PEDIATRIC

MultipleChoice Questions - Select only one answer

1(366) A nurse is caring for a child recently diagnosed with cerebral palsy, and the
parents of the child ask the nurse about the disorder. The nurse bases her response on
the understanding that cerebral palsy is:
a)An infectious disease of the central nervous system
b)An inflammation of the brain as a result of a viral illness
c)A congenital condition that results in moderate to severe retardation
d)A chronic disability characterized by impaired muscle movement and posture
2(367) A nurse performs an admission assessment on a child and suspects physical
abuse. Based on this suspicion, the primary legal nursing responsibility is which of the
following?
a)Refer the family to the appropriate support groups.
b)Assist the family in identifying resources and support systems.
c)Report the case in which the abuse is suspected to the local authorities.
d)Document the child's physical assessment findings accurately and thoroughly.
3(368) A mother arrives at an emergency department with her 5-year-old child and
states that the child fell off a bunk bed. A head injury is suspected, and a nurse checks
the child's airway status and assesses the child 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
5(370) A nurse is caring for an infant with a diagnosis of hydrocephalus. Preoperatively,
a priority nursing intervention is to:
a)Test the urine for protein.
b)Reposition the infant frequently.

c)Provide a stimulating environment.

d)Assess blood pressure every 15 minutes.
6(371) A nurse is reviewing the record of a child with increased intracranial pressure
and notes that the child has exhibited signs of decerebrate posturing. On assessment of
the child, the nurse expects to note which of the following if this type of posturing is
present?
a)Flaccid paralysis of all extremities
b)Adduction of the arms at the shoulders
c)Rigid extension and pronation of the arms and legs
d)Abnormal flexion of the upper extremities and extension and adduction of the
lower extremities
8(373) A nurse develops a plan of care for a child at risk for tonic-clonic seizures. In the
plan of care, the nurse identifies seizure precautions and documents that which item(s)
need to be placed at the child's bedside?
a)Emergency cart
b)Tracheotomy set
c)Padded tongue blade
d)Suctioning equipment and oxygen
9(374) A lumbar puncture is performed on a child suspected to have 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, decreased pressure, and elevated protein level
b)Clear CSF, elevated protein, and decreased glucose levels
c)Cloudy CSF, elevated protein, and decreased glucose levels
d)Cloudy CSF, decreased protein, and decreased glucose levels

10(375) A nurse is planning care for a child with acute bacterial meningitis. Based on
the mode of transmission of this infection, which of the following should be included in
the plan of care?
a)Maintain enteric precautions.
b)Maintain neutropenic precautions.
c)No precautions are required as long as antibiotics have been started.
d)Maintain respiratory isolation precautions for at least 24 hours after the
initiation of antibiotics.
11(444) A child has a right femur fracture caused by a motor vehicle accident and is
placed in skin traction temporarily until surgery can be performed. During assessment,
the nurse notes that the dorsalis pedal pulse is absent on the right foot. What action
should the nurse take?
a)Notify the physician.
b)Administer an analgesic.
c)Release the skin traction.
d)Apply ice to the extremity.
12(445) A child is placed in skeletal traction for treatment of a fractured femur. The
nurse develops a plan of care for the child and includes which intervention in the plan?
a)Ensure that all ropes are outside the pulleys.
b)Ensure that the weights are resting lightly on the floor.
c)Restrict diversional and play activities until the child is out of traction.
d)Check the physician's prescriptions for the amount of weight to be applied.
22(1133) A nurse employed in a neonatal intensive care nursery receives a telephone
call from the delivery room and is told that a newborn with spina bifida
(myelomeningocele type) will be transported to the nursery. The maternity nurse
prepares for the arrival of the newborn and places which priority item at the newborn's
bedside?
a)A rectal thermometer
b)A blood pressure cuff

