Pediatrics Exam 3: Practice Questions

A 4-year-old child with a history of anaphylaxis due to a nut allergy presents to the clinic. Which nursing action is a priority in the plan of care?

A) Administer an antihistamine immediately after exposure to an allergen.

B) Ensure the child has a prescription for an epinephrine auto-injector.

C) Teach the parents that antihistamines are sufficient to treat anaphylaxis.

D) Advise the parents to avoid all allergenic foods, including dairy.

B) Ensure the child has a prescription for an epinephrine auto-injector.

A nurse is educating the parents of a preschooler diagnosed with asthma. Which statement indicates an understanding of asthma management?

A) “We will avoid all physical activity to prevent asthma attacks.”

B) “Peak flow monitoring will help us detect early changes in asthma control.”

C) “We will give albuterol daily to prevent attacks.”

D) “Our child should only use the inhaler when experiencing symptoms.”

B) "Peak flow monitoring will help us detect early changes in asthma control."

During an asthma assessment, the nurse notes prolonged expiration in a preschooler. What is the most appropriate action?

A) Reassess lung sounds after activity.

B) Instruct the child to take rapid breaths.

C) Implement bronchodilator therapy as ordered.

D) Obtain a chest X-ray immediately.

C) Implement bronchodilator therapy as ordered.

A preschool child diagnosed with iron-deficiency anemia is prescribed ferrous sulfate. Which instruction should the nurse include in the teaching?

A) Administer with milk for better absorption.

B) Give with orange juice to enhance absorption.

C) Provide iron supplements immediately before meals.

D) Limit iron supplementation to one week.

B) Give with orange juice to enhance absorption.

A 5-year-old child with hemophilia A sustains a minor injury. What is the priority nursing intervention?

A) Apply a warm compress to the site.

B) Administer acetaminophen for pain.

C) Initiate factor VIII replacement as ordered.

D) Encourage movement of the injured limb.

C) Initiate factor VIII replacement as ordered.

A child is admitted with status asthmaticus. Which assessment finding indicates worsening respiratory status?

A) Increased wheezing

B) Prolonged inspiratory phase

C) Elevated oxygen saturation

D) Decreased use of accessory muscles

A) Increased wheezing

Which symptom should the nurse monitor for in a preschooler with a suspected diagnosis of rheumatic fever?

A) Joint swelling and pain

B) Headache and dizziness

C) Urinary frequency

D) Nausea and vomiting

A) Joint swelling and pain

A nurse is caring for a child with Multisystem Inflammatory Syndrome in Children (MIS-C) related to COVID-19. Which laboratory finding is most likely to be elevated?

A) Hemoglobin

B) CRP (C-reactive protein)

C) Platelets

D) Blood urea nitrogen

B) CRP (C-reactive protein)

The nurse is educating the parent of a preschooler on preventing iron-deficiency anemia. Which food choice should the parent include in the child's diet?

A) Whole milk

B) Applesauce

C) Fortified cereals

D) Cucumber slices

C) Fortified cereals

In preparing to administer an iron dextran injection to a preschooler, which technique should the nurse use to reduce discomfort?

A) Administer in the deltoid muscle

B) Use a Z-track method

C) Administer with an ice pack

D) Use a smaller gauge needle

B) Use a Z-track method

For a child with an asthma exacerbation, which medication should the nurse expect to administer first?

A) Inhaled corticosteroid

B) Oral theophylline

C) Short-acting beta agonist

D) Antihistamine

C) Short-acting beta agonist

A nurse notes an increased use of accessory muscles in a preschooler with asthma. Which intervention should the nurse perform first?

A) Apply oxygen

B) Check the pulse oximeter

C) Administer bronchodilator as prescribed

D) Call for emergency assistance

C) Administer bronchodilator as prescribed

Which complication is a primary concern in a preschooler diagnosed with hemophilia following a minor fall?

A) Skin infection

B) Internal bleeding

C) Dehydration

D) Respiratory distress

B) Internal bleeding

A nurse is caring for a child with acute anemia. What should be included in the child’s diet to manage symptoms?

A) Low-fat dairy products

B) Green leafy vegetables

C) Whole grains

D) Citrus fruits

B) Green leafy vegetables

The nurse should educate the parents of a child with a recent anaphylactic reaction on which critical aspect of emergency care?

A) Use of over-the-counter antihistamines

B) Proper use of an epinephrine auto-injector

C) Administration of albuterol inhaler

D) Avoiding dairy products entirely

B) Proper use of an epinephrine auto-injector

For a child diagnosed with immunodeficiency, the nurse should prioritize which intervention to minimize infection risk?

A) Encourage regular outdoor play

B) Limit visitor contact

C) Administer frequent cold baths

D) Increase dairy intake

B) Limit visitor contact

The nurse is reviewing the symptoms of COVID-19 in children. Which symptom is more common in children compared to adults?

A) Sore throat

B) High fever

C) Tachypnea

D) T-cell mediated response

D) T-cell mediated response

The nurse plans care for a preschooler diagnosed with severe iron-deficiency anemia. Which activity should the nurse limit?

