PEDIA

Question 1

Which of the following organisms is the most common cause
of urinary tract infection (UTI) in children

a. Klebsiella
b. Staphylococcus
c. Escherichia coli
d. Pseudomonas

Answer 1

c. Escherichia coli

Question 2

A nurse is monitoring a child with burns during treatment for
burn shock. The nurse understands that which of the following
assessments provides the most accurate guide to determining
the adequacy of fluid resuscitation?
a. Skin turgor
b. Neurological assessment
c. Level of edema at burn site
d. Quality of peripheral pulses

Answer 2

b. Neurological assessment

Question 3

Which of the following is not a possible systemic clinical
manifestation of severe burns?
a. Growth retardation
b. Hypermetabolism
c. Sepsis
d. Blisters and edema

Answer 3

a. Growth retardation

Question 4

An infant with Down’s syndrome is best described by the
following findings

a. Brush field spots
b. failure to thrive
c. webbed neck
d. gynecomastia

Answer 4

a. Brush field spots

Question 5

A nurse is caring for an infant with bacterial meningitis. The
parents ask how their baby could have contracted the illness.
What does the nurse consider as the most likely route of
transmission to the central nervous system (CNS)?
a. Genitourinary tract
b. Gastrointestinal tract
c. Skin or mucous membrane
d. Cranial apertures or sinuses

Answer 5

d. Cranial apertures or sinuses

Question 6

A nurse is caring for a child after a tonsillectomy. The nurse
monitors the child, knowing that which of the following
indicates that the child is bleeding?
a. Frequent swallowing
b. A decreased pulse rate
c. Complaints of discomfort
d. An elevation in blood pressure

Answer 6

a. Frequent swallowing

Question 7

The following are a chromosomal aberration of Down
Syndrome, EXCEPT:
a. trisomy 21
b. tranlocation15/21
c. trisomy 15
d. mosaicism

Answer 7

c. trisomy 15

Question 8

A type of Hydrocephalus wherein the decreased absorption of
the CSF is caused by post meningitis or intraventricular
hemorrhage.
a. Communicating
b. Non-communicating
c. Brain Edema
d. Meningitis

Answer 8

a. Communicating

Question 9

In antibiotic therapy for otitis media the nurse should advise
the parents that it should be given for a period of 10 days and
a follow-up visit is needed in:
a. 3 days
b. 5 days
c. 7 days
d. 10 days

Answer 9

c. 7 days

Question 10

A nurse is caring for a patient with acute lymphoblastic
leukemia (ALL). Which of the following is the most likely age
range of the patient?
a. 3-10 years.
b. 25-35 years.
c. 45-55 years.
d. over 60 years

Answer 10

a. 3-10 years.

Question 11

The nurse is reviewing the laboratory report of a client who
underwent a bone marrow biopsy. The finding that would
most strongly support a diagnosis of acute leukemia is the
existence of a large number of immatures:
a. lymphocytes
b. thrombocytes
c. reticulocytes
d. leukocytes

Answer 11

d. leukocytes

Question 12

A client is admitted with acute leukemia. The nurse is assessing
for signs and symptoms of bleeding. Where is the best site for
examining for the presence of petechiae?
a. The abdomen
b. The thorax
c. The earlobes
d. The soles of the feet

Answer 12

d. The soles of the feet

Question 13

For acute otitis media, the treatment is prompt antibiotic
therapy. Delayed treatment may result to complications of.
a. tonsilitis
b. brain damage
c. eardrum perforation
d. Infections

Answer 13

c. eardrum perforation

Question 14

The cause of down’s syndrome is

c. chromosomal defect
a. an infection
b. an autoimmune disorder
d. heavy smoking

Answer 14

c. chromosomal defect

Question 15

The nurse is caring for a toddler with Down syndrome. To help
the toddler cope with painful procedures, the nurse can:
a. prepare the child by positive self-talk
b. establish a time limit to get ready for the procedure.
c. hold and rock him and give him a security object.
d. count and sing with the child.

Answer 15

c. hold and rock him and give him a security object.

Question 16

A child with leukemia is being discharged after beginning
chemotherapy. What instructions will the nurse include in the
teaching plan for the parents of this child?
a. Provide a diet low in protein and high in carbohydrates
b. Avoid fresh vegetables that are not cooked or peeled
c. Notify the M.D. if the child’s temperature exceeds (39 C)
d. Increase the use of humidifiers throughout the house

Answer 16

b. Avoid fresh vegetables that are not cooked or peeled

Question 17

A neonate born with myelomeningocele should be maintained
in which position pre-operatively.
a. Prone.
b. Supine.
c. Trendelenberg.
d. Semi-Fowler.

