1.
Molly, with suspected rheumatic fever, is nurse in charge anticipates that the doctor will
admitted to the pediatric unit. When obtaining
the childs history, the nurse considers which
information to be most important?
A. A fever that started 3 days ago
B. Lack of interest in food
C. A recent episode of pharyngitis
D. Vomiting for 2 days
2. Nurse Analiza is administering a medication via
the intraosseous route to a child. Intraosseous
drug administration is typically used when a child
is:
A. Under age 3
B. Over age 3
C. Critically ill and under age 3
D. Critically ill and over age 3
3. When assessing a childs cultural background,
the nurse in charge should keep in mind that:
A. Cultural background usually has little bearing
on a familys health practices
B. Physical characteristics mark the child as part
of a particular culture
C. Heritage dictates a groups shared values
D. Behavioral patterns are passed from one
generation to the next
4. While examining a 2-year-old child, the nurse
in charge sees that the anterior fontanel is open.
The nurse should:
A. Notify the doctor
B. Look for other signs of abuse
C. Recognize this as a normal finding
D. Ask about a family history of Tay-Sachs
disease
5. The nurse is aware that the most common
assessment finding in a child with ulcerative
colitis is:
A. Intense abdominal cramps
B. Profuse diarrhea
C. Anal fissures
D. Abdominal distention
6. When administering an I.M. injection to an
infant, the nurse in charge should use which site?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus lateralis
7. A child with a poor nutritional status and
weight loss is at risk for a negative nitrogen
balance. To help diagnose this problem, the
order which laboratory test?
A. Total iron-binding capacity
B. Hemoglobin
C. Total protein
D. Serum transferrin
8. When developing a plan of care for a male
adolescent, the nurse considers the childs
psychosocial needs. During adolescence,
psychosocial development focuses on:
A. Becoming industrious
B. Establishing an identity
C. Achieving intimacy
D. Developing initiative
9. When developing a plan care for a hospitalized
child, nurse Mica knows that children in which
age group is most likely to view illness as a
punishment for misdeeds?
A. Infancy
B. Preschool age
C. School age
D. Adolescence
10. Nurse Sunshine suspects that a child, age 4,
is being neglected physically. To best assess the
childs nutritional status, the nurse should ask
the parents which question?
A. Has your child always been so thin?
B. Is your child a picky eater?
C. What did your child eat for breakfast?
D. Do you think your child eats enough?
11. A female child, age 2, is brought to the
emergency department after ingesting an
unknown number of aspirin tablets about 30
minutes earlier. On entering the examination
room, the child is crying and clinging to the
mother. Which data should the nurse obtain first?
A. Heart rate, respiratory rate, and blood
pressure
B. Recent exposure to communicable diseases
C. Number of immunizations received
D. Height and weight
12. A mother asks the nurse how to handle her
5-year-old child, who recently started wetting the
pants after being completely toilet trained. The
child just started attending nursery school 2 days
a week. Which principle should guide the nurses
response?
A. The child forgets previously learned skills
B. The child experiences growth while regressing,
regrouping, and then progressing
C. The parents may refer less mature behaviors
D. The child returns to a level of behavior that
increases the sense of security.
13. A female child, age 6, is brought to the
health clinic for a routine checkup. To assess the
childs vision, the nurse should ask:
A. Do you have any problems seeing different
colors?
B. Do you have trouble seeing at night?
C. Do you have problems with glare?
D. How are you doing in school?
14. During a well-baby visit, Liza asks the nurse
when she should start giving her infant solid
foods. The nurse should instruct her to introduce
which solid food first?
A. Applesauce
B. Egg whites
C. Rice cereal
D. Yogurt
15. To decrease the likelihood of
bradyarrhythmias in children during endotracheal
intubation, succinylcholine (Anectine) is used
with which of the following agents?
A. Epinephrine (Adrenalin)
B. Isoproterenol (Isuprel)
C. Atropine sulfate
D. Lidocaine hydrochloride (Xylocaine)
16. A 1-year-and 2-month-old child weighing 26
lb (11.8 kg) is admitted for traction to treat
congenital hip dislocation. When preparing the
patients room, the nurse anticipates using which
traction system?
A. Bryants traction
B. Bucks extension traction
C. Overhead suspension traction
D. 90-90 traction
17. Hannah, age 12, is 7 months pregnant. When
teaching parenting skills to an adolescent, the
nurse knows that which teaching strategy is least
effective?
A. Providing a one-on-one demonstration and
requesting a return demonstration, using a live
infant model
B. Initiating a teenage parent support group with
first and second-time mothers
C. Using audiovisual aids that show discussions of
feelings and skills
D. Providing age-appropriate reading materials
18. When performing a physical examination on
an infant, the nurse in charge notes abnormally
low-set ears. This finding is associated with:
A. Otogenous tetanus
B. Tracheoesophageal fistula
C. Congenital heart defects
D. Renal anomalies
19. Nurse Walter should expect a 3-year-old child
to be able to perform which action?
A. Ride a tricycle
B. Tie the shoelaces
C. Roller-skates
D. Jump rope
20. Nurse Kim is teaching a group of parents
about otitis media. When discussing why children
are predisposed to this disorder, the nurse should
mention the significance of which anatomical
feature?
A. Eustachian tubes
B. Nasopharynx