A) Television watching

B) Quiet reading time

C) Physical activity

D) Group play

C) Physical activity

When teaching parents about managing asthma, which response indicates a need for further teaching?

A) “We will ensure our child avoids any pets at home.”

B) “Our child will take a steroid inhaler whenever wheezing occurs.”

C) “We’ll monitor daily with a peak flow meter.”

D) “Our home will remain smoke-free.”

B) "Our child will take a steroid inhaler whenever wheezing occurs."

A child with hemophilia is prescribed Factor VIII. What outcome indicates the therapy was effective?

A) Improved energy levels

B) Decreased joint swelling

C) Improved iron levels

D) Reduced respiratory effort

B) Decreased joint swelling

Which assessment finding should prompt the nurse to administer a bronchodilator to a child with asthma?

A) Tachycardia

B) Wheezing

C) Bradycardia

D) Hemoptysis

B) Wheezing

The nurse is reviewing asthma management with the parent of a preschooler. Which statement should be corrected by the nurse?

A) “We should avoid triggers like dust.”

B) “We will use the inhaler at the onset of symptoms.”

C) “I will keep an epinephrine injection available.”

D) “We’ll limit outdoor activities when pollen is high.”

C) "I will keep an epinephrine injection available."

What is the primary purpose of administering penicillin for a child diagnosed with rheumatic fever?

A) Relieve joint pain

B) Prevent recurrence of infection

C) Reduce fever

D) Decrease inflammation

B) Prevent recurrence of infection

A child with severe anemia is ordered iron supplements. Which lab result indicates a need to continue therapy?

A) Hemoglobin of 10 g/dL

B) Ferritin of 50 ng/mL

C) Hematocrit of 28%

D) Platelet count of 150,000/mm³

C) Hematocrit of 28%

Which nursing diagnosis is a priority for a child with asthma admitted for an exacerbation?

A) Risk for infection

B) Ineffective airway clearance

C) Fluid volume deficit

D) Altered sensory perception

B) Ineffective airway clearance

A 4-year-old child with a known peanut allergy accidentally ingests peanut butter at a family gathering. The child begins wheezing and showing signs of distress. What is the nurse's priority action?

A) Administer oral diphenhydramine and observe for improvement.

B) Call for emergency medical services immediately.

C) Administer an epinephrine auto-injector.

D) Place the child in a supine position with legs elevated.

C) Administer an epinephrine auto-injector.

Rationale: Epinephrine is the first-line treatment for anaphylaxis and should be administered immediately to prevent further progression of symptoms.

The nurse is educating a parent on the use of an epinephrine auto-injector for their child with a history of anaphylaxis. Which statement by the parent indicates a need for further teaching?

A) “I should inject the epinephrine into my child’s outer thigh.”

B) “After using the epinephrine injector, we should go to the hospital.”

C) “I should wait to see if symptoms improve before using the epinephrine.”

D) “I should keep the epinephrine auto-injector readily available at all times.”

C) “I should wait to see if symptoms improve before using the epinephrine.”

Rationale: Epinephrine should be administered immediately at the first signs of anaphylaxis rather than waiting to see if symptoms worsen.

A nurse is caring for a pediatric patient experiencing an anaphylactic reaction. Which assessment finding requires immediate intervention?

A) Skin rash and itching

B) Swelling of the lips and tongue

C) Redness around the injection site

D) Mild abdominal cramping

B) Swelling of the lips and tongue

Rationale: Swelling of the lips and tongue indicates airway compromise, a life-threatening situation that requires prompt intervention to prevent respiratory obstruction.

In providing discharge teaching for a family with a child at risk of anaphylaxis, which statement by the nurse is most appropriate?

A) “Administer the epinephrine only if your child’s symptoms last longer than 5 minutes.”

B) “Your child should always wear a medical alert bracelet indicating their allergies.”

C) “Keep a first aid kit with diphenhydramine, as it is the first choice for anaphylaxis.”

D) “Once symptoms improve, there’s no need to seek further medical care.”

B) “Your child should always wear a medical alert bracelet indicating their allergies.”

Rationale: Wearing a medical alert bracelet can be lifesaving by notifying caregivers or medical personnel of the child’s allergy in an emergency. Epinephrine, not diphenhydramine, is the first-line treatment for anaphylaxis.

The nurse is educating a school staff member on the recognition of anaphylaxis in children. Which symptom should the staff member recognize as a potential indicator of anaphylaxis?

A) Swelling at the site of a bee sting

B) Slight cough after exposure to an allergen

C) Hoarseness or stridor

D) Rash confined to the arms

C) Hoarseness or stridor

Rationale: Hoarseness and stridor indicate possible airway obstruction and are serious signs of anaphylaxis that require immediate intervention

A nurse is assessing a child admitted with suspected MIS-C following a recent COVID-19 infection. Which assessment finding would be a priority to report to the healthcare provider?

A) Abdominal pain and vomiting

B) Mild fever and headache

C) Red, cracked lips and conjunctivitis

D) Hypotension and tachycardia

D) Hypotension and tachycardia

Rationale: Hypotension and tachycardia are signs of cardiovascular instability, indicating a potential progression to shock in MIS-C, which requires immediate intervention.