Answer 17

a. Prone.

Question 18

The nurse witnesses a pediatric patient experiencing a seizure.
The primary nursing intervention would be:
a. Careful observation and documentation of the seizure
activity.
b. Maintain patient safety.
c. Minimize the patient’s anxiety
d. Avoid overstimulation and promote rest

Answer 18

b. Maintain patient safety.

Question 19

A child is admitted to the hospital with a diagnosis
of Wilms tumor, stage II. Which of the following
statements most accurately describes this stage?
a. The tumor is less than 3 cm. in size and requires no
chemotherapy.
b. The tumor did not extend beyond the kidney and was
completely resected.
c. The tumor extended beyond the kidney but was
completely resected
d. The tumor has spread into the abdominal cavity and cannot
be resected.

Answer 19

c. The tumor extended beyond the kidney but was
completely resected

Question 20

After a tonsillectomy, a nurse reviews the physician’s
postoperative prescriptions. Which of the following physician’s
prescriptions does the nurse question?
A. Monitor for bleeding.
B. Suction every 2 hours.
C. Give no milk or milk products.
D. Give clear, cool liquids when awake and alert

Answer 20

B. Suction every 2 hours.

Question 21

What are the two categories of pharmacological agents used
in the treatment of asthma?
a. B2 adrenoreceptor antagonists and bronchodilators
b. Anti-inflammatory and glucocorticoids
c. Inhaled medications and oral medications
d. Bronchodilators and anti-inflammatory

Answer 21

d. Bronchodilators and anti-inflammatory

Question 22

A nurse is reviewing the laboratory results for a child scheduled
for tonsillectomy. The nurse determines that which laboratory
value is most significant to review?
a. Creatinine level
b. Prothrombin time
c. Sedimentation rate
d. Blood urea nitrogen level

Answer 22

b. Prothrombin time

Question 23

Is a congenital brain malformation involving the cerebellum
and the fluid-filled spaces around it. The key features of this
syndrome are an enlargement of the fourth ventricle a partial
or complete absence of the area of the brain between the two
cerebellar hemispheres (cerebellar vermis), and cyst formation
near the lowest part of the skull.
a. Chiari malformation
b. Dandy-Walker Syndrome
c. Hydrocephalus
d. Meningitis

Answer 23

b. Dandy-Walker Syndrome

Question 24

Wilmer is diagnosed with acute lymphoid leukemia (ALL) and
beginning chemotherapy. Wlmer is discharged from the
hospital following her chemotherapy treatments. Which
statement of Wlmer’s mother indicated that she understands
when she will contact the physician?
a. “I should contact the physician if Stacy has difficulty in
sleeping”.
b. “I will call my doctor if Stacy has persistent vomiting and
diarrhea”.
c. “My physician should be called if Stacy is irritable and
unhappy”.
d. “Should Stacy have continued hair loss, I need to call the
doctor”.

Answer 24

b. “I will call my doctor if Stacy has persistent vomiting and
diarrhea”.

Question 25

A nurse is caring for a child with the diagnosis of meningitis.
What clinical findings indicate an increase in intracranial
pressure? Select all that apply
a. Bradycardia
b. Hyperalertness
c. Decreased pulse pressure
d. Decreased systolic blood pressure

Answer 25

a. Bradycardia

Question 26

When caring for a child with meningitis, it is essential that the
nurse evaluate for a positive Brudzinski’s sign, which would
indicate
a. increased intracranial pressure.
b. meningeal irritation.
c. encephalitis.
d. intraventricular hemorrhage

Answer 26

b. meningeal irritation.

Question 27

The parents of an infant who just had ventriculoperitoneal
shunt inserted for hydrocephalus are concerned about the
prognosis. What information should the nurse give the parent?
a. The prognosis is excellent, and the valve is permanent
b. The shunt may need to be revised as the child grows older.
c. If any brain damage has occurred, it is irreversible even after
the first year of life.
d. Hydrocephalus usually is self-limiting by 2 years of age, and
then the shunt is removed

Answer 27

b. The shunt may need to be revised as the child grows older.

