PROFESSIONAL SERVICES
CLINICAL DIVISION
PEDIATRIC ASSESSMENT TEST
1.
A baby was born 2 hours ago by Cesarean section. The newborn has a myelomeningocele
with the sac intact and has been places in an incubator. The nurse, when planning care for
the baby, should focus on potential for:
a)
b)
c)
d)
2.
Appropriate nursing interventions for a newborn’s myelomeningocele sac prior to surgery
include using sterile technique and:
a)
b)
c)
d)
3.
Leaving the sac open to air
Applying petrolatum to cover the sac
Applying moist saline dressings
Applying dry dressings
To maintain proper alignment of the hips and lower extremities in a baby with
myelomeningocele, the nursing should position the baby with the:
a)
b)
c)
d)
4.
Disuse syndrome
Infection
Fluid volume deficit
Decreased cardiac output
Hips abducted and feet in a neutral position
Hips adducted and feet flexed
Hops subluxed and feet extended
Hips adducted and feet in a natural position
Prior to surgery for a myelomeningocele, the nurse would place the baby in which of the
following positions?
a)
b)
c)
d)
Prone
Right side
Left side
Dorsal
5.
A newborn baby is diagnosed with a myelomeningocele. The nurse measures his head
circumference daily to assess for the development of what complication?
a)
b)
c)
d)
6.
A 4 –month old infant is admitted to the hospital with acute diarrhea and dehydration.
Initial nursing assessment of the infant reveals:
a)
b)
c)
d)
7.
Reverse
Enteric
Strict
Wound and skin
The nurse should assess a 4-month old infant who has diarrhea and dehydration for:
a)
b)
c)
d)
9.
Tenting of skin
Low hematocrit
Bulging fontanelle
Weight gain
The nurse would place a 4-month old infant with diarrhea in which of the following types of
isolation?
a)
b)
c)
d)
8.
Hydrocele
Hordeolum
Hypsarrhythmia
Hydrocephalus
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
The doctor has ordered that KCl be added to a 4-month old infant’s IV infusion. The nurse
should:
a)
b)
c)
d)
Give the KCL as soon as ordered to prevent hypocalcaemia
Give the KCL within the 1st hour of admission
Wait to give the KCL until an adequate urinary output is documented
Wait to give the KCL until the complete blood count CBC results are available and
within normal limits.
10. As the nurse monitors the 4-month old’s progress, which symptom might indicate she is
becoming over hydrated from IV fluids she is receiving?
a)
b)
c)
d)
Edema at IV site
Vomiting
Below normal temperature
Bubbling rales
11. As part of the admission history, the nurse asked a mother about a 4-month old infant’s
immunization record. Which of the following immunizations are recommended to be given
at 4 months?
a)
b)
c)
d)
Measles
Tetanus
Mumps
Influenza Virus
12. A 13-year old female client has asthma. The nurse teaches her ways to reduce possible
asthma attacks and explains the need to avoid:
a)
b)
c)
d)
Mild exercise
Turtles as pets
Swimming
Extremes in temperature
13. The nurse instructs a client that during an asthma attack she may feel more comfortable in
which of the following positions?
a)
b)
c)
d)
High Fowler
Prone
Side-lying
Dorsal
14. A client is hospitalized with status asthmaticus. The physician has ordered IV theophylline.
Which of the following would be a side effect of the drug the nurse should observe for?
a)
b)
c)
d)
Seizures
Dysrythmias
Drowsiness
Headache
15. As the nurse monitors the progress of a 14-year old client with asthma, she observes for early
signs of impending airway obstruction. Which of the following symptoms would cause the
nurse concern?
a)
b)
c)
d)
Decreased pulse
Flaring nares
Lethargy
Decreased respiratory rate
16. Once a 14-year old client’s post-status-asthmaticus attack has stabilized, which of the
following activities would the nurse choose as being the most appropriate for the client while
in the hospital?
a)
b)
c)
d)
Working a jigsaw puzzle
Talking on the phone to friends
Watching television
Doing arts and crafts
17. A 1-year old infant is admitted to the hospital with eczema. There is an order for “diet for
age.” Which of the following should the nurse avoid in the infant’s diet?
a)
b)
c)
d)
Milk and wheat cereal
Carrots and beef
Apple juice and coke
Mashed potatoes and tea
18. A 1-year old infant with eczema is placed in elbow restraints to keep him from scratching. To
prevent problems with immobility, the nurse should:
a)
b)
c)
d)
Allow him out of restraints when supervised by the nurse or mother
Release restraints for meals and bath time
Release restraints one at a time every 4 hours
Allow him out of restraints when he is asleep at night and during naps
19. The parents of the 1-year old infant with eczema are concerned about his appearance. He
developed a secondary infection that makes him look grotesque. How can the nurse be most
supportive of the parents’ feelings?