The nurse is educating the parents of a child diagnosed with MIS-C. Which statement by the parent indicates a correct understanding of the condition?

A) “My child’s illness is mainly a respiratory issue like COVID-19.”

B) “This condition is primarily treated with antibiotics to prevent infection.”

C) “MIS-C involves inflammation that can affect multiple organs, including the heart.”

D) “Since my child recovered from COVID-19, they won’t develop MIS-C.”

C) “MIS-C involves inflammation that can affect multiple organs, including the heart.”

Rationale: MIS-C is a multisystem inflammatory condition that can involve multiple organs, particularly the heart, gastrointestinal tract, and blood vessels, following a COVID-19 infection.

A nurse is preparing to administer intravenous immunoglobulin (IVIG) to a child with MIS-C. The parent asks about the purpose of this treatment. What is the nurse's best response?

A) “IVIG helps your child’s body fight the virus causing the illness.”

B) “IVIG reduces inflammation in your child’s body and may protect their heart.”

C) “IVIG will prevent future COVID-19 infections in your child.”

D) “IVIG helps improve lung function affected by COVID-19.”

B) “IVIG reduces inflammation in your child’s body and may protect their heart.”

Rationale: IVIG is given to reduce inflammation and can help protect against complications like heart damage in children with MIS-C.

In caring for a pediatric patient with COVID-19, the nurse knows that which sign would warrant closer monitoring for potential development of MIS-C?

A) Fever lasting more than 24 hours

B) Loss of appetite and mild fatigue

C) Red, swollen tongue and abdominal pain

D) Nasal congestion and sore throat

C) Red, swollen tongue and abdominal pain

Rationale: A red, swollen tongue (resembling “strawberry tongue”) and abdominal pain are symptoms associated with MIS-C and may signal a need for further evaluation.

When reviewing laboratory results of a child suspected of having MIS-C, which finding would support this diagnosis?

A) Elevated platelets and normal CRP

B) Increased lymphocyte count and elevated hemoglobin

C) High CRP, elevated ferritin, and increased D-dimer levels

D) Low white blood cell count and low D-dime

C) High CRP, elevated ferritin, and increased D-dimer levels

Rationale: Elevated CRP, ferritin, and D-dimer levels are indicative of systemic inflammation and are common findings in children with MIS-C.

A preschooler recently recovered from a sore throat and is now experiencing joint pain, fever, and a rash. The nurse suspects rheumatic fever. Which diagnostic test should the nurse anticipate as part of the initial evaluation?

A) Complete blood count (CBC)

B) Chest X-ray

C) Anti-streptolysin O (ASO) titer

D) Electrolyte panel

C) Anti-streptolysin O (ASO) titer

Rationale: The ASO titer helps confirm a recent streptococcal infection, a common precursor to rheumatic fever, and is critical in diagnosing the condition.

The nurse is teaching a parent about home care for their preschooler diagnosed with rheumatic fever. Which statement by the parent indicates an understanding of the need for activity restrictions?

A) “I will allow my child to participate in all normal activities.”

B) “We’ll focus on bed rest to reduce the strain on their heart.”

C) “A few hours of outdoor play each day should be fine.”

D) “Engaging in sports will help them recover faster.”

B) “We’ll focus on bed rest to reduce the strain on their heart.”

Rationale: Bed rest is often recommended in the acute phase of rheumatic fever to reduce cardiac workload, especially if carditis is present.

A 4-year-old diagnosed with rheumatic fever presents with involuntary movements of the face and arms (chorea). Which nursing intervention should the nurse prioritize?

A) Encourage the child to play active games to distract them.

B) Provide a quiet environment to minimize stress.

C) Apply restraints to prevent injury.

D) Increase sensory stimulation to reduce chorea episodes.

B) Provide a quiet environment to minimize stress.

Rationale: A quiet, low-stimulation environment can help reduce chorea episodes, which are often exacerbated by stress or sensory overload

The nurse is reviewing the treatment plan for a preschooler with rheumatic fever. Which medication order should the nurse anticipate as part of prophylactic care?

A) High-dose acetaminophen

B) Daily vitamin C supplement

C) Low-dose penicillin

D) Inhaled bronchodilators

C) Low-dose penicillin

Rationale: Prophylactic low-dose penicillin is prescribed to prevent recurrent streptococcal infections, which could exacerbate rheumatic fever.

A preschool child with rheumatic fever is experiencing severe joint pain. The parent asks why antibiotics are still needed even though the sore throat is gone. What is the nurse's best response?

A) “The antibiotics help to relieve your child’s joint pain.”

B) “Penicillin prevents new strep infections that could make rheumatic fever worse.”

C) “Antibiotics will help protect the child’s immune system.”

D) “The infection could still be present and needs to be treated.”

B) “Penicillin prevents new strep infections that could make rheumatic fever worse.”

Rationale: Prophylactic penicillin helps prevent new strep infections, reducing the risk of recurrent episodes of rheumatic fever and associated complications.

