PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)

1. A pediatric patient has a gastrostomy tube inserted B. Anterolateral thigh

for tube feedings. Before starting a continuous feeding, C. Gluteal
the nurse should place the client in which position? D. Deltoid
A. Semi-Fowlers
B. Supine 8. A parent brings their 6-month-old son to the pediatric
C. Reverse Trendelenburg clinic for a routine wellness check. The parent tells the
D. High Fowler’s nurse, “My baby still has a soft spot on the top of his
head. Is that normal?: What is the nurse’s BEST
2. A child with leukemia is being discharged after response?
beginning chemotherapy. Which of the following A. “The baby’s fontanelle will be closing within a month
instructions will the nurse include when teaching the or two.”
parents of this child? B. “It can take up to 18 months for the fontanelle to fully
A. Provide a diet low in protein and high carbohydrates. close. “
B. Avoid fresh vegetables that are not cooked or C. “Many babies have a soft spot until they are 3-years-
peeled. old.”
C. Notify the doctor if the child’s temperature exceeds D. “The soft spot should have closed by three months
101 f (39c) of age.”
D. Increase the use of humidifiers throughout the
house. 9. A 6-month-old infant is being evaluated for Failure to
Thrive (FTT). The most sensitive indicator of the infant’s
3. The initial bolus of crystalloid fluid replacement of a nutritional status is
pediatric client with hypovolemic shock is A. Height
A. 5 mL/kg B. Weight
B. 20 mL/kg C. Activity
C. 10 mL/kg D. Appetite
D. 15 mL/kg
10. A parent contacts the pediatric health care provider
4. A 7-year-old child is being treated for nephrotic to report that their 4-year-old daughter has been wetting
syndrome (NS). A trial of corticosteroid therapy has her pants since recently stating to attend preschool. The
been prescribed for the child’s initial treatment of NS. child had been completely potty-trained at home. The
The nurse understands that the purpose of nurse suspects that the cause of these new toileting
administering a corticosteroid is to accidents is
A. reduce proteinuria A. anger at having to go to preschool
B. lower irritability B. development of type 1 diabetes
C. avoid inflammation C. stress from a new environment
D. prevent infection D. change in meal times and diet

5. Parents bring their 3-month-old to the Emergency 11. The nurse is educating the parents of a 13-year-old
Department, reporting that during the last two days, the girl with a new diagnosis of type 1 diabetes. One of the
infant has experienced vomiting and diarrhea. On parents asks why their daughter can’t take oral
assessment, the nurse notes dry mucous membranes medication instead of doing injections. What is the
and a sunken fontanelle. Which of the following findings nurse’s BEST response
will also indicate a fluid volume deficit? A. “The shots allow her pancreas to rest, so it can
A. increased activity level heal.”
B. Increased blood pressure B. “Pills are only for adults. She can take them when
C. increased urine output she is 18.”
D. increased heart rate C. “Injections replace the insulin her pancreas no
longer makes.”
6. Fetal ultrasound shows the presence of Transposition D. “As soon as her glucose levels stabilize, she can
of the Great Arteries (TGA). Following birth, the surgical switch to pills.”
procedure to correct this defect is called
A. subclavian flap. 12. An adolescent with a major depressive disorder is
B. pulmonary artery banding admitted to the inpatient mental health unit. The nurse
C. surgical ligation knows that compared to an adult with the same
D. arterial switch diagnosis, the adolescent will MOST likely to display
which symptom(s)?
7. The health care provider prescribes a vaccination IM A. Physical complaints
for a 6-year-old child. What is the MOST appropriate site B. Loss of interest
for injection? C. Poor concentration
A. Subcutaneous D. Feelings of guilt
1|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
Answer: A. Physical complaints 19. Following an uncomplicated delivery, the nurse
Rationale: performs a physical assessment on the neonate. The
nurse observes abnormally low-set ears on the
13. A parent brings their 1-month-old infant to the newborn. All of the following syndromes are associated
pediatric clinic for a routine wellness check. The parent with low-set ears EXCEPT.
tells the nurse that when the baby spits up “it flies A. Noonan syndrome
across the room!” The nurse suspects that the infant B. Kawasaki syndrome
likely has C. Potter syndrome
A. pyloric stenosis D. Turner syndrome
B. celiac disease
C. regurgitation 20. A first-time mother asks the nurse when she can
D. intussusception stop worrying about her baby dying from Sudden Infant
Death Syndrome (SIDs). The nurse knows that the peak
14. The pediatric nursing instructor is preparing a occurrence for SIDs is
presentation on intussusception. All of the following A. 1-4 months
statements should be included EXCEPT: B. Birth- 2 months
A. It occurs at the junction of the small and large C. 9-12 months
intestines. D. 5-8 months
B. It often follows a viral illness, such as cold or the flu.
C. It most frequently occurs in school-age children. 21. The community health nurse is preparing a
D. It causes intense pain, alternating with no presentation for caregivers of children with sickle cell
discomfort. disease. Which of the following educating points should
the nurse include?
15. A 1-month-old infant is diagnosed with A. Need to monitor and restrict fluids
Developmental Dysplasia of the hip (DDP). The nurse B. Importance of avoiding opioids
anticipates that the health care provider will prescribe C. Compliance with anticoagulant therapy
which treatment? D. Ways to reduce crisis events
A. Buck’s traction
B. Open reduction 22. The nurse is preparing the parents of a 7-month-old
C. Spica cast to give their baby finger foods. Which of the following is
D. Pavlik harness appropriate for introducing finger foods?
A. Raisins
16. During a routine physical for a 15-year-old girl, the B. Bananas
nurse notes the presence of Russell’s sign. This is an C. Carrots
indication of a/an. D. Grapes
A. self-mutilation
B. Eating disorder 23. EMS transports a 3-year-old who has sustained
C. suicide attempt severe traumatic injuries and is in hypovolemic shock.
D. drug addiction What is the BEST way to rapidly infuse fluid and blood
products into the child’s circulation?
17. Following a liver transplant, a 4-year-old developed A. Intraosseous access
an oral Candida infection. The health care provider B. Central venous catheter
prescribes nystatin. What is the BEST way for the nurse C. Multiple peripheral lines
to administer the medication? D. Nasogastric tube
A. Place half a dose on each side of the child’s mouth.
B. Give the nystatin in a sweetened lozenge form. 24. A week after recovering from an untreated strep
C. Administer the nystatin before each meal. throat, a 9-year-old develops post-streptococcal
D. Mix the nystatin with applesauce or pudding at every glomerulonephritis (GN). When assessing the child,
meal. which of the following is an early sign of recovery?
A. Ignores most discomfort
18. A 7-year-old is being evaluated for type 1 diabetes. B. Interest in activities
While taking the child’s medical history from the C. Increase urine output
parents, which question is MOST important for the D. Improved appetite
nurse to ask?
A. “Does your child get plenty of exercise every day?” 25. The nurse is providing discharge instructions to
B. “How much candy do you allow your child to have?” parents whose child has been diagnosed with a seizure
C. “Are you ready to learn how to manage your child’s disorder. The nurse is teaching them what to do when
disease?” the child has a seizure. Which statement by one of the
D. “Has your child been wetting the bed recently?” parents indicates a need for further education?
A. “I will place my child on their side.”
2|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
B. “I will time how long the seizure lasts.” 32. When helping a school-age child prepare for
C. “I will clear the area around my child.” surgery, the nurse should anticipate that the child may
D. I will restrain my child until the seizure stops.” have concerns about
A. medical procedures being punishment for their “bad
26. The high school nurse is presenting a lecture on behavior”
sexually transmitted infections (STI) to a sophomore B. discussing their illness or surgery in front of their
health class. Which of the following STIs is preventable parents.
by vaccination? C. surgery making them appear different from their
A. Gonorrrhea friends.
B. Hepatitis A D. being separated from their parents and cared for by
C. Hepatitis B strangers.
D. Chlamydia
Answer: B. Hepatitis B 33. A graduate nurse is assigned to provide post-
Rationale: operative care for an infant who had placement of
ventriculoperitoneal (VP) shunt. The new nurse’s
27. When preparing a young child for general preceptor must intervene when the nurse performs
anesthesia, what is the BEST way to explain the which of the following actions?
procedure? A. The nurse places the infant on its back with its head
A. “Don’t be scared. There’s nothing to worry about.” elevated at a 45 degree angle.
B. “We’re going to put you to sleep for a little while.: B. The nurse reports an increase of 0.5 cm in head
C. “You will be asleep while we fix you up.” circumference.
D. “The medicine gives you a special kind of sleep.” C. The nurse observes for abdominal distention related
to paralytic ileus.
28. “Infant Mortality Rate” refers to the D. The nurse assesses the infant for decreases in level
A. record of fetal demise and stillbirths within a hospital of consciousness
setting.
B. number of households who experience the death of 34. During a prenatal ultrasound, a fetus is diagnosed
a baby in a year. with an open myelomeningocele. Surgical repair will be
C. number of children under the age of one who die in performed after birth. The nurse knows that the reason
a year. for the surgery is to
D. socioeconomic outcomes expressed by the A. treat hydrocephalus
surviving infants. B. correct the defect
C. avoid future seizures
29. While the nurse cares for a 6-year-old girl, she tells D. prevent infection
the nurse that she lives with her father, stepmother, the
stepmother’s son, and “a new baby sister.” Which type 35. Which developmental stage is MOST likely to fear
of family is the girl describing? monsters under the bed or in the closet?
A. Exhausted family A. Preschool
B. Blended family B. School-age
C. Nuclear family C. Toddler
D. Cohabitation family D. Infant

