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Molly, with suspected rheumatic fever, is nurse in charge anticipates that the doctor will
admitted to the pediatric unit. When obtaining order which laboratory test?
the childs history, the nurse considers which
information to be most important? A. Total iron-binding capacity
B. Hemoglobin
A. A fever that started 3 days ago C. Total protein
B. Lack of interest in food D. Serum transferrin
C. A recent episode of pharyngitis
D. Vomiting for 2 days 8. When developing a plan of care for a male
adolescent, the nurse considers the childs
2. Nurse Analiza is administering a medication via psychosocial needs. During adolescence,
the intraosseous route to a child. Intraosseous psychosocial development focuses on:
drug administration is typically used when a child
is: A. Becoming industrious
B. Establishing an identity
A. Under age 3 C. Achieving intimacy
B. Over age 3 D. Developing initiative
C. Critically ill and under age 3
D. Critically ill and over age 3 9. When developing a plan care for a hospitalized
child, nurse Mica knows that children in which
3. When assessing a childs cultural background, age group is most likely to view illness as a
the nurse in charge should keep in mind that: punishment for misdeeds?

A. Cultural background usually has little bearing A. Infancy

on a familys health practices B. Preschool age
B. Physical characteristics mark the child as part C. School age
of a particular culture D. Adolescence
C. Heritage dictates a groups shared values
D. Behavioral patterns are passed from one 10. Nurse Sunshine suspects that a child, age 4,
generation to the next is being neglected physically. To best assess the
childs nutritional status, the nurse should ask
4. While examining a 2-year-old child, the nurse the parents which question?
in charge sees that the anterior fontanel is open.
The nurse should: A. Has your child always been so thin?
B. Is your child a picky eater?
A. Notify the doctor C. What did your child eat for breakfast?
B. Look for other signs of abuse D. Do you think your child eats enough?
C. Recognize this as a normal finding
D. Ask about a family history of Tay-Sachs 11. A female child, age 2, is brought to the
disease emergency department after ingesting an
unknown number of aspirin tablets about 30
5. The nurse is aware that the most common minutes earlier. On entering the examination
assessment finding in a child with ulcerative room, the child is crying and clinging to the
colitis is: mother. Which data should the nurse obtain first?

A. Intense abdominal cramps A. Heart rate, respiratory rate, and blood

B. Profuse diarrhea pressure
C. Anal fissures B. Recent exposure to communicable diseases
D. Abdominal distention C. Number of immunizations received
D. Height and weight
6. When administering an I.M. injection to an
infant, the nurse in charge should use which site? 12. A mother asks the nurse how to handle her
5-year-old child, who recently started wetting the
A. Deltoid pants after being completely toilet trained. The
B. Dorsogluteal child just started attending nursery school 2 days
C. Ventrogluteal a week. Which principle should guide the nurses
D. Vastus lateralis response?

7. A child with a poor nutritional status and A. The child forgets previously learned skills
weight loss is at risk for a negative nitrogen B. The child experiences growth while regressing,
balance. To help diagnose this problem, the regrouping, and then progressing
C. The parents may refer less mature behaviors 18. When performing a physical examination on
D. The child returns to a level of behavior that an infant, the nurse in charge notes abnormally
increases the sense of security. low-set ears. This finding is associated with:

13. A female child, age 6, is brought to the A. Otogenous tetanus

health clinic for a routine checkup. To assess the B. Tracheoesophageal fistula
childs vision, the nurse should ask: C. Congenital heart defects
D. Renal anomalies
A. Do you have any problems seeing different
colors? 19. Nurse Walter should expect a 3-year-old child
B. Do you have trouble seeing at night? to be able to perform which action?
C. Do you have problems with glare?
D. How are you doing in school? A. Ride a tricycle
B. Tie the shoelaces
14. During a well-baby visit, Liza asks the nurse C. Roller-skates
when she should start giving her infant solid D. Jump rope
foods. The nurse should instruct her to introduce
which solid food first? 20. Nurse Kim is teaching a group of parents
about otitis media. When discussing why children
A. Applesauce are predisposed to this disorder, the nurse should
B. Egg whites mention the significance of which anatomical
C. Rice cereal feature?
D. Yogurt
A. Eustachian tubes
15. To decrease the likelihood of B. Nasopharynx
bradyarrhythmias in children during endotracheal C. Tympanic membrane
intubation, succinylcholine (Anectine) is used D. External ear canal
with which of the following agents?
21. The nurse is evaluating a female child with
A. Epinephrine (Adrenalin) acute post streptococcal glomerulonephritis for
B. Isoproterenol (Isuprel) signs of improvement. Which finding typically is
C. Atropine sulfate the earliest sign of improvement?
D. Lidocaine hydrochloride (Xylocaine)
A. Increased urine output
16. A 1-year-and 2-month-old child weighing 26 B. Increased appetite
lb (11.8 kg) is admitted for traction to treat C. Increased energy level
congenital hip dislocation. When preparing the D. Decreased diarrhea
patients room, the nurse anticipates using which
traction system? 22. Dr. Jones prescribes corticosteroids for a
child with nephritic syndrome. What is the
A. Bryants traction primary purpose of administering corticosteroids
B. Bucks extension traction to this child?
C. Overhead suspension traction
D. 90-90 traction A. To increase blood pressure
B. To reduce inflammation
17. Hannah, age 12, is 7 months pregnant. When C. To decrease proteinuria
teaching parenting skills to an adolescent, the D. To prevent infection
nurse knows that which teaching strategy is least
effective? 23. Parents bring their infant to the clinic,
seeking treatment for vomiting and diarrhea that
A. Providing a one-on-one demonstration and has lasted for 2 days. On assessment, the nurse
requesting a return demonstration, using a live in charge detects dry mucous membranes and
infant model lethargy. What other findings suggests a fluid
B. Initiating a teenage parent support group with volume deficit?
first and second-time mothers
C. Using audiovisual aids that show discussions of A. A sunken fontanel
feelings and skills B. Decreased pulse rate
D. Providing age-appropriate reading materials C. Increased blood pressure
D. Low urine specific gravity
24. How should the nurse prepare a suspension 30. A child is diagnosed with Wilms tumor.
before administration? During assessment, the nurse in charge expects
to detect:
A. By diluting it with normal saline solution
B. By diluting it with 5% dextrose solution A. Gross hematuria
C. By shaking it so that all the drug particles are B. Dysuria
dispersed uniformly C. Nausea and vomiting
D. By crushing remaining particles with a mortar D. An abdominal mass
and pestle
31. Which of the following would be inappropriate
25. What should be the initial bolus of crystalloid when administering chemotherapy to a child?
fluid replacement for a pediatric patient in shock?
A. Monitoring the child for both general and
A. 20 ml/kg specific adverse effects
B. 10 ml/kg B. Observing the child for 10 minutes to note for
C. 30 ml/kg signs of anaphylaxis
D. 15 ml/kg C. Administering medication through a free-
flowing intravenous line
26. Lily , age 5, with an intelligence quotient of D. Assessing for signs of infusion infiltration and
65 is admitted to the hospital for evaluation. irritation
When planning care, the nurse should keep in
mind that this child is: 32. Which of the following is the best method for
performing a physical examination on a toddler
A. Within the lower range of normal intelligence
B. Mildly retarded but educable A. From head to toe
C. Moderately retarded but trainable B. Distally to proximally
D. Completely dependent on others for care C. From abdomen to toes, the to head
D. From least to most intrusive
27. Mandy, age 12, is brought to the clinic for
evaluation for a suspected eating disorder. To 33. Which of the following organisms is
best assess the effects of role and relationship responsible for the development of rheumatic
patterns on the childs nutritional intake, the fever?
nurse should ask:
A. Streptococcal pneumonia
A. What activities do you engage in during the B. Haemophilus influenza
day? C. Group A -hemolytic streptococcus
B. Do you have any allergies to foods? D. Staphylococcus aureus
C. Do you like yourself physically?
D. What kinds of food do you like to eat? 34. Which of the following is most likely
associated with a cerebrovascular accident (CVA)
28. Sudden infant death syndrome (SIDS) is one resulting from congenital heart disease?
of the most common causes of death in infants.
At what age is the diagnosis of SIDS most likely? A. Polycythemia
B. Cardiomyopathy
A. At 1 to 2 years of age C. Endocarditis
B. At I week to 1 year of age, peaking at 2 to 4 D. Low blood pressure
C. At 6 months to 1 year of age, peaking at 10 35. How does the nurse appropriately administer
months Mycostatin suspension in an infant?
D. At 6 to 8 weeks of age
A. Have the infant drink water, and then
29. When evaluating a severely depressed administer myostatin in a syringe
adolescent, the nurse knows that one indicator of B. Place Mycostatin on the nipple of the feeding
a high risk for suicide is: bottle and have the infant suck it
C. Mix Mycostatin with formula
A. Depression D. Swab Mycostatin on the affected areas
B. Excessive sleepiness
C. A history of cocaine use 36. A mother tells the nurse that she is very
D. A preoccupation with death worried because her 2-year old child does not
finish his meals. What should the nurse advise
the mother?
A. make the child seat with the family in the expands into other areas of discussion. She
dining room until he finishes his meal knows that these youths are trying to find out
B. provide quiet environment for the child before who they are, and discussion often focuses on
meals which directions they want to take in school and
C. do not give snacks to the child before meals life, as well as peer relationships. According to
D. put the child on a chair and feed him Erikson, this stage is known as:

37. The nurse is assessing a newborn who had A. identity vs. role confusion.
undergone vaginal delivery. Which of the B. adolescent rebellion.
following findings is least likely to be observed in C. career experimentation.
a normal newborn? D. relationship testing