c)A specific gravity urinometer

d)A bottle of sterile normal saline
26(1643) A nurse is developing a plan of care for a newborn infant with spina bifida
(myelomeningocele type). The nurse includes assessment measures in the plan to
monitor for increased intracranial pressure. Which of the following assessment
techniques should be performed that will best detect the presence of an increase in
intracranial pressure?
a)Assess blood pressure for signs of hypotension.
b)Monitor for signs of dehydration.
c)Check urine for specific gravity.
d)Assess anterior fontanel for bulging.
28(1861) A child is brought to the hospital emergency department for an injury to the
lower right arm that occurred in a fall off a bicycle. On assessment the nurse notes that
the skin at the site of the injury is intact. A fracture is suspected, and a radiograph is
taken. The nurse can see on the radiograph viewer that the fracture of the bone is
across the entire bone shaft with some possible displacement. The nurse determines
that this child's fracture is a:
a)Simple fracture
b)Compound fracture
c)Greenstick fracture
d)Comminuted fracture
29(1862) A neighborhood nurse is attending a soccer game at a local middle school.
One of the students falls off the bleachers and sustains an injury to the left arm. The
nurse quickly attends to the child and suspects that the child's arm may be
broken. Which nursing action would be of highest priority before transferring the child to
the hospital emergency department?
a)Tell the child that the arm probably is fractured but not to worry because
permanent damage to the arm will not occur.
b)Immobilize the arm.
c)Ask for the name of the child's pediatrician or family physician so that he
or she can be contacted.

d)Have someone call the radiology department of the local hospital to let staff
know that the child will be arriving.
30(2139) A community health nurse is providing information to parents of children in a
local school regarding the signs of meningitis. The nurse informs the parents that the
classic signs of meningitis include which of the following?
a)Severe headache, fever, and changes in the level of consciousness
b)Nausea, delirium, and fever
c)Photophobia, fever, and confusion
d)Severe headache and back pain
31(2339) A nursing student is caring for a child with increased intracranial pressure. On
review of the chart, the student nurse notes that a transtentorial herniation has
occurred. A nursing instructor asks the student about this type of herniation. Which
statement by the student indicates a need for further research about this condition?
a)"The brain herniates downward and around the tentorium cerebelli."
b)"The herniation can be unilateral or bilateral."
c)"It involves only anterior portions of the brain."
d)"It can cause death if large amounts of tissue are involved."
32(2343) A nurse is reviewing a chart for a child with a head injury. The nurse notes that
the level of consciousness has been documented as obtunded. Which of the following
would the nurse expect to note on assessment of the child?
a)Awake, alert, interacting with the environment
b)Loss of the ability to think clearly and rapidly
c)Loss of the ability to recognize place or person
d)Sleeps unless aroused and once aroused has limited interaction with the
environment
33(2344) A nurse is performing an assessment on a child with a head injury. The nurse
notes an abnormal flexion of the upper extremities and an extension of the lower
extremities. The nurse documents that the child is experiencing:
a)Decorticate posturing

b)Decerebrate posturing
c)Flexion of the arms and legs
d)Normal expected positioning after head injury
34(2347) A nurse is preparing a plan of care for a child with a head injury. On review of
the records, the nurse notes that the physician has documented decorticate posturing.
The nurse plans care knowing that this type of posturing indicates which of the
following?
a)Damage to the midbrain
b)Damage to the pons
c)Damage to the diencephalon
d)A lesion in the cerebral hemisphere
36(2401) A child sustains a fall at home and is brought to the hospital emergency
department by the child's mother. After a radiographic examination, the child is
determined to have a fractured arm, and a plaster cast is applied. The nurse provides
instructions to the mother regarding neurocirculatory assessment and function. Which
statement by the mother indicates a need for further instruction?
a)"If her hand gets real cool and pale, I can apply the heating pad to
it."
b)"I'll need to check her skin twice a day at the cast edges."
c)"For the first couple of days, I should try to keep her hand higher than her
heart most of the time, using pillows."
d)"If she seems way too fussy and her arm is painful even after I've
given her the pain medication, it might be a problem and I should call you for help to
decide on what is happening."
41(2776) A nurse is caring for a child who sustained a head injury after falling from a
tree. On assessment of the child, the nurse notes the presence of a watery discharge
from the child's nose. The nurse will immediately test the discharge for the
presence of which of the following substance?
a)Glucose
b)Protein

c)White blood cells

d)Neutrophils

46(3123) The nurse assists a physician in performing a lumbar puncture on a 3-year-old

child with leukemia in whom central nervous system disease is suspected. In which of
the following positions will the nurse place the child during this procedure?
a)Prone with knees flexed to the abdomen and head bent with chin resting on the
chest
b)Modified Sims position
c)Lateral recumbent position with the knees flexed to the abdomen and head bent
with the chin resting on chest
d)Lithotomy position

