Peds Exam 2 Practice Questions

1. A mother brings a 2-month-old infant who has tetralogy of fallor for a health maintenance visit.

Her chief concern is most likely that the infant:

a. Has difficulty sucking

2. An 8-month-old girl has a ventricular septal defect (VSD). Which nursing diagnosis would best

apply to her?

a. Altered tissue perfusion r/t inefficiency of the heart as a pump

3. The nurse takes an apical pulse on 8-month-old client before administering digoxin. The

medication should be held until further instructions are received if the heart rate is

a. 76 beats per minute

4. A nurse is caring for a child who has tetralogy of fallot. While inserting an intravenous catheter

the child’s oxygen saturation level drops from 95% to 86%. What action should the nurse

initiate first?

a. Place the child in the knee-chest position

5. A nurse is conducting discharge teaching with parents of a child who recently had surgery for

correction of a congenital heart lesion. Which of the following information should the nurse

include in the discussion?

a. Call your health care provider for antibiotics before dental work

6. A nurse is assessing a child who has a history of cardiac disease. Which of the following is not a

sign of impaired cardiac output?

a. Increased urine output (GOOD)

7. An appropriate goal for the nursing diagnosis of “activity intolerance r/t poor cardiac output” is

that the adolescent will:

a. Perform all ADL’s with minimal assistance

8. A nurse in the cardiac intensive care unit is caring for 4 children. Which of the following

children should the nurse suspect would most likely have cyanosis and hypoxia from

deoxygenated blood entering the system circulation?

a. A two-year-old with transposition of the great arteries

9. An infant is prescribed digoxin. The nurse plans to teach the infants parents that the action of

this drug is to:

a. Slow and strengthen the infants heart beat

10. A nurse is evaluating the effects of digoxin therapy for a 5-month-old infant. Which of the

following indicates a good response to the medication?

a. Improved urine output

11. To assess for cyanosis in an infant with cardiovascular disease, you would assess:

a. Lips and circumoral area

12. A nurse is caring for a 4-year-old girl who develops congestive heart failure. Which of the

following should be a priority nursing intervention for this child?

a. Place her in a semi-fowlers position

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A mother brings a 2-month-old infant who has tetralogy of fallor for a health maintenance visit. Her chief concern is most likely that the infant: a. Has difficulty sucking
An 8-month-old girl has a ventricular septal defect (VSD). Which nursing diagnosis would best apply to her? a. Altered tissue perfusion r/t inefficiency of the heart as a pump
The nurse takes an apical pulse on 8-month-old client before administering digoxin. The medication should be held until further instructions are received if the heart rate is a. 76 beats per minute
A nurse is caring for a child who has tetralogy of fallot. While inserting an intravenous catheter the child’s oxygen saturation level drops from 95% to 86%. What action should the nurse initiate first? a. Place the child in the knee-chest position
A nurse is conducting discharge teaching with parents of a child who recently had surgery for correction of a congenital heart lesion. Which of the following information should the nurse include in the discussion? a. Call your health care provider for antibiotics before dental work
A nurse is assessing a child who has a history of cardiac disease. Which of the following is not a sign of impaired cardiac output? a. Increased urine output (GOOD)
An appropriate goal for the nursing diagnosis of “activity intolerance r/t poor cardiac output” is that the adolescent will: a. Perform all ADL’s with minimal assistance
A nurse in the cardiac intensive care unit is caring for 4 children. Which of the following children should the nurse suspect would most likely have cyanosis and hypoxia from deoxygenated blood entering the system circulation? a. A two-year-old with transposition of the great arteries
An infant is prescribed digoxin. The nurse plans to teach the infants parents that the action of this drug is to: a. Slow and strengthen the infants heart beat
A nurse is evaluating the effects of digoxin therapy for a 5-month-old infant. Which of the following indicates a good response to the medication? a. Improved urine output
To assess for cyanosis in an infant with cardiovascular disease, you would assess: a. Lips and circumoral area
A nurse is caring for a 4-year-old girl who develops congestive heart failure. Which of the following should be a priority nursing intervention for this child? a. Place her in a semi-fowlers position

