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Peds Exam Practice Questions with Verified
Answers
1.A nurse is conducting a physical examination of a 5-year-old with suspected iron- deficiency
anemia. How would the nurse evaluate for changes in neuro- logic functioning?
A) "Open your mouth so I can look inside your cheeks and lips."
B) "Do you have any bruises on your feet or shins?"
C) "Will you show me how you walk across the room?"
D) "Let me see the palms of your hands and soles of your feet.": C) "Will you show me how you
walk across the room?"
2.The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing
discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching?
A) "We should avoid aspirin and drugs like ibuprofen."
B) "He can resume participation in football in 2 weeks."
C) "Swimming would be a great activity."
D) "Our son cannot take any antihistamines.": B) "He can resume participation in football in 2
weeks."
3.The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the
adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching?
A) "We need to administer Stimate prior to dental work."
B) "We should be aware that she may suffer from menorrhagia."
C) "We should administer desmopressin as often as needed."
D) "We understand that she may have frequent nosebleeds.": C) "We should administer
desmopressin as often as needed."
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4.The nurse is caring for a child who has been admitted for a sickle cell crisis. Which of the following
would the nurse do first to provide adequate pain management?
A) Administer a nonsteroidal anti-inflammatory drug as ordered.
B) Use guided imagery and therapeutic touch.
C) Administer meperidine as ordered.
D) Initiate pain assessment with a standardized pain scale.: D) Initiate pain assessment with a
standardized pain scale.
5.A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided
doses. The nurse interprets this order as indicating which of the following?
A) The child requires a prophylactic dose of iron.
B) The child has mild to moderate iron deficiency.
C) The child has severe iron deficiency.
D) The child is being prepared for packed red blood cell administration.: B)The child has mild to
moderate iron deficiency.
6.The nurse is teaching the parents of a child with a hematologic disorder about the functions of the
various blood cells. The nurse determines that the teaching was successful when the parents state which blood cell as being primarily responsible for blood clotting?
A) Granulocytes B)Erythrocytes
C)Thrombocytes D) Leukocytes: C)Thrombocytes
7.When providing care to a child with aplastic anemia, which nursing diagno- sis most likely would
be the priority?
A) Risk for injury
B) Imbalanced nutrition, less than body requirements
C) Ineffective tissue perfusion
D) Impaired gas exchange: A) Risk for injury
8.The mother of a 5-year-old girl brings the child to the clinic for an evaluation. The mother tells the
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A) "You give the baby some iron, but it is not enough to sustain him after birth."
B) "Because the baby grows rapidly during the first months, he uses up what you gave him."
C) "The iron you give him before birth is different from what he needs once he is born."
D) "If the baby didn't use up what you gave him before birth, he excretes it soon after birth.": B)
"Because the baby grows rapidly during the first months, he uses up what you gave him."
11.A 5-year-old girl is diagnosed with iron-deficiency anemia and is to receive iron supplements.
The child has difficulty swallowing tablets, so a liquid formulation is prescribed. After teaching the parents about administering the iron supplement, which statement indicates the need for additional teaching?
A) "She needs to eat foods that are high in fiber so she doesn't get constipat- ed."
B) "We'll try to get her to drink lots of fluids throughout the day."
C) "We will place the liquid in the front of her gums, just below her teeth."
D) "We need to measure the liquid carefully so that we give her the correct amount.": C) "We will
place the liquid in the front of her gums, just below her teeth."
12.The nurse is assessing a child with aplastic anemia. Which of the following would the nurse
expect to assess? Select all that apply.
A) Ecchymoses
B) Tachycardia
C) Guaiac-positive stool
D) Epistaxis
E) Severe pain
F) Warm tender joints: A) Ecchymoses
B) Tachycardia
C) Guaiac-positive stool
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D) Epistaxis
13.The nurse is caring for a 16-year-old boy with acute myelogenous leukemia who is having
chemotherapy and who has incomplete records for varicella zoster immunization. Which of the following will be the priority nursing diag- nosis?
