Pediatric NCLEX Practice Questions 96-100

Pediatric NCLEX Practice Questions

96. When teaching the parents of an older infant with CF (cystic fibrosis) about the type of diet the child should consume, which of the following would be most appropriate?

a) low protein diet
b) high fat diet
c) low carbohydrate diet
d) high calorie diet

97. a school-age child with CF asks the nurse what sports she can be involved in as she becomes older. Which of the following activities would be most appropriate for the nurse to suggest?

a) swimming
b) track
c) baseball
d) javelin throwing

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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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NCLEX Reviewer Download about Pediatric Nursing (81-85)

NCLEX Reviewer Download about Pediatric Nursing

81. A nurse is caring for an infant with bronchiolitis is assessing for signs of dehydration. The nurse checks which of the following, knowing that it is the most reliable method of determining fluid loss?

a) weight
b) fontanels
c) intake and output
d) mucous membrane

82. An emergency room nurse is caring for a child diagnosed with epiglotitis. Assessing the child, the nurse monitors for which indication that the child may be experiencing airway obstruction?

a) the child exhibits nasal flaring and bradycardia
b) the child is leaning forward, with the chin thrust out
c) the child has low-grade fever and complains of sore throat
d) the child is leaning backward, supporting himself or herself with the hands and arms

83. A sweat test is performed on a child with a suspected diagnosis of cystic fibrosis. The nurse reviews the test results and determines that which of the following is a positive result for cystic fibrosis?

a) chloride level of 20 mEq/L
b) chloride level of 30 mEq/L
c) chloride level of 40 mEq/L
d) chloride level of 70 mEq/L

84. A student nurse is caring for a 2-year old child diagnosed with croup and the nursing instructor asks the student about the clinical manifestations associated with the illness. Which statement by the student indicates a need for further research?

a) the cough is harsh and brassy
b) inspiratory stridor and a low-grad fever may be present
c) symptoms usually worsen at night and are better during the day
d) symptoms usually worsen during the day and are relieved during sleep

85. A nurse receives a telephone call from the admitting office and is told that a child with rheumatic fever will be arriving in the nursing unit for admission. On admission, the nurse prepares to ask the mother which question to elicit assessment information specific to the development of rheumatic fever?

a) has the child complained of back pain?
b) has the child complained of headache
c) has the child had any nausea or vomiting?
d) did the child have a sore throat or fever within the last two months?





NCLEX Reviewer Download about Pediatric Nursing:
ANSWERS AND RATIONALE
81) A
- Weight is the most reliable method of measurement of body fluid loss or gain. A weight change of 1 kg represents 1 L of fluid loss or gain. Although options B, C, and D identify components of the assessment for dehydration, these are not the most reliable determinants, because they require more subjective interpretation than weight, which is more objectively determined.

82) B
- Clinical manifestations suggestive of airway obstruction include tripod positioning (leaning forward while supported by arms, chin thrust out, mouth open), nasal flaring, tachycardia, a high fever, and a sore throat. Option D is an incorrect position. Options A and C are incorrect because epiglottitis causes a high fever and tachycardia.

83) D
- In a sweat test, sweating is stimulated on the child’s forearm with pilocarpine, the sample is collected on absorbent material, and the amounts of sodium and chloride are measured. A sample of at least 50 mg of sweat is required for accurate results. A chloride level higher than 60 mEq/L is considered to be a positive test result. A chloride level of 40 mEq/L suggests cystic fibrosis and requires a repeat test. A chloride level of less than 40 mEq/L indicates no cystic fibrosis.

84) D
- Croup often begins at night and may be preceded by several days of upper respiratory infection symptoms. Croup is characterized by a sudden onset of a harsh, brassy cough, sore throat, and inspiratory stridor. Symptoms usually worsen at night and are better in the day. Croup usually is accompanied by a low-grade fever, but occasionally the temperature may be as high as 104° F.

85) D
- Rheumatic fever characteristically presents 2 to 6 weeks after an untreated or partially treated group A beta-hemolytic streptococcal infection of the upper respiratory tract. Initially, the nurse determines whether the child had a sore throat or an unexplained fever within the past 2 months. Options A, B, and C are unrelated to rheumatic fever.



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NCLEX Reviewer Download about Pediatric Nursing (76-80)

NCLEX Reviewer Download about Pediatric Nursing

76. An emergency room nurse is performing an assessment on a child suspected of being sexually abused. Which assessment data obtained by the nurse most likely support this suspicion?

a) poor hygiene
b) fear of the parents
c) difficulty walking
d) bald spots on the scalp  

77. A nurse is performing an assessment of a 7-year old child who is suspected of having episodes of absence seizures. Which assessment question to the mother will assist in providing information that will identify the symptoms associated with this type of seizure?

a) does twitching occur in the face and neck?
b) does the muscle twitching occur on one side of the body?
c) does the muscle twitching occur on both sides of the body?
d) does the child have a blank expression during these episodes?

78. A nurse has provided discharge instructions to the parents of an infant who has had a ventriculoperitoneal shunt procedure performed for the treatment of hydrocephalus. Which statement, if made by the parents, indicates an accurate understanding of the presence of a shunt complication?

a) I should call my doctor if my infant refuses baby food
b) if my infant has a high-pitched cry, I should call the doctor
c) my infant will pass urine more often now that the shunt is in place
d) I should position my infant on the side with the shunt when sleeping

79. A nurse is performing an admission assessment on a newborn infant with a diagnosis of spina bifida (myelomeningocele). A priority nursing assessment for this newborn is:

a) pulse rate
b) palpation of the abdomen
c) specific gravity of the urine
d) head circumference measurement

80. A mother arrives in an emergency room with her 5-year old child and the mother states that the child fell off a bunk bed. A head injury is suspected, and a nurse is assessing the child continuously for signs of increased intracranial pressure (ICP). Which of the following is a late sign of increased ICP in this child?

a) nausea
b) bradycardia
c) bulging fontanel
d) dilated scalp veins





NCLEX Reviewer Download about Pediatric Nursing:
ANSWERS AND RATIONALE

76) C
- the most likely assessment findings in sexual abuse include difficulty walking or sitting; torn, stained, or bloody underclothing; pain, swelling, or itching of the genitals; and bruises, bleeding, or lacerations in the genitals, or anal area. Poor hygiene may indicate physical neglect. Bald spots on the scalp and fear of the parents most likely are associated with physical abuse.

