1. Molly, with suspected rheumatic fever, is admitted to the pediatric unit.

When obtaining the

A. A fever that started 3 days ago

B. Lack of interest in food

C. A recent episode of pharyngitis

D. Vomiting for 2 days

2. The nurse is aware that the most common assessment finding in a child with ulcerative colitis is:

A. Intense abdominal cramps

B. Profuse diarrhea

C. Anal fissures

D. Abdominal distention

3. When developing a plan of care for a hospitalized child, nurse Mary knows that children in which
age group is most likely to view illness as a punishment for misdeeds?

A. Infancy

B. Preschool age

C. School age

D. Adolescence

4. A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child’s
vision, the nurse should ask:

A. “Do you have any problems seeing different colors?”

B. “Do you have trouble seeing at night?”

C. “Do you have problems with glare?”

D. “How are you doing in school?”

5. Hannah, age 12, is 7 months pregnant. When teaching parenting skills to an adolescent, the
nurse knows that which teaching strategy is least effective?

A. Providing a one-on-one demonstration and requesting a return demonstration, using a live infant
model

B. Initiating a teenage parent support group with first and second-time mothers

C. Using audiovisual aids that show discussions of feelings and skills

D. Providing age-appropriate reading materials

6. A 5-year-old girl Hannah is recently diagnosed with Kawasaki disease. Apart from the identified
symptoms of the disease, she may also likely develop which of the following?

A. Sepsis

B. Meningitis

C. Mitral valve disease

D. Aneurysm formation
 7. When creating a teaching program for the parents of Jessica who is diagnosed with pulmonic
stenosis (PS), Nurse Alex would keep in mind that this disorder involves which of the following?

A. A single vessel arising from both ventricles

B. Obstruction of blood flow from the left ventricle

C. Obstruction of blood flow from the right ventricle

D. Return of blood to the heart without entry to the left atrium

8. Which of the following would Nurse Tony suppose to regard as a cardinal manifestation or
symptom of digoxin toxicity to his patient Clay diagnosed with heart failure?

A. Headache

B. Respiratory distress

C. Extreme bradycardia

D. Constipation

9. It is considered as the bluntly rounded portion of the heart.

A. Base

B. Pericardium

C. Aorta

D. Apex

10. Which of the following disorders leads to cyanosis from deoxygenated blood entering the
systemic arterial circulation?

A. Aortic stenosis (AS)

B. Coarctation of aorta

C. Patent ductus arteriosus (PDA)

D. Tetralogy of Fallot

11. Betty is a 9-year-old girl diagnosed with cystic fibrosis. Which of the following must Nurse Archie
keep in mind when developing a care plan for the child?

A. Pulmonary secretions are abnormally thick.

B. Elevated levels of potassium are found in sweat.

C. CF is an autosomal dominant hereditary disorder.

D. Obstruction of the endocrine glands occurs.

12. Alice is rushed to the emergency department during an acute, severe prolonged asthma attack
and is unresponsive to usual treatment. The condition is referred to as which of the following?

A. Status asthmaticus

B. Reactive airway disease

C. Intrinsic asthma

D. Extrinsic asthma

13. Baby Melody is a neonate who has a very-low-birth-weight. Nurse Josie carefully monitors
inspiratory pressure and oxygen (O2) concentration to prevent which of the following?

A. Meconium aspiration syndrome

B. Bronchopulmonary dysplasia (BPD)

D. Respiratory distress syndrome (RDS)

14. Which of the following instructions should Nurse Cheryl include in her teaching plan for the
parents of Reggie with otitis media?

A. Placing the child in the supine position to bottle-feed

B. Giving prescribed amoxicillin (Amoxil) on an empty stomach

C. Cleaning the inside of the ear canals with cotton swabs

D. Avoiding contact with people who have upper respiratory tract infections

15. When assessing a child’s cultural background, the nurse in charge should keep in mind that:

A. Heritage dictates a group’s shared values

B. Physical characteristics mark the child as part of a particular culture

C. Cultural background usually has little bearing on a family’s health practices

D. Behavioral patterns are passed from one generation to the next

16. Dustin who was diagnosed with Hirschsprung’s disease has a fever and watery explosive
diarrhea. Which of the following would Nurse Joyce do first?

A. Administer an antidiarrheal.

B. Notify the physician immediately.

C. Monitor the child every 30 minutes.

D. Nothing. (These findings are common in Hirschsprung's disease.)

17. Which of the following applies to the defect emerging from residual peritoneal fluid confined
within the lower segment of the processus vaginalis?

A. Inguinal hernia

B. Incarcerated hernia

C. Communicating hydrocele

D. Noncommunicating hydrocele

18. 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

19. Steve is diagnosed with celiac disease and experiences celiac crisis secondary to upper
respiratory tract infection; which of the following would Nurse Nancy expect to assess?

