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Pediatric Nursing Exam 2:
Advanced Pediatric
Assessment and Acute/Chronic
Care Management
Examination2025/
Question 1
A nurse is assessing a 4-year-old child in the pediatric clinic. The child's parent reports that the child has been "acting out" and having temper tantrums. Which of the following responses by the nurse is most appropriate?
A. "This is abnormal behavior for a 4-year-old and should be evaluated."
B. "Temper tantrums are common at this age as the child seeks independence."
C. "You should punish the child immediately when they have a tantrum."
D. "This behavior indicates a developmental delay."
💫RATIONALE✔️ ✔️ : Temper tantrums are a normal part of development for preschoolers as they assert their independence and learn to regulate emotions. The nurse should educate the parent about typical developmental behaviors and provide guidance on setting limits and using positive reinforcement.
💫ANSWER✔️ ✔️ : B. "Temper tantrums are common at this age as the child seeks independence."
Question 2
A nurse is caring for a child with a diagnosis of acute otitis media. Which of the following findings would the nurse expect?
A. Clear drainage from the ear.
B. Erythema and bulging of the tympanic membrane.
C. Decreased pain when lying flat.
D. Normal temperature.
💫RATIONALE✔️ ✔️ : Acute otitis media is characterized by inflammation and infection of the middle ear, leading to erythema, bulging, and decreased mobility of the tympanic membrane. Pain is often worse when lying flat due to increased pressure. Fever and irritability are common.
A nurse is assessing a newborn's Apgar score at 1 minute. The newborn has a heart rate of 100 beats per minute, a weak cry, some flexion of extremities, and acrocyanosis. The respiratory effort is slow and irregular. What Apgar score should the nurse assign?
A. 4
B. 5
C. 6
D. 7
💫RATIONALE✔️ ✔️ : The Apgar score is calculated as follows: Heart rate >100 (2 points), Respiratory effort: slow, irregular (1 point), Muscle tone: some flexion (1 point), Reflex irritability: weak cry (1 point), Color: acrocyanosis (1 point). Total = 2+1+1+1+1 = 6. A score of 6 indicates the newborn may need some assistance with breathing.
💫ANSWER✔️ ✔️ : C. 6
Question 5
A nurse is caring for a child with a diagnosis of croup. Which of the following findings is most characteristic of this condition?
A. Barking cough and stridor.
B. Wheezing and crackles.
C. Productive cough with green sputum.
D. High fever and lethargy.
💫RATIONALE✔️ ✔️ : Croup (laryngotracheobronchitis) is characterized by a barking cough, stridor (high-pitched sound on inspiration), and hoarseness. It is caused by inflammation of the upper airways. Wheezing is more common in asthma or bronchiolitis, and a productive cough with sputum suggests pneumonia.
💫ANSWER✔️ ✔️ : A. Barking cough and stridor.
Question 6
A nurse is providing education to the parents of a child with a new diagnosis of type 1 diabetes mellitus. Which of the following instructions should the nurse include?
A. "Insulin should be given only when the child has symptoms."
B. "Blood glucose should be monitored before meals and at bedtime."
C. "The child will outgrow the need for insulin."
D. "The child should avoid all carbohydrates."
💫RATIONALE✔️ ✔️ : Type 1 diabetes requires lifelong insulin therapy. Blood glucose monitoring before meals and at bedtime is essential for managing the condition. Insulin should be given as
Question 8
A nurse is caring for a child with a diagnosis of acute glomerulonephritis. Which of the following findings would the nurse expect?
A. Hypertension and oliguria.
B. Hypotension and polyuria.
C. Hyperglycemia and glucosuria.
D. Weight loss and dehydration.
💫RATIONALE✔️ ✔️ : Acute glomerulonephritis is characterized by inflammation of the glomeruli, leading to decreased glomerular filtration, fluid retention, hypertension, and oliguria (decreased urine output). Hematuria and proteinuria are also common findings.
💫ANSWER✔️ ✔️ : A. Hypertension and oliguria.
Question 9
A nurse is providing education to the parents of a child with a new diagnosis of attention deficit hyperactivity disorder (ADHD). Which of the following instructions should the nurse include?
A. "Medication should be taken only on school days."
B. "Consistent routines and structure are important."
C. "The child will outgrow this condition."
D. "All physical activity should be limited."
💫RATIONALE✔️ ✔️ : Children with ADHD benefit from consistent routines and structure to help them manage symptoms. Medications are typically taken daily, not just on school days. ADHD is a chronic condition that often persists into adulthood. Physical activity is beneficial and should be encouraged.
💫ANSWER✔️ ✔️ : B. "Consistent routines and structure are important."
Question 10
A nurse is assessing a child with a diagnosis of iron deficiency anemia. Which of the following findings would the nurse expect?
A. Pale skin and conjunctiva.
B. Hyperactivity and irritability.
C. Weight gain and edema.
D. Polyuria and polydipsia.
Question 12
A nurse is providing education to the parents of a child with a new diagnosis of cerebral palsy. Which of the following statements by the parents indicates a correct understanding?
A. "This condition is caused by a genetic defect."
B. "This condition will improve with time."
C. "This condition is caused by injury to the developing brain."
D. "This condition is contagious."
💫RATIONALE✔️ ✔️ : Cerebral palsy is caused by injury to the developing brain, often before, during, or shortly after birth. It is a non-progressive condition, meaning the brain injury does not worsen, but symptoms may change over time. It is not genetic or contagious.
