Room 201, Don Lorenzo Building, P.

Paredes Street, Sampaloc, Manila

ASSESSMENT EXAMINATION
PEDIATRIC NURSING
MAY 28-29,2023

Physiologic Changes
Situation: In the context of Pediatric care, the terms Growth and Development are often used
interchangeably. Both are complex phenomena that involve interrelated facets of physical, cognitive,
emotional and psychological changes. As a nurse one must be well versed about the appropriate usage
of these terms to avoid misconceptions or confusions when rendering care to a pediatric client.

1. Which of the following statements can be considered factual regarding the concrete delineation
between growth and development?
A. Growth denotes the qualitative changes from infancy to adulthood.
B. Development indicates an increase in the complexity and functions and skills progression.
C. Growth is synonymous to maturation.
D. Development means physical changes such as weight and height.

2. A pediatric nurse observes that, at the age of 3 years old, a child uses large crayons in writing
while at 12 years old, the child can already write using fine pens. Which of the following principles
of growth and development can be related to this scenario?
A. Development proceeds from gross to refine skills.
B. Development proceeds from proximal to distal.
C. All body systems do not develop at the same time.
D. Development is cephalocaudal.

3. As Nurse Lea assessed further, she happened to meet John, a 6 year old boy who exhibits irregular
habits and withdraws rather than approach from new situations. Based on the categories of
temperament, Nurse Lea will identify John into?
A. Easy child
B. Moderate child
C. Difficult child
D. Slow –to-Warm-Up Child

4. Nutrition is an essential aspect to growth and development. As Nurse Lea continues to render care
to her pediatric clients, she must always assure that each of them should receive appropriate
servings of food based on the 5 Pyramid Food Groups for Children. One of her patient is Cris, an 8
year old boy. Nurse Lea must provide which appropriate food groups to this child? Select all that
applies:
1. 7 servings of bread, rice or cereals
2. 5 servings of bread, rice or cereals
3. 4 servings of vegetables
4. 1 serving of fruits
5. 3 servings of milk, yogurt, or cheese
6. 3 servings of meat, poultry or fish
7. 4 servings of fruits

A. 1, 3, 4, 5, 6
B. 1, 3, 5, 6, 7
C. 2, 3, 4, 5, 6
D. 2, 3, 5, 6, 7

5. The mother of one patient inquired Nurse Lea about the two groups of vitamins that are essential
for the health of her child. Which statement by the mother warrants a need for discussion about
the subject?
A. “I do understand that Vitamin B6 is also called pyridoxine.”
B. “The main function of Riboflavin is to break down fatty and amino acids for energy.
C. “A deficiency in Cobalamin causes megaloblastic anemia.”
D. “If my child has a deficiency of Folic acid, he might acquire a disease that causes nerve
paralysis.

6. During her health teachings to the mother, Nurse Lea identifies this type of food to be a rich source
of Niacin?
A. Pork
B. Peanut

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 C. Eggyolk
D. Asparagus

7. As the discussion progresses, Nurse Leas provides inputs regarding Vitamin B12. All but one is
functions of this water soluble vitamin.
A. Blood formation
B. DNA and RNA synthesis
C. Myelin formation
D. Collagen structure

8. During the process of health teaching the mother asked Nurse Lea about the significance of
Selenium to her child’s health. Which of the following would be an appropriate response by Nurse
Lea?
A. “Selenium is vital for immunoglobulin formation and prevention of oxidation of cells.”
B. “Selenium is important for the formation of enzymes.”
C. “Selenium aids growth of connective tissues and bones.”
D. “Selenium is a micronutrient that is crucial for glucose metabolism.”

9. A deficiency in Zinc will most likely lead to?

Situation: For the past few years, many theories evolved attempting to explain or describe the
person’s growth and development throughout the lifespan. Although the rate of a person’s growth and
development is highly individual, it follows a sequential pattern.

10. A pediatric nurse is caring for a toddler. What will be the best approach for this type of child?
A. Provide experiences that add to the security of the child such as soft sounds and touch.
B. Offering choices of clothes to wear or toys to play with.
C. Provide opportunities for exploring new activities.
D. Allowing the child to assemble and complete a short project so that child feels rewarded for
accomplishment.