C. Tympanic membrane
D. External ear canal
21. 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?
A. Increased urine output
B. Increased appetite
C. Increased energy level
D. Decreased diarrhea
22. Dr. Jones prescribes corticosteroids for a
child with nephritic syndrome. What is the
primary purpose of administering corticosteroids
to this child?
A. To increase blood pressure
B. To reduce inflammation
C. To decrease proteinuria
D. To prevent infection
23. 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. A sunken fontanel
B. Decreased pulse rate
C. Increased blood pressure
D. Low urine specific gravity
24. How should the nurse prepare a suspension
before administration?
A. By diluting it with normal saline solution
B. By diluting it with 5% dextrose solution
C. By shaking it so that all the drug particles are
dispersed uniformly
D. By crushing remaining particles with a mortar
and pestle
25. What should be the initial bolus of crystalloid
fluid replacement for a pediatric patient in shock?
A. 20 ml/kg
B. 10 ml/kg
C. 30 ml/kg
D. 15 ml/kg
26. 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:
A. Within the lower range of normal intelligence
B. Mildly retarded but educable
C. Moderately retarded but trainable
D. Completely dependent on others for care
27. 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 childs nutritional intake, the
nurse should ask:
A. What activities do you engage in during the
day?
B. Do you have any allergies to foods?
C. Do you like yourself physically?
D. What kinds of food do you like to eat?
28. 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?
A. At 1 to 2 years of age
B. At I week to 1 year of age, peaking at 2 to 4
months
C. At 6 months to 1 year of age, peaking at 10
months
D. At 6 to 8 weeks of age
29. When evaluating a severely depressed
adolescent, the nurse knows that one indicator of
a high risk for suicide is:
A. Depression
B. Excessive sleepiness
C. A history of cocaine use
D. A preoccupation with death
30. A child is diagnosed with Wilms tumor.
During assessment, the nurse in charge expects
to detect:
A. Gross hematuria
B. Dysuria
C. Nausea and vomiting
D. An abdominal mass
31. Which of the following would be inappropriate
when administering chemotherapy to a child?
A. Monitoring the child for both general and
specific adverse effects
B. Observing the child for 10 minutes to note for
signs of anaphylaxis
C. Administering medication through a free-
flowing intravenous line
D. Assessing for signs of infusion infiltration and
irritation
32. Which of the following is the best method for
performing a physical examination on a toddler
A. From head to toe
B. Distally to proximally
C. From abdomen to toes, the to head
D. From least to most intrusive
33. Which of the following organisms is
responsible for the development of rheumatic
fever?
A. Streptococcal pneumonia
B. Haemophilus influenza
C. Group A -hemolytic streptococcus
D. Staphylococcus aureus
34. Which of the following is most likely
associated with a cerebrovascular accident (CVA)
resulting from congenital heart disease?
A. Polycythemia
B. Cardiomyopathy
C. Endocarditis
D. Low blood pressure
35. How does the nurse appropriately administer
Mycostatin suspension in an infant?
A. Have the infant drink water, and then
administer myostatin in a syringe
B. Place Mycostatin on the nipple of the feeding
bottle and have the infant suck it
C. Mix Mycostatin with formula
D. Swab Mycostatin on the affected areas
36. A mother tells the nurse that she is very
worried because her 2-year old child does not
finish his meals. What should the nurse advise
the mother?
A. make the child seat with the family in the
dining room until he finishes his meal
B. provide quiet environment for the child before
meals
C. do not give snacks to the child before meals
D. put the child on a chair and feed him
37. The nurse is assessing a newborn who had
undergone vaginal delivery. Which of the
following findings is least likely to be observed in
a normal newborn?
A. uneven head shape
B. respirations are irregular, abdominal, 30-60
bpm
c. (+) Moro reflex
D. heart rate is 80 bpm
38. Which of the following situations increase the
risk of lead poisoning in children?
A. playing in the park with heavy traffic and with
many vehicles passing by
B. playing sand in the park
C. playing plastic balls with other children
D. playing with stuffed toys at home
39. An inborn error of metabolism that causes a
premature destruction of RBC?
A. G6PD
B. Homocystinuria
C. Phenylketonuria
D. Celiac Disease
40. Which of the following blood study results
would the nurse expect as most likely when
caring for the child with iron deficiency anemia?
A. Increased hemoglobin
B. Normal hematocrit
C. Decreased mean corpuscular volume (MCV)
D. Normal total iron-binding capacity (TIBC)
41. The nurse answers a call bell and finds a
frightened mother whose child, the patient, is
having a seizure. Which of these actions should
the nurse take?
A. The nurse should insert a padded tongue blade
in the patients mouth to prevent the child from
swallowing or choking on his tongue.
B. The nurse should help the mother restrain the
child to prevent him from injuring himself.
C. The nurse should call the operator to page for
seizure assistance.
D. The nurse should clear the area and position
the client safely.
42. At the community center, the nurse leads an
adolescent health information group, which often
expands into other areas of discussion. She
knows that these youths are trying to find out
who they are, and discussion often focuses on
which directions they want to take in school and
life, as well as peer relationships. According to
Erikson, this stage is known as:
A. identity vs. role confusion.
B. adolescent rebellion.
