Peds Final Exam Practice Questions with Answers Latest 2024/2025 Updates, Exams of Pediatrics

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Peds Final Exam Practice Questions with Answers Latest 2024/2025 Updates

1. Water and electrolyte disturbances occur more frequently and more rapidly in children than adults.

In addition, children adjust less promptly to these alterations. Water and electrolyte disturbances are the leading cause of death of children globally. T or F: True

2. Warning signs or "red flags" that warrant an investigation for NAT (non accidental trauma)

include:(select all that apply)

a) any fracture in a child who has learned to walk.

b) any posterior rib fracture.

c) The injury is inconsistant with the explanation of how it occured.

d) multiple fractures at various stages of healing: b) any posterior rib fracture.

c) The injury is inconsistant with the explanation of how it occured.

d) multiple fractures at various stages of healing

3. The Patient Health Questionnaire - 9 (PHQ-9) is a screening tool uses a time frame of two weeks to

assess : levels of depression

4. According to Attachment Theory, children who have developed a trust in their caregivers

availability and responsiveness are categorized as:

a) Secure

b) Resistant

c) Disorganized

d) Avoidant: a) secure

5. In the Syndrome of Inappropriate Antidiuretic Hormone (SIADH) a child will likely

a) be leaking high levels of protien into the urine.

b) viod a very minimal volume of urine and become at risk for seizures related to hyponatremia.

c) void an excessive volume of urine and become at risk for seizures related to hypernatremia

d) have an elevated hemoglobin and hematocrit related to hemoconcentration.

e) be at risk for febrile seizures related to hyperkalemia: b) viod a very minimal volume of urine

and become at risk for seizures related to hyponatremia.

6. A 6 month old infant is being assessed for moderate diarrhea after 2 days of vomiting. Which

physical assessment finding does the nurse expect?

a) Bradycardia

b) Weight gain

c) Buldging posterior fontanel

d) Brisk capillary refill

e) Sunken anterior fontanel: e) Sunken anterior fontanel

7. Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours. The

nurse should further ask the parents if the toddler has which associated factor that may be causing the acute diarrhea:

a) Immunodeficiency

b) Antibiotic therapy

c) Hirschsprung's disease

d) Protein malnutrition: b) Antibiotic therapy

8. Which therapeutic management should the nurse prepare to initiate first for a child with acute

diarrhea and moderate dehydration?

a) Oral rehydration solution (ORS)

b) Antidiarrheal medications such as paregoric

c) Apple juice

d) Adsorbents, such as kaolin and pectin: a) Oral rehydration solution (ORS)

9. A young child is brought to the emergency department with very weak peripheral pulses,

sunken eyes and capillary refill > 4 seconds secondary to acute diarrhea and vomiting. Therapeutic

management of this child should begin with:

a) intravenous (IV) fluids.

b) administration of antidiarrheal medication.

c) clear liquids, 1 to 2 ounces at a time.

d) Oral rehydration solution (ORS): a) intravenous (IV) fluids.

10. Which therapeutic management treatment is implemented for children with Hirschsprung

disease?

a) Daily enemas

b) Low-fiber diet

c) Permanent colostomy

d) Surgical removal of affected section of bowel: d) Surgical removal of affected section of bowel

11. The nurse is explaining to a parent how to care for a school-age child with vomiting

associated with a viral illness. Which action should the nurse include?

a) Brush teeth or rinse mouth after vomiting to decrease contact of hydrochloric acid with tooth enamel.

b) Give nothing by mouth for 24 hours.

c) Give plain water until vomiting ceases for at least 24 hours.

d) Avoid electrolyte-containing liquids.: a) Brush teeth or rinse mouth after vom- iting to

decrease contact of hydrochloric acid with tooth enamel.

12. Which should the nurse include in the plan of care to decrease symptoms of gastroesophageal

reflux disease (GERD) in a 3 month old? Select all that apply.

a) Encourage the parents to burp the infant after every 1-2 ounces consumed.

b) Place the infant in the supine position immediately after feeding to enhance airway opening.

c) Keep the infant in an upright position after feeding.

d) Encourage the parents not to worry since most infants outgrow GERD in the first year of life.

e) Place the infant in the prone position immediately after feeding to decrease the risk of aspiration.:

a) Encourage the parents to burp the infant after every 1-2 ounces consumed. c) Keep the infant in an upright position after feeding.

13. Which clinical manifestation would be the most suggestive of acute appen- dicitis?

a) Bright red or dark red rectal bleeding

b) Abdominal pain that begins in the periumbilical area and then moves to the RLQ of the abdomen.

c) Abdominal pain that is relieved by eating

d) Elevated temperature, elevated WBC count with LLQ abdominal pain: b) Abdominal pain that

begins in the periumbilical area and then moves to the RLQ of the abdomen.