11. Claire, a 3rd year nursing student is preparing for her report about Piaget’s Cognitive Development
Theory. In her readings, she learned that Piaget deduced the cognitive development into?
A. 4stages
B. 5 stages
C. 6 stages
D. 8 stages

12. The student tried to incorporate her knowledge about Piaget’s theory into actual situations. As she
observes a 15 month old child, she noticed that the child is capable of discovering new properties
of objects and events, space and time perception as well as permanence. She would distinguish
this into what schema of the sensorimotor stage?
A. Primary circular reaction
B. Secondary circular reaction
C. Coordination of secondary reactions
D. Tertiary circular reaction

13. As Claire study the topic further, she discovered that each stage has an ideal toy or activity for the
child. Based on Piaget’s theory, she must offer a 6 year old child with?
A. Nesting toys
B. Blocks
C. Colored plastic rings
D. Modeling clay

14. After having insights regarding the cognitive development, Claire clearly understands that the most
appropriate activity for a child belonging to the tertiary circular reaction phase is?
A. Play peek –a-boo
B. Throw and retrieve
C. Collecting sea shells
D. Classifying native plants

15. Piaget proposed that one of a preschooler’s definite attribute is the lack of conservation.
Conservation is best defined as?
A. Ability to discern truth, even though physical properties change.
B. Ability to retrace steps.
C. Ability to look at an object and see only one of its characteristic.
D. Ability to change their ideas to fit in the reality.

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16. A child classified to be part of concrete operational thought usually ages?
A. 18-24 months old
B. 2-7 years old
C. 7-12 years old
D. 12 years old and above

17. Which of the following verbalization from a child best exemplifies Instrumental Relativist
Orientation (Stage 2)?
A. “ I will brush my teeth before I go to bed because mommy will scold me if I will not. “
B. “ It is nice to help my friends in their project.”
C. “ I will take that medicine only if you will lend me your stethoscope.”
D. “ It is my obligation to follow traffic rules.”

18. Ms. Wilson will identify this description as an exception, when pertaining to the Conventional Level
(Level 2):
A. Person reasons in terms of punishment, reward or exchange of favors.
B. Person is concerned with maintaining expectations and rules of the family, group, nation and
society.
C. A sense of guilt has developed and affects behavior.
D. Conformity means good behavior

19. A toddler in the ward often refuses to take his medicines when Ms. Wilson asks him to. Utilizing her
knowledge about Moral development, what would her be the best approach to this kid?
A. Explain to the child patiently the importance of taking the medicines.
B. Allow the child to take the medicines in his own time.
C. Offer rewards when the child follows the demand.
D. Ask a parent to reinforce instructions.

20. If a person construct his own explicit system and has high degree of self consciousness. He will be
classified into what stage of Fowler’s Spiritual development?
A. Synthetic-conventional
B. Individuating-reflexive
C. Paradoxical-consolidative
D. Universalizing

Situation: Nurse Kaye, 30 years old a nurse specialist focusing on pediatric care has proficient
knowledge and skills in rendering care to infants.

21. The birth weight of a newborn is 6 pounds and has a birth length of 65 cm. Nurse Kaye would
anticipate that after 6 months, the child’s weight will be?
A. 12 pounds
B. 18 pounds
C. 24 ponds
D. 30 pounds

22. The mother of the newborn inquired to Nurse Kaye about the possible progress of the birth length
after a year. The best reply to this inquiry is?
A. “The child will gain 15% of his birth length after a year.”
B. “The child will increase 25% of his birth length after a year.
C. “After a year, the child will grow 50% more from his birth length.”
D. “After a year, the child will increase his height for almost 75%.”