77) D
- Absence seizures are brief episodes of altered awareness. No muscle activity occurs except eyelid fluttering or twitching. The child has a blank facial expression. These seizures last only 5 to 10 seconds, but they may occur one after another several times a day. Myoclonic seizures are brief random contractions of a muscle group that can occur on one or both sides of the body. Simple partial seizures consist of twitching of an extremity, face, or neck, or the sensation of twitching or numbness in an extremity or face or neck.

78) B
- If the shunt is broken or malfunctioning, the fluid from the ventricle part of the brain will not be diverted to the peritoneal cavity. The cerebrospinal fluid will build up in the cranial area. The result is increased intracranial pressure, which then causes a high-pitched cry in the infant. The infant should not have pressure placed on the shunt side. Skin breakdown and possible compressions to the apparatus could result. This type of shunt affects the gastrointestinal system, not the genitourinary system. Option A is only a concern if the infant becomes malnourished or dehydrated, which then could raise the body temperature. Otherwise, the infant’s refusing baby food has no direct relationship to the shunt functioning.

79) D
- Newborn infants with spina bifida (myelomeningocele type) are at risk for hydrocephalus; therefore, the head circumference should be measured to obtain a baseline. Options A, B, and C are incorrect because pulse rate will not be affected with this disorder, the specific gravity can indicate hydration status but it is not priority at this time, and abdominal masses do not occur with this disorder.

80) B
- Late signs of increased intracranial pressure (ICP) include a significant decrease in level of consciousness, bradycardia, and fixed and dilated pupils. A bulging fontanel and dilated scalp veins are early signs of increased ICP and would be noted in an infant, not a 5-year-old child. Nausea is an early sign of increased ICP. 


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Pediatric Nurse Education (71-75)

Pediatric Nurse Education Questions 71-75

71. A clinic nurse provides instructions to a parent of a toddler experiencing physiological anorexia. Which statement if made by the parent indicates a need for further instructions?

a) I will not force-feed my child
b) I will be feed my child if she will not eat
c) I will limit the juice intake to less than 12 ounces per day
d) At mealtime, I will offer less than my child may eat and let my child ask for more  

72. A child with autism is being admitted to the hospital for diagnostic tests. The nurse should assign this child to a:

a) private room
b) semiprivate room
c) four-bed ward room
d) contact isolation room

73. A nurse is assigned to care for an 8-year old child with basilar skull fracture. The nurse reviews the physician's orders and contacts the physician to question which order?

a) obtain daily weight
b) suction as needed
c) provide clear liquid diet
d) maintain a patent intravenous line

74. A lumbar puncture is performed on a child suspected of having bacterial meningitis and cerebrospinal fluid (CSF) is obtained for analysis. A nurse reviews the results of the CSF analysis and determines that which of the following results would verify the diagnosis?

a) clear CSF, elevated protein and deceased glucose level
b) clear CSF, decreased pressure and elevated protein level
c) cloudy CSF, elevated protein and decrease glucose level
d) cloudy CSF, decreased protein and decreased glucose level

75. A clinic nurse is observing a child diagnosed with autistic disorder. The nurse would expect to observe which characteristic of this disorder?

a) normal social play
b) lack of social interaction
c) normal responses to sensory stimuli
d) normal verbal but abnormal nonverbal communication




Pediatric Nurse Education:
ANSWERS AND RATIONALE

71) B
- a toddler has the skills required to feed himself or herself. The parent needs to be instructed not to feed children who can feed themselves and not to force-feed a child. To increase nutritious intake at mealtime, juice intake needs to be limited to less than 12 oz per day. At mealtime, the best option is to offer less than the toddler may eat and let the child ask for more food.

72) A
- autistic disorder is a complex childhood disorder that involves abnormalities in behavior, social interactions, and communication. Autistic children are unable to relate to persons or to respond to social and emotional cues. Characteristically, these children engage in repetitive behaviors, including head banging, twirling in circles, biting themselves, and flapping their hands or arms. Abnormal communication patterns include verbal and nonverbal communication. A child with autism needs deceased stimulation, with limited visual and auditory distractions. A private room would be the best environment, allowing for control of visual and auditory distractions. The semiprivate and four-bed ward rooms would be too stimulating for the child with autism. Autism is not a disorder that requires contact isolation.

73) B
- nasotracheal suctioning is contraindicated in a child with a basilar skull fracture. Because of the nature of the injury, there is a high risk of secondary infection and the probability of the catheter entering the brain through the fracture. Fluid balance is monitored closely by daily weight, intake and output measurement, and serum osmolality, determination to detect early signs of water retention, excessive dehydration, and states of hypertonicity or hypotonicity. The child is maintained on an NPO status or restricted to clear fluids until it is determined that vomiting will not occur. An intravenous line is maintained to administer fluids or medications if necessary.

74) C
- meningitis is an infectious process of the central nervous system caused by bacteria and viruses; it may be acquired as a primary disease or a result of complications of neurosurgery, trauma, infection of the sinus or ears, or systemic infections. Meningitis is diagnosed by testing cerebrospinal fluid obtained by lumbar puncture. In the case of bacterial meningitis, findings usually include an elevated pressure, turbid or cloudy cerebrospinal fluid and elevated leukocyte, elevated protein, and decreased glucose levels

75) B

 - Autistic disorder is a complex childhood disorder that involves abnormalities in behavior, social interactions, and communication. Autistic children are unable to relate to persons or to respond to social and emotional cues. Characteristically, these children engage in repetitive behaviors, including head banging, twirling in circles, biting themselves, and flapping their hands or arms. Abnormal communication patterns include verbal and nonverbal communication.





