Johnson J., Keogh J. Pediatric Nursing Demystified: A Self-Teaching Guide
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Pediatric Nursing Demystified
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52. Which of the following conditions would you find in a child who is diagnosed
with pyloric stenosis?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
53. Why would you give a pacifier to an infant who had surgery for a tracheoesophageal
fistula?
a. Keeps the infant quiet.
b. Soothes the infant.
c. Sucking the pacifier helps prepare the infant for speech.
d. The pacifier trains the infant to suck for nourishment.
54. A father of a boy diagnosed with ulcerative colitis wonders why his son is anemic.
What is your best response?
a. The youngster is eating too much junk food.
b. You are not providing a proper diet.
c. Chronic bloody diarrhea as a result of ulcerative colitis causes a decrease in
hemoglobin, which causes the anemic condition.
d. Chronic bloody vomiting as a result of ulcerative colitis causes a decrease in
hemoglobin, which causes the anemic condition.
55. Which of the following conditions would be found in a child who is diagnosed
with ulcerative colitis?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
56. A father of a boy diagnosed with ulcerative colitis asks why he must keep a
stool diary for his son. What is your best response?
a. To identify irritating foods that exacerbate ulcerative colitis
b. To measure the child’s output volume accurately
c. To estimate the amount of water in the stool
d. To identify if your son is taking his medication
57. The mother of a child who is diagnosed with volvulus wonders what could have
caused this disorder. What is your best response?
a. Ingesting a foreign substance
b. Ingesting too much starch
c. Ingesting too much sugar
d. Not ingesting enough water
Final Exam
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58. The mother of a child who underwent an appendectomy asks why her daugh-
ter must wait until bowel sounds return before she can have food. What is your
best response?
a. Before giving your daughter any food we must be sure that the food can move
through her intestine.
b. Bowel sounds are the result of muscles in the intestine contracting. This is nec-
essary for food to move through the intestine. The anesthetic from the appendec-
tomy slows muscle contractions of the intestine. Muscle contractions will return
when the anesthetic wears off and bowel sounds return.
c. Before giving your daughter any food we must be sure that the food can move
through her intestine. This happens by muscles in the intestine contracting,
which causes bowel sounds to occur. The anesthetic from the appendectomy
slows muscle contractions of the intestine. Muscle contractions will return when
the anesthetic wears off. We’ll know when this happens when the bowel sounds
return.
d. The anesthetic reduces peristalsis and therefore food can’t pass through the intes-
tine until bowel sounds return.
59. What would you do if you received an order to administer Kayexalate to a child
who has glomerulonephritis?
a. Question the order because the child’s kidneys are not functionally normally.
b. Administer the medication as order.
c. Assess the child’s potassium level before administering the medication.
d. Administer the medication only if the child’s potassium level is low; otherwise
there is a risk of cardiac arrest.
60. A parent of a child who is recently diagnosed with a kidney disorder asks you
why the health-care provider tests her son’s blood urea nitrogen (BUN) and
creatinine. What is your best response?
a. The health-care provider measures BUN and creatinine to determine if your son’s
kidneys are working. BUN and creatinine are waste products in the blood and
removed from the blood by the kidneys. If the kidneys are functioning, then the
BUN and creatinine levels in the blood are normal. If they are not functioning,
then these levels are abnormal.
b. The health-care provider measures BUN and creatinine to determine if your son’s
kidneys are working.
c. I’ll ask your health-care provider to explain these tests.
d. The health-care provider orders these and other tests to determine your son’s
health.
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61. The mother of a child who has been diagnosed with nephrotic syndrome asks
why you are administering Albuminar to her son. What is your best response?
a. Albumin is released by the kidneys into the urine resulting in decreased albumin
in blood because the glomerular filtration membrane is injured causing a fluid
switch and edema because of the decreased albumin in the blood. Albuminar
replaces the albumin.
b. Your son is experiencing a fluid imbalance caused by nephrotic syndrome. Your
son’s kidneys are releasing a chemical called albumin that helps maintain fluid
balance. Albuminar is a replacement for albumin and restores fluid balance.
c. It is best that you ask your health-care provider to explain the medication.
d. I’ll ask a more experienced nurse to explain once I administer the medication.
62. A new nurse is about to palpate a child who has Wilms tumor. What is your best
response?
a. Always observe the site before palpating.
b. Don’t palpate the site of the tumor. Palpation can rupture the tumor capsule result-
ing in the tumor metastasizing quickly.
c. Always explain the procedure to the patient.
d. Review the disorder before visiting the patient.