23. Nurse Kaye assesses a 3 month old child. She would like to check if the Landau reflex is already
evident to the child. The appropriate ways to elicit Landau reflex is through?
A. While holding the child is held in ventral position, infant’s head, legs and spine are extend
while hips, knees and elbows are flexed.
B. From a ventral position, the infant is suddenly lowered toward an examining table, the arms
will extend as if to protect oneself from falling.
C. Nurse Kaye touches one side of the infant’s cheek and baby to turn their head towards the
direction of being touched on the cheek, often opening their mouth quite wide.
D. While the infant is lying supine in the examination table, Nurse Kaye tap the side of the table
and it will cause baby to fling their arms out, fan their fingers, extend their legs and then
quickly pull their arms back in towards their body in an 'embrace' position.

24. Language development is plays a vital role during infancy. By 9 months, the infant is capable of?
A. Cooing, babbling, and gurgling when spoken to
B. Uttering simple vowels sounds like “goo-goo” or “gah-gah”
C. Imitating a parent’s cough or calling attention by saying “oh”
D. Speaking a first word like “da-da” or “ba-ba”

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25. At what age will the child demonstrate the ability to recognize their name and listen accurately
when spoken to?
A. 5months
B. 6 months
C. 10 months
D. 12 months

26. When a 10 month old child develops object permanence, this means that he is ready for?
A. Playing interactive nursery rhymes and rhythm games.
B. Playing peek-a-boo
C. Exhibiting a social smile
D. All of the above.

27. Nurse Kaye also discussed about the introduction of egg to the child. She would consider the
discussion as effective when a mother conveys?
A. “Egg yolks can be offered at 12 months of age.”
B. “Egg yolk and egg white can be given together.”
C. “Poaching the egg is usually recommended.”
D. “Egg yolk alone should be given first.”

28. Language development is a critical milestone during toddlerhood. For a child to learn more about
words, she/he must be exposed to conversations. A parent approach Nurse Kaye and asked about
the child’s constant expression of the word “NO”. The parent fears that the child is developing a
negative or pessimistic personality. The best response to this would be?
A. “Oh my, for how long does your child manifests this behavior?”
B. “I advise you to seek a child psychologist to mend the behavior.”
C. “Saying no is a normal occurrence during toddlerhood”.
D. “Tell me more how you feel?”

29. Play is also necessary for a child’s development. It serves as an avenue for the enhancement of a
child’s socialization skills. Nurse Kaye would observe that the play of an 18 month old child usually
is manifested by?
A. Ability to stack 2 blocks.
B. Enjoys being read to
C. Imitates household chores
D. Evident parallel play

30. When assessing a 2 years old child, a pediatric nurse would note that at the age of 7 months the
head circumference must be?
A. Head circumference is lesser than the chest circumference.
B. Head circumference is equal to the chest circumference.
C. Head circumference is greater than chest circumference.
D. No significant change will be noted.

31. Nurse Kaye is assessing the toddler’s sleeping pattern. There is a necessity to conduct further
instructions about the sleeping behaviors of a toddler if a parent would articulate which of the
following?
A. “My child is one year old and 6 months old, I let him take a nap twice a day.”
B. “My child who is 3 years old usually naps 3 times a day.”
C. “My 2 year old son spends 12 hours of sleep each night.”
D. “My 3 year old daughter can now sleep for only 8 hours each night.”

32. Health teachings regarding the promotion of nutritional health for toddlers consist of?
A. Teach parents to place a large portion of food on a toddler’s plate to encourage the child’s
appetite.
B. Children ages 1-3 years old should consume 1,000 kcal daily.
C. Fats should be restricted for children.
D. Avoid offering cookies for snacks

Situation: Despite the sluggish physical growth in this stage, Preschool-age is marked with
substantial and distinct cognitive and personality development.

33. During the performance of an assessment to a 4 year old child, this finding will cause immediate
attention from the nurse:
A. Heart murmurs are heard upon auscultation.
B. Pulse rate decreases to about 85 beats per minute.
C. Evident genu valgus
D. Decrease in size of lymphatic tissues.

34. Which of the following situations reflects that the child has reached expected fine motor skills at
the age 5?

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 A. Stacks towers of blocks
B. Can lace shoe
C. Undresses self
D. draws a cross

35. The emergence of Freud’s Oedipus and Electra complexes predominantly appear during this period.
What will be the precise definition of these two phenomena?
A. Electra complex refers to strong emotional attachment of a preschool girl to her mother than
her father.
B. Oedipus complex is defined as a strong affection of a preschool boy to his father.
C. Electra complex occurs when a preschool girl has strong attachment to her father than to her
mother.
D. Oedipus complex is exhibited by a preschool boy who loathes his mother.