C. career experimentation.
D. relationship testing
43. The nurse is assessing a 9-month-old boy for
a well-baby check up. Which of the following
observations would be of most concern?
A. The baby cannot say mama when he wants
his mother.
B. The mother has not given him finger foods.
C. The child does not sit unsupported.
D. The baby cries whenever the mother goes out.
44. Cherry, the mother of an 11-month-old girl,
Elizabeth, is in the clinic for her daughters
immunizations. She expresses concern to the
nurse that Elizabeth cannot yet walk. The nurse
correctly replies that, according to the Denver
Developmental Screen, the median age for
walking is:
A. 12 months.
B. 15 months.
C. 10 months.
D. 14 months.
45. Sunshine, age 13, has had a lumbar puncture
to examine the CSF to determine if bacterial
infection exists. The best position to keep her in
after the procedure is:
A. Prone for two hours to prevent aspiration,
should she vomit.
B. Semi-Fowlers so she can watch TV for five
hours and be entertained.
C. Supine for several hours, to prevent a
headache.
D. On her right sides to encourage return of CSF
46. Bucks traction with a 10 lb. weight is
securing a patients leg while she is waiting for
surgery to repair a hip fracture. It is important to
check circulation- sensation-movement:
A. every shift.
B. every day.
C. every 4 hours.
D. every 15 minutes.
47. Kim is using bronchodilators for asthma. The
side effects of these drugs that you need to
monitor this patient for include:
A. tachycardia, nausea, vomiting, heart
palpitations, inability to sleep, restlessness, and
seizures.
B. tachycardia, headache, dyspnea, temp. 101 F,
and wheezing.
C. blurred vision, tachycardia, hypertension,
headache, insomnia, and oliguria.
D. restlessness, insomnia, blurred vision,
hypertension, chest pain, and muscle weakness.
48. The adolescent patient has symptoms of
meningitis: nuchal rigidity, fever, vomiting, and
lethargy. The nurse knows to prepare for the
following test:
A. blood culture.
B. throat and ear culture.
C. CAT scan.
D. lumbar puncture.
49. The nurse is drawing blood from the diabetic
patient for a glycosylated hemoglobin test. She
explains to the woman that the test is used to
determine:
A. the highest glucose level in the past week.
B. her insulin level.
C. glucose levels over the past several months.
D. her usual fasting glucose level.
50. The twelve-year-old boy has fractured his
arm because of a fall from his bike. After the
injury has been casted, the nurse knows it is
most important to perform all of the following
assessments on the area distal to the injury
except:
A. capillary refill.
B. radial and ulnar pulse.
C. finger movement
D. skin integrity
ENDO
1. The 6-year-old son of Mr. and Mrs. Peters is
admitted to the healthcare facility with the
diagnosis of idiopathic hypopituitarism.
His height is measured below the third percentile
and weight at the 40th percentile. Which of the
following would be the first action of his
attending nurse?
A. Recommend orthodontic referral for
underdeveloped jaw.
B. Collaborate with a dietician to access his
caloric needs.
C. Provide for a tutor for his precocious
intellectual ability.
D. Place him in a room with a 2-year-old boy.
2. Katie is admitted to the intensive care unit of
Nurseslabs Medical Center for diabetic
ketoacidosis; which of the following is of primary
importance when caring for the child?
A. Giving I.V. NPH insulin in high doses
B. Evaluating the child for cardiac abnormalities
C. Limiting fluids to prevent aggravating cerebral
edema
D. Monitoring and recording the childs vital signs
for hypertension
3. Nurse Angelo is attending for a child with
Cushings syndrome; which of the following
nursing interventions would be most necessary?
A. Observing the child for signs and symptoms of
metabolic acidosis
B. Handling the child carefully to prevent bruising
C. Monitoring vital signs for hypertension and
tachycardia
D. Monitoring the child for signs and symptoms of
hypoglycemia
4. While Andres is being assessed at the clinic,
Nurse Shiela observed that the child appears to
be small, with an immature face and chubby
body build. Her parents stated that their childs
rate of growth of all body parts is somewhat
slow, but her proportions and intelligence remain
normal. As a knowledgeable nurse, you know
that the child has a deficiency of which of the
following?
A. Antidiuretic hormone (ADH)
B. Parathyroid hormone (PTH)
C. Growth hormone (GH)
D. Melanocyte-stimulating hormone (MSH)
5. Justine is admitted to the pediatric unit due to
the occurrence of diabetic ketoacidosis signaling
a new diagnosis of diabetes. The diabetes team
explores the cause of the episode and take steps
to prevent a recurrence. Diabetic ketoacidosis
(DKA) results from an excessive accumulation of
which of the following?
A. Sodium bicarbonate from renal compensation
B. Potassium from cell death
C. Glucose from carbohydrate metabolism
D. Ketone bodies from fat metabolism
6. Nurse Aries entered the room of a child with
hypopituitarism and was asked by the couple
about the condition of their child. Which of the
following phrases if stated by the nurse best
describes the condition?
A. Linear growth retardation with skeletal
proportions normal for chronologic age
B. A complete normal growth pattern, but with
the onset of precocious puberty
C. Normal growth for first five years, followed by
progressive linear growth retardation
D. Growth retardation in which height and weight
are equally affected
7. In growing children, growth hormone
deficiency results in short stature and very slow
growth rates. Short stature may result from
which of the following?
A. Anterior pituitary gland hypofunction
B. Posterior pituitary gland hyperfunction