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Pediatric Nurse Education (66-70)

Pediatric Nurse Education Questions 66-70

66. A nurse is evaluating the developmental level of a 2-year old child. Which of the following does the nurse expect to observe?

a) use fork to eat
b) uses a cup to drink
c) pours own milk into a cup
d) uses a knife for cutting food  

67. The parents of a 2-year old child arrive at a hospital to visit their child. The child is in the playroom when the parents arrive. When the parents enter the playroom, the child does not readily approach the parents. The nurse interprets this behavior as indicating that:

a) the child is withdrawn
b) this is a normal pattern
c) the child is self-centered
d) the child has adjusted to the hospital setting

68. A clinic nurse provides information to the mother of a toddler regarding toilet training. Which statement by the mother indicates a need for further information regarding the toilet training?

a) bladder control usually is achieved before bowel control
b) the child should not be forced to sit on the potty for long periods
c) the ability of the child to remove clothing is a sign of physical readiness
d) the child will not be ready to toilet train until the age of about 18 to 24 months

69. A clinic nurse assesses the communication patterns of a 5-month old infant. The nurse determines that the infant is demonstrating the highest level of developmental achievement expected if the infant:

a) coos when comforted
b) links syllables together
c) uses monosyllabic babbling
d) uses simple words such as "mama"

70. A 2-year old child is treated in the emergency room for a burn to the chest and abdomen. The child sustained the burn by grabbing a cup of hot coffee that was left on the kitchen counter. The nurse reviews safety principles with the parents before discharge. Which statement by the parents indicates an understanding of measures to provide safely in the home?

a) we will be sure not to leave hot liquids unattended
b) I guess my children need to understand what the word hot means
c) we will be sure that the children stay in their rooms when we work in the kitchen
d) We will install a safely gate as soon as we get home so the children cannot get into the kitchen




Pediatric Nurse Education:
ANSWERS AND RATIONALE
66) B
- by age 2-years, the child can use a cup and spoon correctly but with some spilling. By age 3 to 4, the child begins to use fork. By the end of the preschool period, the child should be able to pour milk into a cup and begin to use a knife for cutting.

67) B
- the phrases through which young children progress when separated from their parents include protest, despair, and denial or detachment. In the stage of protest, when the parents return, the child readily goes to them. In the stage of despair, the child may not approach them readily or may cling to a parent. In denial or detachment, when the parents return, the child becomes cheerful, interested in the environment and new persons (seemingly unaware of the lost parents), friendly with the staff, and interested in developing superficial relationships. Options A, C,A and D are incorrect interpretations of the child's behavior.

68) A
- bowel control usually is achieved before bladder control. The child should not be forced to sit for long periods. The ability to remove clothing is one of the physical signs of readiness. The physical ability to control the anal and urethral sphincters is achieved some time after the child is walking, probably between the age of 18 and 24 months.

69) C
- using monosyllabic babbling occurs between 3 and 6 months of age. Using simple words such as "mama" occurs between 9 and 12 months of age. Linking syllables together when communicating occurs between 6 and 9 months of age. Cooing begins at birth and continues until 2 months of age.

70) A
- toddler's, with their increased mobility and development of motor skills, can reach hot water or hot objects placed on counters and stoves and can reach open fires or stove burners above their eye level. The nurse should encourage parents to remain in the kitchen when preparing a meal, use the back burners of the stove, and turn pot handles inward and toward the middle of the stove. Hot liquids should never be supervised. The statements in option B, C, and D do not indicate an understanding of the principles of safety.


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Test Prep for Nursing Exam about Pediatric Nursing (61-65)

61. A nurse is planning care for a newborn of a diabetic mother. A priority nursing diagnosis for this infant:

a) hyperthermia related to excess fat and glycogen
b) risk for injury related to low blood glucose levels
c) risk for delayed development related to excessive size
d) risk for aspiration related to impaired suck and swallow  

62. A nursing instructor asks a nursing student to describe the procedure for administering erythromycin (0.5% Ilotycin) ointment on the eyes of a neonate. The instructor determines that the student needs to research this procedure further if the student state that:

a) I will flush the eyes after instilling the ointment
b) I will cleanse the neonate's eyes before instilling the ointment
c) administration of the eye ointment is within 1 hour after delivery
d) I will instill the eye ointment into each of the neonate's conjunctival sacs

63. Which statement would indicate the "law and order orientation" found in level two of Kohlberg's theory of moral development?

a) If I skip down the hall, will the teacher be mad at me?
b) We will spend time talking about the activities for the week
c) I don't like it when you yell while I am talking to my friend. Here are some activities to do until I am finished talking
d) If you do all of your class work today without bothering others in the class, you will get an extra seed for your good garden.

64. A home health nurse visits a 70-year old woman weekly. At each visit, the client reminisces about pas t life experiences in a positive way. Using Erickson's psychosocial development theory, the home health nurse interprets this behavior as:

a) a mental status alteration
b) a normal psychosocial response
c) requiring a psychiatric consultation
d) a sensory deficit requiring social activities

65. Which of the following car safety devices should be used for a child who is 8-years old and is 4 feet tall?

a) seat belt
b) booster seat
c) rear-facing convertible seat
d) front-facing convertible seat



ANSWERS AND RATIONALE

61) B
- the neonate born to a diabetic mother is at risk for hypoglycemia so risk for injury related to low blood glucose levels would be priority nursing diagnosis. The infant would also be at risk for hyperbilirubinemia, respiratory distress, hypocalcemia, and congenital anomalies. Hyperthermia, risk for delayed development, and risk for aspiration are not expected problems.

62) A
- eye prophylaxis protects the neonate against Neisseria gonorrhoeae and Chlamydia tranchomatis. The eyes are not flushed after instillation of the medication because the flush will wash away the administered medication. Option B, C and D are correct statements regarding the procedure for administering eye medication to the neonate.

63) A
- in the law and order orientation of Kohlberg's theory, the child has more concern with society as a whole and emphasis is on obeying laws to maintain social order. The child wants to be considered "good" by persons whose opinions matter to them. Option A is the only option that reflects these criteria. Option B, C, and D are unrelated to the law and order orientation.

64) B
- according to Erickson, late adulthood is the period of old age. The adult reminisces about past life experiences, viewing them in a positive way. The adult needs to feel good about accomplishments, see successes in life, and feel that he or she has made a contribution to society. Option A, C, and D are incorrect interpretations.