36. Which of the following scenarios demonstrate an advanced preschool development activity?
A. A 2 year old girl can follow two-step commands.
B. A 3 year old boy balances using one foot only.
C. A 4 year old girl can count using fingers.
D. A 5 years old child dresses self independently.

37. Chloe, 4 years old was admitted due to hyperthermia. When the nurse is about to administer the
medication, the child asked the nurse” What is that?” and the nurse replied “A teaspoon of your
medicine.” The child asked once again “Why do I have to take that?” The nurse’s appropriate
response will be?
A. “It is to lessen your fever.”
B. “You don’t want to take this medicine?”
C. “Take this medicine and I’ll tell you later ok”
D. “Your doctor will tell you later why do have to take this medicine.”

38. A preschooler was playing with finger paint and modeling clay when his older sister interrupted and
admonished him because their playroom became messy. The preschooler would likely develop?
A. Sense of Rebellion
B. Sense of Shame
C. Sense of inferiority
D. Sense of Guilt

39. Mr. and Mrs. Santos is preparing for the birth of their 2nd child. The first born, Emily must be
transferred from her crib to a new bed. How will Mrs. Santos Mrs. Santos explain this to Emily?
A. “You have to sleep on your new bed now because your baby sister will need the crib.”
B. “Since you are a big girl now, you can already sleep to your new bed.”
C. “When your baby sister is born, she’s going to use your crib so we have to move you to
another bed.”
D. “Would you like to help me prepare your crib for your baby sister?”

Situation: Like Infancy, School-age is marked by drastic physical growth, as the cognitive,
psychological, emotional and spiritual aspects continue to progress. An eminent milestone during this
period is the beginning of sexual maturation.

40. The estimated average of weight gain during school-age period is?
A. 3-5 pounds (1.3-2.2 kg) per year
B. 4.5 pounds (2 kg) per year
C. 5-6 pounds or the whole period
D. 2 pounds per month

41. At the age of 10 years, the brain has reached?

42. During school-age, the brain triggers its hormones to stimulate the testes and ovaries that mark
the beginning of the puberty period. Specific hormones activate the development of the secondary
sex characteristics. The following are characteristic features of a 12-13 years old girl. Select all that
apply.
1. Areolar diameter enlarges
2. Axillary hair present
3. Dramatic growth spurt
4. Menarche occurs

A. 1, 2
B. 2, 4

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 C. 1, 3
D. 3, 4

43. All but one are secondary sex characteristics observed to a 12-13 year old boy?
A. Dramatic linear growth spurt.
B. Breast enlargement.
C. pubic hair present across pubis
D. Sebaceous gland secretions increase.

44. Forming a group of friends is a vital step during school-age. School age peer group has distinctive
features, except?
A. Formed to spite someone
B. Heterogeneous grouping
C. Has secret codes
D. Disbands but reform quickly.

45. During school-age the child develops concrete operational thought where the child learns class
inclusion. Class inclusion is best reflected by?
A. “If I pour 30 ml of my medicine from its tall bottle to a small one, it will remain the same as
30 ml.”
B. “My shell collections can be classified into many ways, grouping it according to size or shape.”
C. “ I have Ms. Sam as my nurse this morning but tonight she will go home and another nurse
will replace her.”
D. All of these

46. Curiosity and peer influence lead the school-age children to recreational drug use. One of the ways
to halt the increasing incidences of drug addiction is through education of these young minds. By
these the children will be aware about the detrimental effects of abusing substances. Among the
abused substance is steroids which is usually utilized to improve muscle mass. Abuse of steroids
poses threats to every child because it causes?
A. Respiratory irregularity
B. Extensive liver damage
C. Pulmonary edema
D. Uncontrollable aggressiveness

Situation: Adolescence is considered as the transitional period from childhood to adulthood. This is a
period in which the person starts to embrace the concept of maturity to physical, psychological,
emotional cognitive and spiritual facets of self.