A. uneven head shape 43. The nurse is assessing a 9-month-old boy for
B. respirations are irregular, abdominal, 30-60 a well-baby check up. Which of the following
bpm observations would be of most concern?
c. (+) Moro reflex
D. heart rate is 80 bpm A. The baby cannot say mama when he wants
his mother.
38. Which of the following situations increase the B. The mother has not given him finger foods.
risk of lead poisoning in children? C. The child does not sit unsupported.
D. The baby cries whenever the mother goes out.
A. playing in the park with heavy traffic and with
many vehicles passing by 44. Cherry, the mother of an 11-month-old girl,
B. playing sand in the park Elizabeth, is in the clinic for her daughters
C. playing plastic balls with other children immunizations. She expresses concern to the
D. playing with stuffed toys at home nurse that Elizabeth cannot yet walk. The nurse
correctly replies that, according to the Denver
39. An inborn error of metabolism that causes a Developmental Screen, the median age for
premature destruction of RBC? walking is:

A. G6PD A. 12 months.
B. Homocystinuria B. 15 months.
C. Phenylketonuria C. 10 months.
D. Celiac Disease D. 14 months.

40. Which of the following blood study results 45. Sunshine, age 13, has had a lumbar puncture
would the nurse expect as most likely when to examine the CSF to determine if bacterial
caring for the child with iron deficiency anemia? infection exists. The best position to keep her in
after the procedure is:
A. Increased hemoglobin
B. Normal hematocrit A. Prone for two hours to prevent aspiration,
C. Decreased mean corpuscular volume (MCV) should she vomit.
D. Normal total iron-binding capacity (TIBC) B. Semi-Fowlers so she can watch TV for five
hours and be entertained.
41. The nurse answers a call bell and finds a C. Supine for several hours, to prevent a
frightened mother whose child, the patient, is headache.
having a seizure. Which of these actions should D. On her right sides to encourage return of CSF
the nurse take?
46. Bucks traction with a 10 lb. weight is
A. The nurse should insert a padded tongue blade securing a patients leg while she is waiting for
in the patients mouth to prevent the child from surgery to repair a hip fracture. It is important to
swallowing or choking on his tongue. check circulation- sensation-movement:
B. The nurse should help the mother restrain the
child to prevent him from injuring himself. A. every shift.
C. The nurse should call the operator to page for B. every day.
seizure assistance. C. every 4 hours.
D. The nurse should clear the area and position D. every 15 minutes.
the client safely.
47. Kim is using bronchodilators for asthma. The
42. At the community center, the nurse leads an side effects of these drugs that you need to
adolescent health information group, which often monitor this patient for include:
A. tachycardia, nausea, vomiting, heart 2. Katie is admitted to the intensive care unit of
palpitations, inability to sleep, restlessness, and Nurseslabs Medical Center for diabetic
seizures. ketoacidosis; which of the following is of primary
B. tachycardia, headache, dyspnea, temp. 101 F, importance when caring for the child?
and wheezing.
C. blurred vision, tachycardia, hypertension, A. Giving I.V. NPH insulin in high doses
headache, insomnia, and oliguria. B. Evaluating the child for cardiac abnormalities
D. restlessness, insomnia, blurred vision, C. Limiting fluids to prevent aggravating cerebral
hypertension, chest pain, and muscle weakness. edema
D. Monitoring and recording the childs vital signs
48. The adolescent patient has symptoms of for hypertension
meningitis: nuchal rigidity, fever, vomiting, and
lethargy. The nurse knows to prepare for the 3. Nurse Angelo is attending for a child with
following test: Cushings syndrome; which of the following
nursing interventions would be most necessary?
A. blood culture.
B. throat and ear culture. A. Observing the child for signs and symptoms of
C. CAT scan. metabolic acidosis
D. lumbar puncture. B. Handling the child carefully to prevent bruising
C. Monitoring vital signs for hypertension and
49. The nurse is drawing blood from the diabetic tachycardia
patient for a glycosylated hemoglobin test. She D. Monitoring the child for signs and symptoms of
explains to the woman that the test is used to hypoglycemia
4. While Andres is being assessed at the clinic,
A. the highest glucose level in the past week. Nurse Shiela observed that the child appears to
B. her insulin level. be small, with an immature face and chubby
C. glucose levels over the past several months. body build. Her parents stated that their childs
D. her usual fasting glucose level. rate of growth of all body parts is somewhat
slow, but her proportions and intelligence remain
50. The twelve-year-old boy has fractured his normal. As a knowledgeable nurse, you know
arm because of a fall from his bike. After the that the child has a deficiency of which of the
injury has been casted, the nurse knows it is following?
most important to perform all of the following
assessments on the area distal to the injury A. Antidiuretic hormone (ADH)
except: B. Parathyroid hormone (PTH)
C. Growth hormone (GH)
A. capillary refill. D. Melanocyte-stimulating hormone (MSH)
B. radial and ulnar pulse.
C. finger movement 5. Justine is admitted to the pediatric unit due to
D. skin integrity the occurrence of diabetic ketoacidosis signaling
a new diagnosis of diabetes. The diabetes team
ENDO explores the cause of the episode and take steps
to prevent a recurrence. Diabetic ketoacidosis
1. The 6-year-old son of Mr. and Mrs. Peters is (DKA) results from an excessive accumulation of
admitted to the healthcare facility with the which of the following?
diagnosis of idiopathic hypopituitarism.
His height is measured below the third percentile A. Sodium bicarbonate from renal compensation
and weight at the 40th percentile. Which of the B. Potassium from cell death
following would be the first action of his C. Glucose from carbohydrate metabolism
attending nurse? D. Ketone bodies from fat metabolism