C. Parathyroid gland hyperfunction
D. Thyroid gland hyperfunction
8. Tara is an 11-year-old girl diagnosed with type
1 diabetes mellitus (DM). She asks her attending
nurse why she cant take a pill rather than shots
like her grandmother does. Which of the following
would be the nurses best reply?
A. If your blood glucose levels are controlled,
you can switch to using pills.
B. The pills correct fat and protein metabolism,
not carbohydrate metabolism.
C. Your body does not make insulin, so the
insulin injections help to replace it.
D. The pills work on the adult pancreas, you can
switch when you are 18.
9. Which type of diabetes mellitus (DM) most
likely results from heterogenous risk factors,
making it preventable?
A. Type 1
B. Type 2
C. Type 1 and 2
D. Gestational diabetes
10. Mr. Lopez has a 7-year-old son with growth
hormone (GH) deficiency. He shares to the nurse
the desire of his son to play ball games.
However, his wife feels the child will be in danger
since he is smaller than the other children. In
planning anticipatory guidance for these parents,
the nurse should keep in mind which of the
following?
A. The child should be allowed to play because
doing so can foster healthy self-esteem.
B. The risk for fractures is increased because a
GH deficiency results in fragile bones.
C. Activity could aggravate insulin sensitivity,
causing hyperglycemia.
D. Activity would aggravate the childs joints,
already over tasked by obesity.
11. Arvic who is diagnosed with diabetes mellitus
type 1 displays symptoms of hypoglycemia;
which of the following actions should the nurse
instruct the parents?
A. Give the child honey (simple sugar).
B. Give the child milk (complex sugar).
C. Contact the healthcare provider before doing
anything.
D. Give the child nothing by mouth.
12. Nurse Dorothy is caring for a child with
Cushings syndrome; which of the following
should she include in the plan of care?
A. Increase fluids to prevent dehydration
B. Encourage a diet high in carbohydrates
C. Monitor weight each day and report for weight
loss
D. Encourage a diet high in potassium
13. A child newly diagnosed with diabetes
mellitus has been stabilized with insulin injections
daily. A nurse prepares discharge teaching plan
regarding the insulin. The teaching plan should
reinforce which of the following concepts?
A. Always keep insulin vials refrigerated
B. Increase the amount of insulin before exercise
C. Ketones in the urine signify a need for less
insulin
D. Systematically rotate injection sites
14. Which of the following should the nurse
include in the insulin administration instruction
for the parents of a child being discharged on
insulin?
A. Insert the needle and aspirate prior to
injecting
B. Inject insulin into the extremity to be
exercised to enhance absorption
C. The muscles in the abdomen and thigh are the
easiest to use for self administration
D. Clean the site of injection with soap and water
and avoid alcohol
15. Nurse Angelo admits a child with suspected
type 1 DM; which should the nurse ask the
parents?
A. Does the child complain of headache?
B. How much exercise does the child get?
C. Has the childs number and type of bowel
movements changed?
D. Has the child experienced nocturia or
bedwetting?
E. How much candy and sweets does your child
take daily?
NEURO
1. A child diagnosed with intellectual disability
(ID) is under the supervision of Nurse Tasha. The
nurse is aware that the signs and symptoms of
mild ID include which of the following?
A. Few communication skills
B. Lateness in walking
C. Mental age of a toddler
D. Noticeable developmental delays
2. Nurse Gloria is teaching the Mr. and Mrs. Diaz
about the early signs and symptoms of lead
poisoning; which of the following if stated by the
couple would indicate the need for further
understanding of the case?
A. Anemia
B. Seizures
C. Irritability
D. Anorexia
3. Dayas child is scheduled for surgery due to
myelomeningocele; the primary reason for
surgical repair is which of the following?
A. To prevent hydrocephalus
B. To reduce the risk of infection
C. To correct the neurologic defect
D. To prevent seizure disorders
4. Nurse Lorna is assessing infantile reflexes in a
9-month-old baby; which of the following would
she identify as normal?
A. Persistent rooting
B. Bilateral parachute
C. Absent moro reflex
D. Unilateral grasp
5. Reyes syndrome is a rare and severe illness
affecting children and teenagers. Its development
has been linked with the use of aspirin and which
of the following?
A. Meningitis
B. Encephalitis
C. Strep throat
D. Varicella
6. Tiffany is diagnosed with increased intracranial
pressure (ICP); which of the following if stated by
her parents would indicate a need for Nurse
Charlie to reexplain the purpose for elevating the
head of the bed at a 10 to 20-degree angle?
A. Help alleviate headache
B. Increase intrathoracic pressure
C. Maintain neutral position
D. Reduce intra-abdominal pressure.
7. The American Association on Mental Deficiency
(AAMD), now American Association on
Intellectual and Developmental Disabilities
(AAIDD) definition of mental retardation
emphasizes which of the following?
A. An IQ level that must be below 50
B. Cognitive impairment occurring after age 22
years
C. Deficits in adaptive behavior with intellectual
impairment
D. No responsiveness to contact
8. Nurse Maritza is caring for a child with
Category A Near Drowning; she should do which
of the following? (Select all that apply.)
A. Give furosemide as ordered.
B. Check for increased intracranial pressure
C. Plan for discharge in 12 to 24 hours.
D. Check for electrolyte imbalances.
E. Keep mechanical ventilation.
F. Provide oxygen as ordered.
9. In diagnosing seizure disorder, which of the
following is the most beneficial?