A) Pain related to adverse effects of treatment verbalized by the child
B) Nausea related to side effects of chemotherapy verbalized by the child
C) Constipation related to the use of opioid analgesics for pain
D) Risk for infection related to neutropenia and immunosuppression: D) Risk for infection related
to neutropenia and immunosuppression
14.The nurse is caring for an 8-year-old girl who has been diagnosed with leukemia and will have a
variety of tests, including a lumbar puncture, before beginning chemotherapy. Which of the following would be the priority?
A) Applying EMLA to the lumbar puncture site
B) Educating the child and family about the testing procedures
C) Administering promethazine as ordered for nausea
D) Educating the family about chemotherapy and its side effects: B) Educating the child and family
about the testing procedures
15.The nurse is caring for a 13-year-old boy with acute myelogenous leukemia who is experiencing
feelings of powerlessness due to the effects of chemotherapy. Which of the following interventions will best help the teen's sense of control?
A) Involving the boy in decisions whenever possible
B) Acknowledging the boy's feelings of anger with the disease
C) Providing realistic expectations of treatments and outcomes
D) Recognizing abilities that are unaffected by the disease: A) Involving the boy in decisions
whenever possible
16.The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they
noticed that the right side of his abdomen was swollen. Which of the following findings would suggest this child has a neuroblastoma?
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D) Imbalanced nutrition, less than body requirements related to nausea and vomiting: B) Impaired
skin integrity related to desquamation from cellular destruc- tion
20.The nurse is planning a discussion group for parents with children who have cancer. Which of
the following would the nurse include when describing the differences between cancer in children and adults?
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A) Most childhood cancers affect the tissues rather than organs.
B) Childhood cancers are usually localized when found.
C) Unlike adult cancers, childhood cancers are less responsive to treatment.
D) The majority of childhood cancers can be prevented.: A) Most childhood cancers affect the
tissues rather than organs.
21.A child is receiving fluorouracil as part of a chemotherapy protocol. Which of the following would
be most important for the nurse to include in the child's plan of care?
A) Monitoring for visual changes
B) Maintaining adequate hydration
C) Using prescribed eye drops to prevent conjunctivitis
D) Avoiding administration with food or meals: B) Maintaining adequate hydra- tion
22.A child diagnosed with stage IV neuroblastoma has undergone abdominal surgery to remove the
tumor. He is now receiving chemotherapy. Which nurs- ing diagnosis would be most important?
A) Risk for infection related to chemotherapy
B) Impaired skin integrity related to abdominal surgery
C) Grieving related to advanced disease and poor prognosis
D) Imbalanced nutrition related to adverse effects of chemotherapy: C) Griev- ing related to
advanced disease and poor prognosis
23.A 14-year-old boy is diagnosed with Hodgkin disease. When palpating for enlarged lymph nodes,
the nurse would expect to find which nodes as most
10 / 16 neurological status When platelets are low, the greatest danger is spontaneous intracranial bleeding. Neurological assessments are therefore a priority of care.
28.A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with
severe abdominal pain. Which type of crisis is the child most likely experiencing?
a. Aplastic
b. Hyperhemolytic
c. Vaso-occlusive
d. Splenic sequestration: c. Vaso-occlusive
Vaso-occlusive crisis, or painful crisis, is caused by obstruction of blood flow by sickle cells, infarctions, and some degrees of vasospasm.
29.Which statement made by a parent indicates an understanding of health maintenance of a child
with sickle cell disease?
a. "I should give my child a daily iron supplement."
b. "It is important for my child to drink plenty of fluids."
c. "He needs to wear protective equipment if he plays contact sports."
d. "He shouldn't receive any immunizations until he is older.": b. "It is important for my child to
drink plenty of fluids." Prevention of dehydration, which can trigger the sickling process, is a priority goal in the care of a child with sickle cell disease.
