Take The Pediatric Nursing NCLEX Exam Questions

1. The nurse is evaluating a female child with acute post streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?

Increased urine output

Increased appetite

Increased energy level

Decreased diarrhea

Increased urine output. a sign of improving kidney function. typically is the first sign that a child with acute post streptococcal glomerulonephritis (APSGN) is improving.Options B. C. and D: Increased appetite. an increased energy level. and decreased diarrhea are not specific to APSGN.

Explanation

Increased urine output. a sign of improving kidney function. typically is the first sign that a child with acute post streptococcal glomerulonephritis (APSGN) is improving.Options B. C. and D: Increased appetite. an increased energy level. and decreased diarrhea are not specific to APSGN.

2. Parents bring their infant to the clinic. seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment. the nurse in charge detects dry mucous membranes and lethargy. What other findings suggests a fluid volume deficit?

A sunken fontanel

Decreased pulse rate

Increased blood pressure

Low urine specific gravity

In an infant. signs of fluid volume deficit (dehydration) include sunken fontanels. increased pulse rate. and decreased blood pressure. They occur when the body can no longer maintain sufficient intravascular fluid volume. When this happens. the kidneys conserve water to minimize fluid loss. which results in concentrated urine with a high specific gravity.

Explanation

In an infant. signs of fluid volume deficit (dehydration) include sunken fontanels. increased pulse rate. and decreased blood pressure. They occur when the body can no longer maintain sufficient intravascular fluid volume. When this happens. the kidneys conserve water to minimize fluid loss. which results in concentrated urine with a high specific gravity.

3. How should the nurse prepare a suspension before administration?

By diluting it with normal saline solution

By diluting it with 5% dextrose solution

By shaking it so that all the drug particles are dispersed uniformly

By crushing remaining particles with a mortar and pestle

The nurse should shake a suspension before administration to dispersed drug particles uniformly.Options A. B. and D: Diluting the suspension and crushing particles are not recommended for this drug form.

Explanation

The nurse should shake a suspension before administration to dispersed drug particles uniformly.Options A. B. and D: Diluting the suspension and crushing particles are not recommended for this drug form.

4. A child is diagnosed with Wilms' tumor. During assessment. the nurse in charge expects to detect:

Gross hematuria

Dysuria

Nausea and vomiting

An abdominal mass

The most common sign of Wilms’ tumor is a painless. palpable abdominal mass. sometimes accompanied by an increase in abdominal girth.Option A: Gross hematuria is uncommon. although microscopic hematuria may be present.Option B: Dysuria is not associated with Wilms’ tumor.Option C: Nausea and vomiting are rare in children with Wilms’ tumor.

Explanation

The most common sign of Wilms’ tumor is a painless. palpable abdominal mass. sometimes accompanied by an increase in abdominal girth.Option A: Gross hematuria is uncommon. although microscopic hematuria may be present.Option B: Dysuria is not associated with Wilms’ tumor.Option C: Nausea and vomiting are rare in children with Wilms’ tumor.

5. Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely?

At 1 to 2 years of age

At I week to 1 year of age. peaking at 2 to 4 months

At 6 months to 1 year of age. peaking at 10 months

At 6 to 8 weeks of age

SIDS can occur any time between 1 week and 1 year of age. The incidence peaks at 2 to 4 months of age.

Explanation

SIDS can occur any time between 1 week and 1 year of age. The incidence peaks at 2 to 4 months of age.

6. What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shock?

20 ml/kg

10 ml/kg

30 ml/kg

15 ml/kg

Fluid volume replacement must be calculated to the child’s weight to avoid over-hydration. Initial fluid bolus is administered at 20 ml/kg. followed by another 20 ml/kg bolus if there is no improvement in fluid status.

Explanation

Fluid volume replacement must be calculated to the child’s weight to avoid over-hydration. Initial fluid bolus is administered at 20 ml/kg. followed by another 20 ml/kg bolus if there is no improvement in fluid status.

7. Lily . age 5. with an intelligence quotient of 65 is admitted to the hospital for evaluation. When planning care. the nurse should keep in mind that this child is:

Within the lower range of normal intelligence

Mildly retarded but educable

Moderately retarded but trainable

Completely dependent on others for care

According to the American Association on Mental Deficiency. a person with an intelligence quotient (IQ) between 50 and 70 is classified as mildly mentally retarded but educable.Option C: One with an IQ between 35 and 50 is classified as moderately retarded but trainable.Option D: One with an IQ below 36 is severely and profoundly impaired. requiring custodial care.

Explanation

According to the American Association on Mental Deficiency. a person with an intelligence quotient (IQ) between 50 and 70 is classified as mildly mentally retarded but educable.Option C: One with an IQ between 35 and 50 is classified as moderately retarded but trainable.Option D: One with an IQ below 36 is severely and profoundly impaired. requiring custodial care.

8. When evaluating a severely depressed adolescent. the nurse knows that one indicator of a high risk for suicide is:

Depression

Excessive sleepiness

A history of cocaine use

A preoccupation with death

An adolescent who demonstrates a preoccupation with death (such as by talking about death frequently) should be considered at high risk for suicide.Options A. B. and C: Although depression. excessive sleepiness. and a history of cocaine use may occur in suicidal adolescents; they also occur in adolescents who are not suicidal.

Explanation

An adolescent who demonstrates a preoccupation with death (such as by talking about death frequently) should be considered at high risk for suicide.Options A. B. and C: Although depression. excessive sleepiness. and a history of cocaine use may occur in suicidal adolescents; they also occur in adolescents who are not suicidal.

9. Mandy. age 12. is brought to the clinic for evaluation for a suspected eating disorder. To best assess the effects of role and relationship patterns on the child's nutritional intake. the nurse should ask:

“What activities do you engage in during the day?”

“Do you have any allergies to foods?”

“Do you like yourself physically?”

“What kinds of food do you like to eat?”

Role and relationship patterns focus on body image and the patient’s relationship with others. which commonly interrelated with food intake.Options A and C: Questions about activities and food preferences elicit information about health promotion and health protection behaviors.Option B: Questions about food allergies elicit information about health and illness patterns.

Explanation

Role and relationship patterns focus on body image and the patient’s relationship with others. which commonly interrelated with food intake.Options A and C: Questions about activities and food preferences elicit information about health promotion and health protection behaviors.Option B: Questions about food allergies elicit information about health and illness patterns.

10. Dr. Jones prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child?

To increase blood pressure

To reduce inflammation

To decrease proteinuria

To prevent infection

The primary purpose of administering corticosteroids to a child with nephritic syndrome is to decrease proteinuria.Option A: Corticosteroids have no effect on blood pressure.Option B: Although they help reduce inflammation. this is not the reason for their use in patients with nephritic syndrome.Option D: Corticosteroids may predispose a patient to infection.

Explanation

The primary purpose of administering corticosteroids to a child with nephritic syndrome is to decrease proteinuria.Option A: Corticosteroids have no effect on blood pressure.Option B: Although they help reduce inflammation. this is not the reason for their use in patients with nephritic syndrome.Option D: Corticosteroids may predispose a patient to infection.