2024 NCLEX Pediatrics Exam Test Bank Practice Test New
Latest Version Best Studying Material with All Questions
and Answers
The nurse is caring for a child who had a tonsillectomy this morning. The child is observed to be
swallowing continuously. What is the most appropriate initial nursing action?
1. Administer acetaminophen for pain
2. Place an ice collar around her throat
3. Call the charge nurse or surgeon
immediately
4. Encourage the child to suck on ice chips ---------- Correct Answer ------------ 3. Continual
swallowing indicates bleeding. The charge nurse or surgeon should be notified at once. None of
the other responses is appropriate. The child may be hemorrhaging.
When selecting play activites for a healthy 4-year-old, the parent should be guided to understand
that the 4-year-old enjoys: ----------- Correct Answer ----------- cooperative play with friends
An example of a therapeutic play activity for a preschool child who is recovering from an
appendectomy would be: ----------- Correct Answer ----------- blowing bubbles
the nurse is guiding a parent concerning techniques of dealing wit ha child with enuresis. The
most appropriate suggestion by the nurse would be to: ----------- Correct Answer ----------- limit
liquids after dinner and have the child void before going to bed
The nurse is caring for a 6-year-old child who had a tonsillectomy this morning. Once the child
is fully awake and alert, which liquid is the best to offer her?
1. A cherry popsicle
2. Apple juice
3. Orange juice
4. Cranberry juice ---------- Correct Answer ------------ 2. The child needs clear, cold liquids that
are not red and are not citrus. Red would make it difficult to determine if vomitus was blood or
juice.
A 10-year-old child has had diagnosed bronchial asthma for three years. The child has been
admitted to the pediatric unit in acute respiratory distress. Which of the following would be most
characteristic of the child's asthmatic attack upon admission?
1. Expiratory wheezing
2. Inspiratory stridor
3. Cyanotic nail beds
4. Prolonged inspiratory phase ---------- Correct Answer ------------ 1. Bronchial constriction
occurs in asthma.
This increases the airway resistance to airflow. The respiratory difficulty is accentuated during
expiration, when the bronchi are supposed to contract and shorten, as opposed to inspiration,
when the bronchi are dilating and elongating. Inspiratory stridor is characteristic of croup. Note
,that answers 2 and 4 both deal with the inspiratory phase. Asthma affects the expiratory phase.
The nurse is caring for an 18-month-old child who has been vomiting. Which is the appropriate
position to place the child during naps and sleep time?
1.A supine position
2.A side-lying position
3.Prone, with the head elevated
4.Prone, with the face turned to the side ---------- Correct Answer ----------- 2.A side-lying
position
The vomiting child should be placed in an upright or side-lying position to prevent aspiration.
Options 1, 3, and 4 will place the child at risk for aspiration if vomiting occurs.
Which interventions should the nurse include when preparing a plan of care for a child with
hepatitis? Select all that apply.
1.Providing a low-fat, well-balanced diet
2.Teaching the child effective hand-washing techniques
3.Notifying the primary health care provider if jaundice is present
4.Scheduling play time in the playroom with other children
5.Instructing the parents about the risks associated with taking medications
6.Arranging for indefinite home schooling because the child will not be able to return to school -
--------- Correct Answer ----------- 1.Providing a low-fat, well-balanced diet
2.Teaching the child effective hand-washing techniques
5.Instructing the parents about the risks associated with taking medications
Because hepatitis can be viral, standard precautions should be instituted in the hospital. The child
should be discouraged from sharing toys, so playtime in the playroom with other children is not
part of the plan of care. The child will be allowed to return to school 1 week after the onset of
jaundice, so indefinite home schooling would not need to be arranged. Jaundice is an expected
finding with hepatitis and would not warrant notification of the primary health care provider.
Provision of a low-fat, well-balanced diet is recommended. Parents are cautioned about
administering any medication to the child because normal doses of many medications may
become dangerous because of the liver's inability to detoxify and excrete them. Hand washing is
the single most effective measure in control of hepatitis in any setting, and effective hand
washing can prevent the compromised child from picking up an opportunistic type of infection.
A child is admitted with asthma. Which aspects of the health history would be most closely
associated with asthma?
1. The child's grandfather died of emphysema at age 76.
2. The child's grandmother died of lung cancer.
3. The child had respiratory distress syndrome following premature birth.
4. The child had eczema as an infant and toddler. ---------- Correct Answer ------------ 4. Asthma
is an allergic condition and frequently follows eczema, also an allergic condition. Having
relatives with emphysema or lung cancer is not usually related to childhood asthma. Respiratory
,distress syndrome as an infant does not predispose the child to asthma.
A stat dose of epinephrine is ordered for a child with asthma. How should the nurse administer
the epinephrine?
