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WorksheetsPediatric Nursing Questions: Development & Basic Care (1-11)
Total questions: 100
Worksheet time: 50mins
The nurse is assessing a 2-year-old. Which behavior best indicates achievement of Erikson’s stage of autonomy?
Throws a toy after being told “no.”
Says “me do it!” while dressing.
Clings to parent during play.
Shares toys willingly.
When teaching parents of a 4-year-old newly diagnosed with diabetes about injections, the nurse should:
Explain in technical terms.
Allow the child to choose the site.
Demonstrate on the child’s arm.
Perform the injection out of view.
The parent of a school-age child states, “She worries she isn’t good enough at soccer.” Which Erikson stage is this?
Initiative vs Guilt
Industry vs Inferiority
Identity vs Role Confusion
Trust vs Mistrust
Which statement about hospitalization is true for adolescents?
They focus on body image and peer acceptance.
Separation anxiety is severe.
Magical thinking predominates.
They regress to earlier behaviors.
A nurse observes a 6-year-old performing a dressing change on a doll. The nurse recognizes this as:
Fantasy play
Medical trauma
Therapeutic play
Manipulative behavior
When planning care for a 5-year-old, which activity best promotes initiative?
Allowing choice of snack.
Assigning simple chores.
Scheduling strict routines.
Providing constant supervision.
The most appropriate toy for a hospitalized toddler on bedrest is:
Puzzle with small pieces
Crayons and coloring book
Pop-up musical toy
Remote-control car
The nurse should expect a 7-month-old to display which developmental ability?
Pincer grasp
Sitting unsupported
Stranger anxiety
Walking with assistance
Which intervention supports a preschooler’s concept of time during hospitalization?
“Your mom will be back after lunch.”
“She’ll return at 2 p.m.”
“Later today.”
“When you finish antibiotics.”
A teenager tells the nurse, “I feel ugly with these acne scars.” The best response is:
“You’ll grow out of it.”
“Appearance is less important than health.”
“Tell me what worries you most about how you look.”
“Use makeup to cover them.”
A child with croup has inspiratory stridor and retractions. Which action takes priority?
Start racemic epinephrine neb.
Obtain throat culture.
Encourage coughing.
Assess lung sounds hourly.
The nurse prepares to administer albuterol to a 7-year-old with asthma. Which statement by the parent needs correction?
I’ll shake the inhaler first.
He’ll hold his breath for 10 seconds.
We’ll rinse his mouth afterward.
He can skip doses when asymptomatic.
The nurse observes nasal flaring and sees-saw respirations in an infant. Which is the most accurate interpretation?
Normal variation
Upper-airway obstruction
Respiratory failure is imminent
Bronchospasm improving
A child with cystic fibrosis has thick pulmonary secretions. Which therapy should the nurse anticipate?
Chest physiotherapy before meals
Oxygen > 6 L/min by mask
Postural drainage after meals
Antibiotics only with fever
The priority for a child experiencing a Tet spell (Tetralogy of Fallot) is to:
Place in knee-chest position
Give furosemide
Provide emotional support
Administer aspirin
After cardiac catheterization, which finding requires immediate intervention?
HR increase of 15 bpm
Mild bruising at site
Pulses weaker on affected leg
Oozing of bright-red blood
The nurse is caring for an infant with patent ductus arteriosus (PDA). Which medication closes the ductus?
Digoxin
Furosemide
Indomethacin
Dopamine
Which assessment best indicates improvement in a child with heart failure receiving digoxin?
Decreased HR, increased urine output
Elevated HR, no edema
Weight gain, cool extremities
Crackles and tachypnea
A school-age child post-open-heart surgery develops chest pain and muffled heart tones. What does the nurse suspect?
Pleural effusion
Cardiac tamponade
Atelectasis
Pneumothorax
The parent of a child with rheumatic fever asks why prophylactic antibiotics are lifelong. Best explanation:
Prevents strep reinfection that could damage the heart.
Prevents immune deficiency.
Decreases inflammation.
Improves kidney function.
The nurse notes periorbital edema and proteinuria in a child. What diagnosis is suspected?
Acute glomerulonephritis
Nephrotic syndrome
Diabetes insipidus
Cystitis
Which lab finding confirms dehydration severity?
Low BUN
High hematocrit
Decreased sodium
Low urine specific gravity
The nurse cares for a child with sickle-cell crisis. Which order should be questioned?
IV fluids at 125 mL/hr
Morphine PRN pain
Cold compresses
Oxygen at 2 L/min
Teaching for parents of a child with hemophilia should include which instruction?