A nurse is caring for a 2-month-old with transposition of the great vessels. Which of these interventions has highest priority? a. Reducing cold stress in the infant
A toddler requires supplemental oxygen therapy for a cyanotic heart defect. In for home care, the nurse should discuss which of the following with the parents? a. Promoting mobility while meeting oxygen needs
A child who has tetralogy of fallot (TOF) is monitored closely for dehydration. The nurse understands that the rationale for this intervention relates to which physiological problem associated with this defect? a. Polycythemia
Pt. with vsd? a. Harsh systolic murmur
A toddler with cystic fibrosis needs to take pancrease medication, how will you give it to them? a. In apple sauce
A parent asks when the toddler can stop taking pancrease med? a. You as nurse needs to respond it is a medication they will need to take for the rest of their life.
A child with coarctation of aorta will have? a. Weakness and pain
Kid with uncorrected heart defect and difficulty gaining weight a. Increase the caloric density of the formula
Grade 2 VUR – a. It will resolve on its own “spontaneously”
Ventriculoperitoneal shunt a. 30-45 degrees in the supine position
The patient with Transposition of the great arteries/vessels what you want to do as a nurse a. Reduce cold stress
The nurse received a report on a new admission: a 3-year-old with Kawasaki disease. Understanding the etiology and major complications of Kawasaki disease, the priority nursing intervention would be: a. Continuous cardiovascular and oxygen saturation monitoring
For a school age child who has Kawasaki disease and is taking aspirin, which laboratory value should be reported to the physician a. PT 14.6 sec. (normal is 11 to 13)
A child has been diagnosed with Kawasaki Disease (KD). The parents are asking questions about the child’s outcome. The nurse explains the most serious complications. Select all that apply a. Coronary thrombosis. b. Coronary stenosis. c. Coronary artery aneurysm.

laboratory result will provide the health-care team with the most important information regarding the child’s respiratory status? a. An ABG.

A pediatric client is admitted in status asthmaticus. The parent reports that the child is currently taking Singulair, albuterol, and Flovent. What is the most important piece of information that the nurse must ask the parent in order to best treat the patient? a. “When was your child’s last dose of medication?”
A 2-year-old is diagnosed with asthma. The parents are big sports fans and want their child to play sports. The parents ask the nurse what impact asthma will have on the child’s future in sports. Which is the nurse’s best response? a. “The earlier a child is diagnosed with asthma, the more significant the symptoms.”
The parent of a pediatric client with asthma is talking to the nurse about administering the child’s albuterol inhaler. Which statement by the parent leads the nurse to believe that the parent needs further education on how to administer the medication? a. “I should administer two quick puffs of the albuterol inhaler using a spacer.”
A 7-year-old female with asthma is playing a soccer game in gym class. During the game the child begins to cough, wheeze, and have difficulty catching her breath. The school nurse is called to the soccer field. Which of the following should the nurse administer to provide quick relief? a. Albuterol
There are several children in the ER waiting area who all have asthma. The nurse has only one room left in the ER. Based on the following information, which child should be seen first? a. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%.
A 3-year-old female is admitted to the hospital with asthma. The nurse is trying to work with the child on breathing exercises to increase her expiratory phase. What should the nurse have the child do? a. Blow a pinwheel
The parents of a 6-year-old who has a new diagnosis of asthma asks the nurse what to do to make their home a more allergy-free environment for the child. Which is the nurse’s best response? a. “Avoid purchasing upholstered furniture.”
A case manager coordinates outpatient care and referrals for patients in an HMO. Which outcome would indicate effective case management for a child with moderate to severe asthma? a. The child attends school regularly with few absences for the year
A young child hospitalized with asthma is ready for discharge. A home nebulizer is ordered by the physician. In order to obtain the nebulizer, a referral should be made to which staff member?