a) Divert the conversation to another topic so they will not focus on the infant’s
appearance
b) Encourage them to discuss their fears and concerns
c) Tell them not to worry, that this condition will improve eventually
20. The nurse is doing discharge teaching to the mother of the infant with eczema because the
infant’s pruritus will continue after he goes home. In evaluating the mother’s understanding,
the nurse would expect her to realize the importance of having the infant:
a)
b)
c)
d)
Take cornstarch batsh
Wear cotton shorts and short-sleeve shirts
Wear wool blend long-sleeve jumpsuits
Take salt baths 3 times a day
21. A 2-year old child is admitted to the hospital with Hirchspring’s disease. During the nursing
history, the mother describe the child’s stool as foul-smelling and:
a)
b)
c)
d)
Small, hard pebbles
Large and frothy
Cordlike
Ribbonlike
22. The nurse explains to a toddler’s parents that the treatment of choice for Hirschspring’s
disease (aganglionic colon) would be:
a)
b)
c)
d)
Surgical removal of affected colon
Modified diet high in fiber
Medication to stimulate the colon
Permanent Colostomy
23. A 7-year old child is admitted to the hospital with nephritic syndrome. During the
assessment, the nurse is aware that a classic symptom is:
a)
b)
c)
d)
Increased urine output
Hematuria
Elevated blood pressure
Proteinura
24. During the edematous phase of nephritic syndrome, an important nursing intervention is to:
a)
b)
c)
d)
Provide meticulous skin care
Encourage fluid intake
Encourage moderate activity
Weigh the client every other day
25. A 7-year old boy with nephritic syndrome is placed on steroid therapy. Which statement by
his mother indicates to the nurse an understanding of steroid therapy?
a)
b)
c)
d)
“Steroids will improve his acne.”
“He will have permanent Cushing features.”
“Steroids will mask infections.”
“He may get diarrhea.”
26. The physician has ordered prednisone for a child who has nephritic syndrome. The nurse
should observe for all side effects, but the one that is most serious is:
a)
b)
c)
d)
Cushing features
Decreased respirations
Metabolic alkalosis
Adrenal suppression
27. In evaluating the effectiveness of the prednisone therapy, the nurse realizes that a child with
nephritic syndrome will continue to take the drug until after:
a)
b)
c)
d)
Edemas has disappeared
Urine no longer contains protein
Hematuria has resolved
His “moon” face has disappeared
28. A 3-year old child is brought to the emergency room by her parents. She has a broken right
leg. The mother tells the admitting nurse that the child had fallen off her tricycle. The father
tells the physician that the child had fallen down the stairs. The parents are concerned about
their child’s condition, and it is obvious she loves them. She is quiet and not talkative. She is
the youngest of four children. During the initial assessment, what should clue the nurse to
the possibility of child abuse?
a)
b)
c)
d)
The child’s not being talkative
Report of conflicting data
The child’s being the youngest child
Parents’ concern about her condition
29. Which of the following data the nurse learns about a mother in conversation support the
possibility of child abuse of her 3-year old daughter?
a)
b)
c)
d)
Has a healthy self-esteem
Has a history of a happy childhood
Viewed the child differently than the other children
Thought the child was developmentally advanced for her age
30. In identifying realistic goals in working with the parents of a 3-year old abused child, the
nurse should understand abusive parents have not mastered the task of:
a)
b)
c)
d)
Developing a trusting relationship
Role gratification
Functioning outside the home
Developing a value system
31. In planning care for a 3-year old abused child, the nurse realizes that the parents are lacking
in knowledge related to:
a)
b)
c)
d)
Appropriate play activities for the child
Normal growth and development
Nutritional needs for the child
Child psychology
32. The nurse has a legal responsibility in child abuse cases to:
a)
b)
c)
d)
Collect additional data before taking further action
Directly report her suspicions to the local child protection agency
Discuss her suspicions with the parents
Notify the physician of her suspicions
33. A 6-year old is hospitalized with a urinary tract infection (UTI). The nurse should teach the
child that the best way to prevent recurrent UTI’s is to:
a)
b)
c)
d)
Void 3 times a day
Wipe from front to back
Drink plenty of milk
Wear nylon underwear
34. A mother brings her 3-month old son to the emergency room. He is crying with apparent
acute abdominal pain. After initial assessment, intussusceptions are suspected. What type of
stool would the nurse expect the mother to report?
a)
b)
c)
d)
Black tarlike
Ribbonlike
Red currant-jellylike
Frothy and foul smelling
35. A 1-month old infant is at the physician’s office for a follow-up visit after surgery for pyloric
stenosis. The nurse would identify which of the following as the best indicator that the infant
is recovering well from his surgery?
a)
b)
c)
d)
Mother reports infant is feeding well every 4 hours
The infant has demonstrated a satisfactory weight gain
The infant is in the 90th percentile in length on the growth chart
Mother reports infant has a normal stool pattern
36. A 15-year old girl is 5 ft 7 in tall and weighs 98 lbs. She perceives herself as overweight. She
has been hospitalized with anorexia nervosa. The nurse, when planning care, should focus
on prevention of:
a)
b)
c)
d)
Vomiting
Weight loss
Malnutrition
Depression
37. A physician diagnosis a teenager as having anorexia nervosa. The nurse would expect the
parents of a patient with anorexia nervosa to describe her as being:
a)
b)
c)
d)
A conformer
Independent
Disruptive
A low achiever
38. With a 15-year old patient’s severe weight loss and disrupted metabolism due to anorexia
nervosa, the nurse would expect to observe which of the following symptoms?