47. The emergence of secondary sex characteristics continues to progress during adolescence period.
At the age of 17-18 years old, the sexual maturation among males involves?
A. Continuing growth spurt
B. End of skeletal growth
C. Voice changes
D. Maturation of sperm production

48. The most common cause of death among teenagers is related to?
A. Suicide
B. Accidents
C. Drowning
D. None of the above

49. Adolescence is also the period characterized as the beginning of parent-child conflicts. According to
some studies, at what age will an adolescent discovers that most adults are far from perfect?
A. 14 years old
B. 15 years old
C. 16 years old
D. 17 years old

50. One of the common problems hurdled by adolescents is the appearance of Acne. All but one are
factors associated with puberty that cause acne to develop.
A. Output of sebum increases.
B. Propionibacterium acne
C. Leakage of free fatty acids
D. Increase in estrogen levels

51. Fear of becoming fat is one of the factors that cause anxiety among adolescents. Adolescence is
the period in which the child becomes skeptical about their body image particularly to their weight.
Adolescents resort reducing food intake to prevent obesity. As a nurse, you should educate them
about the recommended caloric requirement during adolescent period which is composed of?
A. 1,400 calories per day

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 B. 1,500 calories per day
C. 1,600 calories per day
D. 1,800 calories per day

52. Substance abuse is one of the major concerns of parents and authorities among teenagers. Parents
should be warned about the common signs that their child is abusing some substance. If a needle
marks are noticed on the body of the child, coupled with runny nose, watery eyes and drowsiness,
the parents should suspect abuse of?
A. Depressants (barbiturates, alcohol)
B. Marijuana
C. Opiates
D. Hallucinogens

CHILD DISORDERS AND NURSING CARE OF CHILD DISORDERS

53. In assessing a child neurologically, a nurse assesses the cerebral function of a child with different
tests to determine normal functioning. This test refers the ability of the child to recognize an object
by touch and tests sensory interpretation:
A. Kinesthesia
B. Remote memory test
C. Stereognosis
D. Graphesthesia

54. A nurse knows that a slight increase of glucose serum level in cerebrospinal fluid (CSF) of a
newbornmay suggest what occurrence?
A. Viral infection
B. Presence of red blood cells
C. Bacterial infection
D. Subarachnoidhemorrhage

55. A student nurse was assisting a nurse while preparing a 5-year-old child for lumbar puncture. The
nurse asked the student nurse the correct location in the lumbar spine when performing lumbar
puncture. The student nurse would be correct if his answer is at the:
A. Level of L4 and L5
B. Level of L1 and L2
C. Level of L2 and L3
D. Level of L5 and L6

Situation: Malnutrition has been a massive challenge to different health organizations around the
world as this contributes to a huge percentage in the count of mortality. As health professionals try to
combat this dilemma, we nurses must divulge ourselves to dig deep and help do researches to help
prevent nutritional disorders that may further cause metabolic complications especially to children.

56. A nurse is giving proper instructions. She gives instructions to a mother on how to prevent rickets
caused by vitamin D deficiency. It is an indication that the mother needs further instruction if the
mother states:
A. “I will let my child ingest sweetened milk like condensed milk to increase vitamin D.”
B. “I will prepare foods like egg, fish, and cow’s milk.”
C. “I will expose the child to morning sunlight.”
D. “I will feed my child with fortified products.”

57. A school clinic nurse was notified that there is a pupil with meningococcal infection. A
chemoprophylaxis within 24 hours is ideal to those who had contact with the child.
Chemoprophylaxis is not required to the following that had contact with the child except:
A. School physician who assessed the child
B. School janitor
C. Class adviser
D. Classmates

58. A nurse is caring for a child with Reye’s syndrome. Reye’s syndrome is an acute encephalopathy
thus affecting the brain. A nursing intervention with this kind of patient would include:
A. Assessing deafness of the child
B. Urine output monitoring every 2 hours
C. Alternating body positions every 3 hours
D. Providing a quiet environment with lights turned down

59. A child suddenly had a seizure attack. The nurse would be incorrect if she does the following
action:
A. Go to the nurse station and ask assistance from colleagues.
B. Have suction equipment and oxygen available.
C. Place the child on your lap.