Question 28

Which of the following would the nurse identify as the initial
priority for a child with acute lymphocytic leukemia?
a. Instituting infection control precautions
b. Encouraging adequate intake of iron-rich foods
c. Assisting with coping with chronic illness
d. Administering medications via IM injections

Answer 28

a. Instituting infection control precautions

Question 29

Mr. and Ms. Byers’ child failed to pass meconium within the
first 24 hours after birth; this may indicate which of the
following?
a. Celiac disease
b. Intussusception
c. Hirschsprung’s disease
d. Abdominal-wall defect

Answer 29

c. Hirschsprung’s disease

Question 30

A healthy infant has meningitis and is receiving I.V. and oral
fluids. The nurse should monitor this client’s fluid intake
because fluid overload may cause:
a. Hypovolemic shock
b. Heart failure
c. Dehydration
d. Cerebral edema

Answer 30

d. Cerebral edema

Question 31

The discharge of e newborn with a surgically repaired
myelomeningocele is anticipated at about 2 weeks of age.
What teaching should the nurse include when preparing the
parents for discharge?
a. Demonstration of restrictive positions to prevent the
infant from turning
b. Discussion about the need to limit the infant’s fluid intake to
formula only
c. Instructions on how to do passive range-of-motion exercises
to the infant’s lower extremities
d. Explanation of the need to provide the infant with a quiet
environment to reduce external stimuli

Answer 31

a. Demonstration of restrictive positions to prevent the
infant from turning

Question 32

Is a disease in which there is inflammation (swelling) of the
synovium in children aged 16 or younger?
A. Juvenile Idiopathic Arthritis
B. Rheumatoid Arthritis
C. Rheumatic Fever
D. None of the above

Answer 32

A. Juvenile Idiopathic Arthritis

Question 33

What does a nurse determine is the most serious complication
of meningitis in young children?
a. Epilepsy
b. Blindness
c. Peripheral circulatory collapse
d. Communicating hydrocephalus

Answer 33

a. Epilepsy

Question 34

Marie with acute lymphocytic leukemia suffers from nausea
and headache. These clinical manifestations may indicate all of
the following except
a. effects of radiation
b. chemotherapy side effects
c. meningeal irritation
d. gastric distension

Answer 34

d. gastric distension

Question 35

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

Answer 35

d. Bright red blood and mucus in the stools

Question 36

A 1-year-old infant has been admitted with a tentative
diagnosis of bacterial meningitis. A lumbar puncture is
performed to confirm the diagnosis. What laboratory report
the spinal fluid supports this diagnosis?
a. Decreased cell count
b. Elevated protein level
c. Increased glucose level
d. Low spinal glucose level

Answer 36

b. Elevated protein level

Question 37

Sax underwent Ventriculoperitoneal shunting. What is the best
post-operative position?
a. Flat on bed
b. Trendelenburg
c. Side lying
d. Head is elevated

Answer 37

a. Flat on bed

Question 38

Which test would confirm a diagnosis of meningitis in children?
a. Complete blood count
b. Bone marrow biopsy
c. Lumbar puncture
d. Computerized Tomography (CT) scan

Answer 38

c. Lumbar puncture

Question 39

The primary physiological alteration in the development of
asthma is:
a. Bronchiolar inflammation and dyspnea
b. Hypersecretion of abnormally viscous mucus
c. Infectious processes causing mucosal edema
d. Spasm of bronchiolar smooth muscle

Answer 39

a. Bronchiolar inflammation and dyspnea

Question 40

An infant who was born with a meningomyelocele develops
hydrocephalus. A ventriculoperitoneal shunt is inserted. What
nursing intervention is essential in this infant’s care during the
first 24 hours after surgery?
a. Placing in high-fowler position
b. Administering the prescribed sedative
c. Positioning on the same side as the shunt
d. Monitoring for increasing intracranial pressure

Answer 40

d. Monitoring for increasing intracranial pressure

Question 41

The treatment for patients with leukemia is bone marrow
transplantation. Which statement about bone marrow
transplantation is not correct?
a. The patient is under local anesthesia during the procedure
b. The aspirated bone marrow is mixed with heparin.
c. The aspiration site is the posterior or anterior iliac crest.
d. The recipient receives cyclophosphamide (Cytoxan) for 4
consecutive days before the procedure.

