Question 1

A nurse in a pediatric clinic is performing a physical examination of a 30-month-old child.  Which finding requires further evaluation?

Accepted Answer

A) Bladder and bowel control achieved 
B) Chest circumference is greater than abdominal circumference 
C) Current weight is 6 times greater than birth weight 
D) Head circumference increased by 1 in (2.5 cm) in the past year

Question 2

The nurse is providing discharge instructions to the parent of a child with Kawasaki disease.  The nurse informs the parent that the presence of which symptom should be immediately reported to the health care provider?

Accepted Answer

A) Fever 
B) Irritability 
C) Knee pain 
D) Skin peeling

Question 3

The parent of a 1-year-old says to the nurse, "I would like to start toilet training my child as soon as possible."  What information does the nurse provide to the parent that correctly describes a child's readiness for toilet training?

Accepted Answer

A) "A good time to start toilet training is when your child can dress and undress autonomously." 
B) "When your child can sit on the toilet until urination occurs, you can start toilet training." 
C) "Your child may be ready to start toilet training when able to communicate and follow directions." 
D) "Your child will be ready to start toilet training at about age 15 months."

Question 4

A nurse is teaching the parent of an 8-month-old infant who had a febrile seizure about management of future fevers.  Which instruction is appropriate to include in the teaching?

Accepted Answer

A) "Give acetaminophen or ibuprofen every 6 hours to control the fever." 
B) "Give the infant frequent tepid sponge baths to control the fever." 
C) "If the infant develops another seizure, wait 15 minutes to see if it subsides." 
D) "Place ice bags under the arms and around the neck to reduce the fever."

Question 5

The emergency nurse is triaging four clients.  Which client should the nurse assess first?

Accepted Answer

A) 6-month-old client who is constipated, cannot hold the head up, and has a weak cry after eating honey 
B) 4-year-old client who has elbow pain, swelling, and deformity after falling from a playground swing 
C) 6-year-old client who has fever and reports right-sided abdominal pain and difficulty tolerating food 
D) 9-year-old client who is lethargic and reports having painful urination and back pain

Question 6

The clinic nurse cares for a 4-year-old who has been diagnosed with a pinworm infection.  Which client symptom supports this diagnosis?

Accepted Answer

A) Anal itching that is worse at night 
B) Intestinal bleeding with anemia 
C) Poor appetite with weight loss 
D) Red, scaly, blistered rings on skin

Question 7

The nurse is assessing a 4-week-old infant during a routine office visit.  Which assessment finding is most likely to alert the nurse to the presence of right hip developmental dysplasia?

Accepted Answer

A) Decreased right hip adduction 
B) Presence of extra gluteal folds on right side 
C) Right leg longer than the left leg 
D) Right pelvic tilt with lordosis

Question 8

The clinic nurse supervises a student nurse who is preparing to administer routine vaccinations to a child diagnosed with hemophilia.  Which instructions should the clinic nurse provide to the student?  Select all that apply.

Accepted Answer

A) Administer ibuprofen for pain relief 
B) Administer vaccines via the subcutaneous route 
C) Apply a warm compress to the injection site 
D) Hold firm pressure on the site for 5 minutes 
E) Massage the injection site to disperse the medication

Question 9

The nurse assesses a child with intussusception.  Which assessment findings require priority intervention?

Accepted Answer

A) Abdominal rigidity with guarding 
B) Absence of tears in crying child with IV start 
C) Blood-streaked mucous stool in diaper 
D) Sausage-shaped right-sided mass on palpation

Question 10

A newborn is being evaluated for possible esophageal atresia with tracheoesophageal fistula.  Which finding is the nurse most likely to observe?

Accepted Answer

A) Choking and cyanosis during feeding 
B) Concave (scaphoid) abdomen 
C) Diminished lung sounds 
D) Projectile vomiting after feeding

Question 11

A 14-year-old is scheduled for surgery to treat scoliosis.  The child will be hospitalized for about a week and then discharged home to recuperate for 3-4 weeks before returning to school.  What is the best activity the nurse can recommend to promote age-specific growth and development during this time?

Accepted Answer

A) Attending selected after-school events and social activities 
B) Keeping up with schoolwork 
C) Reading teen magazines 
D) Visits from friends

Question 12

A nurse is assessing a 1-month-old infant with an atrial septal defect (ASD).  Which assessment finding does the nurse expect?

Accepted Answer

A) Muffled heart tones 
B) Murmur 
C) Cyanosis 
D) Weak femoral pulses

Question 13

The nurse is discussing child safety with the parents of a 12-month-old who is just beginning to walk.  Which statement by the parents indicates a need for further instruction?

Accepted Answer

A) "Our swimming pool is fenced in with a lock on the gate." 
B) "We have installed childproof gates at the top and bottom of our stairs." 
C) "We need to lower the mattress in our child's crib." 
D) "When we can't be watching, we put our child in a mobile child walker."