A. Lethargy

B. Weight gain

C. Respiratory distress

D. Watery diarrhea
 20. In pediatric gastroesophageal reflux disease (GERD), the immaturity of lower esophageal
sphincter function is manifested by frequent transient lower esophageal relaxations, which
result in retrograde flow of gastric contents into the esophagus. Which statement about the
esophagus is true? Select all that apply.

A. It is a cartilaginous tube.

B. It has upper and lower sphincters.

C. It lies anterior to the trachea.

D. It extends from the nasal cavity to the stomach.

E. It is a highway for food and drinks to travel along to make it to the stomach.

F. All statements describe the esophagus.

21. Nurse Elena is handling a 7-year-old child who has cystitis. Which of the following would Nurse
Elena expect when assessing the child?

A. Dysuria

B. Costovertebral tenderness

C. Flank pain

D. High fever

22. When educating parents regarding known antecedent infections in acute glomerulonephritis,
which of the following should the nurse cover?

A. Scabies

B. Impetigo

C. Herpes simplex

D. Varicella

23. 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

24. Which of the following should be included when developing a teaching plan to prevent urinary
tract infection? Select all that apply.

A. Maintaining adequate fluid intake

B. Avoiding urination before and after intercourse

C. Emptying bladder with urination

D. Wearing underwear made of synthetic material such as nylon

E. Keeping urine alkaline by avoiding acidic beverages

F. Avoiding bubble baths and tight clothing

25. Nurse Jeremy is evaluating a client’s fluid intake and output record. Fluid intake and urine output
should relate in which way?

A. Fluid intake should double the urine output.

B. Fluid intake should be approximately equal to the urine output.

C. Fluid intake should be half the urine output.

26. A child diagnosed with intellectual disability (ID) is under the supervision of Nurse Tasha. The
nurse is aware that the signs and symptoms of mild ID include which of the following?

A. Few communication skills

B. Lateness in walking

C. Mental age of a toddler

D. Noticeable developmental delays

27. Nurse Kathy is assessing infantile reflexes in a 9-month-old baby; which of the following would
she identify as normal?

A. Persistent rooting

B. Bilateral parachute

C. Absent moro reflex

D. Unilateral grasp

28. The American Association on Mental Deficiency (AAMD), now American Association on
Intellectual and Developmental Disabilities (AAIDD) definition of mental retardation emphasizes
which of the following?

A. An IQ level that must be below 50

B. Cognitive impairment occurring after age 22 years

C. Deficits in adaptive behavior with intellectual impairment

D. No responsiveness to contact

29. After explaining to the parents about their child’s unique psychological needs related to a seizure
disorder and possible stressors, which of the following interests uttered by them would indicate
further teaching?

A. Feeling different from peers

B. Poor self-image

C. Cognitive delays

D. Dependency

30. Olivia is an adolescent who has seizure disorder; which of the following would not be a focus of
a teaching program?

A. Ability to obtain a driver's license

B. Drug and alcohol abuse

C. Increased risk of infections

D. Peer pressure

31. The 6-year-old son of Mr. and Mrs. Peters is admitted to the healthcare facility with the diagnosis
of idiopathic hypopituitarism. His height is measured below the third percentile and weight at
the 40th percentile. Which of the following would be the first action of his attending nurse?

A. Recommend orthodontic referral for underdeveloped jaw.

B. Collaborate with a dietician to access his caloric needs.

C. Provide for a tutor for his precocious intellectual ability.

D. Place him in a room with a 2-year-old boy.

32. While Lawrence is being assessed at the clinic, Nurse Rachel observed that the child appears to
be small, with an immature face and chubby body build. Her parents stated that their child’s rate
 of growth of all body parts is somewhat slow, but her proportions and intelligence remain
normal. As a knowledgeable nurse, you know that the child has a deficiency of which of the
following?

A. Antidiuretic hormone (ADH)

B. Parathyroid hormone (PTH)

C. Growth hormone (GH)

D. Melanocyte-stimulating hormone (MSH)

Incorrect

33. In growing children, growth hormone deficiency results in short stature and very slow growth
rates. Short stature may result from which of the following?

A. Anterior pituitary gland hypofunction

B. Posterior pituitary gland hyperfunction

C. Parathyroid gland hyperfunction

D. Thyroid gland hyperfunction

34. Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares to the nurse the
desire of his son to play ball games. However, his wife feels the child will be in danger since he is
smaller than the other children. In planning anticipatory guidance for these parents, the nurse
should keep in mind which of the following?