Answer 41

a. The patient is under local anesthesia during the procedure

Question 42

What should be included in the nursing care of an infant with
increased intracranial pressure?
a. weigh daily before feeding
b. Elevate the head higher than the hips
c. Check the reflexes at regular intervals
d. Monitor alertness with frequent stimulation

Answer 42

b. Elevate the head higher than the hips

Question 43

A nurse is caring for a newborn infant with a suspected
diagnosis of imperforate anus. The nurse monitors the infant,
knowing that which of the following is a clinical manifestation
associated with this disorder?
a. Bile-stained fecal emesis
b. The passage of currant jelly–like stools
c. Failure to pass meconium stool in the first 24 hours after
birth
d. Sausage-shaped mass palpated in the upper right abdominal
quadrant

Answer 43

c. Failure to pass meconium stool in the first 24 hours after
birth

Question 44

An infant is diagnosed with communicating hydrocephalus, the
parents ask for clarification of the health care provider’s
explanation of their baby’s problem. How should the nurse
respond?
a. “Too much spinal fluid is produced within the spaces
(ventricles) of the brain”.
b. “The flow of the spinal fluid through the brain cells does not
empty effectively into the spinal cord”.
c. “The spinal fluid is prevented from adequate absorption by
a blockage in the spaces (ventricles) of the brain”.
d. “There is a part of the brain surface that usually absorbs
spinal fluid after its production that is not functioning
adequately”

Answer 44

d. “There is a part of the brain surface that usually absorbs
spinal fluid after its production that is not functioning
adequately”

Question 45

A 6-year-old boy is admitted to the hospital with complaints of
fatigue and weight loss. Physical examination reveals pallor
and multiple bruises on his arms and legs. The results of the
patients tests reveal acute lymphocytic leukemia and
thrombocytopenia. Which of the following nursing diagnoses
MOST accurately reflects his condition?
a. Potential for injury.
b. Self-care deficit
c. Potential for self-harm.
d. Alteration in comfort.

Answer 45

a. Potential for injury

Question 46

An infant is diagnosed with communicating hydrocephalus,
the parents ask for clarification of the health care provider’s
explanation of their baby’s problem. How should the nurse
respond?
a. “Too much spinal fluid is produced within the spaces
(ventricles) of the brain”.
b. . “The flow of the spinal fluid through the brain cells does
not empty effectively into the spinal cord”.
c. “The spinal fluid is prevented from adequate absorption by
a blockage in the spaces (ventricles) of the brain”.
d. “There is a part of the brain surface that usually absorbs
spinal fluid after its production that is not functioning
adequately”.

Answer 46

d. “There is a part of the brain surface that usually absorbs
spinal fluid after its production that is not functioning
adequately”.

Question 47

Situation: A 9-month old Sax was admitted in a pediatric unit
due to enlarged head circumference, bulging fontanelles and
sunset eyes. He is diagnosed to have a hydrocephalus. The top
priority in rendering care is to
a. Promote normal growth and development of the child
b. Monitor vital signs
c. Provide emotional support
d. Monitor signs of increased intracranial pressure

Answer 47

d. Monitor signs of increased intracranial pressure

Question 48

A patient is undergoing the induction stage of treatment for
leukemia. The nurse teaches family members about infectious
precautions. Which of the following statements by family
members indicates that the family needs more education?
a. We will bring in books and magazines for entertainment.
b. We will bring in personal care items for comfort.
c. We will bring in fresh flowers to brighten the room.
d. We will bring in family pictures and get well cards

Answer 48

c. We will bring in fresh flowers to brighten the room.

Question 49

The nurse formulates a nursing diagnosis of Risk for infection
for a child with Down syndrome. Which condition typically
seen in children with this syndrome supports this nursing
diagnosis?
a. Muscular hypotonicity
b. Muscle spasticity
c. Increased mucus viscosity
d. Hypothyroidism

Answer 49

a. Muscular hypotonicity

Question 50

A patient with leukemia is receiving chemotherapy that is
known to depress bone marrow. A CBC (complete blood count)
reveals a platelet count of 25,000/microliter. Which of the
following actions related specifically to the platelet count
should be included on the nursing care plan?
a. Monitor for fever every 4 hours.
b. Require visitors to wear respiratory masks and protective
clothing.
c. Consider transfusion of packed red blood cells.
d. Check for signs of bleeding, including examination of urine
and stool for blood

Answer 50

d. Check for signs of bleeding, including examination of urine
and stool for blood