The nurse is assessing a preschooler who has a history of asthma and is experiencing wheezing and shortness of breath. Which immediate intervention is the nurse’s priority?

A) Encourage the child to rest in a supine position.

B) Administer a prescribed short-acting bronchodilator.

C) Provide warm fluids to soothe the throat.

D) Perform chest percussion to clear secretions.

B) Administer a prescribed short-acting bronchodilator.

Rationale: Administering a short-acting bronchodilator is a priority to quickly open the airways and improve oxygenation during an asthma exacerbation.

A nurse is educating the parents of a preschooler recently diagnosed with asthma about common asthma triggers. Which parent statement indicates the need for further teaching?

A) “We’ll avoid dust and keep our home clean.”

B) “We should avoid pets that shed fur.”

C) “It’s okay to have someone smoke in the house as long as my child isn’t nearby.”

D) “We will monitor the pollen count before outdoor activities.”

C) “It’s okay to have someone smoke in the house as long as my child isn’t nearby.”

Rationale: Secondhand smoke is a significant asthma trigger; smoking should be completely avoided in the home environment to reduce the risk of exacerbations.

A preschooler is admitted to the emergency department with an acute asthma exacerbation. Which assessment finding should prompt the nurse to take immediate action?

A) Wheezing upon auscultation

B) Prolonged expiration phase

C) Oxygen saturation of 88%

D) Mild cough with clear sputum

C) Oxygen saturation of 88%

Rationale: An oxygen saturation level of 88% indicates hypoxia, and immediate intervention is needed to improve the child's oxygenation status

The nurse is teaching a parent how to use a peak flow meter for their preschool child with asthma. Which instruction should the nurse provide?

A) “Your child should use the peak flow meter only when symptoms occur.”

B) “Have your child blow out as fast and hard as possible into the meter.”

C) “Record only the lowest number from three attempts.”

D) “Peak flow readings are optional if your child is taking medication.”

B) “Have your child blow out as fast and hard as possible into the meter.”

Rationale: The correct technique for peak flow meter use involves blowing out as fast and hard as possible to measure peak expiratory flow, which helps monitor asthma control

A preschooler with asthma has been prescribed a daily inhaled corticosteroid. The nurse is educating the parents about this medication. Which instruction is most important for preventing adverse effects?

A) “Make sure your child avoids physical activities while using this medication.”

B) “Rinse your child’s mouth with water after each dose.”

C) “Take the medication only when symptoms are present.”

D) “Administer the medication with a high-protein snack.”

B) “Rinse your child’s mouth with water after each dose.”

Rationale: Rinsing the mouth after inhaling corticosteroids helps prevent oral thrush, a common side effect of corticosteroid use.

A preschool child with a history of asthma is admitted with status asthmaticus. Which assessment finding would require the nurse to take immediate action?

A) Oxygen saturation of 91%

B) Shortness of breath and nasal flaring

C) Absence of wheezing with minimal air movement on auscultation

D) Mild cough and clear sputum production

C) Absence of wheezing with minimal air movement on auscultation

Rationale: The absence of wheezing with minimal air movement indicates severe airway obstruction, requiring immediate intervention to prevent respiratory failure.

A preschooler with status asthmaticus is receiving continuous nebulized albuterol. Which assessment finding indicates a therapeutic response to the treatment?

A) Decreased respiratory rate and improved oxygen saturation

B) Increased coughing and clear sputum production

C) Restlessness and nasal flaring

D) Increased use of accessory muscle

A) Decreased respiratory rate and improved oxygen saturation

Rationale: Decreased respiratory rate and improved oxygen saturation suggest that the airway obstruction is decreasing, indicating a positive response to treatment.

A nurse is caring for a preschooler admitted with status asthmaticus. The healthcare provider prescribes intravenous corticosteroids. What is the primary purpose of this medication in managing status asthmaticus?

A) To reduce inflammation and edema in the airways

B) To promote relaxation and reduce anxiety

C) To stimulate respiratory effort

D) To decrease mucus production immediately

A) To reduce inflammation and edema in the airways

Rationale: Corticosteroids are used to reduce inflammation and edema in the airways, which helps improve airflow in children experiencing status asthmaticus.

A nurse is educating the parent of a preschooler with iron-deficiency anemia about dietary sources of iron. Which food selection by the parent indicates an understanding of the teaching?

A) Whole milk and cheese

B) Apples and bananas

C) Fortified cereals and lean red meat

D) White rice and chicken breast

C) Fortified cereals and lean red meat

Rationale: Fortified cereals and lean red meat are excellent sources of iron and are appropriate for improving iron levels in a child with iron-deficiency anemia.

A preschooler with iron-deficiency anemia is prescribed oral ferrous sulfate. Which instruction should the nurse provide to the parents to enhance the medication's absorption?

A) “Give the medication with milk to reduce stomach upset.”

B) “Administer the iron supplement with a vitamin C source, like orange juice.”

C) “Give the iron supplement right before bedtime for better absorption.”

D) “Mix the iron supplement in cereal to make it taste better.”

B) “Administer the iron supplement with a vitamin C source, like orange juice.”