A. Recommend orthodontic referral for 6. Nurse Aries entered the room of a child with
underdeveloped jaw. hypopituitarism and was asked by the couple
B. Collaborate with a dietician to access his about the condition of their child. Which of the
caloric needs. following phrases if stated by the nurse best
C. Provide for a tutor for his precocious describes the condition?
intellectual ability.
D. Place him in a room with a 2-year-old boy. A. Linear growth retardation with skeletal
proportions normal for chronologic age
B. A complete normal growth pattern, but with 11. Arvic who is diagnosed with diabetes mellitus
the onset of precocious puberty type 1 displays symptoms of hypoglycemia;
C. Normal growth for first five years, followed by which of the following actions should the nurse
progressive linear growth retardation instruct the parents?
D. Growth retardation in which height and weight
are equally affected A. Give the child honey (simple sugar).
B. Give the child milk (complex sugar).
7. In growing children, growth hormone C. Contact the healthcare provider before doing
deficiency results in short stature and very slow anything.
growth rates. Short stature may result from D. Give the child nothing by mouth.
which of the following?
12. Nurse Dorothy is caring for a child with
A. Anterior pituitary gland hypofunction Cushings syndrome; which of the following
B. Posterior pituitary gland hyperfunction should she include in the plan of care?
C. Parathyroid gland hyperfunction
D. Thyroid gland hyperfunction A. Increase fluids to prevent dehydration
B. Encourage a diet high in carbohydrates
8. Tara is an 11-year-old girl diagnosed with type C. Monitor weight each day and report for weight
1 diabetes mellitus (DM). She asks her attending loss
nurse why she cant take a pill rather than shots D. Encourage a diet high in potassium
like her grandmother does. Which of the following
would be the nurses best reply? 13. A child newly diagnosed with diabetes
mellitus has been stabilized with insulin injections
A. If your blood glucose levels are controlled, daily. A nurse prepares discharge teaching plan
you can switch to using pills. regarding the insulin. The teaching plan should
B. The pills correct fat and protein metabolism, reinforce which of the following concepts?
not carbohydrate metabolism.
C. Your body does not make insulin, so the A. Always keep insulin vials refrigerated
insulin injections help to replace it. B. Increase the amount of insulin before exercise
D. The pills work on the adult pancreas, you can C. Ketones in the urine signify a need for less
switch when you are 18. insulin
D. Systematically rotate injection sites
9. Which type of diabetes mellitus (DM) most
likely results from heterogenous risk factors, 14. Which of the following should the nurse
making it preventable? include in the insulin administration instruction
for the parents of a child being discharged on
A. Type 1 insulin?
B. Type 2
C. Type 1 and 2 A. Insert the needle and aspirate prior to
D. Gestational diabetes injecting
B. Inject insulin into the extremity to be
10. Mr. Lopez has a 7-year-old son with growth exercised to enhance absorption
hormone (GH) deficiency. He shares to the nurse C. The muscles in the abdomen and thigh are the
the desire of his son to play ball games. easiest to use for self administration
However, his wife feels the child will be in danger D. Clean the site of injection with soap and water
since he is smaller than the other children. In and avoid alcohol
planning anticipatory guidance for these parents,
the nurse should keep in mind which of the 15. Nurse Angelo admits a child with suspected
following? type 1 DM; which should the nurse ask the
A. The child should be allowed to play because
doing so can foster healthy self-esteem. A. Does the child complain of headache?
B. The risk for fractures is increased because a B. How much exercise does the child get?
GH deficiency results in fragile bones. C. Has the childs number and type of bowel
C. Activity could aggravate insulin sensitivity, movements changed?
causing hyperglycemia. D. Has the child experienced nocturia or
D. Activity would aggravate the childs joints, bedwetting?
already over tasked by obesity. E. How much candy and sweets does your child
take daily?