Question 14

When monitoring an infant with a left-to-right-sided heart shunt, which findings would the nurse expect during the physical assessment?  Select all that apply.

Accepted Answer

A) Clubbing of fingertips 
B) Cyanosis when crying 
C) Diaphoresis during feedings 
D) Heart murmur 
E) Poor weight gain

Question 15

The nurse just administered routine immunizations to a healthy 15-month-old.  What information should the nurse provide the caregivers before they leave the clinic?

Accepted Answer

A) Call the office if the toddler's temperature is higher than 100 F (37.7 
C)  
B) Fussiness and anorexia are common for 1 week after immunizations 
C) Redness at the injection sites and a mild fever are common 
D) The toddler's activity level should be restricted for 24 hours

Question 16

A parent calls the nurse telehealth triage line with concerns about an allergic reaction to something a child ate.  Which symptoms should the nurse instruct the parent to assess for to determine if the child is having an anaphylactic reaction?  Select all that apply.

Accepted Answer

A) Dyspnea 
B) Fever 
C) Lightheadedness 
D) Skin rash (hives) 
E) Wheezing

Question 17

What is the priority when caring for a 6-month-old diagnosed with atopic dermatitis?

Accepted Answer

A) Encouraging use of humidifier 
B) Exploration of family feelings 
C) Instruction regarding hypoallergenic diet 
D) Prevention of scratching

Question 18

The nurse is caring for a 10-year-old diagnosed with osteomyelitis.  What is the best activity the nurse can suggest to promote age-specific growth and development during hospitalization?

Accepted Answer

A) Fantasy play with puppets 
B) Invite friends to come visit 
C) Provide missed schoolwork 
D) Watch favorite movies

Question 19

The nurse assessing a 2-year-old should expect the child to be able to perform which actions?  Select all that apply.

Accepted Answer

A) Build a tower with blocks 
B) Draw a square 
C) Hop on one foot 
D) Say own name 
E) Walk without help

Question 20

The nurse is caring for an infant diagnosed with Hirschsprung disease who is awaiting surgery.  Which assessment finding requires the nurse's immediate action?

Accepted Answer

A) Abdominal distension with no change in girth for 8 hours 
B) Did not pass meconium or stool within 48 hours after birth 
C) Episode of foul-smelling diarrhea and fever 
D) Excessive crying and greenish vomiting

Exam 2: Child Health

A nurse in a pediatric clinic is performing a physical examination of a 30-month-old child. Which finding requires further evaluation?

The nurse is providing discharge instructions to the parent of a child with Kawasaki disease. The nurse informs the parent that the presence of which symptom should be immediately reported to the health care provider?

The parent of a 1-year-old says to the nurse, "I would like to start toilet training my child as soon as possible." What information does the nurse provide to the parent that correctly describes a child's readiness for toilet training?

A nurse is teaching the parent of an 8-month-old infant who had a febrile seizure about management of future fevers. Which instruction is appropriate to include in the teaching?

The emergency nurse is triaging four clients. Which client should the nurse assess first?

The clinic nurse cares for a 4-year-old who has been diagnosed with a pinworm infection. Which client symptom supports this diagnosis?

The nurse is assessing a 4-week-old infant during a routine office visit. Which assessment finding is most likely to alert the nurse to the presence of right hip developmental dysplasia?

The clinic nurse supervises a student nurse who is preparing to administer routine vaccinations to a child diagnosed with hemophilia. Which instructions should the clinic nurse provide to the student? Select all that apply.

The nurse assesses a child with intussusception. Which assessment findings require priority intervention?

A newborn is being evaluated for possible esophageal atresia with tracheoesophageal fistula. Which finding is the nurse most likely to observe?

A nurse is assessing a 1-month-old infant with an atrial septal defect (ASD) . Which assessment finding does the nurse expect?

The nurse is discussing child safety with the parents of a 12-month-old who is just beginning to walk. Which statement by the parents indicates a need for further instruction?

When monitoring an infant with a left-to-right-sided heart shunt, which findings would the nurse expect during the physical assessment? Select all that apply.

The nurse just administered routine immunizations to a healthy 15-month-old. What information should the nurse provide the caregivers before they leave the clinic?

A parent calls the nurse telehealth triage line with concerns about an allergic reaction to something a child ate. Which symptoms should the nurse instruct the parent to assess for to determine if the child is having an anaphylactic reaction? Select all that apply.

What is the priority when caring for a 6-month-old diagnosed with atopic dermatitis?

The nurse is caring for a 10-year-old diagnosed with osteomyelitis. What is the best activity the nurse can suggest to promote age-specific growth and development during hospitalization?

The nurse assessing a 2-year-old should expect the child to be able to perform which actions? Select all that apply.

The nurse is caring for an infant diagnosed with Hirschsprung disease who is awaiting surgery. Which assessment finding requires the nurse's immediate action?