• 2-year-old with fever, tugging ear, red and bulging • Primary cause of acute glomerulonephritis in
tympanic membrane — nurse’s priority? children?
Answer: Provide acetaminophen for pain and fever Answer: Post-streptococcal infection
• 3-year-old with LTB, stridor at rest, retractions, • Finding that best differentiates nephrotic syndrome
restlessness — next best action? from acute glomerulonephritis?
Answer: Administer oxygen and notify the provider Answer: Massive proteinuria
• Caregiver teaching for child with strep pharyngitis — • Best description of status epilepticus?
which statement shows need for further teaching? Answer: A seizure lasting more than 5 minutes or repeated
Answer: “She can return to school tomorrow after starting seizures without return to consciousness
medicine today.”
• Child with acute renal failure, oliguria, hyperkalemia
• Mother asks why iron therapy continues after — nurse’s priority?
hemoglobin normalizes — best response? Answer: Prepare for dialysis
Answer: “It replenishes iron stores.”
• Most concerning symptom in child with chronic renal
• Lab finding expected in sickle cell crisis? failure?
Answer: High reticulocyte count Answer: Confusion
• Finding that suggests effective fluid resuscitation in • Common complication of peritoneal dialysis in
burned child? children?
Answer: Urine output of 1 mL/kg/hr Answer: Peritonitis
• Child with epiglottitis becomes anxious and agitated • Parent statement indicating child most likely had
— most appropriate nursing action? absence seizure?
Answer: Remain calm and avoid procedures that increase Answer: “They were just staring into space and was totally
agitation unaware.”
• Child with aplastic anemia has epistaxis and bruising • Primary goal of long-term management of epilepsy
— priority intervention? after two unprovoked seizures?
Answer: Apply pressure and notify the provider Answer: Achieve optimal seizure control with minimal
impact on development
• Child with beta thalassemia has frontal bossing,
hepatosplenomegaly, delayed growth — due to? • Maternal factor increasing risk of spina bifida?
Answer: Bone marrow hyperplasia and hemolysis Answer: Folic acid deficiency
• 3-year-old with recurrent barking cough that resolves • Transverse nasal crease and allergic shiners in child
— priority question? indicate?
Answer: “Do these episodes occur suddenly and improve by Answer: Allergic rhinitis
morning?”
• Parents understand elbow restraints after cleft lip
• Child with hemophilia complains of headache after repair — correct statement?
head injury — nurse should? Answer: “They prevent our baby from touching the
Answer: Prepare for CT scan and notify physician incision.”
• Care plan goal for child with severe dehydration and • Most appropriate nursing diagnosis for
metabolic acidosis? hydrocephalus?
Answer: Restore fluid and electrolyte balance Answer: Risk for injury related to increased intracranial
pressure
• Infant with dehydration receiving IV therapy —
assessment indicating improvement? • 13-year-old soccer player with swollen, bruised ankle
Answer: Improved skin turgor after twisting injury — most likely injury?
Answer: Sprain
• Serum sodium 170 mEq/L — what type of
dehydration? • Parent statement indicating need for further teaching
Answer: Hypertonic on long-leg cast care?
Answer: “I will apply powder inside the cast to keep it dry.”
• 3-year-old with partial-thickness burns on 10% BSA
— nurse’s priority? • 6-month-old with untreated DDH — expected physical
Answer: Airway assessment finding?
Answer: Asymmetric thigh folds
• Most appropriate initial nursing action after positive • Best nursing action for 4-year-old crying during
scoliosis screening? chemotherapy?
Answer: Perform further assessment of spinal curvature Answer: Offer a comfort item and explain the procedure
• Most definitive diagnostic test for suspected Hodgkin • Purpose of beta-blockers for child with
lymphoma? hyperthyroidism?
Answer: Excisional lymph node biopsy Answer: Control cardiac symptoms like tachycardia
• Child on chemotherapy for leukemia develops fever — • Best nurse response to 12-year-old in palliative care
first nurse action? saying “I’m scared to die”?
Answer: Notify the physician immediately Answer: “Would you like to talk about what’s frightening
you?”
• Why must thyroid function be monitored during
infancy? • Child with SIADH becomes drowsy — nurse should
Answer: Dosage needs increase with growth assess first?
Answer: Serum sodium
• Child with systemic JIA has daily fevers and salmon-
colored rash — initial intervention? • Stool characteristic indicative of intussusception in
Answer: Administer prescribed corticosteroids infants?
Answer: Red currant jelly-like stools
• Parent asks if baby with condition will walk normally
— best response?
Answer: “Most children walk normally if treatment is
started early.”
• Most likely finding in child with Hirschsprung’s
disease?
Answer: Thin, ribbon-like stools
• Most appropriate nursing goal for school-age child
with DM1?
Answer: Demonstrate proper blood glucose monitoring
• Symptom to monitor first if child with celiac disease
accidentally consumes gluten?
Answer: Abdominal pain and diarrhea
• Most important pre-op nursing intervention for child
with Wilms’ tumor?
Answer: Monitor blood pressure regularly
• Side effect nurse should prepare for with
chemo/radiation for brain tumor?
Answer: Fatigue
• When to use albuterol MDI for exercise-induced
asthma?
Answer: 15–30 minutes before exercise
• Assessment finding needing early surgical intervention
in EA/TEF?
Answer: Choking with every feed attempt
• Post-VP shunt placement in child with achondroplasia
and hydrocephalus — what to monitor?
Answer: High-pitched cry and bulging fontanel
• Priority nursing goal for child with eczema?
Answer: Prevent secondary infection