a. Case manager

A school nurse administers albuterol (Proventil) to a 10-year-old who is having an acute asthma attack. Which of the following assessment findings should the nurse observe? a. Decrease in wheezing.
A child in the emergency room is being treated with albuterol (Proventil) aerosol mist treatments for an acute asthma attack. She requires treatment every 2 hours. Which of the following adverse effects of the medication should the nurse expect? a. 3. Nervousness and tachycardia
A child with moderate asthma is wheezing and coughing. Before the physician sees the child, the nurse should perform which test? a. 4. Peak flowmeter
The physician orders Montelukast (Singulair) for a 10-year-old who has moderate, persistent asthma. The nurse should instruct the child and parents about which characteristic of the medication? Select all that apply. a. This is an add-on medication to the child’s regular medications. b. 3. It is not to be used to treat acute episodes.
Which of the following statements about pneumonia is accurate? a. Children with bacterial pneumonia are usually sicker than children with viral pneumonia
Which of the following children diagnosed with pneumonia would benefit most from hospitalization? a. A 15-year-old who has been vomiting for 3 days and has a fever of 38.5°C(101.3°F).
A pediatric client is admitted to the hospital with left-sided pneumonia. The client is complaining of pain and wants to be repositioned in the bed. The nurse knows the patient may be most comfortable in which position? a. Lying on the left side
A 16-year-old male is hospitalized for cystic fibrosis. He will be an inpatient for 2 weeks while he receives IV antibiotics. As the nurse caring for this patient, what action can you take that will most enhance his psychosocial development? a. Encourage the teen’s friends to visit him in the hospital.
Expected nursing assessments of a newborn with suspected cystic fibrosis would include: a. Observe frequency and nature of stools.
A child with cystic fibrosis is placed on an oral antibiotic to be given four times a day for 14 days. Which of the following schedules is the most appropriate for the child? a. 7 a.m., 1 p.m., 7 p.m. 12 midnight.
A nurse is caring for a child with cystic fibrosis. Which of the following should the nurse include in teaching the parents about administrating pancreatic enzymes? a. The capsules may be opened and sprinkled over acidic food.
Parents are told by the genetic counselor that they have a 1:4 probability of having a second child with cystic fibrosis (CF). They already have one child who is affected. The parents state

Which of the following statements about the inheritance of CF is most accurate? a. The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.
The parent of a 4-month-old with CF asks the nurse what time to begin the child’s first CPT each day. Which is the nurse’s best response? a. “You should do the first CPT 30 minutes before feeding the child breakfast.” – avoids vomiting
The parent of a 10-month-old with CF asks the nurse how to meet the child’s increased nutritional needs. Which is the nurse’s best suggestion? a. “You may need to change your child to a higher-calorie formula.”
A 2-year-old has just been diagnosed with CF. The parents ask the nurse what early respiratory symptoms they should expect to see in their child. Which is the nurse’s best response? a. “You can expect your child to develop wheezing respirations.” And dry non prod. Cough
What does the therapeutic management of CF patients include? Select all that apply. a. Providing a high-protein, high-calorie diet b. Encouraging exercise c. Minimizing pulmonary complication d. Encouraging medication compliance
A sweat chloride test is used to diagnose CF. A chloride level greater than 60 is a positive diagnostic indicator of CF.
A 2-year-old is admitted to the hospital with croup. The parent tells the nurse that her 7-year- old just had croup and it cleared up in a couple of days without intervention. She asks the nurse why her 2-year-old is exhibiting worse symptoms and needs to be hospitalized. Which is the nurse’s best response? a. “Younger children have wider airways that make it easier for bacteria to enter and colonize.” – child has stridor; airway edema and can be treated with aerosolized racemic epinephrine.
A 3-year-old female is admitted to the ER with drooling, difficulty swallowing, sore throat, and a fever of 39°C (102.2° F). The physician suspects epiglottitis. The parents ask the nurse how the physician will know for sure if their daughter has epiglottitis. Which is the nurse’s best response? a. “We will do a lateral neck x-ray of the soft tissue.”
A 2-year-old child is brought to the ER with a high fever, dysphagia, drooling, rapid pulse, and tachypnea. What should the nurse’s first action be? a. Allow the child to sit in the parent’s lap while awaiting an x-ray.
A pediatric client is diagnosed with epiglottitis. The parents ask the nurse what treatment their child will receive. Which is the nurse’s best response? a. “Your child will need to complete a course of intravenous antibiotics.”

A 3-year-old is admitted to the hospital with a diagnosis of epiglottitis. The child is in severe distress and needs to be intubated. The mother is crying and tells the nurse that she should have brought her son in yesterday when he said his throat was sore. Which is the nurse’s best response? a. “Epiglottitis is rapidly progressive; you could not have predicted that his symptoms would worsen so quickly.”
A 5-year-old is brought to the ER with a temperature of 99.5° F (37.5°C), a barky cough, stridor, and hoarseness. Which of the following nursing interventions should the nurse prepare for? a. Respiratory treatment of racemic epinephrine.
A nurse is caring for an 8 year old child who has just returned from undergoing a cardiac catherization. Which of the following interventions would be most important a. Assess and document pedal pulses
A nurse is giving a program on toddler safety regarding foreign body aspiration for a froup of parents. Which of the following statement if made by a parent would indicate a need for further clarification? a. I checked on my child when I gave him peanuts
After a child returns from cardiac cath, the priority nursing intervention is: a. Monitoring the catherization site for bleeding
The mother yells for the nurse stating, “ I think ,y child swallooed one of the little toys.” The child is lying in bed. Which action should the nurse implement? (rank in order) a. Shake child and call childs name b. Perform a head-tilt/ chin-lift maneuver c. Look in mouth for any foreign objects d. Listen and assess for breath sounds e. Attempt to administer a rescue breath
Child with croup; intervention will be a. Turn the shower and sit in the bathroom with the child when the attack occurs
Child is taking steroids a. They should be kept away from large crowds
A nurse is taking care of a patient complaining of chest pain and has a history of asthma a. Obtain a peak flow reading
Acyanotic disorders show which type of S/S: a. Periorbital edema and JVD
A nurse is caring for a newborn with a suspected cardiac disorder. During the assessment the nurse palpates decreased femoral pulses. The next priority action should be to? a. Palpate and percuss the thorax to evaluate for tetralogy of fallot. b. Palpate the point of maximal impulse (PMI) to evaluate for patent ductus arteriorsus. c. Auscultate to evaluate S1 and S2 for transposition of the great arteries.