30.A newly married couple is seeking genetic counseling because they are both carriers of the
sickle cell trait. How can the nurse best explain the children's risk of inheriting this disease?
a. Every fourth child will have the disease; two others will be carriers.
b. All of their children will be carriers, just as they are.
c. Each child has a one in four chance of having the disease and a two in four chance of being a
carrier.
d.The risk levels of their children cannot be determined by this information.: c. Each child has a one
in four chance of having the disease and a two in four chance of being a carrier.
31.A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an
overproduction of immature white blood cells in the bone marrow?
a. Decreased T-cell production
b. Decreased hemoglobin
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c. Increased blood clotting
d. Increased susceptibility to infection: d. Increased susceptibility to infection
An overproduction of immature white blood cells increases the child's susceptibility to infection.
32.The child receiving a transfusion complains of back pain and itching. What is the best initial
action by the nurse?
a. Notify the charge nurse.
b. Disconnect intravenous lines immediately.
c. Give diphenhydramine (Benadryl).
d. Clamp off blood and keep line open with normal saline.: d. Clamp off blood and keep line open
with normal saline.
33.What would the nurse include in a teaching plan about mouth care of a child receiving
chemotherapy?
a. Use commercial mouthwash.
b. Clean teeth with a soft toothbrush.
c. Avoid use of a Water-Pik.
d. Inspect the mouth weekly for ulcerations.: b. Clean teeth with a soft toothbrush.
34.The most recent blood count for a child who received chemotherapy last week shows
neutropenia. What is the priority nursing diagnosis for this child?
a. Risk for infection
b. Risk for hemorrhage
c. Altered skin integrity
d. Disturbance in body image: a. Risk for infection
35.A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if
this disorder goes untreated?
a. Hemorrhage
b. Heart failure
c. Infection
d. Pulmonary embolism: b. Heart failure
36.The nurse is caring for a child with a low platelet count. What skin assess- ments would alert the
nurse to bleeding? (Select all that apply.)
a. Petichiae
b. Purpura
c. Ecchymosis
d. Hematoma
e. Lymphadenopathy: a. Petichiae
b.Purpura
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a. Iron (ferrous sulfate) drops after age 1 month
b. Iron-fortified commercial formula by age 4 to 6 months
c. Iron-fortified infant cereal by age 2 months
d. Iron-fortified infant cereal by age 4 to 6 months: d. Iron-fortified infant cereal by age 4 to 6
months
42.When both parents have sickle cell trait, which is the chance their children will have sickle cell
anemia?
a. 25%
b. 50%
c. 75%
d. 100%: a. 25%
43.The nurse is conducting a staff in-service on sickle cell anemia. Which describes the
pathologic changes of sickle cell anemia?
a. Sickle-shaped cells carry excess oxygen.
b. Sickle-shaped cells decrease blood viscosity.
c. Increased red blood cell destruction occurs.
d. Decreased adhesion of sickle-shaped cells occurs.: c. Increased red blood cell destruction
occurs. The clinical features of sickle cell anemia are primarily the result of increased red blood cell destruction and obstruction caused by the sickle-shaped red blood cells. Sickled red cells have decreased oxygen-carrying capacity and transform into the sickle shape in conditions of low oxygen tension. When the sickle cells change shape, they increase the viscosity in the area where they are involved in the microcirculation. Increased adhesion and entanglement of cells occurs.
44.Which clinical manifestation should the nurse expect when a child with sickle cell anemia
experiences an acute vasoocclusive crisis?
a. Circulatory collapse
b. Cardiomegaly, systolic murmurs
c. Hepatomegaly, intrahepatic cholestasis
d. Painful swelling of hands and feet; painful joints: d. Painful swelling of hands and feet; painful
joints
45.A school-age child is admitted in vasoocclusive sickle cell crisis. The child's care should
include:
a. correction of acidosis.
b. adequate hydration and pain management.
c. pain management and administration of heparin.
d. adequate oxygenation and replacement of factor VIII.: b. adequate hydration and pain
management.