30. Routine childhood immunizations include 36. Viral infections frequently produce a characteristic
administration of live, attenuated vaccines. All of the rash. All of the following common childhood viral
following are examples of live, attenuated vaccines illnesses can be identified by a rash EXCEPT
EXCEPT A. Rubella
A. Rotavirus B. Mumps
B. Measles C. fifth disease
C. Varicella D. rubeola
D. pertussis
37. The health care provider is reviewing the arterial
31. The graduate nurse is assigned to care for a toddler blood gas report for a child with severe, persistent
with a diagnosis of coarctation of the aorta (CoA). Which asthma. The blood gas is pH = 7.28, PaCO2 = 50 mmHg,
of the following findings will support the diagnosis? HCO3 - 25. Which of these assessments are consistent
A. History of severe cyanosis at birth. with this child’s arterial blood gas?
B. Sweating while eating or crying. A. Slow respirations, nausea, and vomiting
C. The child often takes a squatting position. B. Kussmaul respirations and muscle twitching
D. The femoral pulses are weak or absent. C. Rapid, deep respirations and paresthesia
D. Disorientation, headache, and flushed face.

3|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
38. After an argument with her mother, an adolescent D. 12 months
female takes an overdose of Tylenol (acetaminophen).
The healthcare provider knows to watch for 44. In a 3-month-old infant you assess the Babinski
complications in which organ? Reflex. What is the appropriate response in an infant at
A. Kidney this age?
B. Pancreas A. The big toe plantar flexes and the other toes curl
C. Heart downward.
D. Liver B. All the toes curl downward
C. The big toe dorsiflexes and the other toes spread
39. The healthcare provider in a pediatric unit has outward.
received her assignments for the day. Which of the D. The big toe plantar flexes and the other toes fan
following patients should the healthcare provider outward.
assess first?
A. The 3-year-old with asthma, who has an oxygen 45. A newborn is diagnosed with truncus arteriosus.
saturation of 94% on room air. You're educating the parents about this heart defect.
B. The 6-year-old with bronchitis, with an intravenous Which statement by the mother demonstrates she
(IV) antibiotic infusing at 30 mL/hour. understood the education provided about this
C. The 17-year-old with a left pleural effusion, who is condition?
complaining of a chest pain of 9 on a 0-10 scale. A. "My baby has narrowing in the pulmonary artery,
D. The 11-year-old with pneumonia, who is awaiting and the aorta is arising out of the right ventricle
discharge instructions. rather than the left ventricle."
B. "My baby's heart shares one artery that connects the
40. A patient diagnosed with ulcerative colitis is right and left ventricles."
admitted to the medical unit. When a nurse is assessing C. "The left side of my baby's heart is not fully
the patient, which of these findings would be of the most developed."
concern? D. "The natural structure in my baby's heart, the ductus
A. bloody diarrhea arteriosus, has failed to close after birth leading to
B. rebound tenderness more blood flow to the lungs."
C. oral temperature of 99.0 F (37.2 C)
D. borborygmi 46. What other congenital heart defect is most
commonly present in truncus arteriosus?
41. Select the incorrect statement below regarding car A. Atrial septal defect
seat safety: B. Pulmonary stenosis
A. The parent should be educated about the C. Tetralogy of Fallot
importance of using parental locks for the doors and D. Ventricular septal defect
windows when children are riding in the car.
B. Rear-facing car seats are specifically to be used 47. The nurse is planning a staff in-service on childhood
only for children 2 years or less, and then the child spastic cerebral palsy. What characterizes spastic
should be advanced to a forward-facing restraint. cerebral palsy?
C. Children 12 and under should never ride in the front A. Hypertonicity and poor control of posture, balance,
seat of a car. and coordinated motion
D. If a child wears bulky clothes and uses a car seat B. Athetosis and dystonic movements.
restraint, it could decrease the effectiveness of the C. Wide-based gait and poor performance of rapid,
restraint. repetitive movements.
D. Tremors and lack of active movement
42. . During an assessment of an infant, you note that
when the infant's head is turned to the right side, the leg 48. The parents of a child with cerebral palsy ask the
and arm on the right side will extend, while the leg and nurse whether any drugs can decrease their child’s
arm on the left side will flex. You document this as what spasticity. The nurse’s response should be based on
type of reflex? which statement?
A. Rooting Refex A. Anticonvulsant medications are sometimes useful
B. Sucking Reflex for controlling spasticity.
C. Moro Reflex B. Medications that would be useful in reducing
D. Tonic Neck Reflex spasticity are too toxic for use with children.
C. Many different medications can be highly effective in
43. When does the sucking reflex in an infant disappear controlling spasticity.
and become voluntary? D. Implantation of a pump to deliver medication into the
A. 6 months intrathecal space to decrease spasticity has recently
B. 2 months become available.
C. 4 months
4|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
49. The nurse is preparing to admit a newborn with 55. The nurse is admitting a child with Wednig-Hoffman
myelomeningocele to the neonatal intensive care disease (spinal muscular atrophy type 1). Which signs
nursery. Which describes this newborn’s defect? and symptoms are associated with this disease?
A. Fissure in the spinal column that leaves the A. Spinal muscular atrophy
meninges and the spinal cord exposed. B. Neural atrophy of muscles
B. Herniation of the brain and meninges through a C. Progressive weakness and wasting of skeletal
defect in the skull. muscle
C. Hernial protrusion of a saclike cyst of meninges with D. Pseudohypertrophy of certain muscle groups
spinal fluid but no neural elements.
D. Visible defect with an external saclike protrusion 56. Which clinical manifestations in an infant would be
containing meninges, spinal fluid, and nerves. suggestive of spinal muscular atrophy (Werdnig-
Hoffman disease)?
50. The nurse is conducting a staff-in-service on A. Hyperactive deep tendon reflexes
common problems associated with myelomeningocele. B. Hypertonicity
Which common problem is associated with this defect? C. Lying in frog position
A. Hydrocephalus D. Motor deficits on one side of the body
B. Craniostenosis
C. Biliary atresia 57. A 4-year-old child has just been diagnosed with
D. Esophageal atresia psyudohypertrophic (Duchenne) muscular dystrophy.
The management plan should include which action?
51. The nurse is reviewing prenatal vitamin supplements A. Recommended genetic counseling
with an expectant client. Which supplement should be B. Explain that the disease is easily treated.
included in the teaching? C. Suggest ways to limit use of muscles.
A. Vitamin A throughout pregnancy D. Assist family in finding a nursing facility to provide
B. Multivitamin preparations as soon as pregnancy is child’s care.
suspected.
C. Folic acid for all women of childbearing age 58. What should be administered to a child with tetanus?
D. Folic acid during the first and second trimesters of A. Nonsteroidal antiinflammatory drugs (NSAIDs) to
pregnancy. reduce inflammation.
B. Muscle stimulants to counteract muscle weakness.
52. How much folic acid is recommended for women of C. Bronchodilators to prevent respiratory
childbearing age? complications.
A. 1.0 mg D. Tetanus immunoglobulin therapy.
B. 0.4 mg
C. 1.5 mg 59. The nurse is conducting reflex testing on infants at
D. 2.0 mg a well-child clinic. Which reflex finding should be
reported as abnormal and considered as a possible
53. The nurse is caring for a neonate born with a sign of cerebral palsy?
myelomeningocele. Surgery to repair the defect is A. Tonic neck reflex at 5 months of age
scheduled the next day. Which describes the most B. Absent Moro reflex at 8 months of age
appropriate way to position and feed this neonate? C. Moro reflex at 3 months of age
A. Prone and tube-fed D. Extensor reflex at 7 months of age
B. Prone, head turned to side, and nipple-fed
C. Supine in an infant carrier and nipple-fed 60. The nurse is caring for an infant with
D. Supine, with defect supported with rolled blankets, myelomeningocele scheduled for surgical closure in the
nipple-fed. morning. Which interventions should the nurse plan for
the care of the myelomeningocele sac?
54. The nurse is talking to a parent with a child who has A. open to air
a latex allergy. Which statement by the parent would B. Covered with a sterile, moist, non adherent dressing
indicate a correct understanding of the teaching? C. reinforcement of the original dressing if drainage
A. “My child will have an allergic reaction if he comes noted.
in contact with yeast.” D. A diaper secured over the dressing
B. “My child may have an upset stomach if he eats a
food made with wheat or barley.” 61. The nurse is admitting a school-age child with
C. “My child will probably develop an allergy to suspected Guillan-Barre syndrome (GBS). Which is a
peanuts.” priority in the care for this child?
D. “My child should not eat bananas or kiwis.” A. monitoring intake and output
B. Assessing respiratory efforts
C. Placing on a telemetry monitor
D. Obtaining laboratory studies