65) B
- children should remain in a booster seat until the are 8 to 12 years old and at least 4 feet, 9 inches tall. An infant should ride in a car in a semi reclined, rear-facing position in an infant-only seat or a convertible seat until they weigh at least 20 lb and are at least 1 year of age. The transition point for switching to the forward-facing position is defined by the manufacturer of the convertible car safety seat bu is generally at a body weight of 9 kg (20lb) and 1 year of age. Convertible car safety seats are used until the child weighs at least 40 lb. 


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Test Prep for Nursing Exam about Pediatric Nursing (56-60)

56. A nurse on the pediatric unit is caring for four clients and is preparing to do rounds. Which client should the nurse see first?

a) a client being discharged who needs to receive an immunization
b) a client who has returned from the recovery room and is restless
c) a client scheduled for an upper GI series
d) a client with ear tubes that came out spontaneously

57. A nurse in a newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs, if noted in the newborn infant, would alert the nurse to the possibility of this syndrome?

a) tachypnea and retractions
b) acrocyanosis and grunting
c) hypotension and bradycardia
d) presence of a barrel chest with acrocyanosis  

58. A nurse in a newborn nursery is caring for a neonate. On assessment, the infant is exhibiting signs of cyanosis, tachypnea, nasal flaring, and grunting. Respiratory distress syndrome is diagnosed, and the physician prescribes surfactant replacement therapy. The nurse prepares to administer this therapy by:

a) intravenous injection
b) subcutaneous injection
c) intramuscular injection
d) instillation of the preparation into the lung through an endotracheal tube

59. A nurse is assessing a newborn infant who was born to a mother who is addicted to drugs. Which of the following assessment findings would the nurse expect to note during the assessment of this newborn?

a) lethargy
b) sleepiness
c) incessant crying
d) cuddles when being held

60. A nurse notes hypotonia, irritability, and a poor sucking reflex in a full-term newborn infant on admission to the nursery. The nurse suspects fetal alcohol syndrome and is aware that which additional sign would be consistent with fetal alcohol syndrome?

a) length of 19 inches
b) abnormal palmar creases
c) birth weight of 6 lb. 14 oz
d) head circumference appropriate for gestational age




ANSWERS AND RATIONALE
56) B
- the client with unstable condition should be given first priority by the nurse. Restlessness after surgery may indicate bleeding, shock, or hypoxia.

57) A
- the newborn infant with respiratory distress syndrome may present with clinical signs of cyanosis, tachypnea or apnea, nasal flaring, chest wall retractions, or audible grunts. Acrocyanosis is the bluish discoloration of the hands and feet, is associated with immature peripheral circulation, and is not uncommon in the first few hours of life. Options B, C, and D do not indicate clinical signs of respiratory distress syndrome.

58) D
- the aim of therapy in respiratory distress syndrome is to support the disease until the disease runs its course, with the subsequent development of surfactant. The infant may benefit from surfactant replacement therapy. In this therapy, an exogenous surfactant preparation is instilled into the lungs through an endotracheal tube. Option A, B, and C identify incorrect methods of administering surfactant.

59) C
- a newborn infant born to a woman using drugs is irritable. The infant is overloaded easily by sensory stimulation. The infant may cry incessantly and be difficult to console. The infant would hyperextend and posture rather than cuddle when being held.

60) B
- features of newborn infants diagnosed with fetal alcohol syndrome include craniofacial abnormalities, intrauterine growth retardation, cardiac abnormalities, abnormal palmar creases, and respiratory distress. Option A, C, and D are normal assessment findings in the full-term newborn infant.


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Test Prep for Nursing Exam about Pediatric Nursing (51-55)

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51. A nurse is assessing an 8-week old (2 mos.) infant. Which of the following behaviors will the nurse expect to observe first in the infant's development?

a) holds head up when being pulled into a sitting position
b) turns from side to back
c) sits with minimal support
d) discriminates between strangers and familiar figures

52. A nurse in the pediatric clinic is interviewing a mother and a 6 year old child with asthma. Which statement if made by the mother should the nurse follow up on first?

a) my child would like to play on the softball team, but I am afraid to let him
b) my child has used three canisters of his inhaler this past month
c) my child is embarrassed to use his inhaler in front of schoolmates
d) I am concerned because my child has started to bite his nails and use cursatory words

53. A nurse is assessing a 3-year old child. Which of the following behaviors will the nurse expect to observe first in the child's cognitive development.

a) names the days of the week
b) knows primary colors
c) uses sentences well
d) think death is reversible

54. A nurse from medical-surgical unit is assigned to work on the pediatric unit. Which of the following clients is most appropriate for the charge nurse to assign to the float nurse?

a) an 8-year old client with asthma receiving inhaled medications
b) a 5-year old client admitted 24 hours ago for ingestion of household substance
c) a 10-year old client with a right femur fracture
d) a 6-year old client with malnutrition and bruises on the abdomen and buttocks

55. A nurse is teaching a client about the care of a female newborn. It is a priority to teach the client to notify the health care provider if which of the following is noted in the infant?

a) vomiting after feeding
b) more than four bowel movements per day
c) vaginal discharge
d) fever above 37.2C (100F)



ANSWERS AND RATIONALE

51) B

- a 2-month old infant is able to turn from side to back
Choice A describes a 3-4 month old infant
Choice C describes a 6 month old infant
Choice D describes an 8 month old infant

52) B

- excessive use of bronchodilator causes rebound effect, which is bronchoconstriction. It can also trigger asthmatic attack. This situation needs follow-up by the nurse.

53) D

- a 3-year old child thinks death as reversible. Choices A, B, and C are cognitive development among pre-school children.

54) A

- a nurse floated to a nursing unit should be assigned to care for a client with condition similar to her training and experience and those with stable condition. The medical-surgical unit nurse is competent to care for clients with asthma receiving inhaled medications.

55) D

- a newborn's temperature is normally 37C and below. Even slight elevation of temperature in a newborn, indicates acute infection. This situation needs to be reported to health care provider.
The nurse should teach the client to elevate the head of the newborn during feeding and to turn the newborn to the right side after feeding to prevent aspiration.