1. A child diagnosed with intellectual disability 7. The American Association on Mental Deficiency
(ID) is under the supervision of Nurse Tasha. The (AAMD), now American Association on
nurse is aware that the signs and symptoms of Intellectual and Developmental Disabilities
mild ID include which of the following? (AAIDD) definition of mental retardation
emphasizes which of the following?
A. Few communication skills
B. Lateness in walking A. An IQ level that must be below 50
C. Mental age of a toddler B. Cognitive impairment occurring after age 22
D. Noticeable developmental delays years
C. Deficits in adaptive behavior with intellectual
2. Nurse Gloria is teaching the Mr. and Mrs. Diaz impairment
about the early signs and symptoms of lead D. No responsiveness to contact
poisoning; which of the following if stated by the
couple would indicate the need for further 8. Nurse Maritza is caring for a child with
understanding of the case? Category A Near Drowning; she should do which
of the following? (Select all that apply.)
A. Anemia
B. Seizures A. Give furosemide as ordered.
C. Irritability B. Check for increased intracranial pressure
D. Anorexia C. Plan for discharge in 12 to 24 hours.
D. Check for electrolyte imbalances.
3. Dayas child is scheduled for surgery due to E. Keep mechanical ventilation.
myelomeningocele; the primary reason for F. Provide oxygen as ordered.
surgical repair is which of the following?
9. In diagnosing seizure disorder, which of the
A. To prevent hydrocephalus following is the most beneficial?
B. To reduce the risk of infection
C. To correct the neurologic defect A. Skull radiographs
D. To prevent seizure disorders B. EEG
C. Brain scan
4. Nurse Lorna is assessing infantile reflexes in a D. Lumbar puncture
9-month-old baby; which of the following would
she identify as normal? 10. After explaining to the parents about their
childs unique psychological needs related to a
A. Persistent rooting seizure disorder and possible stressors, which of
B. Bilateral parachute the following interests uttered by them would
C. Absent moro reflex indicate further teaching?
D. Unilateral grasp
A. Feeling different from peers
5. Reyes syndrome is a rare and severe illness B. Poor self-image
affecting children and teenagers. Its development C. Cognitive delays
has been linked with the use of aspirin and which D. Dependency
of the following?
11. Spina bifida is one of the possible neural tube
A. Meningitis defects that can occur during early embryological
B. Encephalitis development. Which of the following definitions
C. Strep throat most accurately describes meningocele?
D. Varicella
A. Complete exposure of spinal cord and
6. Tiffany is diagnosed with increased intracranial meninges
pressure (ICP); which of the following if stated by B. Herniation of spinal cord and meninges into a
her parents would indicate a need for Nurse sac
Charlie to reexplain the purpose for elevating the C. Sac formation containing meninges and spinal
head of the bed at a 10 to 20-degree angle? fluid
D. B and C
A. Help alleviate headache E. Spinal cord tumor containing nerve roots
B. Increase intrathoracic pressure
C. Maintain neutral position 12. Janae has a seizure disorder; which of the
D. Reduce intra-abdominal pressure. following would be the lowest priority when
caring for her?
A. Observing and taking down data on all A. Acidic urine
seizures B. Congenital defects
B. Assuring safety and protection from injuring C. Hydronephrosis
C. Assessing for signs and symptoms of increased D. Infection
intracranial pressure (ICP)
D. Educating the family about anticonvulsant 4. When educating parents regarding known
therapy antecedent infections in acute glomerulonephritis,
which of the following should the nurse cover?
13. Angie is an adolescent who has seizure
disorder; which of the following would not be a A. Scabies
focus of a teaching program? B. Impetigo
C. Herpes simplex
A. Ability to obtain a drivers license D. Varicella
B. Drug and alcohol abuse
C. Increased risk of infections 5. Alaric was diagnosed with minimal-change
D. Peer pressure nephrotic syndrome; which of the following signs
and symptoms are characteristics of the said
14. Bennett was rushed to the emergency disorder?
department with possible increased intracranial
pressure (ICP); which of the following is an early A. Hypertension, edema, hematuria
clinical manifestation of increased ICP in older B. Hypertension, edema, proteinuria
children? (Select all that apply.) C. Gross hematuria, fever, proteinuria
D. Poor appetite, edema, proteinuria
A. Macewens sign
B. Setting sun sign 6. Preferred nurses at the Nurseslabs Medical
C. Papilledema Center are about to perform a procedure related
D. Diplopia to a genitourinary (GU) problem to a group of
pediatric patients. Which of the following groups
15. While examining a 2-year-old child, Nurse would find it especially extra stressful?
Galina sees that the anterior fontanel is open.
She should: A. Infants
B. Toddlers
A. Notify the doctor C. Preschoolers
B. Look for other signs of abuse D. School-age children
C. Recognize this as a normal finding
D. Ask about a family history of Tay-Sachs 7. Which of the following organisms is the most
disease common cause of urinary tract infection (UTI) in
A. Klebsiella
1. 7-year-old Damon has cystitis; which of the B. Staphylococcus
following would Nurse Elena expect when C. Escherichia coli
assessing the child? D. Pseudomonas

A. Dysuria 8. Patient S is a sexually active adolescent; which

B. Costovertebral tenderness of the following instructions would be included in
C. Flank pain the preventive teaching plan about urinary tract
D. High fever infections?