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 D. Ensure airway patency.

60. A child with congenital glaucoma is scheduled for goniotomy. Pre-operative drugs were prescribed
by the physician. The nurse would question which drug?
A. Atropine sulphate
B. Acetazolamide
C. Carbonic anhydrase inhibitor
D. Diamox

61. A discharge planning instruction for a mother of child who had myringotomy is essential especially
with the antibiotic regimen. Which statement by the mother would indicate an understanding of the
instructions?
A. “Antibiotic regimen must be continued until the infection is gone.”
B. “I will administer antibiotic if my child develops fever.”
C. “Tapering of the antibiotic after 3 days must be ideal.”
D. “I will administer the antibiotic until he feels well.”

62. A child is being assessed for the diagnosis of epiglottitis. The following are parts of the assessment
if epiglottitis is suspected except:
A. Assess for sore, red and inflamed throat.
B. Assess for retractions and if the child struggles to breathe.
C. Assess the posterior pharynx through visualization of the anatomical area.
D. Place the client in a spine position and assess the child if stridor is aggravated.

63. A child with asthma is coughing and the mother asks the nurse if she could give Boncotron-D to
her child. The nurse would be correct if she’ll respond to the mother:
A. “No ma’am it is not advisable because, it may lead to pneumonia.”
B. “Yes ma’am you can give the medication to the child.”
C. “Yes ma’am as long as the drug is an OTC drug.”
D. “I don’t know ma’am.”

64. Cystic fibrosis is a disease of exocrine gland function that involves multiple organ systems but
chiefly results in chronic respiratory infections, pancreatic enzyme insufficiency and other
associated complications in untreated clients. Different complications may develop but the principal
cause of death is:
A. Cirrhosis and other hepatic dysfunction
B. Chronic diarrhea
C. End-stage lung disease
D. Pancreatitis

65. A nurse studies the pharmacological implementation against cystic fibrosis. Thru extensive
pharmacological researches, it was found out that this medication causes adverse effect to the
patient with cystic fibrosis:
A. Corticosteroids
B. Ivacaftor
C. Hypertonic saline inhalation
D. Pancrealipase (Cotazym)

66. As part of therapeutic management of cystic fibrosis, a nurse gives dietary instructions to the
mother of a child with cystic fibrosis. She would be correct if it includes:
A. High-calorie, high-protein, moderate-fat diet
B. High-calorie, low-protein, moderate-fat diet
C. Low-calorie, moderate-protein, low-fat diet
D. Moderate-calorie, low-protein, low-fat diet

67. In pediatric congestive heart failure, complex interactions of various factors result to diminished
cardiac output. This contributory factor is characterized by diminished ventricular contractility that
results in an impaired ability to increase the stroke volume to meet systemic demands. What is the
contributory factor?
A. Diastolic dysfunction
B. Systolic dysfunction
C. Neurohormonal factors
D. Anatomic stresses

68. A cardiac nurse in the cardiovascular unit is caring for a child with tetralogy of fallot. The nurse
identifies different preferred examinations. The nurse would question what kind of examination
when doing imaging in tetralogy of fallot for preoperative evaluation?
A. Magnetic resonance imaging
B. Echocardiography
C. Intracardiac catheterization
D. Angiography

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69. A nurse observes a child with tetralogy of fallot. The following are symptoms of tetralogy of fallot
seen in a child except:
A. Cyanosis at birth
B. Squatting
C. Poor growth
D. Clubbing

70. A mother asks the nurse with an infant with tetralogy of fallot, “Does our child need special
nutrition?” An incorrect response of the nurse would be:
A. “Salt will be strictly restricted as part of the nutrition.”
B. “Breast-feeding is the preferred method of feeding an average infant with heart disease.”
C. “Infants are generally given iron supplementation to prevent the development of iron
deficiency anemia.”
D. “Small frequent feedings may be necessary especially that your baby has congenital heart
disease and that they tire readily.”