Avoid contact sports.
Administer IM injections for meds.
Use NSAIDs for pain.
Encourage rough play for strength.
A child with thalassemia major is receiving blood transfusions every 3 weeks. Which therapy prevents iron overload?
Chelation therapy
High-iron diet
Vitamin B12
Epoetin alfa
The nurse evaluates a child with dehydration receiving IV fluids. Which finding shows improvement?
Weight loss of 0.5 kg
Capillary refill < 2 seconds
Urine specific gravity 1.030
Dry lips
Which nursing action is appropriate when caring for a child with nephrotic syndrome?
Restrict sodium and monitor daily weight.
Encourage fluids > 2 L/day.
Limit protein intake completely.
Allow salt snacks for appetite.
The nurse suspects hemolytic transfusion reaction when a child develops:
Fever, flank pain, dark urine
Nausea only
Bradycardia
Hypothermia
The nurse recognizes which finding as early renal failure sign?
Decreased urine output
Weight loss
Polyuria
Hypotension
Which instruction helps prevent sickle-cell crisis?
Avoid dehydration and cold exposure.
Use aspirin for fever.
Exercise vigorously daily.
Restrict fluids during travel.
A child with meningitis becomes irritable with a high-pitched cry. Priority action:
Assess fontanel tension.
Give analgesic.
Turn off lights.
Feed small amounts.
Which assessment finding differentiates bacterial from viral meningitis?
Low WBC count
Cloudy CSF with high protein
Normal glucose
Clear CSF appearance
A nurse is caring for an infant post–VP shunt. Which sign indicates malfunction?
Decreased head circumference
Vomiting and irritability
Flat fontanel
Sunken eyes
For a child having a tonic–clonic seizure, the nurse should:
Turn the child to the side.
Insert a tongue blade.
Hold arms firmly.
Place pillow under head after seizure ends.
After a head injury, a child’s urine output suddenly increases to 5 mL/kg/hr. This suggests:
SIADH
Diabetes insipidus
Renal failure
Shock
The nurse notes a positive Kernig sign. This indicates:
Meningeal irritation
Normal reflex
Spinal cord injury
Hydrocephalus
For a child with suspected Reye syndrome, which lab value is expected?
Elevated ammonia
Decreased AST/ALT
Low bilirubin
High creatinine
A child on long-term phenytoin therapy should receive teaching about:
Good oral hygiene to prevent gum overgrowth.
Avoid all vaccines.
Restrict calcium foods.
Limit fluid intake.
When caring for a child with spina bifida myelomeningocele, the priority is to:
Keep sac moist and intact.
Place in supine position.
Feed immediately.
Apply warm dressing.
Early sign of increased intracranial pressure in a child is:
Headache and vomiting
Bradycardia
Fixed pupils
Decreased respirations
A child with pyloric stenosis is admitted with dehydration. The nurse expects which electrolyte imbalance?
Metabolic alkalosis
Metabolic acidosis
Hyperkalemia
Hyponatremia
An infant with Hirschsprung disease is scheduled for surgery. Pre-op priority:
Bowel cleansing with isotonic enema
High-fiber diet
Limit fluids
Encourage dairy intake
The nurse recognizes celiac disease when a child has:
Steatorrhea and abdominal distention
Watery diarrhea
Bloody stool
Pale urine
Appropriate snack for a child with type 1 diabetes before exercise:
Peanut-butter crackers
Diet soda
Cheese stick
Sugar-free gelatin
When mixing NPH and regular insulin for a pediatric patient, the nurse should:
Draw regular before NPH.
Draw NPH before regular.
Mix both in vial simultaneously.
Wait 10 minutes between.
Which assessment requires immediate follow-up for a child with DKA?
Kussmaul respirations
Blood glucose 250 mg/dL
Potassium 3.0 mEq/L
Fruity odor
The nurse educates parents about growth hormone therapy. Which statement indicates understanding?
"We’ll give injections at bedtime."
"We can stop once he grows one inch."
"We’ll apply topical cream daily."
"It cures the cause permanently."
When teaching parents of a child on corticosteroids for asthma, emphasize:
Rinse mouth after inhalation.
Skip dose when well.
Double dose if short of breath.
Stop abruptly if tremors occur.
The nurse suspects lead poisoning when observing which behavior?
Developmental delay and anemia
Hyperactivity only
Polyuria
Weight gain
Which order should the nurse question for a child with suspected appendicitis?
Apply heat to abdomen
Keep NPO
Start IV fluids
Maintain semi-Fowler position
The nurse is caring for a child with full-thickness burns. Which priority assessment finding suggests hypovolemic shock?
