Conditions in Pediatric Nursing

LOCAL NURSING LICENSURE EXAM

Topic 1: Disorders of the Newborn

1. For which of the following symptoms will the nurse assess a neonate diagnosed with
bacterial meningitis?
a. Temperature instability, irritability, and poor feeding
b. Positive Babinski’s disease reflex, motting, and pallor
c. Headache, nuchal rigidity and development delays
d. Positive Moro’s embrace reflex, hyperthermia, and sunken fontanel
2. A newborn is suspected to have coarctation of aorta. The cardinal sign of this defect is
a. Clubbing of fingers and circumoral cyanosis
b. Portal congestion and pedal edema
c. Systolic ejection murmur
d. Upper extremity HPN
3. The nurse understands that the foramen ovale closes after a week from birth. And this
structure will be permanently and functionally close after what month?
a. 1 month
b. 2 months
c. 3 months
d. 4 months
4. This is a condition wherein there is a communication between the left and right atria
persisting after birth:
a. ASD
b. Tetralogy of fallot
c. AV canal
d. PDA
5. Which of the following would the nurse make to a mother of a new baby about infant
nutrition?
a. Eggs are good source of iron and can be introduced at 6 months
b. Solid foods can be introduces in the 6th week of life
c. Rice cereal is the least allergenic of all the cereals for infants
d. Only one new food should be introduced per day
6. A 1 month child manifests all of the following signs and symptoms. Which of the
following signs and symptoms. Which of these is most suggestive of a complication of a
CNS infection?
a. Separation of cranial sutures
b. Depressed anterior fontanel
c. Oliguria
d. Photophobia
7. A mother asked the nurse about the newborn screening. She asked when this can be done.
The nurse is correct when she stated which of the following?
a. Immediately after birth
b. After 24 hours
c. 24-48 hours after
 d. 1 week after
8. Upon screening the newborn was diagnose to have G6PD condition. The nurse
understands that the newborn will be at high risk for what type of anemia?
a. Fanconi’s anemia
b. Sickle cell anemia
c. Hemolytic anemia
d. Iron Deficiency anemia

Topic 2: Disorders of the infant

9. An otherwise healthy 18 month old child has a history of febrile seizures and is in the
well-child clinic today. Which of the following statements by the father would indicate to
the nurse that additional teaching needs to be done?
a. “I have Ibuprofen available in case its needed”
b. “My child will outgrow these seizure by age 5”
c. “I always keep Phenobarbital with me in case needed”
d. “The most likely time for a seizure is when the fever is rising”
10. When assessing a 5 month old infant which of the following symptoms would alert the
nurse that the infant needs further follow up?
a. Absent grasp reflex
b. Rolls back from back to side
c. Balances head when sitting
d. Moro’s embrace reflex is present
11. Which of the following interventions is not recommended for children with an increased
risk of sudden infant death syndrome (SIDS)?
a. Pneumogram
b. Home apnea monitor
c. Respiratory stimulant drug
d. CXR at 1 month age
12. The sudden infant death syndrome is confirmed by which of the following procedure?
a. Autopsy
b. Chest X-ray
c. Skeletal Survey
d. Laboratory analysis
13. The infant’s parents are shocked when they saw their child for the first time with cleft lip.
Which of the following nursing actions would help most the parents accept their infant’s
anomaly?
a. Bring the infant to them more often
b. Reassure them that surgery will correct the defect
c. Show them pictures of babies before and after corrective surgery
d. Allow them to complete their grieving process before seeing the infant again
14. Which of the following goals would the nurse identify as a priority for the infant with
cleft palate?
a. Preventing infection in the infant’s mouth
b. Using Techniques to minimize crying
c. Altering the usual method of feeding
d. Preventing the infant from putting fingers in the mouth
15. Which of the following methods would the nurse use to feed an infant following
cheiloplasty?
a. Gastric gavage
b. Total parenteral nutrition
c. Rubber-tipped medicine dropper
d. Bottle with large hole nipple
16. The infant is admitted to the pediatric surgical unit. In the initial assessment, the nurse
can expect to observe which typical sign of tracheoesophageal fistula (TEF)?
a. Continuous drooling
b. Diaphragmatic breathing
c. Slow response to stimuli
d. Passage of large amounts of frothy meconium
17. A patient suffering from cleft palate is scheduled for palatoplasty. The nurse knew that at
which month should the child be operated?
a. 1-3 months
b. 10-12 months
c. 12-18 months
d. 24-48 months