Rationale: Vitamin C enhances the absorption of iron, so giving the iron supplement with a vitamin C source, like orange juice, increases its effectiveness.

A preschool child with iron-deficiency anemia appears pale and fatigued during play. Which nursing diagnosis should the nurse prioritize?

A) Risk for injury related to increased activity levels

B) Ineffective health maintenance related to knowledge deficit

C) Activity intolerance related to decreased oxygen-carrying capacity

D) Imbalanced nutrition, less than body requirements

C) Activity intolerance related to decreased oxygen-carrying capacity

Rationale: Activity intolerance due to decreased oxygen-carrying capacity is a priority nursing diagnosis, as the anemia reduces oxygen delivery to tissues, leading to fatigue.

The nurse is reviewing lab results of a preschooler with iron-deficiency anemia. Which result would the nurse expect to find?

A) Elevated hemoglobin and hematocrit levels

B) Low hemoglobin and microcytic, hypochromic red blood cells

C) Normal iron levels and macrocytic red blood cells

D) High platelet count and normal RBC indices

B) Low hemoglobin and microcytic, hypochromic red blood cells

Rationale: In iron-deficiency anemia, hemoglobin levels are low, and red blood cells are typically microcytic (small) and hypochromic (pale) due to insufficient iron.

During a follow-up visit, a preschool child taking iron supplements for anemia presents with dark stools. The parent expresses concern. What is the nurse’s best response?

A) “This could indicate bleeding, so we should perform further tests.”

B) “Dark stools are a common and normal side effect of iron supplements.”

C) “This may indicate constipation and will require additional treatment.”

D) “Avoid giving iron supplements until we can check with the provider.”

B) “Dark stools are a common and normal side effect of iron supplements.”

Rationale: Dark stools are a common and harmless side effect of iron supplements and do not indicate a need for further tests unless other symptoms appear.

A nurse is developing a care plan for a preschooler diagnosed with iron-deficiency anemia. Which goal is most appropriate for this child?

A) The child will tolerate oral iron supplements with no adverse effects.

B) The child’s hematocrit and hemoglobin levels will return to age-appropriate norms.

C) The child will drink at least four glasses of milk daily to support growth.

D) The child’s red blood cell count will remain slightly below average.

B) The child’s hematocrit and hemoglobin levels will return to age-appropriate norms.

Rationale: An appropriate goal is to restore hematocrit and hemoglobin levels to age-appropriate norms, as these are indicators of improved iron status

The nurse is providing discharge instructions to the parents of a preschooler with iron-deficiency anemia who is taking ferrous sulfate. Which statement by the parent indicates the need for further teaching?

A) “I should give the iron supplement on an empty stomach for better absorption.”

B) “Using a straw will help prevent my child’s teeth from staining.”

C) “It’s fine to mix the iron supplement with milk to improve the taste.”

D) “I should encourage high-fiber foods to help prevent constipation.

C) “It’s fine to mix the iron supplement with milk to improve the taste.”

Rationale: Mixing iron with milk can reduce its absorption, so this statement indicates the need for further teaching about avoiding dairy close to iron supplement administration.

A nurse is reviewing lab results for a preschooler with iron-deficiency anemia. Which outcome indicates an improvement in the child’s condition?

A) Hemoglobin level of 12 g/dL

B) Ferritin level of 8 ng/mL

C) Hematocrit of 30%

D) Mean corpuscular volume (MCV) below normal range

A) Hemoglobin level of 12 g/dL

Rationale: A hemoglobin level of 12 g/dL falls within the normal range for preschoolers and indicates improved iron status and oxygen-carrying capacity.

A preschool child with hemophilia A is admitted with a swollen knee after a minor fall. Which nursing intervention is the priority?

A) Apply a warm compress to the affected area.

B) Elevate the knee and apply ice to reduce swelling.

C) Encourage the child to bear weight on the knee.

D) Perform range-of-motion exercises with the knee.

B) Elevate the knee and apply ice to reduce swelling.

Rationale: Elevating and icing the joint helps reduce bleeding and swelling in children with hemophilia, particularly after injury.

The nurse is educating the parent of a preschooler with hemophilia about injury prevention. Which statement by the parent indicates a need for further teaching?

A) “I will put soft padding on sharp furniture corners at home.”

B) “I’ll let my child play soccer with protective gear.”

C) “We’ll encourage quiet activities and supervised play.”

D) “I’ll ensure my child wears a helmet when riding a bike.”

B) “I’ll let my child play soccer with protective gear.”

Rationale: Contact sports like soccer pose a high risk for injury and should generally be avoided for children with hemophilia, even with protective gear.

A preschool child with hemophilia A is scheduled to receive factor VIII before a dental procedure. What is the primary purpose of administering factor VIII in this situation?

A) To relieve pain during the procedure

B) To reduce the risk of infection

C) To promote blood clotting and prevent excessive bleeding

D) To improve immune function

C) To promote blood clotting and prevent excessive bleeding

Rationale: Administering factor VIII helps promote clotting, which reduces the risk of excessive bleeding during procedures in children with hemophilia.