2. Niklaus was born with hypospadias; which of A. Drinking acidic juices

the following should be avoided when a child has B. Avoiding urinating before intercourse
such condition? C. Wearing nylon underwear
D. Wiping back to front
A. Surgery
B. Circumcision 9. What is most likely the underlying physiology
C. Intravenous pyelography (IVP) of primary enuresis?
D. Catheterization
A. Psychogenic stress
3. Stefan was diagnosed with secondary B. Delayed bladder maturation
vesicoureteral reflux; such condition usually C. Urinary tract infection
results from which of the following? D. Vesicoureteral reflux
10. Which of the following should be included C. Increased energy level
when developing a teaching plan to prevent D. Decreased diarrhea
urinary tract infection? Select all that apply.
A. Maintaining adequate fluid intake
B. Avoiding urination before and after intercourse 1. Dustin who was diagnosed with Hirschsprungs
C. Emptying bladder with urination disease has a fever and watery explosive
D. Wearing underwear made of synthetic material diarrhea. Which of the following would Nurse
such as nylon Joyce do first?
E. Keeping urine alkaline by avoiding acidic
beverages A. Administer an antidiarrheal.
F. Avoiding bubble baths and tight clothing B. Notify the physician immediately.
C. Monitor the child every 30 minutes.
11. 12-year-old Caroline has recurring nephrotic D. Nothing. (These findings are common in
syndrome; which of the following areas of Hirschsprungs disease.)
potential disturbances should be a prime
consideration when planning ongoing nursing 2. Nurse Nancy is assessing a child with pyloric
care? stenosis; she is likely to note which of the
A. Body image
B. Sexual maturation A. Currant jelly stools
C. Muscle coordination B. Regurgitation
D. Intellectual development C. Steatorrhea
D. Projectile vomiting
12. The nurse is aware that the following
laboratory values support a diagnosis of 3. An 11-year-old girl with celiac disease was
pyelonephritis? discharged from the hospital. An appropriate
teaching was carried out by the nurse if the
A. Myoglobinuria parents are aware of avoiding which of the
B. Ketonuria following?
C. Pyuria
D. Low white blood cell (WBC) count A. Chicken
B. Wheat
13. Nurse Jeremy is evaluating a clients fluid C. Milk
intake and output record. Fluid intake and urine D. Rice
output should relate in which way?
4. Which of the following applies to the defect
A. Fluid intake should be double the urine output. emerging from residual peritoneal fluid confined
B. Fluid intake should be approximately equal to within the lower segment of the processus
the urine output. vaginalis?
C. Fluid intake should be half the urine output.
D. Fluid intake should be inversely proportional to A. Inguinal hernia
the urine output. B. Incarcerated hernia
C. Communicating hydrocele
14. The following are considered functions of the D. Noncommunicating hydrocele
Urinary System EXCEPT: (Select all that apply).
5. Baby Jonathan was born with cleft lip (CL);
A. Vitamin D synthesis Nurse Barbara would be alert that which of the
B. Regulation of red blood cell synthesis following will most likely be compromised?
C. Excretion
D. Absorption of digested molecules A. GI function
E. Regulation of blood volume and pressure B. Locomotion
C. Sucking ability
15. Nurse Kai is evaluating a female child with D. Respiratory status
acute post-streptococcal glomerulonephritis for
signs of improvement. Which finding typically is 6. Will is being assessed by Nurse Lucas for
the earliest sign of improvement? possible intussusception; which of the following
would be least likely to provide valuable
A. Increased urine output information?
B. Increased appetite
A. Abdominal palpation D. Behavioral patterns are passed from one
B. Family history generation to the next
C. Pain pattern
D. Stool inspection 13. In pediatric gastroesophageal reflux disease
(GERD), the immaturity of lower esophageal
7. Mr. and Ms. Byers child failed to pass sphincter function is manifested by frequent
meconium within the first 24 hours after birth; transient lower esophageal relaxations, which
this may indicate which of the following? result in retrograde flow of gastric contents into
the esophagus. Which statement about the
A. Celiac disease esophagus is TRUE? Select all that apply.
B. Intussusception
C. Hirschsprungs disease A. It is a cartilaginous tube.
D. Abdominal-wall defect B. It has upper and lower sphincters.
C. It lies anterior to the trachea.
8. Which of the following parameters would Nurse D. It extends from the nasal cavity to the
Max monitor to evaluate the effectiveness of stomach.
thickened feedings for an infant with E. All statements describe the esophagus.
gastroesophageL REFLUX (GER)?
14. Mrs. Byers tells the nurse that she is very
A. Urine worried because her 2-year old child does not
B. Vomiting finish his meals. What should the nurse advise
C. Weight the mother?
D. Stools
A. Make the child seat with the family in the
9. Baby Ellie is diagnosed with gastroesophageal dining room until he finishes his meal
reflux (GER); which of the following nursing B. Provide quiet environment for the child before
diagnoses would be inappropriate? meals
C. Do not give snacks to the child before meals
A. Risk for aspiration D. Put the child on a chair and feed him
B. Impaired oral mucous membrane
C. Deficient fluid volume 15. Nurse Lonnie is aware that the most common
D. Imbalanced nutrition: Less than body assessment finding in a child with ulcerative
requirements colitis is:

10. Steve is diagnosed with celiac disease and A. Intense abdominal cramps
experiences celiac crisis secondary to upper B. Profuse diarrhea
respiratory tract infection; which of the following C. Anal fissures
would Nurse Nancy expect to assess? D. Abdominal distention

A. Lethargy 1. Betty is a 9-year-old girl diagnosed with cystic

B. Weight gain fibrosis. Which of the following must Nurse Archie
C. Respiratory distress keep in mind when developing a care plan for the
D. Watery diarrhea child?