Topic 3: Disorders of the Gastrointestinal System

18. Which of the following statements by the mother would indicate that she understand
pyloric stenosis?
a. Pyloric stenosis is an enlarged muscle below the stomach sphincter
b. Pyloric stenosis is a telescoping of the large bowel into the smaller bowel
c. Pyloric stenosis is caused by overfeeding the baby
d. Pyloric stenosis is caused by feeding the baby to fast
19. Weng, a 5 y/o with severe diarrhea was admitted due to severe dehydration. Weng was
lethargic and has body malaise. The nurse should assess and be anticipating that weng
will be suffering from:
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
20. Before scheduling the infant for surgery, the physician wants to rehydrate the infant and
orders the administration of fluids and electrolytes. Monitoring which of the following
parameters would provide the nurse with the least accurate information about the infant’s
hydration status?
a. Urine specific gravity
b. Skin color
c. Urine output
d. Daily weight
21. A tentative medical diagnosis of hypertrophic pyloric stenosis is made. Given the
diagnosis, the nurse would anticipate that the client’s vomitus would contain gastric
contents:
a. Bile and streaks of blood
b. Mucus and bile
 c. Mucus and streaks of blood
d. Bile and gross blood
22. Which of the following questions would be most helpful in obtaining pertinent diagnostic
data in a client with intussusception?
a. “Did his stool look like bloody mucoid?”
b. “Did he have fever and pain in his lower back?”
c. “When was the last time he urinated?”
d. “Has he vomited?”
23. The nurse judges the parents with Hirschprung’s disease understand the diagnosis when
the father states:
a. “There is no rectal opening”
b. “The small intestine is not fully developed”
c. “The nerves to the end of the large colon are missing”
d. “The muscles below the stomach is too tight”
24. When assessing the client, the nurse would be alert for signs and symptoms of
appendicitis. A clinical finding consistent with appendicitis is:
a. Costovertebral ankle tenderness
b. Bradycardia
c. Oral temperature
d. Gross hematuria
25. A diagnosis of appendicitis is made. The client is scheduled for an emergency
appendectomy and is to be transferred directly from the emergency room to the operating
room. Which of the following statements by the client would the nurse consider as most
significant?
a. “It suddenly doesn’t hurt at all”
b. “The pain is around my navel”
c. “I feel like I’m going to throw up”
d. “It hurts when you press on my stomach”
26. The client is given Lofenalac, one of the several products on the market used to provide
protein intake to a child with PKU. Lofenalac helps maintain low blood levels of what
substance?
a. Tyrosine
b. Galactose
c. Tryptophan
d. Phenylalanine
27. When comparing the physical characteristics of a well-child with those of a child with
PKU, the nurse expect that the child with PKU typically would have:
a. Shoter stature
b. Larger abdomen
c. Larger head size
d. Lighter skin pigmentation
28. The goal of care for a child with PKU would be:
a. Meet the child’s nutritional needs for optimal growth
b. Ensure that special diet is started at age 4 weeks
c. Maintain a serum phenylalanine level above 15 mg/100 ml
d. Maintain a serum phenylalanine level below 2 mg/100 ml
29. Which substance in the following list is the part of the protein gluten that children with
celiac disease are unable to digest?
a. Gliadin
b. Glucagon
c. Glycogen
d. Thyroxine
30. The nurse teaches the mother about the child’s diet. Which of the following foods should
not be included in a gluten-free diet?
a. Milo
b. Skimmed milk
c. Baked corn
d. Fried rice
31. The nurse should instruct the mother that her child with celiac disease will be on a special
diet:
a. For the rest of the child’s life
b. Until the disease is well controlled
c. Until around puberty
d. Until the desensitization to offending foods occurs
32. The cause of decrease digestion and absorption of ingested nutrients in celiac disease is:
a. Pancreatic duct obstructed with mucus
b. Atrophy in the intestinal villi
c. Inability to produce pancreatic enzymes
d. Necrosis of the ileum
33. Health education for celiac disease include all of the following except:
a. Gluten free diet for 6 months
b. Prevent infection
c. Supplement vitamin, calcium, iron, folate
d. Fluid replacement
34. The characteristics stool in intussusception is:
a. Ribbon like
b. Fatty frothy
c. Bloody mucoid
d. None of the above
35. Priority nursing intervention for intussusception is:
a. Provide patient with health teaching
b. Monitor for peritonitis
c. Monitor for bowel elimination status
d. Care for colostomy
36. What cells will now produce your intrinsic factor for the pernicious anemia is
intussusception?
a. Chief
b. Parietal
c. Acinar
d. Gastric
37. Which of the following is not a part of the cardinal signs of esophageal atresia?
a. Choking
 b. Coughing
c. Cyanosis
d. Clubbing of fingers