A. Skull radiographs
B. EEG
C. Brain scan
D. Lumbar puncture
10. After explaining to the parents about their
childs unique psychological needs related to a
seizure disorder and possible stressors, which of
the following interests uttered by them would
indicate further teaching?
A. Feeling different from peers
B. Poor self-image
C. Cognitive delays
D. Dependency
11. Spina bifida is one of the possible neural tube
defects that can occur during early embryological
development. Which of the following definitions
most accurately describes meningocele?
A. Complete exposure of spinal cord and
meninges
B. Herniation of spinal cord and meninges into a
sac
C. Sac formation containing meninges and spinal
fluid
D. B and C
E. Spinal cord tumor containing nerve roots
12. Janae has a seizure disorder; which of the
following would be the lowest priority when
caring for her?
A. Observing and taking down data on all
seizures
B. Assuring safety and protection from injuring
C. Assessing for signs and symptoms of increased
intracranial pressure (ICP)
D. Educating the family about anticonvulsant
therapy
13. Angie is an adolescent who has seizure
disorder; which of the following would not be a
focus of a teaching program?
A. Ability to obtain a drivers license
B. Drug and alcohol abuse
C. Increased risk of infections
D. Peer pressure
14. Bennett was rushed to the emergency
department with possible increased intracranial
pressure (ICP); which of the following is an early
clinical manifestation of increased ICP in older
children? (Select all that apply.)
A. Macewens sign
B. Setting sun sign
C. Papilledema
D. Diplopia
15. While examining a 2-year-old child, Nurse
Galina sees that the anterior fontanel is open.
She should:
A. Notify the doctor
B. Look for other signs of abuse
C. Recognize this as a normal finding
D. Ask about a family history of Tay-Sachs
disease
GUT
1. 7-year-old Damon has cystitis; which of the
following would Nurse Elena expect when
assessing the child?
A. Dysuria
B. Costovertebral tenderness
C. Flank pain
D. High fever
2. Niklaus was born with hypospadias; which of
the following should be avoided when a child has
such condition?
A. Surgery
B. Circumcision
C. Intravenous pyelography (IVP)
D. Catheterization
3. Stefan was diagnosed with secondary
vesicoureteral reflux; such condition usually
results from which of the following?
A. Acidic urine
B. Congenital defects
C. Hydronephrosis
D. Infection
4. When educating parents regarding known
antecedent infections in acute glomerulonephritis,
which of the following should the nurse cover?
A. Scabies
B. Impetigo
C. Herpes simplex
D. Varicella
5. Alaric was diagnosed with minimal-change
nephrotic syndrome; which of the following signs
and symptoms are characteristics of the said
disorder?
A. Hypertension, edema, hematuria
B. Hypertension, edema, proteinuria
C. Gross hematuria, fever, proteinuria
D. Poor appetite, edema, proteinuria
6. Preferred nurses at the Nurseslabs Medical
Center are about to perform a procedure related
to a genitourinary (GU) problem to a group of
pediatric patients. Which of the following groups
would find it especially extra stressful?
A. Infants
B. Toddlers
C. Preschoolers
D. School-age children
7. Which of the following organisms is the most
common cause of urinary tract infection (UTI) in
children?
A. Klebsiella
B. Staphylococcus
C. Escherichia coli
D. Pseudomonas
8. Patient S is a sexually active adolescent; which
of the following instructions would be included in
the preventive teaching plan about urinary tract
infections?
A. Drinking acidic juices
B. Avoiding urinating before intercourse
C. Wearing nylon underwear
D. Wiping back to front
9. What is most likely the underlying physiology
of primary enuresis?
A. Psychogenic stress
B. Delayed bladder maturation
C. Urinary tract infection
D. Vesicoureteral reflux
10. Which of the following should be included
when developing a teaching plan to prevent
urinary tract infection? Select all that apply.
A. Maintaining adequate fluid intake
B. Avoiding urination before and after intercourse
C. Emptying bladder with urination
D. Wearing underwear made of synthetic material
such as nylon
E. Keeping urine alkaline by avoiding acidic
beverages
F. Avoiding bubble baths and tight clothing
11. 12-year-old Caroline has recurring nephrotic
syndrome; which of the following areas of
potential disturbances should be a prime
consideration when planning ongoing nursing
care?
A. Body image
B. Sexual maturation
C. Muscle coordination
D. Intellectual development
12. The nurse is aware that the following
laboratory values support a diagnosis of
pyelonephritis?
A. Myoglobinuria
B. Ketonuria
C. Pyuria
D. Low white blood cell (WBC) count
13. Nurse Jeremy is evaluating a clients fluid C. Milk
intake and output record. Fluid intake and urine
output should relate in which way?
A. Fluid intake should be double the urine output.
B. Fluid intake should be approximately equal to
the urine output.
C. Fluid intake should be half the urine output.
D. Fluid intake should be inversely proportional to
the urine output.
14. The following are considered functions of the
Urinary System EXCEPT: (Select all that apply).
A. Vitamin D synthesis
B. Regulation of red blood cell synthesis
C. Excretion
D. Absorption of digested molecules
E. Regulation of blood volume and pressure
15. Nurse Kai is evaluating a female child with
acute post-streptococcal glomerulonephritis for
signs of improvement. Which finding typically is
the earliest sign of improvement?
A. Increased urine output
B. Increased appetite
C. Increased energy level
D. Decreased diarrhea
GI
1. Dustin who was diagnosed with Hirschsprungs
disease has a fever and watery explosive
diarrhea. Which of the following would Nurse
Joyce do first?