💫ANSWER✔️ ✔️ : C. "This condition is caused by injury to the developing brain."
Question 13
A nurse is assessing a child with a diagnosis of gastroenteritis. Which of the following findings would the nurse expect?
A. Constipation.
B. Diarrhea and vomiting.
C. Weight gain.
D. Bradycardia.
💫RATIONALE✔️ ✔️ : Gastroenteritis is characterized by inflammation of the gastrointestinal tract, leading to diarrhea, vomiting, abdominal pain, and fever. Dehydration is a common complication, so monitoring hydration status is essential.
💫ANSWER✔️ ✔️ : B. Diarrhea and vomiting.
Question 14
A nurse is caring for a child with a diagnosis of cystic fibrosis. Which of the following interventions is a priority?
A. Encourage a low-fat diet.
B. Administer pancreatic enzymes with meals.
C. Restrict fluid intake.
D. Avoid all physical activity.
Question 16
A nurse is assessing a child with a diagnosis of epiglottitis. Which of the following findings is most concerning?
A. Barking cough.
B. Drooling and tripod positioning.
C. Mild fever.
D. Erythema of the throat.
💫RATIONALE✔️ ✔️ : Epiglottitis is a life-threatening emergency characterized by inflammation of the epiglottis. Drooling, tripod positioning (sitting forward with hands on knees), and stridor are signs of impending airway obstruction. The nurse should prepare for emergency interventions.
💫ANSWER✔️ ✔️ : B. Drooling and tripod positioning.
Question 17
A nurse is caring for a child with a diagnosis of sickle cell anemia. Which of the following interventions is a priority during a vaso-occlusive crisis?
A. Administer antibiotics.
B. Encourage increased fluid intake.
C. Apply cold compresses to painful areas.
D. Administer iron supplements.
💫RATIONALE✔️ ✔️ : During a vaso-occlusive crisis, sickled red blood cells obstruct blood flow, causing severe pain and tissue ischemia. Encouraging increased fluid intake helps to decrease blood viscosity and improve circulation. Pain management and warm compresses are also important.
💫ANSWER✔️ ✔️ : B. Encourage increased fluid intake.
Question 18
A nurse is providing education to the parents of a child with a new diagnosis of asthma about the use of a peak flow meter. Which of the following statements by the parents indicates a correct understanding?
A. "A peak flow meter measures how much oxygen is in the blood."
B. "A peak flow meter measures how well air is moving out of the lungs."
C. "A peak flow meter is used to administer medication."
D. "A peak flow meter is only used during an asthma attack."
Question 20
A nurse is caring for a child with a diagnosis of respiratory syncytial virus (RSV). Which of the following interventions is a priority?
A. Administer antibiotics.
B. Encourage oral fluids.
C. Monitor oxygen saturation.
D. Place the child in a prone position.
💫RATIONALE✔️ ✔️ : RSV is a viral infection that affects the lower respiratory tract, causing bronchiolitis and respiratory distress. Monitoring oxygen saturation is a priority to detect hypoxia early. Supportive care includes airway clearance, fluids, and positioning (semi-Fowler's).
💫ANSWER✔️ ✔️ : C. Monitor oxygen saturation.
Question 21
A nurse is providing education to the parents of a child with a new diagnosis of diabetes insipidus. Which of the following instructions should the nurse include?
A. "Monitor for signs of dehydration."
B. "Limit fluid intake to prevent polyuria."
C. "Administer insulin as prescribed."
D. "Monitor for signs of hypoglycemia."
💫RATIONALE✔️ ✔️ : Diabetes insipidus is characterized by a deficiency of antidiuretic hormone, leading to excessive thirst and urination (polyuria). The priority is to monitor for signs of dehydration and ensure adequate fluid intake. Insulin is not used in this condition.
💫ANSWER✔️ ✔️ : A. "Monitor for signs of dehydration."
Question 22
A nurse is assessing a child with a diagnosis of nephrotic syndrome. Which of the following findings would the nurse expect?
A. Weight loss.
B. Hypotension.
C. Edema and proteinuria.
D. Polyuria and polydipsia.
Question 24
A nurse is providing education to the parents of a child with a new diagnosis of ADHD about medication administration. Which of the following instructions should the nurse include?
A. "Administer the medication with a high-fat meal."
B. "Administer the medication in the evening to prevent insomnia."
C. "Administer the medication in the morning to prevent insomnia."
D. "Administer the medication only on school days."
💫RATIONALE✔️ ✔️ : Stimulant medications used to treat ADHD should be given in the morning to prevent insomnia. They can be taken with or without food. Consistent daily administration is recommended, not just on school days.
💫ANSWER✔️ ✔️ : C. "Administer the medication in the morning to prevent insomnia."
Question 25
A nurse is assessing a child with a diagnosis of Kawasaki disease. Which of the following findings would the nurse expect?
A. Strawberry tongue.
B. Conjunctival injection.
C. Fever.
D. All of the above.
💫RATIONALE✔️ ✔️ : Kawasaki disease is an acute vasculitis that affects children. Classic findings include fever, strawberry tongue, conjunctival injection, and a rash. It can lead to coronary artery aneurysms if untreated.
💫ANSWER✔️ ✔️ : D. All of the above.
Question 26
A nurse is caring for a child with a diagnosis of acute lymphocytic leukemia (ALL). Which of the following interventions is a priority?
A. Administer iron supplements.
B. Monitor for signs of infection.
C. Encourage a low-protein diet.
D. Restrict fluid intake.