Topic 4: Disorders of the Musculoskeletal System

38. The nurse observes the child attempt to rise from a sitting position on the floor. After
attaining a kneeling position, the child “walks” his hands up his legs to stand. The nurse
would document this as an indication of muscular dystrophy referred to as:
a. Galleazzi’s sign
b. Goodell’s sign
c. Good enough sign
d. Gower’s sign
39. Three weeks after the application of the Spica cast, the nurse notes that the child is
afebrile and that his toes are swollen and cold to touch. The nurse would suspect that
these findings are due to the fact that the:
a. Child has had his feet in a dependent position
b. Child has outgrown the cast
c. Cotton wadding lining of the cast has shrunk
d. Child has an infection in the tissue under the cast
40. Which of the following definitions best describes the form of clubfoot called talipes
varus?
a. Inversion of the foot
b. Eversion of the foot
c. Plantar flexion
d. Dorsiflexion
41. Which of the following types of clubfoot is one of the most commonly treated by primary
health care providers?
a. Talipes calcaneus
b. Talipes equinovarus
c. Talipes varus
d. Talipes valgus
42. Scoliosis is most common in which of the following groups?
a. Preteenage girls
b. Preteenage boys
c. Adolescent girls
d. Adolescent boys
43. What sign is manifested with a child who has congenital hip dysplasia and upon
manipulation of the hips, there is a clicking sound?
a. Ortolani
b. Barlow
c. Trendelenburg
d. Alli’s
44. The mother asked the nurse about the considerations in wearing Frejka cast. The mother
asked the nurse how many hours per day shall it be worn. The nurse is correct when she
stated:
a. 16-23 hours per day
 b. 12-20 hours per day
c. 12 hours per day
d. As long as the child can tolerate
45. One of the nursing responsibilities of the nurse in caring for children with cast is to check
frequently not only the cast but as well as the casted part. Which of the following is not a
part of the triad of nursing assessment in caring for patients with casts?
a. Pulse
b. Dryness
c. Warmth
d. Pain
46. This is a test for scoliosis wherein there is a visible curve that fails to straighten when the
child bends forward and hang arms down towards the feet/
a. Allen test
b. Adams test
c. Alli’s test
d. Adequate stand test

