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Peds Exam #2 Practice Questions with
Complete Solution
1. Which of the following should be used in the care of all pediatric care patients to reduce the risk of
transmission of microorganisms from both recognized and unrecognized sources of infection?
a. Transmission-based precautions
b. Airborne precautions
c. Standard precautions
d. Droplet precautions: C
2. Which childhood vaccine provides some protection against bacterial menin-gitis, epiglottis, and bacterial
pneumonia?
a. Hib vaccine
b. Hep B vaccine
c. Varicella vaccine
d. Influenza vaccine: A
3. Which vaccine should pregnant adolescents and women who are not pro-tected against pertussis receive
optimally between 27 and 36 weeks' gestation or postpartum prior to discharge from the hospital?
a. DTap
b. Td
c. IPV
d. Tdap: D
4. Which childhood vaccine provides protection against streptococcal infec-tions such as otitis media,
sinusitis, and pneumonia?
a. Rotavirus vaccine
b. Hib vaccine
c. Pneumococcal vaccine
d. MMR vaccine: C
5. One of the most common intestinal parasitic pathogens in the US acquired from a contaminated water
source such as a lake or swimming pool is:
a. tinea capitis
b. giardia intestinalis
c. pediculosis capitis
d. enterobiasis: B
6. A 9-year-old child in the ED is diagnosed w/ Lyme disease. The nurse antici-pates that the HCP orders will
include the administration of:
a. cefotaxime
b. aqueous penicillin
c. doxycycline
d. thrimethoprim-sulfamethoxazole: C
10. A 4-day-old infant is seen in the ED for a possible seizure earlier in the day. The infant was being
breastfed but w/o much success, so an aunt gave him a bottle of water. The infant continued to cry, and the mother was too exhausted to breastfeed, so another bottle of water was given while someone went to the store to purchase infant formula. The pregnancy, delivery, and postpartum Hx reveal no particular problems for this term infant that might contribute to seizures. The physical exam is unremarkable, with the exception of hypertonic reflexes. The infant is awake, alert, and sucking on his fists. Diagnostic studies are obtained, including and EEG. The nurse anticipates which of the following as the possible explanation for the infant's condition.
a. serum potassium 3.9 mEq
b. serum glucose 69mg
c. serum sodium 118 mEq
d. arterial pH of 7.34: C
11. A burn injury involving the epidermis and varying degrees of the dermal leyer that is painful, moist, red,
and blistered describes which of the follow-ing?
a. superficial or first-degree burn
b. partial-thickness or second-degree burn
c. full-thickness or third-degree burn
d. fourth-degree burn: B
12. A 10-year-old child suffered extensive second- and third-degree burns in an apartment fire. His
weight is 75lbs (34kg). Fluid replacement therapy will optimally:
a. result in an hourly urine output of 1mL/kg
b. result in an hourly urine output of 20mL/kg
c. result in an hourly urine output of 30mL/kg
d. maintain a systolic BP in the 95th percentile for the child's weight: C
13. The nurse is caring for a 4-year-old girl w/ a Hx of frequent UTIs. What should the nurse be aware
of before obtaining a urine sample? Select all that apply.
a.To obtain a clean-catch urine specimen, have the child sit on the toilet facing
backward toward the tank.
b. Since children who have a UTI will have painful urination, have the child drink a large amount of fluid
before obtaining the sample.
c.The specimen must be fresh - less than 1hr after voiding w/ storage at room temp. or less than 4hrs after
voiding w/ refrigeration.
d. If a urinalysis obtained by a bag specimen is negative, a specimen still needs to be obtained by catheterization
or suprapubic aspiration.
e. The key to distinguishing a true UTI from asymptomatic bateriuria is the presence of pyuria.
f. Because the child is febrile, the nurse should immediately start an antimi-crobial and then obtain a urine
culture.: A, C, E
14. A child w/ periorbital edema, decreased urine output, pallor, and fatigue is admitted to the pediatric unit.
The child is being examined for acute glomeru-lar nephritis. Which of the following nursing measures should be considered? Select all that apply.
a. On examination, there is usually a mild to moderate elevation in BP com-pared w/ normal values for age,
although severe HTN may be present.
b. Urinalysis during the acute phase characteristically shows hematuria, pro-teinuria, and increased specific
gravity.