71. Recent investigations about the causative agent for rheumatic fever differin countries and cultures.
An extensive literature has shown that in the aboriginal populations of Australia, infections might
be a sequela of:
A. Streptococcal pharyngitis
B. Streptococcal skin infection
C. Rheumatogenic group A streptococci
D. Streptococcal strains not typically associated with rheumatic fever

72. The following are general treatment of acute episode of rheumatic fever except:
A. Anti-inflammatory agents
B. Steroids
C. Salicylates
D. Orasone

73. To be able to determine a confirmation in diagnosing rheumatic heart fever, what supporting
evidence must be obtained?
A. Two major, three minor
B. One major, one minor
C. Two major, one minor
D. Two major, two minor

74. A nurse is giving home care instructions to a mother whose child is being discharged after cardiac
surgery. An understanding of the instructions is evident if the mother states that:
A. “It would be appropriate for the child to socialize with a large number of people after a week.”
B. “Exersice shouldn’t be initiated for it will add stress to my child. He should rest only.”
C. “I should let my child engage in different activities 3 weeks after the surgery.”
D. “I will not apply lotion or powder to the incision site.”

75. A nurse knows that knowledge of the anatomical sites of the gastrointestinal tract is essential. The
small intestines comprises of the following sections except:
A. Duodenum
B. Jejunum
C. Cecum
D. Ileum

76. A nurse is caring for a child with diarrhea and tries to assess the mother’s knowledge about her
son’s condition. Because of the confusion of parents with the knowledge and understanding about
the condition, this rule must be reinforced to help parents identify the condition.
A. Children must be seen immediately by a health care provider.
B. Provide home remedies when onset of symptom is identified.
C. Give medication immediately when stool texture changes.
D. None of the above.

77. Fluid is normally lost from the body thru urine and feces. When fluid loss occurs thru perspiring,
this is called?
A. Evaporation
B. Condensation
C. Dehydration
D. Insensible loss

78. A nurse in the gastrointestinal unit received a colicky child patient. The child screams because of
abdominal pain and draws his knees to his abdomen like assuming a fetal position. With the
assessment, the nurse suspects that the child has?

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 A. Hirschprung’s disease
B. Intussusception
C. Omphalocele
D. Umbilical Hernia

79. Hirschsprung disease was described by Ruysch in 1691. It was popularized by Hirschsprung in
1886. Who determined the pathophysiology of the disease?
A. Hirschsprung
B. Swenson
C. Kernohan
D. Ruysch

80. Hirschsprung’s disease is a developmental disorder of the enteric nervous system and thus needs
attention especially in the goals of medical care. All but one is the general goal of medical care:
A. Manage bowel function after reconstructive surgery.
B. Treat the complications of unrecognized or untreated Hirschsprung disease.
C. Institute temporary measures until definitive reconstructive surgery can take place.
D. None of the above.

81. A nurse is caring for a child with constipation. The nurse identifies that the following are foods high
in fibers. Select the option that completes the 4 correct foods that contain high fiber.
1. Whole grain bread or rolls
2. Whole grain cereals
3. Strawberry
4. Cauliflower
5. Pancakes and waffles
6. Peanuts
7. Pork meat
8. Orange

A. 1,2,3,4
B. 1,2,4,5
C. 5,6,7,8
D. 3,4,7,8

82. A nurse is caring for a client with Celiac disease. The main problem of this patient is?
A. Intolerance to gluten
B. Deficiency of glucose
C. Vitelline duct
D. Malnutrition

83. The nurse knows that a gluten-free diet is encouraged to the child for life as a therapeutic
management. All but one is the food allowed when having a gluten-free diet:
A. Beef meat
B. Puffed rice
C. Eggs
D. Spaghetti

84. A hospitalized child is vomiting persistently. The nurse anticipates and monitors closely for:
A. Metabolic alkalosis
B. Metabolic acidosis
C. Abnormal bowel sounds
D. Diarrhea