47(3130) A school-age child with Down syndrome is brought to the ambulatory care
center by the mother. The child has bruising all over the body. To work most effectively
with this child, the nurse first addresses which of the following complications associated

with Down syndrome?

a)Children with Down syndrome scratch themselves a lot because of dry, cracked,
and frequently fissuring skin.
b)Children with Down syndrome fall down easily as a result of hyperflexibility and
muscle weakness.
c)Children with Down syndrome are more likely to develop acute leukemia than
the average child.
d)Children with Down syndrome are at risk for physical abuse because of their
low intellectual functioning.
48(3131) A child with cerebral palsy (CP) is in a management program to achieve
maximum potential for locomotion, self-care, and socialization in school. The nurse
works with the child to meet these goals by:
a)Keeping the child in a special education classroom with other children with
similar disabilities
b)Placing the child in the supine position with a 30-degree elevation of the head of
the bed to facilitate feeding
c)Removing ankle-foot orthoses and braces once the child arrives at school
d)Placing the child on a wheeled scooter board
50(3355) A child has just returned from surgery and has a hip spica cast. A priority
nursing action at this time is to:
a)Elevate the head of the bed.
b)Abduct the hips using pillows.
c)Assess the circulatory status.
d)Turn the child onto the right side.
51(3360) A nurse is assessing a child with increased intracranial pressure who has been
exhibiting decorticate posturing. On assessment, the nurse notes that the child is now
exhibiting decerebrate posturing. The nurse interprets that this change in the
child's condition indicates which of the following?
a)An improvement in condition

b)Decreasing intracranial pressure

c)Deteriorating neurological function
d)An insignificant finding
52(3372) A nurse is caring for an infant with spina bifida (myelomeningocele type) who
had the gibbus (sac on the back containing cerebrospinal fluid, the meninges, and the
nerves) surgically removed. The nursing plan of care for the postoperative period will
include which of the following to maintain the infant's safety?
a)Elevating the head with the infant in the prone position
b)Covering the back dressing with a binder
c)Placing the infant in a head-down position
d)Strapping the infant in a baby seat sitting up
53(3467) A nurse is performing an admission assessment on a newborn infant admitted
to the hospital with the diagnosis of subdural hematoma after a difficult vaginal delivery.
The nurse assesses for major signs and symptoms associated with subdural hematoma
by which of the following measures?
a)Testing for contractures of the extremities
b)Testing for equality of reflex responses in extremities by appropriate stimulation
c)Monitoring the urinary output pattern
d)Monitoring the urine for blood
54(3508) A nurse is caring for a child diagnosed with Down syndrome. In describing the
disorder to the parents, the nurse bases the explanation on the fact that Down syndrome
is a condition characterized by:
a)Above-average intellectual functioning with deficits in adaptive behavior
b)Average intellectual functioning and the absence of deficits in adaptive behavior
c)Subaverage intellectual functioning with the absence of deficits in adaptive
behavior
d)Moderate to severe retardation, congenital nature, and linkage to an extra
chromosome 21, group G

57(3686) The nurse is assessing for Kernig's sign in a child with a suspected diagnosis
of meningitis. The nurse performs this test by doing which of the following?
a)Bending the child's head toward the knees and hips and assessing for pain
b)Tapping the child's facial nerve and assessing for spasm
c)Compressing the child's upper arm and assessing for tetany
d)Raising the child's leg with the knee flexed and then extending the leg at the
knee and assessing for pain

58(3857) A nurse notes that an infant with the diagnosis of hydrocephalus has a head
that is heavier than that of the average infant. The nurse determines that special safety
precautions are needed when moving the infant with hydrocephalus. Which statement
would the nurse plan to include in the discharge teaching with the parents to reflect this
safety need?
a)"When picking up your infant, support the infant's neck and head
with the open palm of your hand."
b)"Feed your infant in a side-lying position."
c)"Place a helmet on your infant when in bed."
d)"Hyperextend your infant's head with a rolled blanket under the
neck area."

QUESTIONS ANSWER
1
2
3
5
6
8
9
10
11
12
22
26
28
29
30
31

D
C
B
B
B
D
C
D
A
D
D
D
A
B
A
C

32
33
34
36
41
46
47
48
50
51
52
53
54
57
58

D
A
D
A
A
C
C
D
C
C
A
B
D
D
A