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Test Prep for Nursing Exam about Pediatric Nursing (46-50)

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46. The physician called the nurse and told her to prepare to give "enemas until clear" to an 18-month old child before surgery for Hirschprung's disease. What would the nurse anticipate the physician to order?

a) saline (300 ml)
b) tap water (120 ml)
c) oil retention (250 ml)
d) fleet solution (200 ml)

47. When a doctor has consent form signed for a surgical procedure on a child, the nurse knows that:

a) the person giving the consent must be at least 18 years of age
b) only a parent or legal guardian can sign the consent
c) the risk and benefits of procedures are part of the consent
d) the consent is valid for 72 hours

48. In which of the following situations should the charge nurse in the pediatric unit intervene in the staff nurse's action?

a) the nurse is going to do throat culture to a child who is drooling with saliva and sore throat
b) the nurse feeds the child with gastroesophageal reflux in an upright position
c) the nurse places the child with meningocele in prone position
d) the nurse gives popsicle to a child who had undergone tonsillectomy

49. A child is 8 months old. Which of the following assessment should the nurse find?

a) dancing reflex
b) palmar grasp reflex
c) dorsiflexion of the big toe when the sole of the foot is stroked from the heel upward
d) fencing reflex

50. A nurse receives a child with a cleft palate on the pediatric unit. Which action is best for the nurse to take?

a) to ask the nursing assistant to obtain necessary feeding equipment for the client while the nurse completes the admission assessment.
b) to ask the nursing assistant to take the child's vital signs while the nurse calls the physician
c) to ask the LPN/LVN to talk to the parents while the nurse administers a tube feeding to the child in the next room
d) to ask the parents to leave the room while the nurse completes the admission assessment



ANSWERS AND RATIONALE

46. A
- saline solution is isotonic and will prevent fluid-electrolyte losses.

47) B
- if the client is a child, the parent or legal guardian will sign the consent for procedures.

48) A
- a child who is having drooling with saliva and sore throat is experiencing epiglottitis. Stimulation of the throat like doing throat culture should be avoided to prevent airway spasm and obstruction.

49) C
- positive babinski reflex is normal up to one year of age. Other infantile reflexes will normally disappear by age 3 to 4 months.

50) A
- obtaining equipment is a task of the CNA. Performing nursing process including assessment is a task of RN.


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Test Prep for Nursing Exam about Pediatric Nursing (41-45)

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41. Which of the following physical assessment findings is considered normal?

a) a 6-month old who is drooling
b) a 2-year old with pinkish color of the eyes
c) an 18-month old with no teeth
d) a 3-year old with dimpling in the spine

42. A pediatric nurse has received report from the previous shift. Which of the following patients should the nurse attend to first?

a) a 4-month old baby girl with ventricular septal defect (VSD) with heart murmurs
b) a 3-year old baby girl with Tetralogy of Fallot (TOF) with blue lips when crying
c) a 12-month old baby boy with coarctation of aorta (COA) who has weakness on the right extremity
d) a 10-month old baby boy with patent ductus arteriosus with positive babinski

43. A nurse is assigned in the pediatric unit. Which of the following patients should be assessed first by the nurse?

a) a 6-month old baby boy who vomited three times an hour ago
b) a 1-year old baby boy who cries when his mother leaves
c) a 2-month old baby girl with PR=122
d) a 9-month old baby boy who mobilizes through his abdomen

44. A 6-year old boy was diagnosed to have hemophilia. Which statement when made by the parents indicates correct understanding of the disease?

a) the child inherits the disease from the father
b) the child inherits the disease from the mother
c) the other sons and daughters are at risk to have the disease
d) the boy might not have any children in the future

45. A mother asks where to safely place her 5-year old child in the car. The appropriate response by the nurse is:

a) in the middle of the back seat, rear-facing, using a booster chair
b) in the middle of the back seat, front-facing, using a booster chair
c) in the front seat of the car, ensuring the presence of an airbag
d) in the front seat of the car, using a booster chair



ANSWERS AND RATIONALE

41) A
- it is normal for a 6-month old child to still experience drooling. The sclera is white; pinkish color of the eyes indicates inflammation. Eruption of teeth starts at 5-7 months. An 18-month old child should have 12 teeth (age in months - 6 = number of teeth).
Dimpling in the spine indicates spina bifida occulta.

42) C
- weakness on an extremity needs to be investigated immediately because this indicates that a complication is occurring.

43) A
- an infant's fluid electrolyte balance can easily be upset, which may pose severe problems. Eighty percent of an infant's weight is fluid; most of the fluid is found in the ECF compartment which can be lost easily.

44) B
- hemophilia is X-linked disorder, which is inherited from the mother. Only the sons will have the disease, daughters are carriers of the traits.

45) B
- the recommended place of a child who is over 2 years of age or over 20 lbs. in weight, when riding a car is middle of the back seat, front-facing. Booster chair is to be used until the child is 6 years of age or below 60 lbs in weight.

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Test Prep for Nursing Exam about Pediatric Nursing (36-40)

36. Which of the following growth and development changes is not expected in an adolescent?

a) growth of body hair
b) voice changes
c) loss of subcutaneous tissues
d) increased activity of sweat glands and sebaceous glands

37. A young mother brings her 6-month old daughter to the ER about midnight. The infant is not crying, but has bruises on her arms and legs. The baby is not able to sit even when held in an upright position. The mother says the baby fell out of her crib. The mother is quite non-committal about events leading up to the baby's fall. In order to complete the assessment, which of the following actions by the nurse is a priority?

a) ask the mother to call her husband to the hospital
b) determine whether the infant has any serious physical problems
c) sit down and chat with the mother in order to reassure her
d) order a blood level for alcohol on both parents

38. A medical-surgical nurse is to work in a pediatric unit for 8 hours. Which of these patients should be assigned to her?

a) a school-aged child with bronchial asthma and teenager who had an appendectomy 4 hours ago
b) a 2-month old infant with cleft palate and a 3-year old with inguinal hernia
c) a 4-year old male with nephrotic syndrome and a week old infant who just had a pylorotomy
d) a 10-year old female with Down's syndrome admitted for pneumonia and a 3-year old with Tetralogy of Fallot who is scheduled for surgery the next day

39. A mother calls the clinic and says her 6-year old son swallowed some toilet bowl cleaner. The nurse should tell the mother to do which of the following first?

a) bring the child to the hospital
b) give the child syrup of ipecac
c) wrap a blanket around the child
d) try to get the child to drink milk

40. A new order is written for eardrops on a 3-year old child. Which nursing action has the lowest priority in preparation for this procedure?

a) anticipate the need for assistance to restrain the child
b) check the child's name bracelet before administration of the medication
c) explain the purpose of the medication to the child
d) check which ear is to receive the drops prior to instillation



ANSWERS AND RATIONALE

36) C
- there is usually accumulation of subcutaneous tissues among adolescents

37) B
- when there is incongruence between the severity of injury and explanation of how the injury occurred, consider abuse. Serious physical problems support presence of abuse. Suspicion of abuse should be reported to the local authority.