1. Intramuscular
2. Sublingual
3. Subcutaneous
4. Nebulization ---------- Correct Answer ------------ 3. Epinephrine is a rapid-acting drug of short
duration. The subcutaneous route is the most effective for rapid relief of respiratory distress. The
stat dose is not given intramuscularly, sublingually, or by nebulizer.
A child with an asthma attack has received epinephrine. The child is also to receive isoproterenol
(Isuprel) via intermittent positive pressure breathing. When should the isoproterenol be given in
relation to the epinephrine?
1. Isoproterenol should be given 30 minutes prior to the administration of epinephrine.
2. Isoproterenol should never be given in conjunction with epinephrine. Check with the
physician.
3. Isoproterenol should not be given within one hour after the administration of epinephrine.
4. Isoproterenol should be given at the same time as epinephrine for maximum benefit. ----------
Correct Answer ------------ 3. The side effects of epinephrine (tachycardia, increase in blood
pressure, tremors, weakness, and nausea) are potentiated by isoproterenol. Therefore, when given
concurrently, isoproterenol should not be given within one hour after administration of
epinephrine.
A 13-month-old child is diagnosed with croup and placed in a croup tent. Which toy is most
appropriate for the nurse to give the child?
1. A doll made of cotton
2. A music box
3. A soft fuzzy toy made of synthetic materials
4. A wind-up bunny ---------- Correct Answer ------------ 1. The major concern regarding toys for
a child in a croup tent is that there not be any chance of static electricity or a spark because the
croup tent contains oxygen. Cotton does not create static electricity. Wool and synthetic
materials create static electricity. A wind-up toy could create a spark.
A child is having an asthma attack. The nurse places the child in an upright position for which of
the following reasons?
1. To prevent the aspiration of mucus
2. To visualize abnormal inspiratory excursion
3. To prevent atelectasis
4. To relieve dyspnea ---------- Correct Answer ------------ 4. By providing for maximum
ventilatory efficiency, the upright position increases the oxygen supply to the lungs and helps to
relieve dyspnea. This is most important for the asthmatic child who is experiencing a diminished
ventilatory capacity.
The nurse is caring for a 5-year-old child who has cystic fibrosis. What should the nurse do to
help the child manage secretions and avoid respiratory distress?
, 1. Administer continuous oxygen therapy
2. Perform chest physiotherapy every four hours
3. Administer pancreatic enzymes as ordered
4. Encourage a diet high in calories ---------- Correct Answer ------------ 2. Chest physiotherapy
aids in loosening secretions throughout the respiratory tract. Oxygen therapy does not loosen
secretions and may be contraindicated because many children with cystic fibrosis experience
carbon dioxide retention and respiratory depression with too high levels of oxygen. Pancreatic
enzymes will be given to this child, but to improve the absorption of nutrients, not to facilitate
respiratory effort.
A diet high in calories is appropriate for a child with cystic fibrosis. However, it does not
facilitate respiratory effort.
The nurse is to administer pancreatic enzymes to an 8-month-old child who has cystic fibrosis.
When should this medication be administered?
1. A half hour before meals
2. With meals
3. An hour after meals
4. Between meals ---------- Correct Answer ------------ 2. Pancreatic enzymes should be given
with meals. They can be mixed with applesauce. The purpose of the enzymes is to help with the
digestion and absorption of nutrients. Therefore, they must be given when the child is having
food.
A 10-month-old child is being treated for otitis media. What is the most important nursing action
to prevent recurrence of the infection?
1. Administer acetaminophen as ordered
2. Encourage the parents to maintain a smoke-free home environment
3. Explain to the parents that they must give the child all of the prescribed antibiotic therapy
4. Encourage the parents to bottle-feed the child in an upright position ---------- Correct Answer -
----------- 3. The child should receive all of the antibiotic medication. Parents are apt to stop
giving it to the child when he/she begins to feel better. This encourages recurrence of the
infection that may be resistant to antibiotic therapy. Acetaminophen may be given to the infant,
but it is for pain and does not prevent recurrence of the infection. There is some evidence that
children who live around smokers have a higher incidence of otitis media. This teaching is
relevant but not the most important. Children who go to sleep with milk or juice in their mouths
after feeding have a higher incidence of otitis media, but this is not the most important nursing
action to prevent recurrence of infection.
The nurse is caring for a 6-month-old infant who is in a croup tent. The child's mother calls and
tells the nurse that the child's clothes are all wet. What is the best action for the nurse to take?
1. Explain to the mother that this is normal because the croup tent has high humidity
2. Change the child's clothing
3. Cover the child with a dry blanket
4. Remove the child from the croup tent until his/her clothes are dry ---------- Correct Answer ----
-------- 2. A croup tent is high humidity, and the child's clothes will get wet. When they do, they
should be changed so that the child will not get chilled. It is appropriate to explain this to the
mother, but the best response is to change the child. Covering the child will not prevent chilling.
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