a. 1920 mL/day
b. 1740 mL/day
c. 1840 mL/day
d. 1620 mL/day: B
18. A 16-month-old has a Hx of diarrhea for 3 days w/ poor oral intake. He received IV fluids, has
tolerated some oral fluids in the ED, and is being discharged home. Instructions for diet for this child should include:
a. BRAT diet (bananas, rice, applesauce, toast) for 24hrs, then a soft diet as tolerated
b. Chicken or beef broth for 24hrs, then resume a soft diet
c. Offer a regular diet as child's appetite warrants
d. Keep on clear liquids and toast for 24hrs: C
19. A 5-month-old infant is seen in the well-child clinic for a complaint of vomiting and failure to
grow. His birth weight was 7lbs, and he now weighs 8lbs, 10oz. The infant's mother reports that he is taking 4- 7oz of formula every 4-5hrs, be he "spits up a lot after eating and then is hungry again." The child is noted to be alert appears malnourished. The mother reports his stools are brown in color, and he has 1-2 bowel movements every day. Based on these findings, the nurse anticipates the infant has:
a. meckel diverticulum
b. hypertropic pyloric stenosis
c. intussusception
d. Hirschprung disease: B
20. Because children w/ celiac disease must limit their intake of products con-taining gluten in wheat, rye,
oats, and barley, they are at risk for which of the following nutritional deficiencies? Select all that apply.
a. iron deficiency anemia
b. folic acid deficiency
c. zinc deficiency
d. vitamin A, D, E, and K deficiency
e. vitamin B12 deficiency: A, B, D
21. A formerly preterm infant who had surgery for necrotizing enterocolitis is now 6 months old and
has short bowel syndrome. He is unable to absorb most nutrients taken by mouth and is totally dependent on parenteral nutrition, which he receives via Broviac catheter. The clinic nurse following this infant is aware that this infant should be closely observed for the development of:
a. gastroesophageal reflux
b. chronic diarrhea
c. cholestasis
d. failure to thrive: C
22. The nurse caring for a 4-month-old infant w/ biliary atresia and significant urticaria can anticipate
administering:
a. diphenhydramine
b. ursodiol (ursodeoxycholic acid)
10 / 13
d. High-calorie, high-protein diet
e. Antibiotics ordered for any existing infection: B, D, E
26. You are working with a recent graduate on the pediatric unit. You are assigned to take care of an
adolescent w/ B-thalassemia. The nurse needs more info about this disease if she states which of the following? Select all that apply.
a. "We need to check the patient's iron level to make sure he is not anemic."
b. "I believe this is most common in those of Hispanic descent, although this patient is Mediterranean."
c. "The doctor will be prescribing deverasirox (Exjade) or defoxamine (Desfer-al) for chelation therapy."
d. "This patient looks much younger than I would expect. I guess he's just a late bloomer."
e. "I think a transfusion will be ordered, since his Hgb is 9.0": A, B, D
27. Which is the most accurate genetic explanation for a family w/ hemophilia?
a. it is a Y-linked dominant d/o
b. it is equally distributed among males and females
c. it is an X-linked recessive d/o
d. it is an autosomal recessive d/o: C
28. You are discharging a patient w/ hemophilia. Which of the following re-sponses by the parents
indicate an understanding of this d/o? Select all that apply.
a. "My child should remain active to decrease joint problems, and most chil-dren w/ hemophilia can
participate in the same activities as peers."
b. "Care should be taken to avoid bleeding of gums, and softening the tooth-brush in warm water before
11 / 13 brushing or using a sponge-tipped disposable toothbrush may be helpful."
c. "Signs of internal bleeding should be recognized, such as H/A, slurred speech, loss of consciousness
(from cerebral bleeding), and black tarry tools (from GI bleeding)."
d. "If there is bleeding in a joint, elevation, ice, and rest should help and may prevent the need for factor VIII
replacement."
e. "All of my son's teachers need to be aware of what to do if he gets a bloody nose.": B, C, E
29. Discharge teaching for parents of a school-age patient w/ DI should include which of the following?
Select all that apply.
a. education and support regarding the rationale for fluid restrictions
b. info for school personnel regarding the diagnosis so they can grant children unrestricted use of the
lavatory
c.a thorough explanation regarding the condition w/ specific clarification that DI is a different condition from
DM
d. understanding that treatment will only be need until the child reaches puberty
e. knowing that school-age children may assume full responsibility for their care: B, C, E
30. You are working w/ a nurse who is new to your endocrine unit and has never worked w/ an infant born
w/ congenital adrenal hyperplasia (CAH). You want to make sure he has a full understanding of this diagnosis. Which statement by the nurse indicates a need for further teaching?
a. "definitive diagnosis is confirmed by evidence of increase 17-ketosteroid levels in most types of CAH."
b. "blood studies to identify elevated calcium and decreased phosphorus levels are routinely performed."
13 / 13
b. fruity breath odor and decreasing level of consciousness
c. H/A, huger, excessive irritability
d. Normal urine output w/ specific gravity less than 1.020 and a trace of ketones: B