38) A
- older children with medical-surgical conditions like asthma are more appropriate to be taken good care of by the medical-surgical nurse. This is similar to her training and experience.

39) D
- to neutralize the corrosive effect of the toilet bowl cleaner, try to get the child to drink milk. Do not induce vomiting when the ingested substance is corrosive. Therefore, do not give syrup of ipecac, an emetic.

40) C
- a 3-year old child is still unable to comprehend the purpose of the medication. Explanation should be given to the parents.

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Test Prep for Nursing Exam about Pediatric Nursing (31-35)

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31. Which of the following data best indicates dehydration in an 8-year old child?

a) dry mucuous membrane
b) poor skin turgor
c) 5% decrease in weight
d) fever

32. A 15-month old child was brought by his mother for regular clinic visit. The child is scheduled to receive MMR immunization. Which of the following is a contraindication for MMR immunization of the child?

a) the client has been receiving prednisone since two weeks ago
b) the client has been taking non-steroidal anti-inflammatory drugs (NSAID's) for the past three days
c) the client has temperature of 37.4 C
d) the client's teeth are about to erupt

33. A mother brought her child in a clinic for scheduled physical examination. What essential question does the nurse need to ask regarding lead poisoning?

a) do you live near the chemical dump site
b) when was the last time that you have your plumbing checked?
c) what toys does your child usually play
d) where do you keep your cleaning chemicals?

34. An 8-year old child is admitted in the pediatric unit. Which of the following is the most appropriate activity for the client?

a) talking on the phone
b) collecting baseball cards
c) listening to music
d) playing chess

35. A nurse is interviewing a mother in a regular clinic visit. Which of the following children should concern the nurse most?

a) my 5-year old son doesn't want to eat breakfast every morning
b) my 8-year old so doesn't like to wear helmet while riding on a bicycle
c) my 9-year old son who rides on a bicycle with his helmet on goes in the same direction with the traffic
d) my 3-year old son bed wets every night



ANSWERS AND RATIONALE

31) C
- weight loss is one of the most accurate indicators of dehydration

32) A
- a child who is receiving steroids is immuno-compromised. A child who is immune-compromised should not receive MMR.

33) B
- lead poisoning (plumbism) sources are as follows: lead-based plumbing -> water, soil, dust, vehicles (leaded gas), lead-based paint.

34) B
- a schools age child likes to engage in activities that involve classifying, sorting, collecting, like collecting baseball cards.

35) B
- safety should be given highest priority. Helmet, elbow pads and knee pads should be worn by a child while riding a bicycle.


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Test Prep for Nursing Exam about Pediatric Nursing (26-30)

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26. Which of the following situations is most dangerous among children?

a) medications are placed in the cupboard
b) gun is found inside the locker but the child doesn't know where the keys are
c) an 11-year old boy is skating along highway, going the same direction with the cars
d) a 4-year old playing tricycle with pedal in the backyard wearing helmet, elbow pads and knee pads

27. Which of the following toys is appropriate for a 10-month old infant?

a) brightly colored mobiles with sounds
b) large interlocking blocks
c) push-and-pull toys
d) cups of different sizes that fit inside each other

28. A child is 2-year old. Which of the following is expected in the child?

a) runs well
b) walks with support
c) hops on one foot
d) walks up stairs without grasping the handrails

29) The 15-month old child can do which of the following?

a) sits without support
b) drinks from a cup
c) creeps
d) throws ball on the floor

30. The newborn was delivered 6 hours ago. During assessment of the client, which of the following findings need to be reported to the physician?

a) nystagmus
b) posterior fontanel is closed
c) arms actively flexed upon stimulation
d) respiration are irregular



ANSWERS AND RATIONALE

26) B
- presence of gun inside the home is very dangerous for children. There is a possibility that they may find the keys.

27) B
- large interlocking blocks are most appropriate for a 10-month old infant. Mobiles are appropriate for 0 to 6 months old infant. Push and pull toys and toys that fit inside each other are for toddlers.

28) A
- a 2-year old child is able to run well.
Choice B - is for a 10 - 12 month old who is able to walk with support
Choice C - for a 4-year old who is able to hop on one foot
Choice D - for a 5-year old who is able to walk upstairs without grasping the handrails.

29) D
- a 15-month old child can throw a ball on he floor, can drop a pellet into a narrow-necked bottle. Casting or throwing objects and retrieving them become almost obsessive activities at about 15 months.

30) B
- posterior fontanel normally closes at age 2-3 months. Premature closure of posterior fontanel is called craniosynostosis. Choices A, C, and D are normal findings.

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Test Prep for Nursing Exam about Pediatric Nursing (21-25)

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21. Which of the following toys is inappropriate for an 18-month old child?

a) low rocking horses
b) push-pull toys
c) plastic blocks
d) rattles

22. An infant is 7 months. Which of the following comments when made by the mother indicates normal growth and development of the child?

a) my child is cross-eyed
b) my child can sit up by himself
c) my child puts his toes into his mouth
d) my child starts to crawl

23. The child is undergoing repair of cleft lip and palate. What should the nurse prepare in the room while waiting for the child?

a) papoose board
b) mummy restraint
c) elbow restraint
d) jacket restraint

24. Which of the following situations increase risk of lead poisoning in children?

a) playing in the park with heavy traffic and with many vehicles passing by
b) playing sand in the park
c) playing plastic balls with other children
d) playing with stuffed toys at home

25. The nurse is caring for a child who has intussusception. Which of the following assessment is most important to report to the physician?

a) greasy, bulky, foul-smelling stool
b) pellet-like stool
c) formed stool
d) currant jelly stool



ANSWERS AND RATIONALE

21) D
- rattles are appropriate for an infant. Low rocking horses, push-pull toys, and plastic blocks are appropriate for a toddler.