85. A nurse would likely to notice upon admission a child with pyloric stenosis, which of following
symptoms:
A. Distended abdomen
B. Projectile vomiting
C. Recurrent abdominal
D. Generalized edema
86. Pediatric pyloric stenosis’ etiologic factors are believed to be both environmental and hereditary.
The following are factors that contribute to the development of pyloric stenosis except:
A. Infantile hypergastrinemia
B. Abnormal myenteric plexus innervation
C. Deficient nitric oxide synthase containing neurons
D. None of the above

87. A nurse is assigned to do prehospital care to an infant with pyloric stenosis. Intravenous access
has been obtained. An initial bolus of how many mL/kg of crystalloid fluid must be started?
A. 5 mL/kg
B. 10 mL/kg

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 C. 15 mL/kg
D. 20 mL/kg

88. A mother rushed her child to the emergency room because her child had self-induced poisoning.
Priority nursing actions in the event of poisoning are as follows. What would be the first step?
A. Take measures to prevent poison absorption.
B. Terminate exposure to the poison.
C. Identify the poison.
D. Assess the child.

89. An infant is believed to suffer from lead poisoning and is subject to diagnostic tests to confirm the
suspected situation. This preferred examination had been used extensively in diagnosing lead
poisoning in children:
A. Plain skeletal radiographs
B. Blood lead level test
C. Urine examination
D. None of these

90. Chelation therapy is the medical management of lead poisoning. The following are medication for
lead poisoning except:
A. Edetate calcium disodium
B. Calcium Disodium Versenate
C. British anti-Lewsite
D. None of these

91. A 13-year-old child with type 1 diabetes mellitus plays basketball every afternoon. The nurse
instructs the child measures to avoid hypoglycaemia by?
A. Drinking a cup of juice before playing.
B. Doubling meal at lunch time.
C. Tapering insulin when playing.
D. Taking insulin at noon.

92. A child with type 1 diabetes mellitus is brought to the emergency room and is diagnosed with
ketoacidosis. What is the appropriate and initial solution to be prepared for the child?
A. Prepare Normal saline IV solution
B. Prepare NPH insulin
C. Prepare potassium infusion
D. Prepare 5% dextrose.

93. There are two congenital defects involving abnormal placement of the urethral orifice of the penis.
This is a urethral defect in which the urethral opening is not at the end of the penis but in the
ventral (lower) aspect of the penis.
A. Epispadias
B. Hypospadias
C. Cryptorchidism
D. Patent urachus

94. A nurse is teaching a family tips who had a relative who had a urinary tract infection a year ago to
help prevent recurrence of urinary tract infection (UTI). The following are correct except:
A. Encourage to drink liquid everyday periodically.
B. Inform that bubble bathing is safe and not to worry about
C. Inform to wear underwear that is made from cotton not from synthetic materials.
D. Urge to urinate at least every 4 hours to prevent urinary stasis of urine in the bladder.

95. Preoperative care in kidney transplantation needs primary attention to decrease the risk of failed
operation. Children receive pretransplantation blood transfusion and receive at least five blood
transfusions preoperatively for the purpose of:
A. Avoiding hypovolemic shock
B. Decreasing adverse anesthetic effects
C. Having an improved chance of transplant success.
D. Preventing blood transfusion when transplantation has already began.

96. A nurse is assigned to a child who has glomerulonephritis. The nurse identifies that the following is
associated with glomerulonephritis?
A. Decreased blood urea nitrogen level
B. Low urinary specific gravity
C. Cola-colored urine
D. Hypotension

97. A most important monitoring when a child is being monitored for integumentary disorder would be
monitoring of what?

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 A. Systemic infection
B. Hereditary skin infections
C. Lifestyle
D. Source of the infection

98. This is the infestation of hair and scalp with lice.

99. What is the relative burn percentage of a 1-year-old child when ½ of one leg is affected?
A. 9 ½
B. 8 ½
C. 2 ½
D. 3 ¼

100. A nurse is monitoring a child with burns. The most accurate guide to determine that fluid
resuscitation was adequate is the?
A. Peripheral pulses
B. Neurologic assessment
C. Edema at burn site
D. Turgor of the skin

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