Topic 5: Disorders of the CNS

47. The mother of a 3 year old with a myelomeningocele is thinking of having another baby.
The nurse should inform the woman that she should increase her intake to which of the
following acids?
a. Folic acid to 0.04mg/day
b. Folic acid to 4mg/day
c. Ascorbic acid to 0.4 mg/day
d. Ascorbic acid to 4 mg/day
48. Which of the following types of behavior demonstrated by a 6 year old would help the
school nurse differentiate between attention deficit disorder (ADD) and learning
disability?
a. The child reverses letters and words while reading
b. The child is easily distracted and reacts impulsively
c. The child is always getting into fights during recess
d. The child has difficulty time reading a chapter book
49. Which of the following signs and symptoms would the nurse expect to be present in a 12
year old child admitted to the pediatric unit with a diagnosis of possible brain tumor?
a. Bulging fontanel
b. High pitched cry
c. Behavioral changes
d. Change in vital signs
50. A 10 year old child is started on valporic acid to seizure. Which of the following
statement should be included when educating the child?
a. This medication has no adverse effect
b. A common adverse effect is weight gain
c. Drowsiness and irritability occur frequently
d. Early morning dosing is recommended to decrease insomnia
51. Which of the following pathogenic process often associated with aseptic meningitis?
a. Ischemic infarction of cerebral tissue
 b. Childhood disease of viral caution such as mumps
c. Brain abscess caused by variety of pyogenic organisms
d. Cerebral ventricular irritation from a traumatic brain injury
52. A preschool child is admitted to the pediatric unit with the diagnosis of bacterial
meningitis. The nurse would include which of the following recommendations in the
nursing plan?
a. Take vital signs every 4 hours
b. Monitor temperature every 4 hours
c. Decrease environmental stimulation
d. Encourage the parents to hold the child
53. A 2-year old child is admitted to the pediatric unit with the diagnosis of bacterial
meningitis. Which of the following diagnostic measure would be appropriate for the
nurse to perform list?
a. Obtain a urine specimen
b. Obtain ordered laboratory specimens
c. Place in respiratory isolation
d. Place in oxygen mask with 2-3 lpm oxygen flow
54. The pupils of a child with a head injury are dilated and react sluggishly. This is indicative
of:
a. Barbiturate overdose
b. Damage to the diencephalons
c. Damage to the SNS
d. Damage to the PNS
55. Assessment for increased intracranial pressure include all except:
a. Sunset eyes
b. Tet spells
c. Bossing
d. Macewen sign
Disorders of the cardiovascular system
56. Which of the following tests would show the direction and the amount of shunting in a
child with tetralogy of fallot?
a. chest radiography
b. Echocardiography
c. electrocardiography
d. cardiac catheterization
57. Which of the following disease is not a part of the right to left shunt?
a. Truncus arteriosus
b. Tricuspid atresia
c. Coarctation of the aorta
d. Total anomalous venous return
58. Which of the following statements about transportation of the great arteries is correct?
a. Diagnosis is made at birth
b. Diagnosis can be made in utero
c. Chest x-ray can show an accurate view of the defect
d. Heart failure in not a related complication
59. Which of the following tests result may contribution to the diagnosis of Kawasaki
disease?
a. Hematuria
b. Elevated leukocyte count
c. Normal or decrease platelet count
d. Decrease erythrocyte sedimentation rate
60. Which of the following assessment findings is expected in a child with acute rheumatic
fever?
a. Leukocytes
b. Normal ECG
c. High fever for 5 or more days
d. Normal ESR
61. Which of the following is not part of the tetralogy of fallot?
a. Low oxygen saturation
b. Polycythemia vera
c. Cardiac murmurs
d. Activity tolerance
62. A 4yo child is admitted with RF. In addition to carditis, the nurse should assess the child
for the presence of:
a. Arthritis
b. Bronchitis
c. Malabsorption
d. Oliguria
63. Jenny, a 2 year old child with tetralogy of fallot has been admitted. What equipment is
most important to have at the bedside?
a. Morphine
b. BP cuff
c. Thermometer
d. Oxygen set up
64. A 10 year old has been diagnosed to have RF and is now being discharged. What
statement made by the parents show an understanding a lone term care?
a. “she will need penicillin each day”
b. “She will need antibiotic prophylaxis when she has dental work”
c. “we will have yearly checkups”
d. “the murmur will go away by adolescence”
65. Joey was suffering from a cyanotic condition. Which of these nursing interventions
would be the last?
a. Monitor for hypotension
b. Promote rest
c. Administer medications as ordered
d. Monitor for hypoxemia
66. Palliative treatment of tetralogy of fallot is:
a. Modified fontan procedure
b. Rashkind procedure
c. Blalock-Taussig shunt
d. Rastell’s procedure
 e. 67. One of the signs of RHD is elevated erythrocyte sedimentation rate. The
nurse understands
that this is due to the:
a. Increase hemolysis of RBC
b. Inflammatory process of the disease condition
c. Bone marrow suppression
d. Mitral valve stenosis
68. The acute systemic vasculitis is frequently seen in boys under the age of 2 the nurse. The
Nurse understands that the main cause of this phenomenon is:
a. Virus
b. Unknown
c. Bacteria
d. Fungal infection
69. What statement is correct about the treatment of Kawasaki Disease in relation to the
administration of IV Ig?
a. This should be given in the early stage
b. This should be given at night
c. This should be given at the sight of rashes
d. This should be given intermittently

