Pediatric NCLEX Practice Questions (86-90)

Pediatric NCLEX Practice Questions

86. A nurse is caring for a child with a suspected diagnosis of rheumatic fever. The nurse reviews the laboratory results, knowing that which laboratory study would assist in confirming the diagnosis?

a) immunoglobulin
b) red blood cell count
c) white blood cell count
d) antistreptolysin O titer

87. A nurse is preparing for the admission of a child with a diagnosis of acute-stage Kawasaki disease. on assessment of the child, the nurse expects to note which clinical manifestation of the acute stage of the disease?

a) cracked lips
b) a normal appearance
c) conjunctival hyperemia
d) desquamation of the skin

88. A nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record?

a) increased crying
b) coughing at nighttime
c) chocking with feedings
d) severe projectile vomiting

89. A nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On admission assessment, which data would the nurse expect to obtain when asking the mother about the child's symptoms?

a) watery diarrhea
b) projectile vomiting
c) increased urine output
d) vomiting large amounts of bile

90. A nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented?

a) watery diarrhea
b) ribbon-like stools
c) profuse projectile vomiting
d) bright red blood and mucus in the stools




Pediatric NCLEX Practice Questions:
ANSWERS AND RATIONALE

86) D
- A diagnosis of rheumatic fever is confirmed by the presence of two major manifestations or one major and two minor manifestations from the Jones criteria. In addition, evidence of a recent streptococcal infection is confirmed by a positive antistreptolysin O titer, Streptozyme assay, or an anti-DNase B assay. Options A, B, and C will not help to confirm the diagnosis of rheumatic fever.

87) C
- In the acute stage, the child has a fever, conjunctival hyperemia, red throat, swollen hands, rash, and enlargement of the cervical lymph nodes. In the subacute stage, cracking lips and fissures, desquamation of the skin on the tips of the fingers and toes, joint pain, cardiac manifestations, and thrombocytosis occur. In the convalescent stage, the child appears normal, but signs of inflammation may be present.

88) C
- Any child who exhibits the “3 Cs”—coughing and choking with feedings and unexplained cyanosis—should be suspected of tracheoesophageal fistula. Options A, B, and D are not specifically associated with tracheoesophageal fistula.

89) B
- Clinical manifestations of pyloric stenosis include projectile vomiting, irritability, hunger and crying, constipation, and signs of dehydration, including a decrease in urine output.

90) D
- Intussusception is a telescoping of one portion of the bowel into another. The condition results in an obstruction to the passage of intestinal contents. The child with intussusception typically has severe abdominal pain that is crampy and intermittent, causing the child to draw in the knees to the chest. Vomiting may be present but is not projectile. Bright red blood and mucus are passed through the rectum and commonly are described as currant jelly–like stools. Watery diarrhea and ribbon-like stools are not manifestations of this disorder.


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