1.

Which assessment findings is the nurse most likely to observe in a newborn diagnosed
with Hirschsprung’s disease (megacolon)?
a. Acute diarrhea and poor skin turgor
b. Currant jelly stool and abdominal pain INTUSSECTION
c. Projectile vomiting and hypochloremia. pylory
d. Failure to pass meconium and abdominal distension

2. The nurse assigned to a 6-year-old child with an intravenous infusion notices the site to
be red and moderately swollen. Which action should the nurse take first?
a. Ask the child if IV site hurts
b. decrease the IV infusion rate
c. flush the IV site with normal saline
d. stop the infusion and notify the physician

3. Which one of the following is a priority diagnosis for a 2-year-old child who is
hospitalized for vomiting and loose stools for 2 days?
a. Risk for alteration in skin integrity
b. Alteration in nutrition
c. Impaired family process
d. Fluid Volume Deficit

4. On assessing a child with Acute Glomerulonephritis, the nurse would expect which
findings?
a. Swollen Eyelids
b. Abdominal distension
c. Projectile vomiting
d. Oliguria

5. The nurse is attempting to administer an oral liquid medication to a 15-month-old child

who is protesting and crying. What approach should the nurse take first?
a. Tell the child the medication will help her get better
b. Document the child’s refusal in the electronic health record
c. Allow the mother to hold the child in her lap and sing to her while the nurse gives
the medication.
d. Allow the child to rest and return at a later time.
6. The primary goal of a family-centered care on pediatric units in hospitals is to:
a. Allow parents to help feed and bather their child
b. Meet the emotional needs of children
c. Reduce the nurse to patient care ratio
d. Reduce length of the child’s hospitalization

7. An 8-year-old child with a diagnosis of glomerulonephritis is complaining of a headache

and a blurred view of the television in his room. What action should the nurse take first?
a. Assess the child’s pain level using the faces pain scale.
b. Monitor the child’s blood pressure.
c. Notify the maintenance department of a malfunctioning television.
d. Apply cool cloth to the child’s head.

8. The physician orders Vitamin K (Aquamephyton) 1 mg IM for a newborn infant. The

medication is available 2mg/1mL. How should the nurse administer this medication?
(Select all that apply)
a. In the child’s buttocks
b. In a single syringe
c. In the anterior thigh
d. In 2 divided doses.

9. A new nurse is caring for a 7-month-old infant 2-days post-op for repair of aganglionic
megacolon and a transverse colostomy. Which intervention needs reconsideration?
a. Taking rectal temperature every 4 hours.
b. Using FLACC scale to assess the child’s pain level.
c. Auscultating bowel sounds
d. Assessing the skin around the stoma.

10. The Rotovirus vaccination is given to prevent diarrheal infections.

a. True
b. False

11. A 4-year-old child with a Nephrotic Syndrome has a nursing diagnosis of Risk for
Intravascular Fluid Volume Deficit. Which interventions should the nurse include in the
patient’s care related to this diagnosis? (select all that apply)
 a. Explain to the child and his parents the important of taking a 10-day course of
oral penicillin.
b. Monitor blood pressure every 4 hours.
c. Observe for dry mucous membranes and poor skin turgor
d. Check frequently for urine output

12. The health care provider orders Ceftriaxone Sodium (Rocephin) 600 mg. intravenous Q
12 hours for a child weighing 45 lbs. The drug reference states the dose as 50-
75mg/kg/day in 2 divided doses (maximum dose 2gm/day). The ordered dose is safe to
administer to this child.
a. True
b. False

13. What assessment finding(s) would the nurse expect in a 2-year old child after
administering an albuterol treatment?
a. Increased oxygen saturation level
b. Decreased nasal discharge
c. Increased Respiratory Rate
d. Intercostal retractions

14. The parents of a newborn daughter diagnosed with Cystic Fibrosis are concerned that
they may have other children with this condition. What advise should the nurse offer?
a. Tell the women that she can have an amniocentesis to test for affected genes.
b. Explain that the illness is caused by a genetic mutation and will rarely affect
future children.
c. Explain that the disease is caused by an autosomal dominant disorder.
d. Tell them that all of their future children will have cystic fibrosis.