5|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
62. The nurse is caring for an intubated infant with C. Respiratory distress syndrome
botulism in the pediatric intensive care unit. Which D. Bacterial sepsis of the newborn
health care provider prescription should the nurse
clarify with the health care provider before 68. Which leading cause of death topic should the nurse
implementing? emphasize to a group of African-American boys ranging
A. Administer 250 mg botulism immune globulin in age from 15 to 19 years?
intravenously (BIG-IV) one time. A. Suicide
B. Provide total parenteral nutrition (TPN) at 25 m:/hr B. Cancer
intravenously. C. Firearm homicide
C. Titrate oxygen to keep pulse oximetry saturations D. Occupational injuries
greater than 92.
D. Administer gentamicin sulfate (Garamycin) 10 mg 69. Which is major cause of death for children older than
per intravenous piggyback. 1 year?
A. Cancer
63. A home care nurse is caring for an adolescent with B. Heart disease
a T1 spinal cord injury. The adolescent suddenly C. Unintentional injuries
becomes flushed, hypertensive, and diaphoretic. Which D. Congenital anomalies
intervention should the nurse perform first?
A. Place the adolescent in a flat right side-lying 70. Which is the leading cause of death from
position. unintentional injuries for females ranging in age from 1
B. Place a cool washcloth on the adolescent’s forehead to 14?
and continue to monitor the blood pressure. A. Mechanical suffocation
C. Implement a standing prescription to empty the B. Drowning
bladder with a sterile in and out Foley catheter. C. Motor vehicle-related fatalities
D. Take a full set of vital signs and notify the health care D. Fire and burn-related fatalities
provider. Answer: C. Motor vehicle-related fatalities
Rationale:
64. A child steps on a nail and sustains a puncture
wound of the foot. Which is the most appropriate 71. Which of the following would be inappropriate when
method for cleansing this wound? administering chemotherapy to a child?
A. Wash wound thoroughly with chlorhexidine. A. Monitoring the child for both general and specific
B. Wash wound thoroughly with povidone-iodine. adverse effects.
C. Soak foot in warm water and soap. B. Observing the child for 10 minutes to note for signs
D. Soak foot in solution of 50% of hydrogen peroxide of anaphylaxis.
and 50% water. C. Administering medication through a free flowing
intravenous line
65. A nurse is planning a teaching session for parents D. Assessing for signs of infusion infiltration and
of preschool children. Which statement explains why irritation
the nurse should include information about morbidity
and mortality? 72. Which of the following is the best method for
A. Life span statistics are included in the data. performing a physical examination on a toddler?
B. It explains effectiveness of treatment. A. From head to toe
C. Cost-effective treatment is detailed for the general B. Distally to proximally
population C. From abdomen to toes, then to head
D. High-risk age groups for certain disorders or D. From least to most intrusive
hazards are identified.
73. Which of the following organisms is responsible for
66. A clinic nurse is planning a teaching session about the development of rheumatic fever?
childhood obesity prevention for parents of school-age A. Streptococcal pneumonia
children. The nurse should include which associated B. Haemophilus influenza
risk of obesity in the teaching plan? C. Group A B-hemolytic streptococcus
A. Type I diabetes D. Staphylococcus aureus
B. Respiratory disease
C. Celiac disease 74. Which of the following is most likely associated with
D. Type II diabetes a cerebrovascular accident (CVA) resulting from
congenital heart disease?
67. Which is the leading cause of death in infants A. Polycythemia
younger than 1 year? B. Cardiomyopathy
A. Congenital anomalies C. Endocarditis
B. Sudden infant death syndrome D. Low blood pressure
6|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
75. How does the nurse appropriately administer D. The nurse should clear the area and position the
mycostatin suspension in an infant? client safely.
A. Have the infant drink water, and then administer
mycostatin in a syringe 82. At the community center, the nurse leads an
B. Place mycostatin on the nipple of the feeding bottle adolescent health information group, which often
and have the infant suck it. expands into other areas of discussion. She knows that
C. Mix mycostatin with formula these youths are trying to find out “who they are”, and
D. Swab mycostatin on the affected areas. discussion often focuses on which directions they want
to take in school and life, as well as peer relationships.
76. A mother tells the nurse that she is very worried According to Erikson, this stage is known as:
because her 2-year-old child does not finish his meals. A. Identity vs. role confusion
What should the nurse advise the mother? B. adolescent rebellion
A. Make the child sit with the family in the dining room C. career experimentation
until he finishes his meal. D. relationship testing
B. Provide quiet environment for the child before
meals. 83. The nurse is assessing a 9-month-old boy for a well-
C. Put the child on a chair and feed him. baby check up. Which of the following observations
would be of most concern?
77. The nurse is assessing a newborn who had A. The baby cannot say “mama” when he wants his
undergone vaginal delivery. Which of the following mother.
findings is least likely to be observed in a normal B. The mother has not given him finger foods.
newborn? C. The child does not sit unsupported.
A. uneven head shape D. The baby cries whenever the mother goes out.
B. respirations are irregular, abdominal, 30-60 bpm
C. (+) moro reflex 84. Cheska, the mother of an 11-month-old girl, KC, is in
D. heart rate is 80 bpm the clinic for her daughter’s immunizations. She
expresses concern to the nurse that Shannon cannot
78. Which of the following situations increase risk of yet walk. The nurse correctly replies that, according to
lead poisoning in children? the Denver Developmental Screen, the median age for
A. playing in the park with heavy traffic and with many walking is:
vehicles passing by A. 12 months
B. playing sand in the park B. 15 months
C. playing plastic balls with other children C. 10 months
D. playing with stuffed toys at home D. 14 months

79. An inborn error of metabolism that causes 85. Sally Kent., age 13, has had a lumbar puncture to
premature destruction of RBC? examine the CSF to determine if bacterial infection
A. G6PD exists. The best position to keep her in after the
B. Homocystinuria procedure is:
C. Phenylketonuria A. Prone for two hours to prevent aspiration, should
D. Celiac Disease she vomit.
B. Semi-fowler’s so she can watch TV for five hours
80. Which of the following blood study results would the and be entertained.
nurse expect as most likely when caring for the child C. Supine for several hours, to prevent headache.
with iron deficiency anemia? D. On her right side to encourage return of CSF.
A. Increased hemoglobin
B. Normal hematocrit 86. Buck’s traction with a 10 lb. weight is securing a
C. Decreased mean corpuscular volume (MCV) patient’s leg while she is waiting for surgery to repair a
D. Normal total iron-binding capacity (TIBC) hip fracture. It is important to check circulation-
sensation movement:
81. The nurse answers a call bell and finds a frightened A. every shift
mother whose child, the patient, is having a seizure. B. every day
Which of these actions should the nurse take? C. every four hours
A. The nurse should insert a padded tongue blade in D. every 15 minutes
the patient’s mouth to prevent the child from
swallowing or choking on his tongue. 87. Carol Smith is using bronchodilators for asthma. The
B. The nurse should help the mother restrain the child side effects of these drugs that you need to monitor this
to prevent him from injuring himself. patient for include:
C. The nurse should call the operator to page for A. tachycardia, nausea, vomiting, heart palpitations,
seizure assistance. inability to sleep, restlessness, and seizures.
7|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
B. tachycardia, headache, dyspnea, temp. 101 F, and 94. Which of the following is the most common problem
wheezing. in infants when it comes to their gastrointestinal
C. blurred vision, tachycardia, hypertension, problem?
headache, insomnia, and oliguria. A. Achalasia
D. restlessness, insomnia, blurred vision, B. Gastric ulcer
hypertension, chest pain, and muscle weakness. C. Intussusceptions
D. None of the above
88. The adolescent patient has symptoms of meningitis:
nuchal rigidity, fever, vomiting, and lethargy. The nurse 95. Which of the following effective nursing intervention
knows to prepare for the following test: in order to prevent the occurrence of Gastroesophageal
A. blood culture reflux?
B. throat and ear culture A. Giving solid foods
C. CAT scan B. Giving frequent small feedings
D. lumbar puncture C. Giving semi-solid foods
D. Giving osterized feeding
89. The nurse is drawing blood from the diabetic patient
for a glycosolated hemoglobin test. She explains to the 96. The following are signs and symptoms of asthma
woman that the test is used to determine: except:
A. the highest glucose level in the past week. A. Fatigue
B. her insulin level. B. Yellowish skin
C. glucose levels over the past several months. C. Moist skin
D. her usual fasting glucose level. D. Use of accessory muscles.