Urine output < 1 mL/kg/hr
HR 100 bpm
Warm dry skin
Pink mucous membranes
Which statement by parents of a child with eczema requires further teaching?
"We’ll use fragrance-free soaps."
"We’ll apply thick moisturizer right after a bath."
"We’ll keep his fingernails short."
"We’ll use hot water to remove scales."
Which finding suggests impetigo contagiosa?
Honey-colored crusted lesions around mouth
Blisters on palms
Silvery scales
Dry flaky patches on elbows
The nurse teaches parents of a child with tinea corporis to:
Use topical antifungal for 2–4 weeks.
Cover the lesion with a bandage.
Stop treatment once lesions clear.
Use steroid cream twice daily.
Which intervention is appropriate for a child in a cast who complains of itching?
Blow cool air into the cast with a hairdryer.
Insert a pencil to scratch.
Use lotion inside the cast.
Tap on the cast firmly.
The nurse suspects compartment syndrome when a child with a long-leg cast reports:
Pain unrelieved by analgesics
Mild swelling
Warm toes
Pink skin
Teaching for scoliosis brace management includes:
Wear brace 18–23 hours per day.
Remove brace during school hours.
Apply powder under brace.
Adjust straps daily for comfort.
Which child is at greatest risk for osteomyelitis?
10-year-old with recent strep infection
4-year-old with eczema
7-year-old post-appendectomy
12-year-old with sprained ankle
When caring for a child receiving chemotherapy, the nurse should:
Monitor for fever and bleeding.
Restrict protein intake.
Avoid all vaccines.
Encourage live flowers in the room.
Which lab value in a child receiving chemotherapy requires immediate intervention?
ANC < 1000/mm³
Hemoglobin 11 g/dL
Platelets 250,000/mm³
WBC 6000/mm³
The nurse should initiate neutropenic precautions for which child?
Leukemia with ANC 800
Sickle-cell anemia with crisis
Hemophilia A
Rheumatic fever
For a child receiving radiation therapy, the nurse should teach:
Avoid lotions or powders on irradiated skin.
Expose site to sunlight daily.
Wash vigorously with hot water.
Massage the site to prevent dryness.
Which statement by parents of a child with Down syndrome indicates need for follow-up?
"He may have heart defects."
"He might need speech therapy."
"He will outgrow intellectual disability."
"We’ll provide early stimulation activities."
A child receiving methotrexate should be monitored for:
Oral ulcers and liver toxicity
Polyuria
Hypertension
Rash only
Priority intervention when administering chemotherapy via central line:
Verify blood return before infusion.
Flush with heparin first.
Give rapidly to reduce exposure.
Clamp line immediately after.
Which isolation precautions are required for a child with varicella (chickenpox)?
Airborne and contact
Droplet only
Standard only
Contact only
A nurse caring for a child with measles (rubeola) should expect which manifestation?
Koplik spots in mouth
Sandpaper rash
Strawberry tongue
Parotid swelling
Which vaccine is safe for a child with a mild cold?
DTaP
MMR
Varicella
Rotavirus
A 10-year-old with type 1 diabetes reports shakiness, sweating, and headache. The nurse should:
Give a fast-acting carbohydrate.
Administer additional insulin.
Encourage vigorous exercise.
Delay treatment and recheck in 1 hour.
Which statement by parents of a child with hypothyroidism shows correct understanding?
Medication will likely be lifelong.
We can stop it if she gains weight.
He'll need daily insulin.
We'll give the pill with milk.
In diabetic ketoacidosis, which lab result is expected?
pH < 7.35 and serum ketones positive
Glucose < 70 mg/dL
Bicarbonate > 26 mEq/L
Sodium 150 mEq/L
Which finding is a priority to report for a child with syndrome of inappropriate antidiuretic hormone (SIADH)?
Serum sodium 126 mEq/L
Urine output 50 mL/hr
Weight stable
Urine specific gravity 1.020
The nurse should question which order for a child with suspected epiglottitis?
Throat culture with tongue depressor
Prepare for intubation
Humidified oxygen
Keep child calm
Which assessment best indicates effective pain control in a 6-year-old after surgery?
Child rates pain < 4 on scale.
Parent reports comfort.
Child remains awake quietly.
HR decreases slightly.
Which action ensures safe medication administration for a pediatric patient?
Double-check calculations with another nurse.
Use adult doses scaled down.
Round doses to nearest whole number.
Rely on caregiver's recollection.
Which child should the nurse see first?