63. A mother of an 8-year-old is curious why her daughter has frequent urinary
tract infections. What is your best response?
a. You probably want to remind your daughter about proper hygiene when toileting
because a urinary tract infection is commonly caused by Escherichia coli entering
the urinary tract. E. coli is found in stool.
b. Mention this to the health-care provider.
c. Urinary tract infection is commonly caused when E. coli enters the urinary tract.
d. Your child has a kidney infection.
64. The parents of a recently diagnosed child with Wilms tumor asks for a defini-
tion of stage III of the disorder? What is your best response?
a. The tumor has metastasized to lymph nodes and the abdomen.
b. The tumor is contained in one kidney.
c. The tumor has metastasized to the bone, liver, lung, and brain.
d. The tumor has metastasized to both kidneys.
65. A parent of a child who is diagnosed with chronic renal failure asks why this
condition seemed to develop so suddenly. What is your best response?
a. It is best that you ask your health-care provider.
b. The symptoms usually go unnoticed because they resemble a simple head cold.
c. The symptoms were there but you didn’t notice them.
d. Chronic renal failure is asymptomatic until kidney function declines 20% at
which time the child becomes lethargic and fatigued.
Final Exam
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66. The health-care provider ordered amoxicillin, phenazopyridine, and aceta-
minophen for a child diagnosed with pyelonephritis. What is your best
response?
a. Question the order for acetaminophen because it causes an adverse reaction with
amoxicillin.
b. Question the order for amoxicillin.
c. Tell the child and the family that phenazopyridine causes orange-colored
urine.
d. Question the order for phenazopyridine because it causes an adverse reaction
with amoxicillin.
67. A mother brings her 9-year-old boy to the ED with an ankle injury. She tells you
he broke his ankle. What is your best response?
a. Suspect child abuse.
b. Assess for compartment syndrome.
c. Most ankle injuries in children are sprains; however, the health-care provider typ-
ically orders a radiograph to rule out a fracture.
d. Prepare to move the child to the ICU as a result of Compartment syndrome.
68. The parents of a 1-year-old diagnosed with type I osteogenesis imperfecta
didn’t fully understand the nature of the disorder. What is your best
response?
a. Your health-care provider is the best one to explain this to you.
b. Type I, the most common, occurs when there is severe bone deformity and numer-
ous fractures resulting in respiratory problems at or shortly after birth.
c. Type I, the most common, occurs because bones fracture easily before puberty.
d. Type I, the most common, occurs when fractures present at birth healed.
69. The parent of a child diagnosed with Legg-Calvé-Perthes disease is fearful
that her child will have a limp for the rest of his life. What is your best
response?
a. Your child’s body will adjust for the limp.
b. Your child will partially recover after the disease has run its course.
c. Your child will fully recover after the disease has run its course.
d. Surgery can be performed to minimize the limp.
70. Parents of a child who is diagnosed with talipes ask how this disorder is treated.
What is your best response?
a. A splint, cast, or special shoes might be applied and possible surgery.
b. A 10-day antibiotic therapy will return child to normal.
c. Your child will fully recover after the disorder has run its course.
d. A daily routine of range-of-motion exercises is a common treatment for this
disorder.
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71. Parents of a child who was diagnosed with polyarticular juvenile rheumatoid
arthritis wonder how this differs from juvenile rheumatoid arthritis. How
should you respond?
a. This is a type of juvenile rheumatoid arthritis that affects fewer than five joints
and might exhibit inflammation of the iris without joint symptoms.
b. This is a type of juvenile rheumatoid arthritis that affects the entire body result-
ing in high fevers that suddenly drop to normal.
c. This is a type of juvenile rheumatoid arthritis that has a rash that suddenly appears
and disappears.
d. This is a type of juvenile rheumatoid arthritis that affects the small joints of the
hands and weight-bearing joints.
72. How should you care for a child who has scoliosis?
a. Support the back, feet, and knees with pillows when the patient lies on the side.
b. Avoid twisting or turning the spine when moving the child.
c. Perform range-of-motion exercises to maintain muscle tone.
d. All of the above.
