fall. What’s the nurse’s action?
Apply heat
Immobilize and elevate the limb
Administer ibuprofen
Apply tourniquet
What is a common complication of untreated anemia in children?
Seizures
Developmental delay
What symptom is associated with Wilms’ tumor?
Non-tender abdominal mass
Hematuria
Pain with urination
Polyuria
Priority nursing action for a child receiving chemotherapy:
Allow fresh fruits
Monitor for bruising and petechiae
Delay treatment if neutropenic
Administer growth hormone
Which is a nursing intervention for mucositis in a child on chemo?
Encourage citrus juices
Use alcohol-based mouthwash
Provide soft toothbrush and oral care
A child with leukemia has WBC 500. What is the priority?
Encourage fluid intake
Restrict visitors
Administer antipyretics
Begin blood transfusion
Parent teaching for retinoblastoma includes:
Radiation is rarely used
Genetic counseling may be needed
Always presents with eye pain
Glasses correct the issue
A brain tumor symptom the nurse would report immediately:
Irritability
Vomiting in the morning
Lethargy
All of the above
A child undergoing treatment has ANC < 500. What is the appropriate nursing action?
Monitor stool pattern
Restrict all visitors
Implement neutropenic precautions
Withhold all medications
A nurse supports a dying child and their family. What is the priority?
Avoid discussing prognosis
Offer presence and silence
Provide clinical updates only
Restrict room visitors
Which statement by the nurse reflects understanding of pediatric death?
Children don’t understand death.
Let me sit with you and your child.
Don’t cry in front of your child.
There’s nothing we can do now.
Best communication method with a child with autism?
Fast-paced explanations
Loud voice and repetition
Visual aids and structured routine
Group discussions
Nurse identifies which behavior as a concern in a 9-year-old?
Occasional temper tantrums
Refusal to attend school due to fear
A nurse is assessing a teen for depression. Which tool is appropriate?
FLACC scale
CRAFFT
PHQ-9
Apgar score
A nurse is teaching a parent of a child with a congenital heart defect about signs of worsening heart failure. Which statement by the parent indicates understanding?
My child will sleep more if the condition improves.
Increased sweating while feeding is a concern.
Fast breathing is expected in babies.
If her weight increases, she's improving.
Which congenital heart defect leads to increased pulmonary blood flow?
Tetralogy of Fallot
Coarctation of the Aorta
Patent Ductus Arteriosus
Pulmonary Stenosis
A nurse is caring for a child with coarctation of the aorta. What is an expected finding?
Bounding pulses in lower extremities
Weak femoral pulses
Cyanosis in hands
Decreased capillary refill in arms
Parent education following cardiac surgery should include:
“Your child may take long naps for several weeks.”
“There are no restrictions once you're home.”
“Limit contact with others for the first 2 weeks.”
Which food should be included in the diet of a child with iron-deficiency anemia?
Cheese and yogurt
Whole milk
Fortified cereals and lean red meat
Applesauce and bananas
A child with sickle cell disease is admitted with joint pain. What is the nurse’s priority?
Administer oxygen
Encourage ambulation
Apply ice to joints
Offer high-protein diet
Which clinical manifestation is common in hemophilia?
Petechiae
Frequent nosebleeds
Hematuria
Prolonged bleeding after injury
A child undergoing chemotherapy has a platelet count of 18,000/mm³. What is the priority nursing intervention?
Encourage fluids
Provide bleeding precautions
Monitor temperature
Give iron supplements
Parent teaching for a child with leukemia should include:
"Your child should return to school as soon as chemo ends."
"Vaccinations should continue on schedule."
"Call the provider for a fever over 100.4°F."
"Hair loss is not expected with treatment."
The nurse is reviewing lab results for a child receiving chemotherapy. Which lab finding should be reported immediately?
WBC: 3,000/mm³
Hemoglobin: 11 g/dL
Platelets: 150,000/mm³
ANC: 200/mm³
A child with a brain tumor is being monitored post-op. What finding should be reported to the provider?
Irritability
Pupil changes
Mild headache
Nausea
What is a nursing priority when caring for a neutropenic child?
Monitor for bleeding
Restrict fluid intake
Administer NSAIDs for fever
Use aseptic technique for all procedures
Which sign in a casted limb requires immediate attention?
Itching under the cast
Swelling at the edges
Cool toes and delayed cap refill
Slight odor from the cast
Teaching a parent about cast care includes all of the following except:
Keeping the cast dry
Using a hairdryer to dry the cast
Checking for swelling or discoloration
Allowing the child to walk on the cast immediately
A child is in traction. What is most appropriate for the nurse to include in care?
Remove weights daily to reposition
Ensure ropes move freely through pulleys
Loosen ropes if child is uncomfortable
Keep the bed in high Fowler’s position
A nurse is screening a 14-year-old for depression. Which finding warrants further evaluation?
Occasional arguments with peers
Sleeps 6 hours per night
Reports feeling "empty" and tired
Expresses frustration with homework
When communicating with a child who has anxiety, which is most effective?
Provide short, simple instructions
Use complex and detailed explanations
Avoid giving any instructions
Speak in a loud and authoritative voice
Which approach supports a dying child's developmental needs (age 4)?
Provide privacy and minimize touch
Allow child to play with medical equipment
Avoid discussing death directly
Use concrete explanations and maintain routine
A child is dying and the parent asks, “How can I help my child right now?” What is the best response?
You can talk or hold your child—your presence matters.
There’s nothing more you can do now.
Let’s discuss organ donation first.
Just wait here while the doctor assesses.