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46.In which of the conditions are all the formed elements of the blood simul- taneously depressed?
a. Aplastic anemia
b. Sickle cell anemia
c. Thalassemia major
d. Iron deficiency anemia: a. Aplastic anemia
Aplastic anemia refers to a bone marrow-failure condition in which the formed elements of the blood are simultaneously depressed. Sickle cell anemia is a he- moglobinopathy in which normal adult hemoglobin is partly or completely replaced by abnormal sickle hemoglobin. Thalassemia major is a group of blood disorders characterized by deficiency in the production rate of specific hemoglobin globin chains. Iron deficiency anemia results in a decreased amount of circulating red cells.
47.Parents of a hemophiliac child ask the nurse, "Can you describe hemo- philia to us?" Which
response by the nurse is descriptive of most cases of hemophilia?
a. Autosomal dominant disorder causing deficiency in a factor involved in the blood-clotting reaction
b. X-linked recessive inherited disorder causing deficiency of platelets and prolonged bleeding
c. X-linked recessive inherited disorder in which a blood-clotting factor is deficient
d. Y-linked recessive inherited disorder in which the red blood cells become moon-shaped: c. X- linked recessive inherited disorder in which a blood-clotting factor is deficient
48.The nurse is conducting a staff in-service on childhood blood disorders. Which describes the
pathology of idiopathic thrombocytopenic purpura?
a. Bone marrow failure in which all elements are suppressed
b. Deficiency in the production rate of globin chains
c. Diffuse fibrin deposition in the microvasculature
d. An excessive destruction of platelets: d. An excessive destruction of platelets
49.Which is most descriptive of the pathophysiology of leukemia?
a. Increased blood viscosity occurs.
b. Thrombocytopenia (excessive destruction of platelets) occurs.
c. Unrestricted proliferation of immature white blood cells (WBCs) occurs.
d. First stage of coagulation process is abnormally stimulated.: c. Unrestricted proliferation of
immature white blood cells (WBCs) occurs.
50.Myelosuppression, associated with chemotherapeutic agents or some ma- lignancies such as
leukemia, can cause bleeding tendencies because of a(n):
a. decrease in leukocytes.
b. increase in lymphocytes.
c. vitamin C deficiency.
d. decrease in blood platelets.: d. decrease in blood platelets.
51.Which is the most effective pain-management approach for a child who is having a bone marrow
aspiration?
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d. Enlarged, firm, nontender lymph nodes: d. Enlarged, firm, nontender lymph nodes
NON TENDER!NOT PAIN FUL
58.An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed
precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of:
a. air emboli.
b. allergic reaction.
c. hemolytic reaction.
d. circulatory overload.: d. circulatory overload.
59.An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the
bone marrow will be administered by which route?
a. Bone grafting
b. Bone marrow injection
c. IV infusion
d. Intra-abdominal infusion: c. IV infusion
Bone marrow from a donor is infused intravenously, and the transfused stem cells will repopulate the marrow. Because the stem cells migrate to the recipient's marrow when given intravenously, this is the method of administration.
60.The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which
interventions should the nurse plan to implement for this child? (Select all that apply.)
a. Finger sticks for blood work instead of venipunctures
b. Avoidance of IM injections
c. Acetaminophen (Tylenol) for mild pain control
d. Soft tooth brush for dental hygiene
e. Administration of packed red blood cells: b. Avoidance of IM injections
c. Acetaminophen (Tylenol) for mild pain control d. Soft tooth brush for dental hygiene
61.Which should the nurse teach about prevention of sickle cell crises to parents of a preschool
child with sickle cell disease? (Select all that apply.)
a. Limit fluids at bedtime.
b. Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs.
c. Give penicillin as prescribed.
d. Use ice packs to decrease the discomfort of vasoocclusive pain in the legs.
e. Notify the health care provider if your child begins to develop symptoms of a cold.: b. Notify the
health care provider if a fever of 38.5° C (101.3° F) or greater occurs. c. Give penicillin as prescribed. e. Notify the health care provider if your child begins to develop symptoms of a cold.