15. What information should the nurse include when teaching the parents of an 8-month old
infant with a congenital heart defect who is receiving oral Digoxin?
a. Explain that this medicine will help increase the baby’s appetite.
b. Offer the medicine to the child in her bottle with juice.
c. Notify the physician immediately if the baby vomits the medicine.
d. Skip the medicine is the infant’s pulse rate is a regular rhythm.
16. The nurse caring for a child with a suspected diagnosis of cystic fibrosis would expect
which findings:
a. Hard dry stools.
b. Frothy urine.
c. Pale, sweaty skin.
d. Increased appetite and weight loss.

17. Which statement by a 9-year old with reactive airway disease (asthma), indicated
understanding of her medications and treatments?
a. “When my peak flow meter is in the red zone, I don’t need to take any of my
medicine”.
b. “I use my Albuterol inhaler when my chest feels too tight”.
c. “I only take my Pulmicort if I’m having trouble breathing.”
d. “I still put milk on my cereal even though it sometimes makes me cough and have
a lot of mucous.”

18. The nurse caring for a 4-year old child with suspected intussusception notices the child
holding his abdomen and grimacing after eating half of his lunch. Which action should
the nurse take first?
a. Ask the child if he would prefer another meal selection.
b. Auscultate his abdomen for hyperactive bowel sounds.
c. Call the physician to report these findings.
d. Give the child an analgesic for his pain.

19. A 9-year old child with a recent diagnosis of rheumatic fever is being seen in the
pediatric clinic. In order to evaluate the family’s compliance with the plan of care, the
nurse should:
a. Monitor the child’s weight.
b. Assess the child’s hearing level.
c. Ask if the child is taking his antibiotic medication.
d. Remind the child to exercise his swollen joints to prevent contractures.

20. The nurse understands the pathophysiology of nephrotic syndrome causes:

a. A loss in circulating proteins.
b. An increase in fluid osmotic pressure.
c. Dehydration and weight loss.
d. Hyperglycemia
21. The mother, whose 6-month infant received his DTaP (dipthera, tetanus, pertussis)
vaccination earlier that morning, calls the children’s clinic stating that her baby is
irritable and has a temperature of 100.8 degrees F. The child’s injection site is also warm
and painful to touch. What advise should the nurse give to the mother?
a. Administer pediatric Tylenol (Acetaminophen) as directed on the package.
b. Continue to monitor the infant’s temperature and administer Tylenol when it
reaches 101 degrees F.
c. Appy hot compress to the injection site.
d. Bring the infant to the nearest Emergency Department.

22. A two-year with a diagnosis of diarrhea and mild dehydration is admitted to the
Children’s unit. The nurse should incorporate which actions into plan of care? (select all
that apply)
a. Daily weight
b. Whole Milk to coat the child’s stomach
c. Use of gloves when changes diapers
d. Placing the child in a private room

23. A 3-month-old has had a recent repair of his cleft lip. In order to reduce injury to the
operative site, which nursing intervention would be best?
a. Position the baby in a prone position.
b. Administer medication to keep him lightly sedated until discharge.
c. Apply restraints to his arms and legs.
d. Encourage the parents to hold the infant frequently.

24. The mother of an 8-year old asks the nurse if her daughter’s rheumatic fever will affect
her other children. How should the nurse respond?
a. Tell her that rheumatic fever is not contagious.
b. Explain that there is a 7–10-day incubation period in which other family members
could be affected.
c. Tell her that rheumatic fever is an autoimmune disorder.
d. Explain that she and her child should receive prophylactic treatment.

25. Which nursing diagnosis would be appropriate for an infant with a ventricular septal
defect?
a. Acute chest pain related to the tachycardia secondary to ventricular hypertrophy.
 b. Fluid volume deficit related to hyperthermia secondary to the Congenital Heart
Defect.
c. Hypothermia related to decreased metabolic state.
d. Impaired gas exchange related to pulmonary congestion secondary to increased
pulmonary blood flow.