a. Control of dust in the child's bedroom is an important aspect of environmental control for asthma management.

98. A nurse is caring for a child who has Kawasaki disease. In planning care for

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Peds Exam 2 Practice Questions

98. A nurse is caring for a child who has Kawasaki disease. In planning care for

the child, which of the following would be most important?

a. Teach him to live with a chronic disease

b. Make sure he receives respiratory therapy treatments on schedule

c. Encourage coughing and deep breathing

d. Observe the child for signs of tinnitus (b/c aspirin can cause this as well as

GI upset and bleeding)

99. A nurse is caring for a child who has rheumatic fever. Which of the following

questions is important to ask during the health?

a. “Did the child have a sore throat within the last month?”

b. “Has the child had any nausea and vomiting?”

c. “Has the child complained of headaches?”

d. “Has the child complained of back pain?”

A nurse is caring for a child who has acute Kawasaki disease in stage one. Which of the

following should the nurse expect to find during the assessment?

a. Conjunctivitis (conjunctival hyperemia)

b. Cracked lips (sub-acute stage)

c. Desquamation of the skin

d. A normal appearance

A 6-year-old child is hospitalized for Kawasaki disease. Which treatment plan should the

nurse discuss with the parents?

a. Aspirin therapy (to reduce risk of cardiovascular complications, take temp

before each dose of aspirin)

b. Intravenous immunoglobulin G (purified antibodies in blood that

help fight off infection)*

c. Oral Reopro

d. Prednisone 120 mg IV daily

A child who is experiencing a vaso-occulsive crisis is admitted to the pediatric unit. Priority

concerns for this patient should focus on:

a. Nutrition and hydration

b. Nutrition and infection

c. Pain management and infection

d. Hydration and pain management

A nurse is caring for a child who has been admitted for a sickle cell crisis. In order to

provide adequate pain management, the nurse plans to:

a. Administer NSAIDs as ordered

b. Use therapeutic touch

c. Administer Meperidine as ordered

d. Conduct a pain assessment using an appropriate pain scale

A home care nurse is instructing parents of a child with iron deficiency anemia regarding

the administration of a liquid oral supplement. What should the nurse instruct the parents

to do?

a. Administer the iron through a straw

b. Administer the iron at mealtimes

c. Add the iron to the bottle of formula for easy administration

d. Mix the iron with cereal then administer

A child is being evaluated for possible cystic fibrosis. The sweat test will show an elevation

of which electrolyte?

a. Fluoride

b. Potassium

c. Calcium

d. Chloride

A 5-year-old child underwent a tonsillectomy this morning. As the nurse giving the

discharge instructions, which comment by the child’s mother suggests she understands

the care requirements?

a. “I plan to take my child back to the play group tomorrow. I know that my

child will not want to stay home.”

b. “I will give aspirin if my child becomes irritable.”

c. “My child is just waiting for the ice cream promised before surgery.”

d. The child will be intubated in the emergency department or the

operating room and then transferred the the pediatric intensive care.

A 10-year-old is admitted to the hospital in a sickle cell crisis. Which patient goal is most

appropriate for this child?

a. The patient will participate in aerobic exercises daily. (Should be on bed

rest)

b. The patient will increase fluid intake. – HOP (Hydration, O2, Pain

management)

c. The patient will take antibiotics until the temperature is within normal

limits. (yes but hydration first)

d. The patient will utilize cold compresses to control pain. (Cold promotes

vasoconstriction. Use warm compress for pain.)