A. The child should be allowed to play because doing so can foster healthy self-esteem.

B. The risk for fractures is increased because a GH deficiency results in fragile bones.

C. Activity could aggravate insulin sensitivity, causing hyperglycemia.

D. Activity would aggravate the child's joints, already over tasked by obesity.

35. A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A
nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should
reinforce which of the following concepts?

A. Always keep insulin vials refrigerated

B. Increase the amount of insulin before exercise

C. Ketones in the urine signify a need for less insulin

D. Systematically rotate injection sites

36. Mr. and Mrs. Andrews’ child was diagnosed with Duchenne’s muscular dystrophy; which of the
following usually is the first indication of the condition?

A. Inability to suck in the newborn

B. Lateness in walking in the toddler

C. Difficulty running in the preschooler

D. Decreasing coordination in the school-age child

37. Which of the following is the most common permanent disability in childhood?

A. Scoliosis

B. Muscular dystrophy

C. Cerebral palsy

D. Developmental dysplasia of the hip (DDH)

A. Rheumatoid arthritis

B. Permanent nerve damage

C. Osteomyelitis

D. Bone growth d

39. Mrs. Cooper is concerned about her 4-month-old son’s unusual condition; which of the following
statements made by her would indicate that the child may have cerebral palsy?

A. "He holds his left leg so stiff that I have a hard time putting on his diapers."

B. "My baby won't lift his head up and look at me; he's so floppy."

C. "My baby's left hip tilts when I pull him to standing position."

D. "I'm very worried because my baby has not rolled all the way over yet."isruption

40. Scott is a teenager suffering from osteomyelitis; the nurse would expect which of the following
symptoms? Select all that apply.

A. Fever

B. Irritability

C. Pallor

D. Tenderness

E. Swelling

41. Nurse Emma is planning a client education program for sickle cell disease (SCD); What topic
should be included in the plan of care?

A. Aerobic exercise to improve oxygenation

B. Fluid restraint to 1 qt (1 L)/day

C. A high-iron, high-protein diet

D. Proper hand washing and infection avoidance

In children diagnosed with sickle cell disease (SCD), tissue damage results from which of the following?

A. Air hunger and respiratory alkalosis due to deoxygenated red blood cells.

B. Hypersensitivity of the central nervous system (CNS) due to elevated serum bilirubin levels

C. A general inflammatory response due to an autoimmune reaction from hypoxia

D. Local tissue damage with ischemia and necrosis due to obstructed circulation

Which of the following tests is most effective in diagnosing hemophilia?

A. Bleeding time

B. Complete blood count (CBC)

C. Partial thromboplastin time (PTT)

D. Platelet count

42. A child with thalassemia was given deferoxamine (Desferal); which of the following should alert
the nurse to notify the physician?

A. Decreased hearing

B. Hypertension

C. Red urine d. vomiting

A. Bleeding time

B. Complete blood count (CBC)

C. Partial thromboplastin time (PTT)

D. Platelet count

44. A child with thalassemia was given deferoxamine (Desferal); which of the following should alert
the nurse to notify the physician?

A. Decreased hearing

B. Hypertension

C. Red urine

D. Vomiting

45. Mr. and Mrs. Robertson’s son was diagnosed with idiopathic thrombocytopenic purpura. They
should be aware that the drug to be avoided is:

A. Acetaminophen

B. Aspirin

C. Codeine

D. Morphine

46. A nurse provides medication instructions to a first-time mother. Which statement made by the
mother indicates a need for further instructions?

A. "I should mix the medication in the baby food and give it when I feed the child".

B. "I should administer the oral medication sitting in an upright position and with the head elevated".

C. "I will give my child a toy after giving the medication".

D. "I will offer my child a juice drink after swallowing the medication".

47. A physician prescribes an IV solution of 500 ml 0.45% Saline with an incorporation of 20mEq
potassium chloride for a child with dehydration. The nurse should check which of the following
before administering this IV prescription?

A. Blood pressure

B. Height

C. Weight

D. Urine output

48. An infant with a patent ductus arteriosus is admitted to the pediatric unit ward. The nurse
anticipates which of the following medications will be given to the infant?

A. Prednisone

B. Ibuprofen

C. Penicillin

D. Albuterol

49. A child with Kawasaki disease is admitted to the pediatric ward. Which of the following
medications will you expect to be a part of the treatment? Select all that apply.

A. Gamma Globulin

B. Warfarin.

C. Acetaminophen
D. Aspirin

E. Atenolol

50. A 6-year-old child is scheduled to have measles, mumps, and rubella (MMR) vaccine. Which of
the following routes will you expect the nurse to administer the vaccine?

A. Intramuscularly in the vastus lateralis muscle.

B. Intramuscularly in the deltoid muscle.

C. Subcutaneously in the gluteal area.

D. Subcutaneously in the outer aspect of the upper arm.