Practice Pediatrics Exam
The nurse is giving preoperative instructions to a 14-year-old female client who is scheduled tor surgery
to correct a spinal curvature. Which statement by the client best demonstrates that learning has taken
place?
A "l will read all the literature you gave me before surgery. "
B "I have had surgery before when I broke my wrist in a bike accident, so I know what to expect"
C "All the things people nave told me will help me take care of my back."
D "l understand that I will be in a body cast and I will snow you now you taught me to turn." - correct
answer D
Outcome of learning is best demonstrated when the client not only verbalizes an understanding but can
also provide a return demonstration (D). A 14-year-old may or may not follow through with (A), and
there is no measurement of that learning. Having previous surgery (8) may help the client understand
the surgical process, but wrist surgery is very different from spinal surgery and emergency surgery is
different from elective surgery. In (C), the client may be saying what the nurse wants to near, without
expressing any real understanding of what to do after surgery
To take the vital signs of a 4-month-old child, which order will give the most accurate results?
A. Respiratory rate, heart rate, then rectal temperature.
B Heart rate, rectal temperature, then respiratory rate.
C Rectal temperature, heart rate, then respiratory rate.
D Rectal temperature, respiratory rate, then heart rate. - correct answer A
The respiratory rate should be taken first (A) in infants, since touching them or performing unpleasant
procedures usually makes them cry, elevating the heart rate and making respirations difficult to count
Rectal temperature is the most invasive procedure, and is most likely to precipitate crying, so should be
done last (C and D).
3. During routine screening at a school clinic: an otoscope examination of a child's ear reveals a
tympanic membrane that is pearly gray, slightly bulging, and not movable. What action should the nurse
take next?
,A. A. No action required, as this is an expected finding tor a school-aged child.
B Ask the child if he/she has had a cold, runny nose, or any ear pain lately.
C Send a note home advising the parents to nave the child evaluated by a healthcare provider as soon as
possible.
D Call the parents and nave them take the child home from school tor the rest of the day. - correct
answer B
More information is needed to interpret these findings The tympanic membrane is normally pearly gray,
not bulging, and moves when the client blows against resistance or a small puff of air is blown into the
ear canal. Since this child's findings are not completely normal, further assessment of history and related
signs and symptoms is indicated tor accurate interpretation of the findings. (A, C, and D) are
inappropriate actions based on the data obtained from the otoscope examination.
4. Which restraint should be used tor a toddler after a cleft palate repair?
A Glove.
B Mummy.
C Elbow.
D Jacket - correct answer C
Elbow restraints prevent children from bending their arms and bringing their hands to the oral surgical
site. (A) restrains the hands, but the child can bend and bring their head to their hands. (B) is used
during procedures. (D) restrains the body torso and is not appropriate.
5. What preoperative nursing intervention should be included in the plan of care tor an infant with
pyloric stenosis?
A Monitor tor signs of metabolic acidosis.
B Estimate the quantity of diarrhea stools.
C Place in a supine position after feeding.
D Observe tor projectile vomiting. - correct answer D
Projectile vomiting (D), which contributes to metabolic alkalosis (A), is the classic sign of pyloric stenosis.
(B) is not indicated. (C) is dangerous, due to the potential tor aspiration with frequent vomiting.
,A six-month-old returns from surgery with elbow restraints in place. What nursing care should be
included when caring tor any restrained child?
A Keep restraints on at all times.
B Remove restraints one at a time and provide range of motion exercises.
C Remove all restraints simultaneously and provide play activities.
D Renew the healthcare provider's prescription tor restraints every 72 hours. - correct answer
B
Removing restraints one at a time (B) is safer than removing all of them at once (C). The child needs to
exercise and should not be kept in restraints at all times (A). The renewal of the healthcare provider's
prescription varies with hospitals (D), and it does not really answer the question.
A 2-year-old child with Down syndrome is brought to the clinic tor his regular physical examination. The
nurse knows which problem is frequently associated with Down syndrome?
A Congenital heart disease.
B Fragile X chromosome.
C Trisomy 13.
D Pyloric stenosis. - correct answer A
Congenital heart disease (A) is the most common associated detect in children with Down syndrome. (C)
might have seemed possible since Down syndrome is a trisomal chromosomal abnormality of
chromosome 21. (3) is a sex-linked abnormality also causing mental retardation. (D) is not associated
with Down syndrome.
When assessing a child with asthma, the nurse should expect intercostal retractions during
A inspiration.
B coughing.
C apneic episodes.
D expiration - correct answer A
Intercostal retractions result from respiratory effort to draw air into restricted airways (A).
, When planning the care tor a child who has had a cleft lip repair, the nurse knows that crying should be
minimized because it
A increases salivation
B increases the respiratory rate
C leads to vomiting
D stresses the suture line - correct answer D
Prevention of stress on the lip suture line (D) is essential for optimum healing and the cosmetic
appearance of a cleft lip repair. Although crying also causes (A, B, and C), these conditions do not create
a problem tor the child with a cleft lip repair.
A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects that
the infant may have an esophageal atresia Which symptoms is this newborn likely to have exhibited?
A Choking, coughing, and cyanosis.
B Projectile vomiting and cyanosis.
C Apneic spells and grunting.
D Scapnoid abdomen and anorexia. - correct answer A
(A) includes the "3 Cs" of esophageal atresia caused by the overflow of secretions into the trachea. (B) is
characteristic of pyloric stenosis in the infant. (C) could be due to prematurity or sepsis, and grunting is a
sign of respiratory distress. (D) is characteristic of diaphragmatic hernia.
Which behavior would the nurse expect a two-year-old child to exhibit?
A Build a house with blocks.
B Ride a tricycle.
C Display possessiveness of toys
D Look at a picture tor 15 minutes. - correct answer C
Two-year-old children are egocentric and unable to share with other children. (A, B, and D) are
behaviors of a preschooler.