14. When caring for a child with probable appendicitis, the nurse should be alert to recognize that

which condition or symptom is a sign of perforation?

a) Anorexia

b) Decreased abdominal distention

c) Sudden relief from pain

d) Bradycardia: c) Sudden relief from pain

15. Which observation made by the nurse is most indicative of pyloric steno- sis?

a) Abdominal rigidity

c) The infant's lack of hunger.

d) Substernal retraction

e) Very forceful vomiting by the infant

f) Absence of distention over the abdomen: e) Very forceful vomiting by the infant

16. In which condition is "currant jelly" stool (mixing of stool, blood and mucous) found from the

telescoping of one segment of bowel within another is called:

a) Herniation

b) Stenosis

c) Atresia

d) Coarctation of the sigmoid colon.

e) Intussusception: e) Intussusception

17. Which of the following are causes of failure to thrive: (select all that apply)

a) Defective utilization of nutrients

b) Inadequate caloric intake

c) Developmental delay

d) Excessive increase of metabolic rate

e) Inadequate absorption: a) Defective utilization of nutrients

b) Inadequate caloric intake

d) Excessive increase of metabolic rate

e) Inadequate absorption

18. The Nissen fundoplication is...

a) A surgical procedure to treat gastroesophageal reflux

b) The scale used to assess for severe dehydration

c) An electric car

d) A surgical intervention to correct hypospadias

e) A treatment to remove endotoxins in a patient with hemolytic uremic syn- drome: a) A surgical

procedure to treat gastroesophageal reflux

19. Signs of malrotation and volvulous in infants include the following: (select all that apply)

a) Intermittent bilious vomiting

b) An olive-like mass in the left upper quadrant (LUQ.)

c) Abdominal distention

d) Projectile vomiting

e) Lower GI bleeding: a) Intermittent bilious vomiting

c) Abdominal distention e) Lower GI bleeding

20. The nurse is teaching parents about prevention of urinary tract infections in children. Which

factors predispose the urinary tract to infection? (Select all that apply)

a) The use of Deflux

b) Frequent emptying of the bladder

c) Poor self-hygiene

d) Decreased fluid intake

e) Short urethra in young females: c) Poor self-hygiene

d) Decreased fluid intake

e) Short urethra in young females

21. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which

finding in this newborn?

a) The urethral opening is along the underside of the penis.

b) Absence of a urethral opening.

c) The urethra is not attached to the bladder.

d) Penis appears shorter than usual for age.: a) The urethral opening is along the underside of the

penis.

22. A five year old boy has marked pallor, oliguria, and bruising. His BUN and serum creatinine

levels are elevated. The nurse would first consider a diagnosis of:

a) Aguilar Syndrome with hematuria B

b) Group A beta hemolytic Staphylococcus

c) Group A beta hemolytic Streptococcus

d) Hemolytic Uremic Syndrome: d) Hemolytic Uremic Syndrome

23. An eight month old with cryptorchidism had an orchiopexy two days ago. The nurse would

include the following in the discharge instructions: select all that apply

a) The need for a voiding cystourethrogram (VCUG) in one month

b) Directions towards preventing infection

c) Pain control

d) The child should avoid toys that are straddled (one leg on either side) for 2-4 weeks: b)

Directions towards preventing infection

c) Pain control

d)The child should avoid toys that are straddled (one leg on either side) for 2-4 weeks

24. Which explains physiologically the edema formation that occurs with burns?

a) Decreased hydrostatic pressure within capillaries

b) Decreased capillary permeability and shunting

c) Capillary damage and increased capillary permeability

d) Vasoconstriction with oncotic pressure elevation: c) Capillary damage and increased capillary

permeability

25. A child weighing 21 kg arrives in the ED with 30% TBSA full thickness burns. Her lips are not

swollen and her voice is not hoarse. Her eyebrows are not singed. What is the fluid resuscitation volume required for her in the first 24 hours after the injury?

a) Fluid resucitation: 1520 mL,

b) Fluid resucitation: 1850 mL,

c) Fluid resucitation: 1890 mL,

d) Fluid resucitation: 1600 mL,: c) Fluid resucitation: 1890 mL,

26. After the acute stage and during the healing process, the primary compli- cation from burn

injury is:

a) renal shutdown

b) asphyxia

c) infection

d) shock: c) infection

27. A neonate is born with unilateral mild talipes equinovarus (clubfoot). When the parents ask the

nurse how this will be corrected, the nurse should give which explanation?

a) Surgical intervention is needed.

b) Traction is tried first

c) Frequent, serial casting is tried first.

d) Children outgrow this condition when they learn to walk.: c) Frequent, serial casting is tried first.

28. A school nurse is conducting a staff in-service to other school nurses on idiopathic scoliosis.

During which period of child development does idiopath- ic scoliosis become most noticeable?

a) Newborn period

b) When child starts to walk

c) Preadolescent growth spurt

d) Late adolescence: c) Preadolescent growth spurt

29. A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta

(OI). Further teaching is indicated if the parents make which statement?

a) "We will schedule follow-up appointments as instructed."

b) "At what age do children normally grow out of this condition?"

c) "We will lift the baby by the buttocks, not the legs when diapering."

d) "We will be very careful handling the baby.": b) "At what age do children normally grow

out of this condition?"