90. The twelve-year-old boy has fractured his arm 97. A mother would like to know the reason why there is
because of a fall from his bike. After the injury has been asthma in her child. How would you explain it?
casted, the nurse knows that it is most important to A. An asthma attack is a response to the release of
perform all of the following assessments on the area inflammatory mediators to epithelial cells. The
distal to the injury except: autonomic neural control of the airway is affected.
A. capillary refill B. An asthma attack can happen when the child is
B. radial and ulnar pulse exposed to certain allergens that would trigger an
C. finger movement allergic reaction to the bronchioles causing
D. skin integrity constriction of the bronchial tree. This is either
acquired or being hereditary.
91. You have to teach the mother a proper way of C. An asthma attack is an inborn problem of a child that
providing nutrition to the child. The following are correct involves abnormal growth of the bronchial tree
steps except: causing restriction.
A. Use rubber nipples with a small opening in order to D. All of the above
prevent aspiration
B. Place the child in a semi-upright position when 98. According to the National Asthma Education, mild
feeding intermittent asthma is occurring when the symptoms
C. Feeding session should be done slowly are:
D. Teach the mother to stimulate the sucking reflex by A. Symptoms can happen twice a week
rubbing the nipple against the lower lip of the baby. B. Symptoms can happen more than twice a week
C. There is no symptom only a sudden attack
92. You were asked by the mother when is the best time D. Symptoms can happen continuously in a week
for surgical intervention for a cleft palate?
A. one to three months old 99. In the ER department, a child was rushed due to
B. four to seven months old difficulty breathing due to an asthma attack. What is the
C. eight to eleven months old least nursing action?
D. six to eighteen months old A. Provide health teaching to the family
B. Check for airway patency
93. A child has been recovering from an operation on C. Request for Chest X-ray STAT
the cleft lip. What is your priority nursing care? D. Give hydrocortisone STAT
A. Bleeding tendency
B. Wound care 100. These are common irritants that would start an
C. Airway patency asthma attack, except:
D. Risk for Infection A. Psychological stress
B. Fast and binge eating
C. Environmental factors such as air pollution and
smoke
8|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
D. Dust mites 1. Correct Answer: A.
➢ To prevent aspiration of stomach contents, the
101. The nurse is caring for a child with a documented nurse should place the client in semi-Fowler’s
history of conduct disorder. Which behavior can the position.
nurse expect to observe?
A. Needing to arrange objects 2. Correct Answer: B
B. Excessive worry about parents ➢ Fresh fruits and vegetables harbor microorganisms,
C. Harmful aggression to others which can cause infections in immune-compromised
D. Being defiant with adults children. Fruits and vegetables should either be
peeled or cooked. The physician should be notified
102. The nurse is teaching a group of nursing students of a temperature above 100F. A diet low in protein
about newborns born with the congenital defect of is not indicated, and humidifiers harbor fungi in the
myelomeningocele. Which common problem is water containers.
associated with this defect?
A. Neurogenic bladder 3. Correct Answer: B
B. Cognitive impairment ➢ With pediatric clients, fluid volume replacement is
C. Respiratory compromise always calculated using the child’s weight, to avoid
D. Cranioschisis fluid overload. Initial fluid bolus of an isotonic
crystalloid is 20 mL/kg, followed by another 20
mL/kg if required.
4. Correct Answer: A
➢ NS is a condition where the kidneys leak protein
from the blood into the urine. When untreated,
children can often die from infections. Most children
with INS respond to corticosteroid drugs
(prednisone, prednisolone). Corticosteroid
treatment is often prescribed for children 1-12 years
of age, when a kidney biopsy is not indicated.
Criteria for corticosteroid therapy include: 1. Normal
kidney function; 2. No gross (macroscopic)
hematuria; 3. No symptoms of infection of systemic
disease; 4. Negative antinuclear antibody (ANA)
assay; 5. Negative viral screens (i.e., for human
immunodeficiency virus [HIV], hepatitis B and C
viruses); 6. No family history of kidney disease.
While corticosteroids can reduce inflammation, that
is not why they are prescribed for NS. They can
actually increase the risk of infection, as well as
cause irritation and mood swings.

5. Correct Answer: D
➢ Signs of dehydration include Fever, increased heart
rate, increased respiratory rate, and decreased
blood pressure. Infants will seem listless or sleepy.
The kidneys conserve water to minimize fluid loss,
resulting in concentrated urine and high specific
gravity.