11. Nurse Karen is providing postoperative care A. Pulmonary secretions are abnormally thick.
for Dustin who has cleft palate (CP); she should B. Elevated levels of potassium are found in the
position the child in which of the following? sweat.
C. CF is an autosomal dominant hereditary
A. In an infant seat disorder.
B. In the supine position D. Obstruction of the endocrine glands occurs.
C. In the prone position
D. On his side 2. Veronicas parents were told that their
daughter needs ribavirin (Virazole). This drug is
12. Nurse Joyce is assessing a childs cultural used to treat which of the following?
background, she should keep in mind that:
A. Cystic fibrosis
A. Cultural background usually has little bearing B. Otitis media
on a familys health practices C. Respiratory syncytial virus (RSV)
B. Physical characteristics mark the child as part D. Bronchitis
of a particular culture
C. Heritage dictates a groups shared values
3. Beta-adrenergic agonists such as albuterol with asthma. Which of the following statements
are given to Reggie, a child with asthma. Such indicate a need for further home care teaching?
drugs are administered primarily to do which of
the following? A. He should increase his fluid intake regularly
to thin secretions.
A. Dilate the bronchioles B. Well make sure that he avoids exercise to
B. Reduce secondary infections prevent attacks.
C. Decrease postnasal drip C. He is to use his bronchodilator inhaler before
D. Reduce airway inflammation the steroid inhaler.
D. We need to identify what things trigger his
4. Alice is rushed to the emergency department attacks.
during an acute, severe prolonged asthma attack
and is unresponsive to usual treatment. The 10. Which of the following instructions should
condition is referred to as which of the following? Nurse Cheryl include in her teaching plan for the
parents of Reggie with otitis media?
A. Status asthmaticus
B. Reactive airway disease A. Placing the child in the supine position to
C. Intrinsic asthma bottle-feed
D. Extrinsic asthma B. Giving prescribed amoxicillin (Amoxil) on an
empty stomach
5. Which of the following infants is least probable C. Cleaning the inside of the ear canals with
to develop sudden infant death syndrome cotton swabs
(SIDS)? D. Avoiding contact with people who have upper
respiratory tract infections
A. Baby Angela who was premature
B. A sibling of Baby Angie who died of SIDS 11. Immunization of children with Haemophilus
C. Baby Gabriel with prenatal drug exposure influenzae type B (Hib) vaccine decreases the
D. Baby Gabby who sleeps on his back incidence of which of the following conditions?

6. Fred is a 12-year-old boy diagnosed with A. Bronchiolitis

pneumococcal pneumonia. Which of the following B. Laryngotracheobronchitis (LTB)
would Nurse Nica expect to assess? C. Epiglottitis
D. Pneumonia
A. Mild cough
B. Slight fever 12. Which of the following respiratory conditions
C. Chest pain is always considered a medical emergency?
D. Bulging fontanel
A. Asthma
7. Baby Melody is a neonate who has a very low- B. Cystic fibrosis (CF)
birth-weight. Nurse Josie carefully monitors C. Epiglottiditis
inspiratory pressure and oxygen (O2) D. Laryngotracheobronchitis (LTB)
concentration to prevent which of the following?
13. When assessing a childs cultural background,
A. Meconium aspiration syndrome the nurse in charge should keep in mind that:
B. Bronchopulmonary dysplasia (BPD)
C. Respiratory syncytial virus (RSV) A. Heritage dictates a groups shared values
D. Respiratory distress syndrome (RDS) B. Physical characteristics mark the child as part
of a particular culture
8. Archie who weighs 44 lb has been given an C. Cultural background usually has little bearing
order for amoxicillin 500 mg b.i.d. The drug text on a familys health practices
notes that the daily dose of amoxicillin is 50 D. Behavioral patterns are passed from one
mg/kg/day in two divided doses. What dose in generation to the next
milligrams is safest for this child?
14. Which of the following is the best method for
A. 1000 mg performing a physical examination on a toddler
B. 750 mg
C. 500 mg A. From head to toe
D. 250 mg B. Distally to proximally
C. From abdomen to toes, the to head
9. The Andrews family has been taking good care D. From least to most intrusive
of their youngest, Archie, who was diagnosed
15. Nurse Veronica is teaching a group of parents ventricle
about otitis media. When discussing why children D. Return of blood to the heart without entry to
are predisposed to this disorder, the nurse should the left atrium
mention the significance of which anatomical
feature? 5. Bryce is a child diagnosed with coarctation of
aorta. While assessing him, Nurse Zach would
A. Nasopharynx expect to find which of the following?
B. Eustachian tubes
C. External ear canal A. Squatting posture
D. Tympanic membrane B. Absent or diminished femoral pulses
C. Severe cyanosis at birth
CARDIO D. Cyanotic (tet) episodes

1. A 5-year-old girl Hannah is recently diagnosed 6. Which of the following instructions would
with Kawasaki disease. Apart from the identified Nurse Courtney include in a teaching plan that
symptoms of the disease, she may also likely focuses on initial prevention for Sheri who is
develop which of the following? diagnosed with rheumatic fever?