A. Administer an antidiarrheal.
B. Notify the physician immediately.
C. Monitor the child every 30 minutes.
D. Nothing. (These findings are common in
Hirschsprungs disease.)
2. Nurse Nancy is assessing a child with pyloric
stenosis; she is likely to note which of the
following?
A. Currant jelly stools
B. Regurgitation
C. Steatorrhea
D. Projectile vomiting
3. An 11-year-old girl with celiac disease was
discharged from the hospital. An appropriate
teaching was carried out by the nurse if the
parents are aware of avoiding which of the
following?
A. Chicken
B. Wheat
D. Rice
4. Which of the following applies to the defect
emerging from residual peritoneal fluid confined
within the lower segment of the processus
vaginalis?
A. Inguinal hernia
B. Incarcerated hernia
C. Communicating hydrocele
D. Noncommunicating hydrocele
5. Baby Jonathan was born with cleft lip (CL);
Nurse Barbara would be alert that which of the
following will most likely be compromised?
A. GI function
B. Locomotion
C. Sucking ability
D. Respiratory status
6. Will is being assessed by Nurse Lucas for
possible intussusception; which of the following
would be least likely to provide valuable
information?
A. Abdominal palpation
B. Family history
C. Pain pattern
D. Stool inspection
7. Mr. and Ms. Byers child failed to pass
meconium within the first 24 hours after birth;
this may indicate which of the following?
A. Celiac disease
B. Intussusception
C. Hirschsprungs disease
D. Abdominal-wall defect
8. Which of the following parameters would Nurse
Max monitor to evaluate the effectiveness of
thickened feedings for an infant with
gastroesophageL REFLUX (GER)?
A. Urine
B. Vomiting
C. Weight
D. Stools
9. Baby Ellie is diagnosed with gastroesophageal
reflux (GER); which of the following nursing
diagnoses would be inappropriate?
A. Risk for aspiration
B. Impaired oral mucous membrane
C. Deficient fluid volume
D. Imbalanced nutrition: Less than body
requirements
10. Steve is diagnosed with celiac disease and
experiences celiac crisis secondary to upper
respiratory tract infection; which of the following
would Nurse Nancy expect to assess?
A. Lethargy
B. Weight gain
C. Respiratory distress
D. Watery diarrhea
11. Nurse Karen is providing postoperative care
for Dustin who has cleft palate (CP); she should
position the child in which of the following?
A. In an infant seat
B. In the supine position
C. In the prone position
D. On his side
12. Nurse Joyce is assessing a childs cultural
background, she should keep in mind that:
A. Cultural background usually has little bearing
on a familys health practices
B. Physical characteristics mark the child as part
of a particular culture
C. Heritage dictates a groups shared values
D. Behavioral patterns are passed from one
generation to the next
13. In pediatric gastroesophageal reflux disease
(GERD), the immaturity of lower esophageal
sphincter function is manifested by frequent
transient lower esophageal relaxations, which
result in retrograde flow of gastric contents into
the esophagus. Which statement about the
esophagus is TRUE? Select all that apply.
A. It is a cartilaginous tube.
B. It has upper and lower sphincters.
C. It lies anterior to the trachea.
D. It extends from the nasal cavity to the
stomach.
E. All statements describe the esophagus.
14. Mrs. Byers tells the nurse that she is very
worried because her 2-year old child does not
finish his meals. What should the nurse advise
the mother?
A. Make the child seat with the family in the
dining room until he finishes his meal
B. Provide quiet environment for the child before
meals
C. Do not give snacks to the child before meals
D. Put the child on a chair and feed him
15. Nurse Lonnie is aware that the most common
assessment finding in a child with ulcerative
colitis is:
A. Intense abdominal cramps
B. Profuse diarrhea
C. Anal fissures
D. Abdominal distention
1. Betty is a 9-year-old girl diagnosed with cystic
fibrosis. Which of the following must Nurse Archie
keep in mind when developing a care plan for the
child?
A. Pulmonary secretions are abnormally thick.
B. Elevated levels of potassium are found in the
sweat.
C. CF is an autosomal dominant hereditary
disorder.
D. Obstruction of the endocrine glands occurs.
2. Veronicas parents were told that their
daughter needs ribavirin (Virazole). This drug is
used to treat which of the following?
A. Cystic fibrosis
B. Otitis media
C. Respiratory syncytial virus (RSV)
D. Bronchitis
3. Beta-adrenergic agonists such as albuterol
are given to Reggie, a child with asthma. Such
drugs are administered primarily to do which of
the following?
A. Dilate the bronchioles
B. Reduce secondary infections
C. Decrease postnasal drip
D. Reduce airway inflammation
4. Alice is rushed to the emergency department
during an acute, severe prolonged asthma attack
and is unresponsive to usual treatment. The
condition is referred to as which of the following?
A. Status asthmaticus
B. Reactive airway disease
C. Intrinsic asthma
D. Extrinsic asthma
5. Which of the following infants is least probable
to develop sudden infant death syndrome
(SIDS)?
A. Baby Angela who was premature
B. A sibling of Baby Angie who died of SIDS
C. Baby Gabriel with prenatal drug exposure
D. Baby Gabby who sleeps on his back
6. Fred is a 12-year-old boy diagnosed with
pneumococcal pneumonia. Which of the following
would Nurse Nica expect to assess?
A. Mild cough
B. Slight fever
C. Chest pain
D. Bulging fontanel
7. Baby Melody is a neonate who has a very low-
birth-weight. Nurse Josie carefully monitors
inspiratory pressure and oxygen (O2)
concentration to prevent which of the following?
A. Meconium aspiration syndrome
B. Bronchopulmonary dysplasia (BPD)
C. Respiratory syncytial virus (RSV)
D. Respiratory distress syndrome (RDS)