6. Correct Answer: D
➢ In a normal heart, the aorta comes from the left side
of the heart, and the pulmonary artery comes from
the right side. In Transposition of the Great Arteries
(also called Transposition of the Great Vessels),
these arteries come from the opposite sides of the
heart. In most cases of transposition, an arterial
switch operation is performed. The arterial switch
operation involves cutting off the aorta and
pulmonary arteries just above the point where they
leave the heart, and reconnecting them to the proper
ventricle. The valve stays attached to the ventricle,
9|Page I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
so what was once the pulmonary valve is now the prolonged undernutrition. Up to 80% of children with
aortic valve and vice versa. Subclavian flap is one of growth failure do not have an apparent growth-
the surgical methods for Coarctation of the Arteries. inhibiting (organic) disorder; growth failure occurs
Pulmonary artery banding is performed to decrease because of environmental neglect (eg, lack of food),
pulmonary artery pressure and excess pulmonary stimulus deprivation, or both. FTT is defined as
blood flow. Surgical ligation is performed to treat decelerated or arrested physical growth (height and
Patent Ductus Arteriosus. weight measurements fall below the third or fifth
percentile, or a downward change in growth across
7. Correct Answer: D two major growth percentiles).
➢ According to the CDC, For all intramuscular
injections, the needle should be long enough to 10. Correct Answer: C
reach the muscle mass and prevent vaccine from ➢ Stress can cause a child to experience temporary
seeping into subcutaneous tissue, but not so long as regression in toilet-training. New situations, such as
to involve underlying nerves, blood vessels, or bone. a new daycare environment, a new baby, or parental
The needle gauge for intramuscular injection is 22- discord can cause stress and regression. Other
25 gauge. For most infants (0-12 months) the causes for accidents include being too distracted to
anterolateral aspect of the thigh is the use the toilet, waiting too long before going,
recommended site, with a 1-inch needle. For constipation, or a possible urinary tract infection.
toddlers (12-24 months) the anterolateral thigh Different schedule and foods should not cause
muscle is preferred, and when this site is used, the wetting accidents. Intentional wetting is rare. Type 1
needle should be at least 1 inch long. The deltoid diabetes has other signs, such as constant hunger
muscle can be used if the muscle mass is adequate. and thirst, accompanied by weight loss.
If 2 vaccines are to be administered in a single limb,
they should be spaced an inch apart. The deltoid 11. Correct Answer: B
muscle is preferred for children aged 3-10 years ➢ Type 1 diabetes (formerly called juvenile diabetes or
(21); the needle length for deltoid site injections can insulin-dependent diabetes) is a chronic condition in
range from ⅝ to 1 inch on the basis of technique. which the pancreas produces little or no insulin.
The anterolateral thigh can also be used (23). In this There is no cure. Insulin is a hormone required to
case the needle length should be 1 inch to 1.25 transport glucose into cells. Clients with type 1
inches. For adolescents aged 11-18, The deltoid diabetes must monitor their blood glucose and
muscle is preferred. The anterolateral thigh can also administer insulin daily in order to stay alive. Oral
be used. For injection into the anterolateral thigh, medications are prescribed for type 2 diabetes
most adolescents will require a 1-1.5-inch needle to (formerly called adult-onset) to stimulate insulin
ensure intramuscular administration. The gluteal production or help control glucose levels.
muscle should not be used for routine vaccinations.
Subcutaneous is not an intramuscular site. 12. Correct Answer: A
➢ Adults with MDD express emotional pain, while
8. Correct Answer: B adolescents report more physical pain, such as
➢ The spaces between the bones that remain open in headaches, stomachaches, or general malaise.
babies and young children are called fontanelles Adults feel sad, while teens become irritable,
(also spelled fontanels). Colloquially, they are called impatient, and defiant. Adults may withdraw, while
"soft spots." These spaces are a part of normal adolescents tend to keep a few close friends,
development. The anterior fontanelle (on the top of change peer groups or shift their focus to online
the middle of the head) closes between 9 to 18 activities. In a comparative study published in 2018,
months. The posterior fontanelle (In the middle of Vegetative symptoms (appetite and weight change,
the back of the head) closes at 1 to 2 months, loss of energy and insomnia) were more common in
although it can also be closed at birth. All cranial adolescent MDD than adult MDD. Anhedonia/loss of
bones remain separate for about 12 to 18 months. interest and concentration problems were more
They then grow together as part of normal growth. common in adults with MDD.
They stay connected throughout adulthood.
13. Correct Answer: A
9. Correct Answer: B ➢ Pyloric stenosis occurs most often in babies under
➢ The underlying cause for non-organic Failure to six months. In this condition, the pylorus muscles
Thrive (FTT) is inadequate nutrition. According to block food from entering the small intestine. It occurs
the Merck Professional Manual, weight is the most more often in males. The most common symptom
sensitive indicator of nutritional status. When FTT is noted in a baby with pyloric stenosis is forceful,
due to inadequate caloric intake, weight falls from projectile vomiting. It can lead to dehydration and
the baseline percentile before length (height) does. weight loss. Babies with this condition may seem to
Reduced linear growth usually indicates severe, always be hungry. the other options are incorrect.
10 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
Steatorrhea (fatty stools) is the excretion of child's mouth, and the remaining half on the other
abnormal quantities of fat with the feces owing to side. Next, the child should swish the suspension
reduced absorption of fat by the intestine; it is around their entire mouth, keeping the liquid inside
indicative of celiac disease. Intussusception is as long as possible before swallowing. Nystatin is
characterized by "currant jelly" stools. Regurgitation given following food; no food or fluid should be taken
is indicative of gastroesophageal reflux. for 30 minutes after administration. Nystatin is not
an antibiotic, but in a class of antifungal medications
14. Correct Answer: C called polyenes. Medications should not be mixed
➢ Intestinal obstruction. Although intussusception can with food or formula.
occur anywhere in the gastrointestinal tract, it
generally occurs at the junction of the small and 18. Correct Answer: D
large intestines. It occurs most commonly between ➢ Bedwetting in a child who previously stayed dry all
the ages of 3 and 36 months, but may appear at any might can be an early sign of type 1 diabetes. Other
age. It occurs most frequently in the fall and winter signs and symptoms may include passing large
months during viral season, and often about a week amounts of urine at once, increased thirst, fatigue
after a viral illness, such as a cold or the flu. The and weight loss in spite of a good appetite. The
main symptom of intussusception is loud crying from amount of exercise or sugary foods do not cause
severe, crampy abdominal pain lasting 10-15 diabetes. The child is still being evaluated, so it is
minute, alternating with periods of no pain. It is too soon for education.
considered a life-threatening emergency and
requires immediate intervention. 19. Correct Answer: B
➢ Kawasaki syndrome (also called Kawasaki disease)
15. Correct Answer: D is a cardiac condition found in young children; low-
➢ The Pavlik harness is a soft splint. It is most set ears are not part of the syndrome. Low-set ears
commonly used for treating infants with and pinna abnormalities refer to an abnormal shape
developmental dysplasia of the hip (DDH). It keeps or position of the outer ear (pinna or auricle). Turner
the infant's hips and knees bent, with the thighs syndrome is a rare genetic condition in which a
spread apart. It can also help promote healing in female does not have the usual pair of X
babies with fractured femurs. In the majority of chromosomes. Noonan syndrome is characterized
cases, the harness is worn 24 hours a day for 8–12 by mildly unusual facial features including low-set
weeks. DDH occurs when the ball-and-socket hip ears, short stature, heart defects, bleeding
joint does not form normally. The socket is a cup- problems, skeletal malformations, and other signs
shaped structure in the pelvis called the acetabulum. and symptoms. In Potter syndrome, the primary
The ball, or head, is the rounded upper end of the problem is kidney failure. The kidneys fail to develop
femur. In DDH, the acetabulum is shallower than properly as the baby is growing in the womb. The
normal. As a result, the head of the femur does not kidneys normally produce the amniotic fluid (as
fit into it well. The femoral head may slide partially urine).
out of the socket (sublux). A spica cast is sometimes
used for babies 6-18 months. Open reduction 20. Correct Answer: A
treatment happens between 18 months-6 years. ➢ Although SIDS can occur anytime between the ages
Buck's skin traction is used for femoral fractures. of 1 week and 1 year, the peak is 1-4 months, with
90% occurring before 6 months. According to the
16. Correct Answer: B CDC, only 35 in 100,000 babies are affected by
➢ Russell's sign is the development of calluses on the SIDS; before the early 1990s "Back to Sleep"
knuckles or back of the hand, caused by repeated campaign, the rate was 130 per 100,000 infants .
self-induced vomiting. The calluses are the result of Infants learn to roll over at about 3-5 months.
knuckles making contact with the client's incisor
teeth while inducing the gag reflex. Russell's sign is 21. Correct Answer: D
primarily found on clients with eating disorders, such ➢ While there is no way to completely prevent sickle
as bulimia nervosa or anorexia nervosa. The other cell crises, helpful measures include: 1. Avoid
responses are incorrect. temperature extremes; 2. Get enough oxygen; 3.
Drink plenty of fluids; 4. Treat infections promptly.
17. Correct Answer: A Opioids may be necessary to manage the pain of
➢ Oral Candida (also called thrush) is a fungal SCD. Anticoagulant therapy does not prevent
infection in the mouth. Nystatin suspension is used sickling.
to treat fungal infections of the inside of the mouth.
A tablet (lozenge, troche, or pastille) may be used 22. Correct Answer: B
for children who are older than 5 years. The nurse ➢ At about 7-8 months, a baby will begin to have the
should place half the total dose on one side of the dexterity to pick food up, release or mash it. They
11 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
will also will become more efficient and independent the neck and remove eyeglasses; 6. Time the
as they master the pincer grip around 9 months. seizure. Call 911 if it lasts longer than five minutes
Finger foods to introduce include cereal, scrambled
eggs, small pieces of pasta or bread; finely chopped 26. Correct Answer: B
soft vegetables; and fruits like bananas, avocado, ➢ Sexually transmitted infections (STI) are also called
and ripe peaches or nectarines. The nurse should sexually transmitted diseases (STD). The CDC
instruct the parents to avoid round, firm foods like estimates that youth ages 15-24 account for almost
carrots, grapes, and hot dogs and skip anything like half of the new sexually transmitted infections each
raw veggies and peanuts. Raisins and popcorn are year. Hepatitis B vaccine is administered at birth, 1-
dangerous for babies. 4 months, and 6-18 months. Older children and
adolescents receive an initial dose, a second dose
23. Correct Answer: A 1 month later, then a third dose at 6 months.
➢ Initiation of IO access is indicated in adults, children, Hepatitis A spread when a person unknowingly
infants, or newborns in any clinical situation where ingests the virus from objects, food, or drinks that
vascular access is emergently needed but not are contaminated by small amounts of fecal matter
immediately available via a peripheral vein. The from an infected person or source. Chlamydia and
intraosseous infusion technique uses the medullary gonorrhea do not have vaccines.
cavity in the tibia as a "non collapsible vein" for
parenteral infusion. It is indicated in a child in shock 27. Correct Answer: D
or cardiac arrest when two attempts to access ➢ Avoid causing the young child to be afraid of sleep
peripheral vasculature have failed or when more (going to bed, taking a nap) after a procedure.
than 2 minutes have elapsed in the attempt to gain Explain that they will have a "special kind of sleep,"
access. Intraosseous (IO) access has been used that is different from what they know. "Put to sleep"
therapeutically since 1934 and has been proved to is a phrase often used with pets, so should not be
be a safe, reliable, and rapid means of introducing used. Being anxious or frightened is normal, so don't
crystalloids, colloids, medications, and blood dismiss these feelings.
products into the systemic circulation. IO needle
placement is not an ultimate therapy; it allows 28. Correct Answer: C
administration of life-saving medications, fluids, and ➢ Infant Mortality Rate is an indicator calculated by the
blood when intravascular access is vital. IO needles number of infant (under one year of age) deaths per
may be left in place in bone marrow for up to 72-96 1,000 live births in any given year. The formula is the
hours. number of deaths in the first year of life divided by
the number of live births, multiplied by 1000. The
24. Correct Answer: C World Health Organization (WHO) states, "Infant
➢ Glomerulonephritis (GN) may develop a week or two mortality rate is the probability of a child born in a
after recovery from a strep throat infection. specific year...dying before reaching the age of
Poststreptococcal GN causes the tiny blood vessels one."
in the filtering units of the kidneys (glomeruli) to
become inflamed. This makes the kidneys less able 29. Correct Answer: B
to filter the urine. Children ages 6-10 are more likely ➢ A blended family (sometimes called a step family)
to develop post-streptococcal glomerulonephritis consists of married parents with a child or children
than are adults, and they also have >90% full from a previous relationship. A nuclear family
recovery rate. Increased urine output is an early sign (traditional family) includes parents and biological or
of kidney recovery. The other options are general adopted children. An extended family (also called a
signs of improvement, not specific to multi-generational family) contains at least one
glomerulonephritis. parent and child, as well as any of the following:
grandparents, aunts, uncles, or cousins. Members
25. Correct Answer: D of an extended family may be related by blood or
➢ Restraining or holding a child down during a seizure marriage. A cohabitation family is similar to a
is not an appropriate action. It can make the child blended family, but the parents are not married.
uncomfortable and does not stop the seizure. Also, 30. Correct Answer: D
do not put anything in the child's mouth. This can ➢ Live, attenuated vaccines contain weakened
injure teeth or the jaw. A child having a seizure microorganisms that stimulate the immune
cannot swallow their tongue. According to the CDC, response and production of antibodies. They
the following actions are appropriate: 1. Ease the provide 90-95% protection for more than 20 years.
child to the floor; 2. Turn the child gently to one side; Measles, mumps, rubella (MMR), rotavirus, and
3. Clear the area of anything hard or sharp; 4. Place varicella are live, attenuated vaccines. Inactivated
something small and flat (pillow, folded jacket, etc.) (killed) vaccines provide a weaker response, and
under the child's head; 5. Loosen clothing around require booster immunizations. Examples of
12 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
inactivated vaccines include diphtheria and tetanus membrane, surgery will be performed within 24 to 48
toxoids, inactivated poliovirus, pertussis, and hours after birth. This is to prevent infection. If
hepatitis B. hydrocephalus is present, a VP shunt may be
placed, but this is not the primary reason for surgery.
31. Correct Answer: D Seizures are not prevented by surgery. The neural
➢ With coarctation of the aorta (CoA) in children, the defect cannot be corrected.
portion of the aorta just after the upper-body arteries
branch off is too narrow, restricting blood flow to the 35. Correct Answer: A
lower body. High blood pressure can develop. ➢ Preschoolers (ages 3-5) have active imaginations
Cyanosis is typical of transposition of the great and are learning to pretend. However, they can't
vessels. A squatting position is seen with Tetralogy always tell what is real and what is not. The scary
of Fallot. Sweating while eating or crying is seen with monsters they imagine seem real. Preschoolers
Patent Ductus Arteriosus. may also fear the dark, large animals, and loud
noises, such as thunder. Infants (Birth-1 year) can
32. Correct Answer: C fear strangers, as well as loud noises. Toddlers (1-2
➢ School-age children are curious and interested in years) can have separation anxiety and people in
learning, so they are receptive to teaching about costumes. School-age children fear real-life
their surgery. However, they do have concerns and dangers, such as "bad guys," natural disasters, or
fears: 1. Surgery may change their appearance and getting sick
make them "different" from their friends; 2. Surgery
may damage their body; 3. They want to appear 36. Correct Answer: B
grown-up, so they may hesitate talking about their ➢ Mumps do not cause a rash. The most common
fears; 4. They may wake up during the surgical symptom of infection is a painful swelling of the
procedure; 5. They may say or do embarrassing parotid glands, called parotitis. Fifth disease causes
things. Infants and toddlers are most fearful of being a red rash on the arms, legs, and cheeks. it’s also
separated from their parents. Preschoolers may known as “slapped cheek disease.” Rubella, also
associate surgery or medical procedures as called German measles, produces a red rash on the
punishment for "bad behavior." Adolescents are entire body. Rubeola (Measles) first produces Koplik
more likely to want to discuss procedures or their spots, then flat, red spots that spread from the
illness without parents around. hairline down to the feet.