A. Sepsis A. Treating streptococcal throat infections with an

B. Meningitis antibiotic
C. Mitral valve disease B. Giving penicillin to patients with rheumatic
D. Aneurysm formation fever
C. Using corticosteroid to reduce inflammation
2. Clay is an 8-year-old boy diagnosed with heart D. Providing an antibiotic before dental work
failure. Which of the following shows that he is
strictly following the directed therapeutic 7. Which of the following would Nurse Tony
regimen? suppose to regard as a cardinal manifestation or
symptom of digoxin toxicity to his patient Clay
A. Daily use of an antibiotic diagnosed with heart failure?
B. Pulse rate less than 50 beats/minute
C. Normal weight for age A. Headache
D. Elevation in red blood cell (RBC) count B. Respiratory distress
C. Extreme bradycardia
3. The Foley Family is caring for their youngest D. Constipation
child, Justin, who is suffering from tetralogy of
Fallot. Which of the following are defects 8. Appropriate intervention is vital for many
associated with this congenital heart condition? children with heart disease in order to go on to
live active, full lives. Which of the following
A. Aorta exits from the right ventricle, pulmonary outlines an effective nursing intervention to
artery exits from the left ventricle, and two decrease cardiac demands and minimize cardiac
noncommunicating circulations workload?
B. Ventricular septal defect, overriding aorta,
pulmonic stenosis (PS), and right ventricular A. Feeding the infant over long periods
hypertrophy B. Allowing the infant to have her way to avoid
C. Coarctation of aorta, aortic valve stenosis, conflict
mitral valve stenosis, and patent ductus C. Scheduling care to provide for uninterrupted
arteriosus rest periods
D. Tricuspid valve atresia, atrial septal defect, D. Developing and implementing a consistent
ventricular septal defect, and hypoplastic right care plan
9. Mr. and Mrs. Bakers only daughter is
4. When creating a teaching program for the diagnosed with heart failure. Which of the
parents of Jessica who is diagnosed with following interventions would be appropriate to
pulmonic stenosis (PS), Nurse Alex would keep in promote optimal nutrition for the infant?
mind that this disorder involves which of the
following? A. Replacing regular nipples with easy-to-suck
A. A single vessel arising from both ventricles B. Allowing the infant to feed for at least 1 hour
B. Obstruction of blood flow from the left C. Providing large feedings evenly spaced every 4
ventricle hours
C. Obstruction of blood flow from the right
D. Offering formula that is high in sodium and ventricle to the left ventricle in Transposition of
calories the Great Arteries (TGA) is:

10. It is considered as the bluntly rounded A. Rashkind Procedure

portion of the heart B. Rastelli Procedure
C. Pulmonary Artery Banding
A. Base D. Jatene Procedure
B. Pericardium
C. Aorta 15. The ductus arteriosus is another fetal
D. Apex structure that is important in the intrauterine life.
It functions to:
11. Arrange these parts of the conduction system
of the heart in the correct order as an action A. Shunts the combined cardiac output from the
potential would pass through them. pulmonary artery to the aorta going to the lungs
B. Shunts the combined cardiac output from the
1. AV node pulmonary artery to the systemic circulation
C. Shunts the combined cardiac output from the
2. Purkinje fibers aorta to the pulmonary artery and later to the
pulmonary veins
D. Shunts the combined cardiac output from the
3. Atrioventricular bundle
aorta to the pulmonary artery to the right
4. R and L bundle of His

5. SA node

A. SA Node Purkinje Fibers R and L bundle of

His Atrioventricular bundle AV Node
B. SA Node AV Node Purkinje fibers R and L
bundle of His Atrioventricular bundle
C. SA Node Purkinje Fibers Atrioventricular
Bundle R and L bundle of His AV Node
D. SA Node AV Node Atrioventricular bundle
R and L bundle of His Purkinje Fibers

12. Which of these statements regarding the

conduction system of the heart is NOT correct?
Select all that apply.

A. The sinoatrial (SA) node of the heart acts as

the pacemaker.
B. The SA node is located on the upper wall of
the left atrium.
C. The AV node conducts action potentials rapidly
through it.
D. Action potentials are carried slowly through
the atrioventricular bundle.

13. Which of the following disorders leads to

cyanosis from deoxygenated blood entering the
systemic arterial circulation?

A. Aortic stenosis (AS)

B. Coarctation of aorta
C. Patent ductus arteriosus (PDA)
D. Tetralogy of Fallot

14. The procedure that has to be performed in

order to shift the high pressure from the right