The nurse is reviewing laboratory results for a preschooler with hemophilia. Which finding would the nurse expect to see in this patient?

A) Prolonged partial thromboplastin time (PTT)

B) Low platelet count

C) Decreased hematocrit

D) Elevated white blood cell count

A) Prolonged partial thromboplastin time (PTT)

Rationale: A prolonged PTT is expected in patients with hemophilia due to deficient clotting factors, particularly factor VIII in hemophilia A.

A preschool child with hemophilia experiences a nosebleed. Which action should the nurse instruct the parent to take first?

A) Tilt the child’s head back to reduce bleeding.

B) Apply firm pressure to the nose and keep the child calm.

C) Give the child aspirin to relieve discomfort.

D) Use a warm compress to promote clotting

B) Apply firm pressure to the nose and keep the child calm.

Rationale: Applying pressure to the nose and keeping the child calm are key first steps in managing bleeding in hemophilia to help prevent prolonged bleeding.

A nurse is assessing a preschool child suspected of having a UTI. Which finding would most likely prompt the nurse to suspect a UTI?

A) Cough and congestion

B) Low-grade fever and abdominal pain

C) Sore throat and headache

D) Itchy skin and redness

B) Low-grade fever and abdominal pain

The nurse is teaching a parent of a preschooler with recurrent UTIs. Which instruction is most important for preventing future UTIs?

A) Increase milk intake

B) Encourage proper wiping from front to back

C) Reduce fluid intake

D) Provide low-fiber foods

B) Encourage proper wiping from front to back

The nurse is preparing to collect a urine specimen for culture from a non-toilet-trained preschooler. Which method is most appropriate?

A) Clean-catch sample

B) Suprapubic aspiration

C) First void of the morning

D) Bagged urine sample

B) Suprapubic aspiration

A preschooler is prescribed nitrofurantoin for a UTI. Which statement by the parent indicates a need for further teaching?

A) “I’ll make sure to complete the full course of antibiotics.”

B) “This medication will treat any kidney infection as well.”

C) “I will monitor for any signs of side effects.”

D) “I’ll follow up with a urine sample if needed.”

B) "This medication will treat any kidney infection as well."

The nurse explains the importance of completing the full course of antibiotics to the parents of a preschooler with a UTI. What complication can occur if the antibiotics are not completed?

A) Chronic kidney disease

B) Decreased white blood cells

C) High blood glucose

D) Low blood pressure

A) Chronic kidney disease

A preschool child with recent strep throat presents with hematuria and periorbital edema. Which condition is the nurse most likely to suspect?

A) Urinary tract infection

B) Cystitis

C) Acute glomerulonephritis

D) Functional constipation

C) Acute glomerulonephritis

The nurse is educating parents of a preschooler with AGN. Which statement by the parents demonstrates an understanding of dietary management for AGN?

A) “We should provide a low-salt diet to help manage the swelling.”

B) “Increasing protein intake will prevent further complications.”

C) “We’ll encourage sugary drinks to promote energy.”

D) “A dairy-free diet is required for recovery.”

A) "We should provide a low-salt diet to help manage the swelling."

A nurse is assessing a child with AGN and notes tea-colored urine. What does this finding suggest?

A) Presence of protein in the urine

B) Presence of blood in the urine

C) Low urine output

D) Elevated urine pH

B) Presence of blood in the urine

Which symptom would be a priority for the nurse to monitor in a child with AGN?

A) Increased urine output

B) Blood pressure changes

C) Loose stools

D) Increased appetite

B) Blood pressure changes

The nurse is educating a parent on signs of worsening AGN. Which symptom should the parent report immediately?

A) Mild fever

B) Swelling in the face

C) Seizure activity

D) Nausea

C) Seizure activity

A nurse is assessing a preschooler with functional constipation. Which behavior suggests stool withholding?

A) Hiding when needing to pass stool

B) Drinking large amounts of water

C) Complaining of thirst

D) Sitting calmly on the toilet

A) Hiding when needing to pass stool

The nurse is teaching the parent of a child with functional constipation about dietary management. Which dietary change is most appropriate?

A) Increase fiber intake with fruits and vegetables

B) Provide a high-protein diet

C) Restrict water intake to decrease bloating

D) Avoid all dairy products

A) Increase fiber intake with fruits and vegetables

For a child with functional constipation, the nurse recommends sitting on the toilet after meals. What is the rationale for this intervention?

A) It stimulates the gastrocolic reflex to promote bowel movement

B) It helps the child learn to hold stool longer

C) It reduces the risk of urinary incontinence

D) It decreases the frequency of bowel movements

A) It stimulates the gastrocolic reflex to promote bowel movement

The nurse is preparing a plan for a preschooler with functional constipation. Which outcome is appropriate?

A) The child will have two or more bowel movements per week without pain.

B) The child will avoid fruits and vegetables to reduce stool size.

C) The child will drink only milk during meals.

D) The child will limit bathroom time to once daily.

A) The child will have two or more bowel movements per week without pain.

A parent of a preschooler with constipation reports stool leakage. What should the nurse explain is causing this symptom?