26. The nurse caring for a 9-month old with bronchiolitis notices the child rubbing her ears
and crying. What action should the nurse take.
a. Report this finding to the physician.
b. Place the baby on its back to encourages rest.
c. Auscultate the baby’s lungs for evidence of rhonchi.
d. Administer Aspirin to alleviate the infant’s pain

27. The cardiologist orders IV Indomethacin (Indocin) for an infant with patent ductus
arteriosus. The therapeutic effect that the nurse should observe in the …
a. Slow apical pulse rate.
b. Increased systolic blood pressure.
c. Decreased urinary output.
d. Increase in oxygen saturation level.

28. The nurse caring for a child with Wilm’s Tumor (nephroblastoma) should include what
assessment in the plan of care? (Select all that apply).
a. Refrain from abdominal palpation.
b. Assess the child’s lungs
c. Monitor bowel movements.
d. Check for signs of anemia.

29. The mother of a 5-month-old with atrial septal defect tells the nurse at the cardiac clinic
that her infant gets tired during feeding. The nurse should advise the mother to:
a. Switch to breast feeding since it is more easily digested.
b. Limit the feedings to three times a day.
c. Offer the baby smaller amounts of the feedings at more frequent intervals.
d. Instruct the mother to enlarge the nipple hole of the infant’s bottle.

30. The major focus of health care for the pediatric population is on which one of the
following:
 a. Prevention of illness.
b. Treatment of congenital anomalies
c. Management of acute illnesses.
d. Hospice care.

31. The nurse assessing the respiratory status of a child with croup would expect to hear?
a. Rattling or bubbling sounds
b. Whistling sounds on expiration
c. Snoring sounds on inspiration
d. A brassy barking coughs

32. Which statement by a new mother indicates understanding of the role of immunizations
for her infant’s child?
a. “My baby doesn’t need any vaccination as long as I breastfeed.”
b. “My husband and I got our flu shot so our baby is protected from germs.”
c. “I heard that vaccinations can cause mental illness like autism.”
d. “Having the “shots” will help my baby’s body to fight off infections that causes
serious diseases.”

33. The majority of children from low income families receive their health care in which one
of the following settings.
a. Emergency rooms
b. Urgent care centers
c. Physician’s offices
d. Pediatric Clinics

34. The pathophysiological impact of prolonged vomiting may result in:

a. Metabolic alkalosis due to the loss of gastric hydrochloric acid.
b. Decreased renal absorption of hydrogen ions and hyperkalemia.
c. Sodium bicarbonate losses and a serum pH below 7.35
d. Hypernatremia and increases in extracellular fluid volume.

35. The mother of a 6-year-old post-op appendectomy patient reports to the nurse that her
daughter is complaining of pain. What action should the nurse take first?
a. Ask the child’s mother to describe her daughter’s pain.
b. Ask the child to rate her pain level using the faces pain scale.
 c. Administer the pain medication that is ordered.
d. Try distracting the girl with computer games.

36. In order to minimize the incidence of COVID-19 and other infectious respiratory
conditions in young children the nurse should teach families and children to: (select all
that apply)
a. Wash their hands with warm soapy water frequently throughout the day
b. Receive their annual influenza vaccination
c. Refrain from playing with other children
d. Use their hands to cover their mouth and nose when coughing and sneezing.

37. A 2- year old child is seen in the pediatric unit for treatment of otitis media and febrile
seizures. What information would be a priority for the nurse to include in the discharge
teaching for this child and his parents?
a. Explaining that both conditions will diminish as the child gets older.
b. Teaching them how to take child’s temperature using a digital thermometer.
c. Showing them how to properly restrain the child during seizures.
d. Encouraging the parents to have the child wear a hat during cold weather.