Topic 7: Disorders of the Respiratory System

70. A 3 year old child is given a preliminary diagnosis of acute epiglottitis. Which of the
Following nursing interventions is appropriate?
a. Obtain throat culture immediately
b. Place the child in side lying position
c. Don’t attempt to visualize the epiglottis with tongue depressor
d. Use spoon in feeding the child
71. Which of the following findings would you expect in a typical x-ray of a child with asthma?
a. Atelectasis
b. Hemothorax
c. Infiltrates
d. Pneumothorax
72. Which of the following test give a positive diagnosis for bronchitis with respiratory syncytial
virus (RSV)?
a. Blood test
b. Nasopharyngeal washing
c. Sputum culture
d. Throat culture
73. This is an adventitious sound wherein the nurse auscultates and noted for high pitch sound
during expiration:
a. Wheezing
b. Stridor
c. Gurgles
d. Rales
74. Part of the treatment of the croup is administration of oxygen. The nurse understands that the
Amount of oxygen that the child should be receiving via face mask is:
 a. 2-4 LPM
b. 4-5 LPM
c. 6-7 LPM
d. None of the above
75. Which of the following is not a pathophysiological part of asthma?
a. Increase mucus production
b. Alveolar inflammation
c. Bronchial spasm
d. Tracheal irritation
76. What enzyme is absent in cystic fibrosis?
a. Sodium
b. Trypsin
c. Phenylalanine hydroxylase
d. Pepsin
77. In addition for assessing for hemorrhage, the most important objective in child care \
Following a tonsillectomy is a prevention of:
a. Coughing
b. Swallowing blood
c. Aspiration of mucus
d. Airway constriction
78. While a 1 year old is hospitalized with bronchitis she is receiving care for the respiratory
condition. An appropriate toy for her would be:
a. Book with pop up pages
b. Set of blocks
c. Mobile hanging from the crib
d. Terry cloth teddy bear
79. The nurse understands that the croup produces a barking sound due to obstruction of larynx.
The causative agent of the laryngotracheobronchitis?
a. Parainfluenza virus
b. Haemophilus influenza type B
c. Respiratory syncytial virus
d. Pseudomonas aeroguinosa
80. The asthma is a condition wherein there is hypersensitivity of the bronchial lining. This
Allergic response will cause bronchoconstriction and increase in mucus production. The
Nurse understands that the laboratory value that will increase is:
a. Neutrophils
b. Eosinophils
c. Basophils
d. Dmonocytes
81. All of the following are complications of invasive pneumococcal disease except:
a. Meningitis
b. Otitis media
c. Bacteremia
d. Carditis
Top 8: Pediatric Hematology and Oncology
82. The nurse reviews the laboratory result of a client seen in the clinic. She notes that the RBC
count is decreased. She determines that this finding occurs in which of the following
conditions?
a. IDA
b. Severe diarrhea
c. Dehydration
d. Polycythemia Vera
83. Angela has provided medication instructions to a client with IDA who will be taking iron
supplements. Which statement if made by the client indicates an understanding of this use?
a. “I should ensure to chew the tablet thoroughly before swallowing”
b. “I need to increase my fluid intake”
c. “I need to take the medication with water before meal”
d. “I should eliminate fiber foods from the diet”
84. The nurse understands that the child with Christmas disease is suffering from a deficiency
In what clotting factor in hemophilia?
a. Clotting factor 8
b. Cotting factor 9
c. Clotting factor 10
d. Clotting factor 11
85. What is the reason why the nurse must place a “NO PALPATION OF THE ABDOMEN”
Sign in the chart and in the child’s room if the diagnosis is Wilm’s tumor?
a. The palpation can cause excruciating pain in the child
b. The palpation can trigger the development of a new cancer in the unaffected
Kidney
c. The palpation can stimulate leakage of blood cells
d. The palpation can trigger eruption of the encapsulated cells
86. The mother of a child with neuroblastoma asked the nurse where the primary site of this
condition is. The nurse is correct when she stated which body part?
a. Brain
b. Adrenal gland
c. Spinal cord
d. Kidneys
87. A child with neuroblastoma was admitted in the pediatric unit. The nurse understands that
This child will be expected of what in his/her urine?
a. Blood
b. Catecholamines
c. Bacteria
d. Virus
88. A prudent nurse understands that the causative agent of Hodgkin’s disease is:
a. EBV
b. HTLV 1
c. CMV
d. RSV
89. Clinical Instructor cascaded the question to the pediatric nurse. The nurse is correct when
She stated:
 a. Presence of Reed-Sternberg cells
b. Presence of Waldeyer’s ring
c. Presence of maculopapular rash
d. Presence of beefy-red tongue