33. Correct Answer: A 37. Correct Answer: D

➢ Post-operatively, the infant is placed on the ➢ This patient has respiratory acidosis. These are the
unoperative side in either a flat position or on the normal ranges for arterial blood gases (ABGs): pH,
back with head elevated at a slight (15-30 degree) 7.35–7.45; PaCO2, 35–45 mmHg; HCO3, 22–26
angle. Raising the head too high can cause rapid mEq/L. The increased acid has a depressant effect
CSF drainage, resulting in a subdural hematoma. on the central nervous system, causing
Post-operative care of an infant or child with VP disorientation. The increased carbon dioxide also
placement includes: 1. Observing for decreased causes vasodilation of the cerebral and peripheral
LOC and vomiting; 2. Monitoring for signs of shunt vasculature, causing headache and facial flushing.
infection; 3. Observing for abdominal distention or Other signs of respiratory acidosis include lethargy
discomfort related to paralytic ileus or peritonitis; and shortness of breath.
and 4. Measuring head circumference daily and
reporting an increase of more than 0.5 cm to the 38. Correct Answer: D
health care provider. ➢ The liver is the primary site for acetaminophen
metabolism. The drug undergoes sulphation
34. Correct Answer: D (binding to sulphate molecules) and glucuronidation
➢ Myelomeningocele is a neural tube defect and (binding to glucuronide molecules) before it is
severe form of spina bifida, in which the spinal cord eliminated from the body. An overdose stresses the
and nerves develop outside of the body and are glucuronidation process, forcing the drug to be
contained in a fluid-filled sac that is visible outside of passed to another pathway (cytochrome P450),
the back area. These babies typically have which forms a toxic metabolite called NAPQI. As
weakness and loss of sensation below the sac. It is NAPQI accumulates, it causes liver damage and
diagnosed with prenatal blood work, amniocentesis, possible liver failure.
physical exam, ultrasound, and MRI. Surgical repair
is performed after birth; sometimes, Intrauterine 39. Correct Answer: C
surgery can close the defect. After birth, the defect ➢ The patient with a pleural effusion and chest pain is
is covered by a sterile dressing. If the the priority. The patient is demonstrating an actual
myelomeningocele is not covered by skin or a problem that requires immediate assessment and
13 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
intervention. Though asthma and bronchitis are right and left ventricles and enter the truncus artery.
potential airway and breathing issues, the patients It is very uncommon for one not to be present.
are stable.
47. Correct Answer: A
40. Correct Answer: B ➢ Hypertonicity and poor control of posture, balance,
➢ Rebound tenderness is a sign of peritonitis that and coordinated motion are part of the classification
could be the result of rupture of the colon. It is a of spastic cerebral palsy. Athelosis and dystonic
clinical sign that occurs during physical examination, movements are part of the classification of
referring to pain upon removal of pressure, not dyskinetic (athetoid) cerebral palsy. Wide-based
during application of pressure. Bloody diarrhea is a gait and poor performance of rapid, repetitive
common finding because of bleeding lesions and movements are part of the classification of ataxic
anal excoriation. A temperature of 99.0 °F (37.2 °C) cerebral palsy. Tremors and lack of active
is within the normal range, and chronic inflammation movement may indicate other neurologic disorders.
may keep temperatures within the high normal
range or above. Borborygmi are the sounds made 48. Correct Answer: D
by air or fluids moving through the intestines. ➢ Baclofen, given intrathecally, is best suited for
children with severe spasticity that interferes with
41. Correct Answer: B activities of daily living and ambulation.
➢ All the other options are true. Option B is false Anticonvulsant medications are used when seizures
because new guidelines set by the AAP (in 2018) occur in children with cerebral palsy. The intrathecal
states that children should continue to use a rear- route decreases the side effects of the drugs that
facing restraint until they outgrow it. This typically is reduce spasticity. Few medications are currently
until about 4 years of age. In 2018, the AAP available for the control of spasticity.
removed the age criteria of 2 years of age and
recommends a child uses a rear-facing restraint 49. Correct Answer: D
longer. ➢ A myelomeningocele is a visible defect with an
external saclike protrusion, containing meninges,
42. Correct Answer: D spinal fluid, and nerves. Rachischisis is a fissure in
➢ When the infant’s head is turned to a particular side, the spinal column that leaves the meninges and the
the leg and arm on that side will extend, while the spinal cord exposed. Encephalocele is a herniation
leg and arm on the opposite side will flex. of brain and meninges through a defect in the skull,
producing a fluid-filled sac. Meningocele is a hernial
43. Correct Answer: C protrusion of a saclike cyst of meninges with spinal
➢ The sucking reflex in an infant will disappear and fluid, but not neural elements.
become a voluntary function at about 4 months of
age. 50. Correct Answer: A
➢ Hydrocephalus is a frequently associated anomaly
44. Correct Answer: C in 80% to 90% of children. Craniostenosis is the
➢ The Babinski Reflex should disappear around 1 year preterm closing of the cranial sutures and is not
of age, However, in an infant this age, the big toe associated with myelomeningocele. Biliary and
should dorsiflex (bend back) and the other toes esophageal atresia is not associated with
spread outward. myelomeningocele.