38. The nurse understands that the altered hemodynamics of atrial septal defect results in
which one of the following:
a. Left to right shunting of blood and right ventricular hypertrophy.
b. Right to left shunting of blood and cyanosis.
c. Right to left shunting of blood and pulmonary edema.
d. Left to right shunting of blood and left sided heart failure.

39. A 15-year old is injured while playing in school. He is brought to the local hospital
emergency department where he’s diagnosed with a broken arm. The surgeon on call
explains that the b… continue with the plan of care the surgeon will require
a. The written permission of the school principal.
b. The verbal permission of the school nurse.
c. The signature of the patient.
d. The permission of one of the boy’s parents.

40. The priority nursing action for a toddler 2-hours post cardiac catheterization is to:
a. Limit the child’s oral intake.
 b. Elevate the affected extremity
c. Assess for equality of pedal pulses
d. Remove the dressing to inspect the site for bleeding.

41. The spontaneous squatting behavior observed in children with Tetralogy of Fallot can be
explained as:
a. Compensation for hypoxia
b. Narrowing of the aortic arch
c. Prevention of pulmonary edema
d. A side effect of right ventricular hypertrophy

42. ? The nurse is administering oral Digoxin to an infant with a congenital heart defect.
Prior to administering the medicine, the nurse assess the apical rate to be 92BPM. What
action should the nurse take first?
a. Administer the medication as ordered.
b. Take the infant’s blood pressure.
c. Reassess the heart rate for a full minute.
d. Notify physician

43. A mother of a 9-year old child with cystic fibrosis of the lung and pancreas explains the
daily routine. Which comment requires further teaching by a nurse?
a. He takes is inhaler without much reminding from me.
b. I give my son’s enzymes with is meals and snacks.
c. Our son enjoys riding his bicycle after school.
d. We perform his chest physiotherapy each morning right after breakfast.

44. Which statement by the mother of an infant born with a cleft lip and palate requires
further assessment by the nursery nurse?
a. “I don’t feel comfortable taking this baby home.”
b. “Sometimes when I feed him formula it comes out of his nose.”
c. “I think he has his father’s eyes.”
d. “I’m getting used to the way he looks.”

45. The doctor orders an IV infusion of the D5% 1⁄2 normal saline to infuse at a rate of
60mL/Hr via microdrip tubing for a child. the nurse hangs a 500 mL bag at 8:00am. at
what time should a new bag be hung?
 a. 4:00 pm

46. 6-year old Elton Wilson has been taking oral Prednisone for treatment of his nephrosis
symptoms his mother states that Elton has been recently complaining of stomach aches
for the past week. what advice should the nurse give to Mrs. Wilson and Elton?
a. hold off on taking the medication until his abdominal pain subsides
b. ask if Elton has any blood in his bowel movements
c. ask Alton and Mrs. Wilson if he has been eating any salty food
d. advise Mrs. Wilson to make sure that Elton takes his medication at night

47. The doctor orders amoxicillin po 200 mg twice a day for a child weighing 30 lb. The drug
reference recommends 25 to 50 mg/kg/day. is this an accurate dose of medication for the
child?
a. True
b. False

48. In order to achieve the primary desired outcome for a 6-week old infant who is day one
post-op for repair of pyloric stenosis the nurse should
a. give the baby a pacifier to suck
b. Offer the child small amounts of a liquid diet
c. Continue to maintain NPO status until the infant has a bowel movement
d. place the infant in an isolate to maintain his temperature

49. The drug reference dates that ampicillin should be infused over 30 minutes. The nurse
will add the antibiotic to the patient song you set chamber that contains 30 ml of IV
solution. Good IV tubing used delivers 60 drops per milliliter. The nurse should set the
IV pump at ___ ml/hr? 60

50. A 4-year-old is seen in the emergency department with signs of an acute asthma attack.
What action should the nurse take first to alleviate his respiratory distress?
a. Auscultate his lung fields
b. Administer IV steroid medication
c. Position the child in a semi sitting position
d. Performed intermittent chest physiotherapy