Asthmatic with silent chest sounds
Sickle-cell patient requesting pain meds
Febrile child with rash
Post-op tonsillectomy drinking fluids
The nurse receives report on four patients. Whose assignment can be delegated to an LPN?
Stable child with pneumonia receiving oral antibiotics
New admission with DKA
Child requiring blood transfusion initiation
Infant on ventilator
Which prescription should the nurse question for a 3-year-old with otitis media?
Amoxicillin PO
Aspirin PRN fever
Acetaminophen PRN fever
Warm compress
A newly licensed nurse is observed checking an apical pulse for 10 seconds before giving digoxin. What should the preceptor do?
Remind to count for 1 full minute.
Approve technique.
Ask another nurse to verify.
Administer medication anyway.
During blood transfusion, the child develops back pain and chills. First action:
Stop the transfusion.
Administer antihistamine.
Notify provider.
Restart with slower rate.
Which child should be placed in a private room?
Immunocompromised child on chemo
Child with eczema
Child with anemia
Post-surgical child stable
A nurse reinforces teaching to parents of a toddler post-cardiac surgery. Which statement needs correction?
“We’ll prevent infection by keeping incision clean.”
“We’ll limit activity for several weeks.”
“We’ll stop diuretics when swelling improves.”
“We’ll weigh daily at home.”
The nurse caring for an adolescent receiving isotretinoin (Accutane) must ensure:
Negative pregnancy test before starting.
Avoidance of sunscreen.
Increased vitamin A intake.
Use of acetaminophen for pain.
A child receiving IV antibiotics suddenly develops urticaria and wheezing. First action:
Stop infusion.
Administer diphenhydramine.
Notify provider.
Maintain IV access with saline.
To prevent medication errors in pediatrics, the nurse should:
Use weight in kilograms only.
Estimate by age.
Use household spoons.
Round doses to nearest mL.
The nurse notes that a child’s oxygen saturation drops to 84% on 2 L/min via nasal cannula. Priority action:
Assess airway and reposition.
Increase O2 to 4 L/min.
Call respiratory therapy.
Notify provider immediately.
During CPR on a 3-year-old, the correct compression-to-breath ratio is:
30:2 for single rescuer.
15:2 for single rescuer.
10:1
5:1
The nurse evaluates fluid resuscitation effectiveness in a burn patient by:
Urine output ≥ 1 mL/kg/hr.
BP > 120/80 mm Hg.
Weight gain 2 kg.
Cap refill > 3 s.
Which lab should be monitored closely in a child receiving furosemide?
Potassium
Calcium
Glucose
Phosphorus
For a child with leukemia receiving a bone-marrow transplant, which finding indicates graft-versus-host disease?
Rash, jaundice, diarrhea
Pale skin only
Fever resolved
Increased appetite
During a lumbar puncture, the nurse’s role is to:
Maintain position and ensure safety.
Collect specimen independently.
Restrain child’s legs firmly.
Apply heat after procedure.
Which order is appropriate for a child with increased intracranial pressure?
Elevate head 30°
Encourage coughing
Administer hypotonic fluids
Insert NG tube for suction
Which intervention reduces separation anxiety in toddlers during hospitalization?
Encourage parental presence.
Provide group playtime.
Limit parental contact to bedtime.
Offer long explanations.
Which child requires contact precautions?
Child with RSV
Child with tuberculosis
Child with varicella
Child with measles
A nurse notes bruising in different stages of healing on a child’s back. Best initial action:
Report findings per protocol.
Confront parents directly.
Document and ignore.
Take photographs.
A parent asks about car seat safety for a 2-year-old. Correct teaching:
Use a rear-facing seat until age 2 or longer.
Use front-facing seat at 12 months.
Lap belt alone is fine.
Booster seat at age 2.
Which intervention promotes safety for a hospitalized preschooler?
Keep side rails up when unattended.
Allow child to wander halls.
Keep bed in high position.
Offer unlabeled meds as “candy.”
The most appropriate method to identify a pediatric patient before medication administration is:
Verify two identifiers (name and DOB).
Ask parent only.
Room number check.
Glance at wristband color.
The nurse reviews labs: Hgb 6 g/dL, Hct 19%, pale, tachycardic. Priority intervention:
Prepare for blood transfusion.
Encourage oral fluids.
Restrict activity.
Apply oxygen only.
Which statement by the parent of a child with autism spectrum disorder indicates effective teaching?
“We’ll maintain consistent routines and transitions.”
“We’ll introduce many new foods weekly.”
“We’ll avoid all structure.”
“We’ll change caregivers often for stimulation.”