45. Correct Answer: B 51. Correct Answer: C

Truncus arteriosus is a congenital heart defect where there ➢ The widespread use of folic acid among women of
is ONE artery along with one truncal valve that connects the childbearing age has decreased the incidence of
right and left ventricles. This structure will function to carry spina bifida significantly
blood to both the lungs and body. In a normal heart, there 52. Correct Answer: B
should be TWO separate arteries (pulmonary artery and ➢ It has been estimated that a daily intake of 0.4 mg of
aorta) with their own valves (instead of one truncal valve). folic acid in women of childbearing age will prevent
The pulmonary artery will carry blood from the right side of 50% to 70% of cases of neural tube defects; 1.0 mg
the heart to the lungs, and the aorta will carry blood from the is too low a dose; 1.5 to 2.0 mg are not the
left side of the heart to the body. recommended dosages of folic acid.

46. Correct Answer: D 53. Correct Answer: B

➢ A ventricular septal defect (VSD) is commonly ➢ In the prone position, feeding is a problem. The
present in this CHD. The VSD will be near the infant’s head is turned to one side for feeding. If the
truncus arteriosus and it will allow blood to mix in the child is able to nipple-feed, tube feeding is not
needed. Before surgery, the infant is kept in a prone
14 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
position to minimize tension on the sac and risk of for reflex excitability. NSAIDs are not routinely used.
trauma. Sedatives or muscle relaxants are used to help
reduce titanic spasm and prevent seizures.
54. Correct Answer: D Respiratory status is carefully evaluated for an signs
There are cross-reactions between latex allergies and a of distress because muscle relaxants, opioids, and
number of foods such as bananas, avocados, kiwi, and sedatives may be prescribed may cause respiratory
chestnuts. Children with a latex allergy will not develop depression. Bronchodilators would not be used
allergies to other food products such as yeast, wheat, barley, unless specifically indicated.
or peanuts.
59. Correct Answer: D
55. Correct Answer: C ➢ Establishing a diagnosis of cerebral palsy may be
➢ Werdnig-Hoffman disease (spinal muscular atrophy confirmed with the persistence of primitive reflexes:
type 1) is the most common paralytic form of floppy (1) either the asymmetric tonic neck reflex or
infant syndrome (congenital hypotonia). It is persistent Moro reflex (beyond 4 months of age) and
characterized by progressive weakness and wasting (2) the crossed extensor reflex. The tonic neck reflex
of skeletal muscle caused by degeneration of normally disappears between 4 and 6 months of
anterior horn cells. Kugelberg-Welander disease is age. The crossed extensor reflex, which normally
a juvenile spinal muscular atrophy with a later onset. disappears by 4 months, is elicited by applying a
Charcot-Marie-Tooth disease is a form of noxious stimulus to the sole of one foot with the knee
progressive neural atrophy of muscles supplied by extended. Normally, the contralateral foot responds
the peroneal nerves. Progressive weakness is found with extensor, abduction, and then adduction
on the distal muscles of the arms and feet. movements. The possibility of CP is suggested if
Duchenne muscular dystrophy is characterized by there reflexes occur after 4 months.
muscles, especially in the calves, thighs, and upper
arms, which become enlarged from fatty infiltration 60. Correct Answer: B
and feel unusually firm or woody on palpation. The ➢ Before the surgical closure, the myelomeningocele
term pseudohypertrophy is derived from this is prevented from drying by the application of a
muscular enlargement. sterile, moist, non adherent dressing over the defect.
The moistening solution is usually sterile normal
56. Correct Answer: C saline. Dressings are changed frequently (every 2 to
➢ The infant lies in the frog position with the legs 4 hours), and the sac is closely inspected for leaks,
externally rotated, abducted, and flexed at the abrasions, irritation, and any signs of infection. The
knees. The deep tendon reflexes are absent. The sac must be carefully cleansed if it becomes soiled
child has hypotonia and inactivity as the most or contaminated. The original dressing would not be
prominent features. The motor deficits are bilateral. reinforced but changed as needed. A diaper is not
placed over the dressing because stool
57. Correct Answer: A contamination can occur.
➢ Pseudohypertrophic (Duchene) muscular dystrophy
is inherited as an X-linked recessive gene. Genetic 61. Correct Answer: B
counseling is recommended for parents, female ➢ Treatment of GBS is primarily supportive. In the
siblings, maternal aunts, and their female offspring. acute phase, patients are hospitalized because
No effective treatment exists at this time for respiratory and pharyngeal involvement may require
childhood muscular dystrophy. Maintaining optimal assisted ventilation, sometimes with a temporary
function of all muscles for as long as possible is the tracheostomy. Treatment modalities include
primary goal. It has been found that children who aggressive ventilatory support in the event of
remain as active as possible are able to avoid respiratory compromise, intravenous (IV)
wheelchair confinement for a longer time. Assisting administration of immunoglobulin (IVIG), and
the family in finding a nursing facility to provide the sometimes steroids; plasmapheresis and
child's care is inappropriate at the time of diagnosis. immunosuppressive drugs may also be used. Intake
When the child becomes increasingly incapacitated, and output, telemetry monitoring, and obtaining
the family may consider home-based care, a skilled laboratory studies may be part of the plan of care but
nursing facility, or respite care to provide the are not the priority.
necessary care.
62. Correct Answer: D
58. Correct Answer: D ➢ The nurse should clarify the administration of an
➢ Tetanus immunoglobulin therapy, to neutralize aminoglycoside antibiotic. Antibiotic therapy is not
toxins, is the most specific therapy for tetanus. part of the management of infant botulism because
Tetanus toxin acts at the myoneural junction to the botulism toxin is an intracellular molecule, and
produce muscular stiffness and lowers the threshold antibiotics would not be effective; aminoglycosides
15 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
in particular should not be administered because with obesity, and celiac disease is the inability to
they may potentiate the blocking effect of the metabolize gluten in foods and is not associated with
neurotoxin. Treatment consists of immediate obesity.
administration of botulism immune globulin
intravenously (BIG-IV) without delay for laboratory 67. Correct Answer: A
diagnosis. Early administration of BIG-IV neutralizes ➢ Congenital anomalies account for 20.1% of deaths
the toxin and stops the progression of the disease. in infants younger than 1 year. Sudden infant death
The human-derived botulism antitoxin (BIG-IV) has syndrome accounts for 8.2% of deaths in this age
been evaluated and is not available nationwide for group. Respiratory distress syndrome accounts for
use only in infant botulism. Approximately 50% of 3.4% of deaths in this age group. Infections specific
affected infants require intubation and mechanical to the perinatal period account for 2.7% of deaths in
ventilation; therefore, respiratory support is crucial, this age group.
as is nutritional support, because these infants are
unable to feed. 68. Correct Answer: C
➢ Firearm homicide is the second overall cause of
63. Correct Answer: C death in this age group and the leading cause of
➢ The adolescent is experiencing an autonomic death in African-American males. Suicide is the
dysreflexia episode. The paralytic nature of third-leading cause of death in this population.
autonomic function is replaced by autonomic Cancer, although a major health problem, is the
dysreflexia, especially when the lesions are above fourth-leading cause of death in this age group.
the mid-thoracic level. This autonomic phenomenon Occupational injuries do not contribute to a
is caused by visceral distention or irritation, significant death rate for this age group.
particularly of the bowel or bladder. Sensory
impulses are triggered and travel to the cord lesion, 69. Correct Answer: C
where they are blocked, which causes activation of ➢ Unintentional injuries (accidents) are the leading
sympathetic reflex action with disturbed central cause of death after age 1 year through
inhibitory control. Excessive sympathetic activity is adolescence. Congenital anomalies are the leading
manifested by a flushing face, sweating forehead, cause of death in those younger than 1 year. Cancer
pupillary constriction, marked hypertension, ranks either second or fourth, depending on the age
headache, and bradycardia. The precipitating group, and heart disease ranks fifth in the majority
stimulus may be merely a full bladder or rectum or of the age groups.
other internal or external sensory input. It can be a
catastrophic event unless the irritation is relieved. 70. Correct Answer: C
Placing a cool washcloth on the adolescent’s ➢ Motor vehicle–related fatalities are the leading
forehead, continuing to monitor blood pressure and cause of death for females ranging in age from 1 to
vital signs, and notifying the health care provider 14, either as passengers or as pedestrians.
would not reverse the sympathetic reflex situation. Mechanical suffocation is fourth or fifth, depending
on the age. Drowning is the second- or third-leading
64. Correct Answer: C cause of death, depending on the age. Fire- and
➢ Puncture wounds should be cleansed by soaking burn-related fatalities are the second-leading cause
the foot in warm water and soap. Chlorhexidine, of death.
hydrogen peroxide, and povidone-iodine should not
be used because they have a cytotoxic effect on 71. Correct Answer: B
healthy cells and minimal effect on controlling ➢ When administering chemotherapy, the nurse
infection. should observe for an anaphylactic reaction for 20
minutes and stop the medication if one is suspected.
65. Correct Answer: D Chemotherapy is associated with both general and
➢ Analysis of morbidity and mortality data provides the specific adverse effects, therefore close monitoring
parents with information about which groups of for them is important.
individuals are at risk for which health problems. Life
span statistics is a part of the mortality 72. Correct Answer: D
data. Treatment modalities and cost are not ➢ When examining a toddler or any small child, the
included in morbidity and mortality data. best way to perform the exam is from least to most
intrusive. Starting at the head or abdomen is
66. Correct Answer: D intrusive and should be avoided. Proceeding from
➢ Childhood obesity has been associated with the rise distal to proximal is inappropriate at any age.
of type II diabetes in children. Type I diabetes is not
associated with obesity and has a genetic 73. Correct Answer: C
component. Respiratory disease is not associated
16 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
➢ Rheumatic fever results as a delayed reaction to 83. Correct Answer: C
inadequately treated group A B-hemolytic ➢ Over 90% of babies can sit unsupported by nine
streptococcal infection. months. Most babies cannot say “mama” in the
sense that it refers to their mother at this time.
74. Correct Answer: A
➢ The child with congenital heart disease develops a 84. Correct Answer: A
polycythemia resulting from an inadequate ➢ By 12 months, 50% of children can walk well.
mechanism to compensate for decreased oxygen
saturation. 85. Correct Answer: C
➢ Lying flat keeps the patient from having a “spinal
75. Correct Answer: D headache”. Increasing the fluid intake will assist in
➢ Mycostatin suspension is given as a swab. Never replenishing the lost fluid during this time.
mix medications with food and formula.
86. Correct Answer: C
76. Correct Answer: C ➢ The patient can lose vascular status without the
➢ If the child is hungry, he/she more likely would finish nurse being aware if left for more than 4 hours, yet
his/her meals. Therefore, the mother should be checks should not be so frequent that the patient
advised not to give snacks to the child. The child is becomes anxious. Vital signs are generally checks
a “busy toddler”. He/she will not be able to keep still q4h, at which time the CSM checks can easily be
for a long time. performed.