8. Archie who weighs 44 lb has been given an
order for amoxicillin 500 mg b.i.d. The drug text
notes that the daily dose of amoxicillin is 50
mg/kg/day in two divided doses. What dose in
milligrams is safest for this child?
A. 1000 mg
B. 750 mg
C. 500 mg
D. 250 mg
9. The Andrews family has been taking good care
of their youngest, Archie, who was diagnosed
with asthma. Which of the following statements
indicate a need for further home care teaching?
A. He should increase his fluid intake regularly
to thin secretions.
B. Well make sure that he avoids exercise to
prevent attacks.
C. He is to use his bronchodilator inhaler before
the steroid inhaler.
D. We need to identify what things trigger his
attacks.
10. Which of the following instructions should
Nurse Cheryl include in her teaching plan for the
parents of Reggie with otitis media?
A. Placing the child in the supine position to
bottle-feed
B. Giving prescribed amoxicillin (Amoxil) on an
empty stomach
C. Cleaning the inside of the ear canals with
cotton swabs
D. Avoiding contact with people who have upper
respiratory tract infections
11. Immunization of children with Haemophilus
influenzae type B (Hib) vaccine decreases the
incidence of which of the following conditions?
A. Bronchiolitis
B. Laryngotracheobronchitis (LTB)
C. Epiglottitis
D. Pneumonia
12. Which of the following respiratory conditions
is always considered a medical emergency?
A. Asthma
B. Cystic fibrosis (CF)
C. Epiglottiditis
D. Laryngotracheobronchitis (LTB)
13. When assessing a childs cultural background,
the nurse in charge should keep in mind that:
A. Heritage dictates a groups shared values
B. Physical characteristics mark the child as part
of a particular culture
C. Cultural background usually has little bearing
on a familys health practices
D. Behavioral patterns are passed from one
generation to the next
14. Which of the following is the best method for
performing a physical examination on a toddler
A. From head to toe
B. Distally to proximally
C. From abdomen to toes, the to head
D. From least to most intrusive
15. Nurse Veronica is teaching a group of parents
about otitis media. When discussing why children
are predisposed to this disorder, the nurse should
mention the significance of which anatomical
feature?
A. Nasopharynx
B. Eustachian tubes
C. External ear canal
D. Tympanic membrane
CARDIO
1. A 5-year-old girl Hannah is recently diagnosed
with Kawasaki disease. Apart from the identified
symptoms of the disease, she may also likely
develop which of the following?
A. Sepsis
B. Meningitis
C. Mitral valve disease
D. Aneurysm formation
2. Clay is an 8-year-old boy diagnosed with heart
failure. Which of the following shows that he is
strictly following the directed therapeutic
regimen?
A. Daily use of an antibiotic
B. Pulse rate less than 50 beats/minute
C. Normal weight for age
D. Elevation in red blood cell (RBC) count
3. The Foley Family is caring for their youngest
child, Justin, who is suffering from tetralogy of
Fallot. Which of the following are defects
associated with this congenital heart condition?
A. Aorta exits from the right ventricle, pulmonary
artery exits from the left ventricle, and two
noncommunicating circulations
B. Ventricular septal defect, overriding aorta,
pulmonic stenosis (PS), and right ventricular
hypertrophy
C. Coarctation of aorta, aortic valve stenosis,
mitral valve stenosis, and patent ductus
arteriosus
D. Tricuspid valve atresia, atrial septal defect,
ventricular septal defect, and hypoplastic right
ventricle
4. When creating a teaching program for the
parents of Jessica who is diagnosed with
pulmonic stenosis (PS), Nurse Alex would keep in
mind that this disorder involves which of the
following?
A. A single vessel arising from both ventricles
B. Obstruction of blood flow from the left
ventricle
C. Obstruction of blood flow from the right
ventricle
D. Return of blood to the heart without entry to
the left atrium
5. Bryce is a child diagnosed with coarctation of
aorta. While assessing him, Nurse Zach would
expect to find which of the following?
A. Squatting posture
B. Absent or diminished femoral pulses
C. Severe cyanosis at birth
D. Cyanotic (tet) episodes
6. Which of the following instructions would
Nurse Courtney include in a teaching plan that
focuses on initial prevention for Sheri who is
diagnosed with rheumatic fever?
A. Treating streptococcal throat infections with an
antibiotic
B. Giving penicillin to patients with rheumatic
fever
C. Using corticosteroid to reduce inflammation
D. Providing an antibiotic before dental work
7. Which of the following would Nurse Tony
suppose to regard as a cardinal manifestation or
symptom of digoxin toxicity to his patient Clay
diagnosed with heart failure?
A. Headache
B. Respiratory distress
C. Extreme bradycardia
D. Constipation
8. Appropriate intervention is vital for many
children with heart disease in order to go on to
live active, full lives. Which of the following
outlines an effective nursing intervention to
decrease cardiac demands and minimize cardiac
workload?
A. Feeding the infant over long periods
B. Allowing the infant to have her way to avoid
conflict
C. Scheduling care to provide for uninterrupted
rest periods
D. Developing and implementing a consistent
care plan
9. Mr. and Mrs. Bakers only daughter is
diagnosed with heart failure. Which of the
following interventions would be appropriate to
promote optimal nutrition for the infant?
A. Replacing regular nipples with easy-to-suck
ones
B. Allowing the infant to feed for at least 1 hour
C. Providing large feedings evenly spaced every 4
hours
D. Offering formula that is high in sodium and ventricle to the left ventricle in Transposition of
calories the Great Arteries (TGA) is:

10. It is considered as the bluntly rounded A. Rashkind Procedure

portion of the heart B. Rastelli Procedure
C. Pulmonary Artery Banding
A. Base D. Jatene Procedure
B. Pericardium
C. Aorta 15. The ductus arteriosus is another fetal
D. Apex structure that is important in the intrauterine life.
It functions to:
11. Arrange these parts of the conduction system
of the heart in the correct order as an action A. Shunts the combined cardiac output from the
potential would pass through them. pulmonary artery to the aorta going to the lungs
B. Shunts the combined cardiac output from the
1. AV node pulmonary artery to the systemic circulation
C. Shunts the combined cardiac output from the
2. Purkinje fibers aorta to the pulmonary artery and later to the
pulmonary veins
D. Shunts the combined cardiac output from the
3. Atrioventricular bundle
aorta to the pulmonary artery to the right
ventricle
4. R and L bundle of His

5. SA node

A. SA Node Purkinje Fibers R and L bundle of

His Atrioventricular bundle AV Node
B. SA Node AV Node Purkinje fibers R and L
bundle of His Atrioventricular bundle
C. SA Node Purkinje Fibers Atrioventricular
Bundle R and L bundle of His AV Node
D. SA Node AV Node Atrioventricular bundle
R and L bundle of His Purkinje Fibers

12. Which of these statements regarding the

conduction system of the heart is NOT correct?
Select all that apply.

A. The sinoatrial (SA) node of the heart acts as

the pacemaker.
B. The SA node is located on the upper wall of
the left atrium.
C. The AV node conducts action potentials rapidly
through it.
D. Action potentials are carried slowly through
the atrioventricular bundle.

13. Which of the following disorders leads to

cyanosis from deoxygenated blood entering the
systemic arterial circulation?

A. Aortic stenosis (AS)

B. Coarctation of aorta
C. Patent ductus arteriosus (PDA)
D. Tetralogy of Fallot

14. The procedure that has to be performed in

order to shift the high pressure from the right