A) A side effect of fiber supplements

B) Diarrhea from dietary issues

C) Leakage due to rectal distension from stool buildup

D) Increased absorption of nutrients

C) Leakage due to rectal distension from stool buildup

A nurse is assessing a preschooler with suspected celiac disease. Which finding would support this diagnosis?

A) Dry skin and brittle nails

B) Distended abdomen and foul-smelling stools

C) Decreased urination frequency

D) Frequent nosebleeds

B) Distended abdomen and foul-smelling stools

Which statement by the parent of a child with celiac disease indicates correct understanding of dietary management?

A) “My child can have oats since they don’t contain gluten.”

B) “I will replace wheat flour with rice flour in our recipes.”

C) “We will limit dairy intake to control symptoms.”

D) “A high-protein diet will help manage the disease.”

B) "I will replace wheat flour with rice flour in our recipes."

The nurse is teaching the family of a child with celiac disease about potential long-term complications. Which complication is associated with untreated celiac disease?

A) Cardiovascular disease

B) Liver failure

C) Malnutrition and growth delays

D) Elevated blood pressure

C) Malnutrition and growth delays

A preschool child with celiac disease starts a gluten-free diet. Which expected outcome indicates improvement?

A) Decreased appetite and fatigue

B) Improved growth patterns and reduced stool frequency

C) Development of new rashes

D) Increased abdominal bloating

B) Improved growth patterns and reduced stool frequency

The nurse is reviewing signs of gluten exposure with the parents of a child with celiac disease. Which symptom should they report immediately?

A) Mild fatigue

B) Diarrhea and abdominal pain

C) Runny nose

D) Mild headache

B) Diarrhea and abdominal pain

The nurse is assessing a preschool child with cerebral palsy. Which early sign of CP would be expected in a child of this age?

A) Frequent falling and unsteady gait

B) Able to perform fine motor tasks with ease

C) Ability to ride a bicycle

D) Independent walking by age 3

A) Frequent falling and unsteady gait

For a child with cerebral palsy, which intervention would the nurse prioritize to prevent contractures?

A) Provide daily passive range-of-motion exercises

B) Encourage bed rest to reduce muscle strain

C) Limit movement to prevent injury

D) Administer high doses of analgesics

A) Provide daily passive range-of-motion exercises

The nurse is teaching a parent about medication options for managing spasticity in a preschooler with CP. Which medication should the nurse anticipate being discussed?

A) Baclofen

B) Amoxicillin

C) Insulin

D) Acetaminophen

A) Baclofen

A preschooler with CP uses adaptive devices to walk. Which outcome indicates that the intervention is successful?

A) The child relies solely on a wheelchair

B) The child avoids participating in physical activities

C) The child is able to perform activities of daily living independently

D) The child reports increased muscle stiffness

C) The child is able to perform activities of daily living independently

The nurse is caring for a child with cerebral palsy. Which finding would require immediate action?

A) Increased spasticity

B) Frequent seizures

C) Slow motor development

D) Limited joint range of motion

B) Frequent seizures

The nurse is assessing a preschool child who presents with fever, abdominal pain, and enuresis. A UTI is suspected. Which diagnostic test would the nurse anticipate to confirm the diagnosis?

A) Blood culture

B) Urinalysis and urine culture

C) Complete blood count (CBC)

D) Stool culture

B) Urinalysis and urine culture

Rationale: Urinalysis and urine culture are essential for diagnosing UTIs and identifying the causative organism in pediatric patients.

A nurse is teaching parents of a preschool child with a UTI about preventing future infections. Which statement by the parent indicates a need for further teaching?

A) “I will teach my child to wipe from front to back.”

B) “I’ll make sure my child drinks plenty of water throughout the day.”

C) “It’s okay for my child to take frequent bubble baths.”

D) “I’ll encourage my child to urinate regularly.

C) “It’s okay for my child to take frequent bubble baths.”

Rationale: Frequent bubble baths can irritate the urethra and increase the risk of UTIs, so this statement indicates a need for further teaching.

A preschooler is diagnosed with a UTI and is prescribed a course of antibiotics. Which instruction is most important for the nurse to provide the parents regarding antibiotic administration?

A) “Give the antibiotics only until your child starts feeling better.”

B) “Complete the full course of antibiotics as prescribed.”

C) “Skip a dose if your child has no symptoms that day.”

D) “Save any leftover antibiotics for future use if symptoms recur.”

B) “Complete the full course of antibiotics as prescribed.”

Rationale: Completing the full course of antibiotics is essential to fully eradicate the infection and prevent recurrence or antibiotic resistance.

The parent of a preschooler with recurrent UTIs asks about symptoms to monitor for a kidney infection. Which symptom should the nurse emphasize as a possible sign of pyelonephritis?

A) Frequent urination with no pain

B) Low-grade fever and fatigue

C) High fever, flank pain, and vomiting

D) Dry skin and increased thirst

C) High fever, flank pain, and vomiting

Rationale: High fever, flank pain, and vomiting are signs of pyelonephritis, a more severe kidney infection that may require prompt medical intervention.