22) B
- a child who is 6 to 8 months of age is able to sit up. Crossed-eyedness is resolved at 3 to 4 months of age. A 5-month old child is able to put his toes into his mouth. A 9-month old child is able to crawl and creep.

23) C
- elbow restraint should be applied to prevent trauma to the operated area.

24) A
- lead poisoning may be caused by inhalation of dusk and smoke from leaded gas. It may also be caused by lead-based paint, soil, water (especially from plumbings of old houses).

25) C
- formed stool indicates resolution of intussusception. Surgery is no longer indicated.


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Test Prep for Nursing Exam about Pediatric Nursing (16-20)

16. Which of the following assessment findings is normal in a 6-month old infant?

a) is able to hold his bottle
b) is able to sit unsupported
c) is able to use a spoon
d) is able to creep

17. After receiving endorsement, which of the following clients should the nurse see first?

a) a 2-day old infant, lying quietly, is alert, with a heart rate of 135 bpm
b) a day-old infant, who is crying, with anterior fontanel bulging
c) a 12-hour old infant held by the mother with respiration of 45 cpm
d) a 3-hour old infant, whose temperature is 36.7 C, with irregular abdominal breathing; respiratory rate of 50 cpm

18. Which of the following statements when made by the father of a 2-month old infant indicates that he understands the normal growth and development of the child?

a) I expect my baby to hold his bottle
b) I expect my baby to smile back at me
c) I expect my baby to have complete head control
d) I expect my baby to roll over

19. Which of the following toys is most appropriate for a 2 1/2-year old child?

a) squeeze toys
b) stacking blocks
c) colored mobiles
d) video games

20. Which of the following findings is expected in a 6-month old infant?

a) turns from side to back
b) turns from back to side
c) turns from side to stomach
d) turns from side to side



ANSWERS AND RATIONALE

16) A
- a six-month old infant is able to hold his bottle
Choice B - describes an 8-month old
Choice C - describes a 10-12 month old
Choice D - describes a 9-month old

17) B
- the infant with bulging fontanel is experiencing increased intracranial pressure. Choices A, C, and D indicate stable conditions.

18) B
- a two month old infant is capable of "social smile".

19) B
- stacking blocks are appropriate for a toddler. Squeeze toys and colored mobiles are appropriate for an infant. Video games are appropriate for a school age child.

20) D
- a 6-month old infant can completely roll over (side to side). a 2-month old can turn from side to back. A 4-month old can turn from back to side.


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Test Prep for Nursing Exam about Pediatric Nursing (11-15)

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11. How does the nurse appropriately administer mycostatin suspension in an infant?

a) have the infant drink water, and then administer mycostatin in a syringe
b) place mycostatin on the nipple of the feeding bottle and have the infant suck it
c) mix mycostatin with formula
d) swab mycostatin on the affected areas

12. Which of the following actions should concern the nurse most, about a newborn with petechiae delivered 3 hours ago

a) whether vit. K injection was administered
b) whether eye drops had been instilled
c) whether feeding had been started
d) whether IV fluid had been given

13. Which of the following signs and symptoms in a newborn indicates syphilis?

a) diarrhea, vomiting
b) absent reflex
c) palmar rash
d) respiratory distress

14. What assessment tool would the nurse use first on a sleeping infant?

a) palpation
b) percussion
c) observing the infant as he inhales and exhales
d) auscultation

15. Which of the following is the best therapeutic diversional activity for 7-year old client confined in the hospital?

a) playing checkers with the nurse
b) watching video
c) listening to radio
d) talking over the telephone with friends



ANSWERS AND RATIONALE

11) D
- mycostatin suspension is given as swab. Never mix medications with food and formula.

12) A
- petechiae is a sign of bleeding. Vit. K will stop bleeding because it promotes synthesis of prothrombin and other clotting factors. In the absence of bacterial flora in the colon. Vit. K cannot be absorbed. Bacteria in the colon will be present once the child had taken milk.

13) C
- palmar rash is a characteristic manifestation of syphilis in an newborn.

14) C
- observe infant's respiration first, before touching him. When crying occurs, respiration can't be observed accurately.

15) B
- watching video is appropriate for a 7-year old patient. Playing checkers with the nurse is appropriate for an adult client. Listening to radio and talking over the telephone with friends are appropriate for adolescents.


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Test Prep for Nursing Exam about Pediatric Nursing (6-10)

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6. A mother tells the nurse that she is very 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 dining room until he finishes his meal
b) provide quiet environment for the child before meals
c) do not give snacks to the child before meals
d) put the child on a chair and feed him

7. When teaching a primiparous client about the growth and development of the neonate, which of the following would the nurse include as the usual age at which most babies are able to drink from a cup independently?

a) 5 to 7 months
b) 8 to 10 months
c) 12 to 14 months
d) 15 to 16 months

8. Which of the following assessment data in 6-month old infant needs a follow-up?

a) posterior fontanel is closed
b) slight head lag when pulled to sitting position
c) positive babinski reflex
d) cries when approached by stranger

9. Which of the following doctor's orders for 4-hour newborn should you carry out?

a) administer 1L of oxygen for acrocyanosis
b) NaCl 0.9% 30 ml/kg, for a client with depressed fontanels
c) suction mouth and nose for irregular, abdominal breathing
d) report respiratory rate of 30-50 per minute

10. Which of the following questions should you ask the mother of a 5-month old infant with serum Na level of 132 mEq/L, who is bottle-feeding?

a) what solid foods do you give your baby?
b) what vitamin supplement do you give your baby?
c) how much water do you use to dilute formula?
d) how many diapers does your baby wet in a day?



ANSWERS AND RATIONALE

6) C
- if the child is hungry he/she more likely would finish his meals. Therefore, the mother should be advised not to give snacks to the child. The child is a "busy toddler." He/she will not able to keep still for a long time.

7) C
- at 12 to 14 months, the child is able to drink from cup.