a)
b)
c)
d)
Heat intolerance
Decreased temperature
Dysmenorrhea
Tachycardia
39. A baby has died from sudden infant death syndrome (SIDS). SIDS is often initially mistaken
for:
a)
b)
c)
d)
Failure to thrive
Viral infection
Meningitis
Child abuse
40. When the parents have lost an infant to SIDS, the nurse would plan to insert teaching content
about the parents’ reactions. The nurse would plan to include content related to:
a)
b)
c)
d)
Anger
Depression
Guilt
Hostility
41. A 5-year old child is hospitalized with bilateral eye patches in place following surgery.
Which of the following is the most important nursing intervention?
a)
b)
c)
d)
Speak to him when entering the room
Allow his parents to stay with him
Let him have familiar toys from home
Keep the side rails up
42. The nurse is teaching a mother how to administer eye drops to her 5-year old son. The nurse
tells her to place the drops:
a)
b)
c)
d)
Under the upper eyelid
On the sclera as the child looks to the side
In the conjunctival cul-de-sac
Anywhere that make contact with the eyes surface
43. During a parenting class for toddlers, the nurse informs parents that the major cause of
blindness in children older than 2 years old is:
a)
b)
c)
d)
Glaucoma
Trauma
Hyperopia
Infection
44. The nurse in the newborn nursery is assessing an infant. The nurse observes an opacity of
the lens of the eyes, which she knows is a symptom of:
a)
b)
c)
d)
Retinoblastoma
Cataracts
Glaucoma
Blindness
45. During the initial assessment of child with Reye’s Syndrome, the mother reports that about a
week ago the child had:
a)
b)
c)
d)
Mumps
Meningitis
Influenza
Cellulites
46. The most important nursing intervention in caring for a child with Reye’s Syndrome is to:
a)
b)
c)
d)
Prevent skin breakdown
Monitor intake and output
Do range of motion exercises
Turn every 2 hours
47. Because of liver involvement associated with Reye’s Syndrome, the nurse should use which
special precaution when caring for children with this condition?
a)
b)
c)
d)
Administering IM injections
Monitoring output from the catheter
Assessing the level of consciousness
Turning the child
48. A 1-year old infant is admitted to the hospital to rule out cystic fibrosis. During the
admission process, the infant passes a stool. The nurse, realizing that his stool is
symptomatic of cystic fibrosis, charts it as:
a)
b)
c)
d)
Small and constipated
Green and odorous
Large and bulky
Yellow and loose
49. A 15-lb, 1-year old infant is admitted to rule out cystic fibrosis. He weighed 7 lb at birth. In
analyzing data related to the infant’s weight, the nurse knows he should currently weigh
how many pounds?
a)
b)
c)
d)
14
16
21
24
50. The nurse would expect the physician to order which of the following tests to diagnose cystic
fibrosis:
a)
b)
c)
d)
Sputum culture
Stool culture
Chest x-ray
Sweat test
51. The priority nursing goal for a family whose son is diagnosed with cystic fibrosis. He is
receiving pancreatic enzymes. Once the pancreatic enzymes the child is taking are effective,
he will:
a)
b)
c)
d)
Stabilize his condition
Provide emotional support
Locate financial resources
Develop long-range plans
52. A child is diagnosed with cystic fibrosis. He is receiving pancreatic enzymes. Once the
pancreatic enzymes the child is taking are effective, he will:
a)
b)
c)
d)
Have normal bowel movements
Increase 2 lb in weight per week
Have decreased NaCl in his sweat
Have fewer respiratory infections per year
53. A 6-year old girl is hospitalized with acute lymphocyte leukemia. She is placed on protective
isolation, which concerns her parents. The nurse should explain that this will:
a)
b)
c)
d)
Protect her from too many visitors
Protect her from infectious organisms
Provide a quiet, private environment for her
Keep other children away from the child
54. A child who has lymphocytic leukemia is upset about alopecia from her chemotherapy
treatments. The nurse should explain to her that:
a)
b)
c)
d)
She can wear a wig
This is an unavoidable side effect
Her hair will grow back in a few months
She can stay home until she adjusts to her hair loss
55. The nurse discusses mouth care with a 6-year old girl who has acute lymphocytic leukemia
and her mother. The nurse explains that when toothbrushing is contraindicated, the most
effective way to clean teeth is:
a)
b)
c)
d)
Rinsing with water
Chewing gum after eating
Rinsing with hydrogen peroxide
Use of a water pick
56. A 12-year old girl is hospitalized with a diagnosis of rheumatic fever. To minimize her joint
pain during acute episodes, the nurse should teach the parents to:
a) Immobilize the joints in a functional position
b) Do full range of motion on all joints
c) Massage joints briskly with lotion after her bath
57. Discharge planning of a child with rheumatic fever should include teaching the child and
parents to recognize which of the following toxic symptoms of sodium salicylate?
a)
b)
c)
d)
Blurred vision and itching
Chills and fever
Acetone breath odor
Tinnitus and nausea