A preschool child with a UTI is experiencing pain with urination. Which intervention should the nurse recommend to help alleviate this discomfort?

A) Restrict fluid intake

B) Apply a warm compress to the abdomen

C) Provide cranberry juice for pain relief

D) Limit bathroom trips to twice daily

B) Apply a warm compress to the abdomen

Rationale: A warm compress can help relieve abdominal discomfort associated with UTIs, while cranberry juice is generally used for prevention, not immediate pain relief.

A nurse is assessing a preschool child with suspected acute poststreptococcal glomerulonephritis (AGN). Which finding would be most indicative of this condition?

A) Cloudy urine with a low pH

B) Tea-colored urine and periorbital edema

C) Pale skin and excessive thirst

D) Frequent urination and abdominal cramps

B) Tea-colored urine and periorbital edema

Rationale: Tea-colored urine and periorbital edema are characteristic signs of AGN, due to hematuria and fluid retention.

The parent of a preschooler with AGN asks why blood pressure monitoring is necessary. What is the nurse's best response?

A) “High blood pressure is common in AGN due to fluid retention and can affect the heart.”

B) “Low blood pressure is expected with AGN, so monitoring is crucial.”

C) “High blood pressure only occurs with dehydration, which is a concern in AGN.”

D) “Blood pressure monitoring helps us detect anemia.”

A) “High blood pressure is common in AGN due to fluid retention and can affect the heart.”

Rationale: High blood pressure often occurs in AGN due to fluid retention and can lead to complications like cardiac stress, making monitoring essential.

A preschooler with AGN is experiencing oliguria. Which action should the nurse take to manage this symptom?

A) Encourage frequent fluid intake to improve urine output.

B) Restrict fluids as prescribed to prevent further fluid overload.

C) Administer a diuretic to increase urination.

D) Position the child upright to promote kidney drainage

B) Restrict fluids as prescribed to prevent further fluid overload.

Rationale: Fluid restriction is often required to prevent further fluid overload in AGN, as oliguria indicates impaired kidney function

The nurse is educating a parent on dietary restrictions for a preschooler with AGN. Which food should the parent be instructed to avoid?

A) Low-sodium snacks

B) High-potassium fruits like bananas

C) High-fiber vegetables

D) Whole-grain cereals

B) High-potassium fruits like bananas

Rationale: High-potassium foods, such as bananas, should be limited in children with AGN due to potential kidney impairment that may lead to hyperkalemia.

A preschool child with AGN presents with hypertension and mild edema. The nurse is reviewing interventions with the parent. Which statement by the parent indicates correct understanding?

A) “I should encourage my child to drink water frequently to help flush the kidneys.”

B) “We’ll follow a low-sodium diet to help control my child’s blood pressure.”

C) “I’ll add extra protein to my child’s meals to help with kidney recovery.”

D) “We should monitor for frequent urination as a sign of improvement.”

B) “We’ll follow a low-sodium diet to help control my child’s blood pressure.”

Rationale: A low-sodium diet is essential in managing edema and controlling hypertension in AGN.

A nurse is assessing a preschooler with functional constipation. Which behavior is most indicative of stool withholding?

A) Drinking large amounts of water

B) Asking to use the bathroom frequently

C) Hiding and crossing legs when needing to pass stool

D) Having a bowel movement every morning

C) Hiding and crossing legs when needing to pass stool

Rationale: Stool withholding behaviors, such as hiding or crossing legs, are common in children with functional constipation as they try to avoid the discomfort of passing hard stool.

The nurse is educating a parent on dietary recommendations for a preschooler with functional constipation. Which meal choice demonstrates appropriate understanding of a high-fiber diet?

A) Macaroni and cheese with white bread

B) Chicken nuggets with French fries

C) Oatmeal with apple slices and water

D) Pancakes with syrup and orange juice

C) Oatmeal with apple slices and water

Rationale: Oatmeal and apples are high in fiber, which can help soften stool and promote regular bowel movements.

The nurse is discussing toilet habits with the parent of a preschooler with functional constipation. Which recommendation should the nurse emphasize to support healthy bowel patterns?

A) Encourage the child to use the bathroom immediately after meals.

B) Limit bathroom time to once daily.

C) Avoid sitting the child on the toilet after meals.

D) Encourage the child to wait until the end of the day to use the bathroom.

A) Encourage the child to use the bathroom immediately after meals.

Rationale: Sitting on the toilet after meals takes advantage of the gastrocolic reflex, which stimulates bowel movements and can help children with constipation establish regular patterns.

A preschooler with functional constipation is prescribed polyethylene glycol as a stool softener. The parent asks how this will help their child. What is the nurse’s best response?

A) “It will add fiber to the diet to make stool easier to pass.”

B) “It will retain water in the stool, making it softer and easier to pass.”

C) “It will increase intestinal motility by stimulating bowel muscles.”

D) “It will reduce bowel movements to prevent straining.”

B) “It will retain water in the stool, making it softer and easier to pass.”

Rationale: Polyethylene glycol retains water in the stool, softening it and making it easier to pass without straining, which is especially helpful in managing functional constipation