77. Correct Answer: D 87. Correct Answer: A

➢ Normal heart rate of the newborn is 120 to 160 bm. ➢ Bronchodilators can produce the side effects listed
All other choices are normal findings (uneven head in answer choice (A) for a short time after the patient
shape is molding). begins using them

78. Correct Answer: A 88. Correct Answer: D

➢ Lead poisoning may be caused by inhalation of dusk ➢ Meningitis is an infection of the meninges, the outer
and smoke from leaded gas. It may also be caused membrane of the brain. Since it is surrounded by
by lead-based paint, soil, water (especially from cerebrospinal fluid, a lumbar puncture will help to
plumbings of old houses) identify the organism involved.

79. Correct Answer: A 89. Correct Answer: C

➢ G6PD is an X-linked recessive hereditary disease ➢ The glycosylated hemoglobin test measures
characterized by abnormally low levels of glucose- glucose levels for the previous 3 to 4 months.
6-phosphate dehydrogenase (abbreviated G6PD or
G6PDH), a metabolic enzyme involved in the 90. Correct Answer: D
pentose phosphate pathway, especially important in ➢ Capillary refill, pulses, and skin temperature and
red blood cell metabolism. color are indicative of intact circulation and absence
of compartment syndrome. Skin integrity is less
80. Correct Answer: C important.
➢ For the child with iron deficiency anemia, the blood
study results most likely would reveal decreased 91. Correct Answer: A
mean corpuscular volume (MCV) which ➢ This does not belong to the group since it is advised
demonstrates microcytic anemia, decreased to use rather soft nipples with large openings.
hemoglobin, decreased hematocrit, and elevated
total iron binding capacity. 92. Correct Answer: D
➢ The surgical intervention is planned on this stage
81. Correct Answer: D since it may require a series of operations for the
➢ The primary role of the nurse when a patient has a child to undergo.
seizure is to protect the patient from harming him or
herself. 93. Correct Answer: C
➢ This is still the most important nursing care at the
82. Correct Answer: A moment. While the rest are also correct, however
➢ During this period, which lasts up to the age of 18- after the surgical procedure, airway and
21 years, the individual develops a sense of “self”. oxygenation are important aspects for faster
Peers have a major big influence over behavior, and healing.
the major decision is to determine a vocational goal.
94. Correct Answer: A
17 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE
 PEDIATRIC NURSING QUESTIONS PART II (100-ITEM TEST BANK)
➢ Otherwise known as Gastroesophageal reflux is a very upset. The thoughts are called obsessions. The
disorder wherein the stomach contents would return behaviors are called compulsions.
to the esophagus resulting to vomiting of previously
drinking milk. 102. Correct Answer: A
95. Correct Answer: B ➢ Myelomeningocele is one of the most common
➢ This is the best way in order to give the stomach time causes of neuropathic (neurogenic) bladder
to digest the food. The rest of the options were not dysfunction among children. Risk of cognitive
appropriate in the situation. impairment is minimized through early intervention
and management of hydrocephalus. Respiratory
96. Correct Answer: B compromise is a common problem in
➢ This is a symptom of the liver problem rather than a myelomeningocele. Cranioschisis is a skull defect
respiratory problem. The rest are typical symptoms through which various tissues protrude. It is not
of asthma. associated with myelomeningocele.

97. Correct Answer: B

➢ Talking to a mother means giving information
according to the level of their understanding.
Informing the mother using medical terms can
generally be misunderstood. As a general rule, it is
always important to gauge the level of
understanding.

98. Correct Answer: A

➢ This is the correct answer according to the National
Asthma Education. The rest are symptoms of
persistent or chronic asthma.

99. Correct Answer: A

➢ Teaching the family about caring for a child with
asthma can be the least nursing action since there
is a higher need for attention to the child’s
respiratory status.

100. Correct Answer: B

➢ The rate of eating does not necessarily cause
asthma rather than the food additives in it. The rest
of the options were proven to be contributing factors
to cause asthma.

101. Correct Answer: C

➢ Conduct disorder is a severe condition
characterized by hostile and sometimes physically
violent behavior and a disregard for others. Children
with CD exhibit cruelty, from early pushing, hitting
and biting to, later, more than normal teasing and
bullying, hurting animals, picking fights, theft,
vandalism, and arson. Arguing with or defying adults
can indicate Oppositional Defiant Disorder (ODD).
Children with ODD are more likely to act
oppositional or defiant around people they know
well, such as family members, a regular care
provider, or a teacher. Separation anxiety is
indicated by excessive worry or fear without the
presence of parents or caregivers. Children may
have an obsessive-compulsive disorder (OCD)
when unwanted thoughts, and the behaviors they
feel they must do because of the thoughts, happen
frequently, take up a lot of time (more than an hour
a day), interfere with their activities, or make them
18 | P a g e I WILL PASS & TOP THE BOARD EXAM! COMPILED BY: ADMIN
RYE