8) B
- head lag should no longer be present in a 6-month old infant. Good head control is achieved at 3 to 4 months of age. Choices A, C, and D are normal findings in a 6-month old infant. Posterior fontanel closes at 3 to 4 months; positive babinski reflex is normal up to 12 months; fear of stranger is normal in an infant.

9) B
- depressed fontanels indicate dehydration. Acrocyanosis is normal in a newborn. Irregular, abdominal breathing and respiratory rate of 30-50 bpm are also normal findings and do not require intervention.

10) A
- at age 4-6 months, the infant should already have solid foods. Foods are the best sources of electrolytes.


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NCLEX Peds Questions (1-5)

Let us try to answer nclex peds questions . . .

1. A mother of a 1-month old infant expresses concern because one of the infant's eye appears to be crossed. The most appropriate and supportive response by the nurse is which of the following?
a) this is normal in the young infant but should not be present after about age 4 months
b) this condition is probably permanent
c) the infant will probably need surgery
d) it needs observation because this thing may happen to the other eye

2. The nurse is taking good care of a one-day old newborn. Which of the following assessment findings does the nurse expect?

a) temp-37.7C, apical rate-100 bpm, RR-45, BP-65/41 mmHg
b) temp-37.4C, apical rate-120 bpm, RR-28, BP-65/41 mmHg
c) temp-36.7C, apical rate-130 bpm, RR-irregular, BP-65/41 mmHg
d) temp-36.5C, apical rate-140 bpm, RR-regular, BP-95/58 mmHg

3. Who among the following pediatric client should be assessed first by the nurse?

a) the child with 2 episodes of soft stools during the shift
b) the child who had cough for the past three days, with clear nasal discharge and is irritable
c) the child with 2 episodes of inconsolable crying while the knees are drawn over the abdomen and plays between the episodes
d) the child with skin rashes on his face and trunk

4. The nurse is assessing a newborn who had undergone vaginal delivery. Which of the following findings is least likely to be observed in a normal newborn?

a) uneven head shape
b) respirations are irregular, abdominal, 30-60 bpm
c) (+) moro reflex
d) heart rate is 80 bpm

5. The nurse is caring for several infants who are 2-day old. Who among these infants should be given highest priority by the nurse?

a) a bottlefed infant who takes 1-ounce of milk every 3 to 5 hours
b) a breastfed infant who lost 0.5 ounce of his weight
c) a bottlefed infant who takes 2 to 3 ounces of milk every 2 to 4 hours
d) a breastfed infant who feeds every 2 to 4 hours






NCLEX PEDS QUESTIONS
ANSWERS AND RATIONALE

1) A
- strabismus is normal in an infant and it normally resolves before age 4 months

2) C
- the body temperature of the newborn is slightly lower than 37C, apical rate is 120-160 bpm, respiration are irregular (30-60 per min)

3) C
- this indicates appendicitis. The pattern of abdominal pain in appendicitis is as follows: pain occurs for 2 to 3 hours, pain is relieved in 2 to 3 hours, the n pain recurs and persists. During the time that pain subsides, it is when rupture of appendicitis may occur unnoticed.

4) D
- normal heart rate of the newborn is 120 to 160 bpm. Choices A, B, and C are normal assessment findings (uneven head shape is molding).

5) A
- the client experiences poor feeding (1 ounce = 30 ml) which indicates specific problems. The infant normally looses weight during the first week of life and he/she usually gains weight on the second week.


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NCLEX Peds Questions (6-10)

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Test Prep for Nursing Exam about Pediatric Nursing (91-95)

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91. A nurse is performing an assessment on a 10-year old child suspected having Hodgkin's disease. The nurse understands that which of the following assessment findings is characteristic of this disease?

a) fever and malaise
b) anorexia and weight loss
c) painful, enlarged inguinal lymph nodes
d) painless, firm, and movable adenopathy in the cervical area

92. When assessing a 2 year-old child brought by his mother to the clinic for a routine check-up, which of the following would the nurse expect the child to be able to do?

a) ride a tricycle
b) tie his shoelaces
c) kick a ball forward
d) use blunt scissors

93. After having blood sample drawn, a 5 year-old child insists that the site be covered with an adhesive bandage strip. When the mother tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse interprets this behavior as indicating a fear of which of the following?

a) injury
b) compromised body integrity
c) pain
d) loss of control

94. After teaching a group of mothers about temper tantrums, the nurse knows the teaching has been effective when one of the mothers states which of the following?

a) I will ignore the temper tantrums
b) I should pick up the child during the tantrums
c) I'll talk to my daughter during the tantrums
d) I would put my child in time out

95. After teaching the parents of a preschooler who has undergone T and A (Tonsillectomy and Adenoidectomy) about appropriate foods to give the child after discharge, which of the following, if stated by the parents as appropriate foods, indicates successful teaching?

a) meatloaf and uncooked carrots
b) pork and noodle casserole
c) cream of chicken soup and orange sherbet
d) hot dog and potato chips




ANSWERS AND RATIONALE

91) D

- Clinical manifestations specifically associated with Hodgkin’s disease include painless, firm, and movable adenopathy in the cervical and supraclavicular areas. Hepatosplenomegaly also is noted. Although fever, malaise, anorexia, and weight loss are associated with Hodgkin’s disease, these manifestations are seen in many disorders.

92) C
-  a 2 year old usually can kick a ball forward. Riding a tricycle is characteristic of a 3 year old. Tying a shoelaces is a behavior to be expected of a 5 year old. Using blunt scissors is characteristic of a 3 year old.

93) B
-  the preschool child does not have an accurate concept of skin integrity and can view medical surgical treatments as hostile invasions that can destroy or damage the body. The child does not understand that exsanguination will not occur from an injection site. Fear of pain would be manifested if the child thought that bodily harm would occur. If the child thought that he would urinate in his pants, then he would be demonstrating fear of loss of control.

94) A
-  children who have temper tantrums should be ignored as long as they are safe. They should not receive either positive or negative reinforcement to avoid perpetuating the behavior. Temper tantrums are a toddler's way of achieving independence.

95) C
-  for the first few days after a T and A, liquids and soft foods are best tolerated by the child while the throat is sore. Avoid hard and scratchy foods until throat is healed.

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