73. Parents of a child diagnosed with torticollis asked what caused this disorder.
What is your best response?
a. Viral infection
b. Bacterial infection
c. Intrauterine malposition
d. Fungal infection
74. A child who has a cast on his left arm complains about pain and being unable
to move his fingers on his left hand. You notice that the left hand is pale and you
are unable to detect a pulse. What is your best response?
a. Open the cast immediately per protocol.
b. Call the health-care provider immediately.
c. Assess if the child can move fingers on his right hand.
d. Assess if the child can move his legs.
75. You have been assigned to care for an infant diagnosed with diphtheria. What
must be monitored?
a. Reverse isolation procedures.
b. That the infant doesn’t scratch scabs on the sites of the rash.
c. The child’s airway. Lesion can obstruct the airway especially in infants.
d. That the infant’s legs are kept at a 30-degree angle.
76. The health-care provider orders you to administer penicillin G to a child who
has been diagnosed with diphtheria. What is your best response?
a. Question the order because diphtheria is a viral infection.
b. Administer the medication.
c. Assess if the child is allergic to penicillin.
d. Administer the medication because diphtheria is a bacterial infection.
Final Exam
357
77. The health-care provider orders Sumycin for a 6-year-old who has been diagnosed
with Lyme disease. What is your best response?
a. Question the order because Sumycin will permanently stain the child’s teeth.
b. Administer the medication.
c. Question the order because you expected the health-care provider to order
tetracycline.
d. Question the order because Lyme disease is a viral infection.
78. What would you expect the health-care provider to order if a child diagnosed
with pertussis is unable to tolerate erythromycin?
a. Penicillin G
b. Sumycin
c. Bactrim
d. Tetracycline
79. Why is a child diagnosed with tetanus placed in the ICU?
a. To prevent transmitting tetanus to other children.
b. To limit the spreading of the Clostridium tetani bacterium.
c. To monitor cardiorespiratory function because muscles tightening the mouth
make it difficult to breathe and swallow.
d. To protect the child from seizures.
80. A mother of a 3-year-old called saying she noticed a small red flat spot on the
roof of her child’s mouth. What is your best response?
a. Bring the child to the ED immediately.
b. Bring the child to the health-care provider immediately.
c. Ask the woman if she is pregnant.
d. Tell her to mention this to her health-care provider during her next scheduled
appointment.
81. A parent of a child who is diagnosed with rubeola asks if she can send her child
to child care tomorrow since the rash disappeared 2 days ago. What is your best
response?
a. Yes, he is no longer contagious.
b. No, not until she is examined by the health-care provider.
c. No, he remains contagious for 5 days after the rash subsides.
d. Yes, as long as no other child at the child-care center is infected.
82. Father of 7-year-old who is diagnosed with the measles tells his son that he will
be fine after taking an antibiotic for 10 days. How would you respond?
a. The measles is a viral infection. Antibiotics are prescribed for bacterial infections
and won’t have any therapeutic effect on the measles virus.
b. The measles is self-limiting.
c. The treatment for the measles is to let it run its course.
d. The treatment for the measles is to let it run its course and treat the symptoms of
the infection.
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83. A hydrocolloid occlusive dressing is applied to a large abrasion. The dressing
was applied for what primary purpose?
a. To deliver vitamin E to the wound
b. Improves the appearance of the wound
c. Provides a moist environment for healing
d. Promotes mechanical friction to remove abrasion
84. What physiological process results in edema form as a result of a burn?
a. Capillary vasoconstriction
b. Reduced capillary permeability
c. Hydrostatic pressure in the capillaries
d. Increased capillary permeability
85. What systemic response is involved with severe burns in a child?
a. Acute metabolic alkalosis
b. Decreased metabolic rate
c. Abrupt drop in cardiac output
d. Increased renal plasma flow
86. What should the nurse suspect and prepare for if a child is admitted with exten-
sive burns with burns on the lips and singed nasal hairs?
a. An inhalation injury
b. A hot-water scald
c. An electrical burn
d. A chemical burn
87. What is the primary intended impact of a high-protein diet for the child with
major burns?
a. To promote weight gain
b. To improve the child’s appetite
c. To minimize muscle breakdown
d. To avoid stress-induced hyperglycemia
88. Prior to burn wound debridement, Fentanyl and midazolam (Versed) are
given. What is the primary reason for this action?
a. Facilitate healing
b. Provide pain relief
c. Minimize risk of infection
d. Decrease amount of debridement needed
Final Exam
359
89. Nursing actions related to the application of biologic or synthetic skin cover-
ings for a child with partial-thickness burns of both legs include which of the
following?
a. Immobilize legs to prevent movement
b. Observe burn area for signs of infection
c. Monitor closely for signs of cardiovascular shock
d. Assess dressings for indications of tissue overgrowth
90. A mother rushed her daughter to the ED claiming they were in the woods today
for the first time in years and she thinks her daughter contracted Lyme disease.