Topic 9: Disorders of the Genitourinary System

90. Which of the following is not a part of the cardinal signs of urinary tract infection?
a. Burning sensation upon urination
b. Flank pain
c. Constant fever
d. Hematuria
91. The mother of a child with UTI asked the nurse on how to eliminate the bacteria without
using antibiotics. The nurse is correct when she stated:
a. “Force more fluids at least 3-4 L/day”
b. “Encourage an acid ash diet to the child.”
c. “Consume at least 2 glasses of buko juice per day”
d. “stop giving the child soft drinks”
92. This is a medical condition used to described the unilateral or bilateral absence of testes in
The scrotal sac.
a. Peyronies disease
b. Cryptorchidism
c. Anencephaly
d. Aspadias
93. One of the treatments for undescended testes is by the use of hormones. Which of the
Following hormones will the nurse prepare if the child is for treatment of such condition?
a. Testosterone
b. Estrogen
c. Human chorionic Gonadotropin
d. Androgens
94. This is a congenital defect of the penis wherein the urethral opening is at the ventral surface
a. Hypospadia
b. Hyperspadia
c. Omnispadia
d. Paraspadia
95. One of the reasons why surgery is done at 6-18 months in hypo/hyperspadia is due to the
Fact that the child has not yet developed what psychological aspect?
a. Separation anxiety
b. Castration anxiety
c. Concept of death
d. Concept of illness
96. The nurse understands that one of the major causes of a child with Nephrotic Syndrome is:
a. Minimal change disease
b. Rheumatic heart disease
c. Acute glomerulonephritis
d. Urinary tract infection
97. A prudent nurse notes that the child with nephritic syndrome is having proteinuria. Upon
 Knowing this condition, the nurse will expect what change in the child’s dietary regimen?
a. Increase protein in the diet
b. Decrease protein the diet
c. Increase carbohydrates in diet
d. Increase water intake
98. The nurse understands that one of the major factors for the development of acute glomerulo
Nephritis is the having a history of what condition?
a. Minimal change disease
b. Rheumatic heart disease
c. Urinary tract infection
d. Nephrolithiasis
99. A child came in to the clinic with a diagnosed with RHD. The nurse understands that the
Child knowing the causative agent of RHD may be at high risk for developing what
Condition?
a. UTI
b. AGN
c. Cryptorchidism
d. Hypospadias
100. A mother of a child with UTI came to the nurse asking for some health teachings with
regards to the appropriate diet. The nurse is correct when she stated which statement?
a. Eat a high carbohydrate, low protein diet, low fat diet
b. The child can have sips of cola and juice given alternatively
c. Increase sodium intake and oral fluid to prevent dehydration
d. Low carbohydrate, high protein, low fat diet