What is your best response?
a. Tell me how it makes you feel that your daughter may have deer tick bites.
b. Bring your daughter back in 3 days and we can tell if the bacterium that causes
Lyme disease was transmitted to your daughter.
c. Let’s examine your daughter for deer tick bites. It takes up to 72 hours before the
bacterium that causes Lyme disease is transmitted to your daughter.
d. It is unlikely your daughter has the bacterium that causes Lyme disease unless she
has been in contact with a child or adult who is infected with Lyme disease.
91. A clinic nurse assesses a 1-year-old and notes small moist, circular eruptions on
the child’s arms. The nurse knows that further investigation is needed because
the lesions could be a sign of what condition? Choose all that apply.
a. Impetigo
b. Ringworm
c. Cigarette burns
d. Eczema
92. A pediatric client, who has been treated for anemia, has a hemoglobin level of
11.2 g/dL, down from an earlier finding of 12.2 g/dL. Which intervention by the
nurse is most appropriate?
a. Notify the physician to get orders for a blood transfusion.
b. Advise the client to remain on bed rest.
c. Instruct the client on a diet that is high in iron.
d. Assess the client for symptoms of anemia.
93. Which laboratory test should a nurse monitor to determine if a client is
responding to the administration of iron for iron deficiency anemia?
a. Eosinophils
b. Monocytes
c. Reticulocytes
d. Lymphocytes
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94. The nurse would record which name to most accurately describe an elevated,
superficial, distinct, purulent fluid-filled lesion?
a. Cyst
b. Papule
c. Pustule
d. Vesicle
95. Baby boy Johnson is a newborn who is experiences hypoxia and cyanosis. The
most likely diagnosis is a congenital heart defect caused by what type of shunt?
a. Right-to-left
b. Left-to-right
c. Pulmonary infection
d. Dilated pulmonary artery
96. Which description would best support a newborn suspected of having coarctation
of the aorta?
a. Cyanosis
b. Bulging carotid arteries
c. Cool arms
d. Weak or absent femoral pulses
97. What is the name of the structure between the aorta and pulmonary artery in
fetal circulation?
a. Foramen ovale
b. Mitral value
c. Ductus arteriosus
d. Foramen magnum
98. Baby Alice was born weeks ago and now presents with poor feeding, fatigue,
dyspnea, and a murmur. She is diagnosed with a patent ductus arteriosus. How
would you describe the alteration?
a. Increased cardiac output
b. Right-to-left shunt
c. Left-to-right shunt
d. Increased systemic blood flow
99. Jason arrives to his physician for his 8-week-old well-baby check. The exami-
nation reveals a murmur, and the electrocardiogram (ECG) reveals a large
ventricular septal defect. Left untreated, this defect will result in which of the
following conditions?
a. Pulmonary hypertension
b. Cyanosis
c. Pulmonary stenosis
d. Right ventricular atrophy
Final Exam
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100. Congestive heart failure precipitated by a ventricular septal defect in a
6-month-old is likely to produce which of the following?
a. Failure to thrive and periorbital edema
b. Dependent edema to the hands and feet
c. Weight loss and jaundice
d. Flat neck veins and decreased urinary output
ANSWERS
1. a 2. d 3. a 4. c
5. c 6. d 7. d 8. c
9. b 10. b 11. c 12. d
13. b 14. d 15. c 16. a
17. b 18. d 19. b 20. b
21. d 22. a 23. b 24. a
25. d 26. a 27. d 28. b
29. a 30. b 31. b 32. b
33. b 34. c 35. d 36. a
37. c 38. c 39. b 40. c
41. c 42. c 43. c 44. b
45. a 46. d 47. c 48. b
49. c 50. b 51. d 52. b
53. c 54. c 55. a 56. a
57. a 58. c 59. c 60. a
61. b 62. b 63. a 64. a
65. d 66. c 67. c 68. c
69. c 70. a 71. d 72. d
73. c 74. a 75. c 76. c
77. a 78. c 79. c 80. b
81. c 82. a 83. c 84. d
85. c 86. a 87. c 88. b
89. b 90. c 91. a and c 92. c
93. c 94. c 95. a 96. d
97. c 98. c 99. a 100. a