30. The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical

manifestations will the nurse expect to observe? Select all that apply.

a) Positive Barlow sign

b) Apparent shortening of the femur at the level of the knees when hips are flexed.

c) Negative Pavlik sign

d) Positive Ortolani click

e) Asymmetry of the thigh and gluteal folds: a) Positive Barlow sign

b) Apparent shortening of the femur at the level of the knees when hips are flexed.

d) Positive Ortolani click

e) Asymmetry of the thigh and gluteal folds

31. A school-age child has been admitted to the hospital with an exacerbation of nephrotic

syndrome. Which of the following are clinical signs of nephrotic syndrome: (Select all that apply)

a) Fatigue

b) Weight loss

c) Facial edema

d) A positive ASO titer

e) Frothy-appearing urine: a) Fatigue

c) Facial edema e) Frothy-appearing urine

32. Which is an objective of care for a 10-year-old child with nephrotic syn- drome?

a) Reduce excretion of urinary protein.

b) Increase excretion of urinary protein.

c) Increase heart rate.

d) Increase ability of tissues to retain fluid.: a) Reduce excretion of urinary protein.

33. Which is instituted for the therapeutic management of nephrotic syn- drome?

a) Antihypertensive agents

b) Increased fluids to promote diuresis

c) Long-term diuretics

d) Corticosteroids: d) Corticosteroids

34. A hospitalized child with nephrotic syndrome is receiving high doses of prednisone. Which is

an appropriate nursing goal related to this?

a) Detect evidence of edema.

b) Stimulate appetite.

c) Ensure compliance with prophylactic antibiotic therapy.

d) Prevent infection.: d) Prevent infection

35. Which child is most at risk for developing glomerulonephritis?

a) A 4 year old who had impetigo 2 weeks ago.

b) A 6 year old with new onset type 1 diabetes mellitus.

c) A 5 year old with a history of 4 UTIs in the previous year.

d) An 8 year old recovering from viral pnemonia.: a) A 4 year old who had impetigo 2 weeks

ago.

36. The nurse notes that a child has lost 2.7 kg after 4 days of hospitalization for acute

glomerulonephritis. This is most likely the result of:

a) poor appetite.

b) increased potassium intake.

c) reduction of edema.

d) restriction to bed rest.: c) reduction of edema.

37. Which is the most appropriate nursing diagnosis for the child with acute glomerulonephritis?

a) Fluid Volume Excess related to fluid accumulation in tissues and third spaces

b) Fluid Volume Deficit related to excessive losses

c) Risk for Injury related to malignant process and treatment

d) Fluid Volume Excess related to decreased plasma filtration: a) Fluid Volume Excess related to

fluid accumulation in tissues and third spaces

38. A preschool child is being admitted to the hospital with dehydration and a urinary tract infection

(UTI). Which urinalysis result should the nurse expect with these conditions?

a) WBC <2; specific gravity 1.

b)WBC >2; specific gravity 1.

c) WBC <2; specific gravity 1.

d) WBC >2; specific gravity 1.009: b)WBC >2; specific gravity 1.

39. Which best describes a full-thickness (third-degree) burn?

a) Destruction of all layers of the epidermis and dermis

b) Skin showing erythema followed by blister formation

c) Erythema and pain

d) Destruction injury involving underlying structures

e) such as muscle, fascia, and bone: a) Destruction of all layers of the epidermis and dermis

40. A child is admitted with extensive burns. The nurse notes that there are burns on the child's

lips and singed nasal hairs and eyebrows. The nurse should suspect that the child has a(n):

a) radiation burn.

b) inhalation injury.

c) chemical burn.

d) hot-water scald.

e) electrical burn.: b) inhalation injury.

41. The pathophysiology of vesicoureteral reflux includes: Select all that ap- ply.

a) Urine flow from the bladder to the kidneys.

b) Edema

c) A positive ASO titer

d) Stenosis of the urethra

e) Malfunction of the valves at the distal end of the ureters

f) Hypoproteinemia: a) Urine flow from the bladder to the kidneys.

e) Malfunction of the valves at the distal end of the ureters

42. Which is one of the first signs of overwhelming sepsis in a child with burn injuries?

a) Decreased blood pressure

b) Disorientation

c) Bradycardia

d) Seizures: b) Disorientation

43. The parent of a child diagnosed with Wilm's tumor asks the nurse what the treatment plan will

be. The nurse explains the usual protocol for this condition. What information should the nurse give the parent? Select all that apply.

a) Palpation of the abdomen is to be avoided and then the tumor and the effected kidney will be

removed in surgery.

b) The child will receive radiation treatment and monthly follow up assess- ments for two years.

c) The child will receive chemotherapy and radiation treatments.

d) Palpation of the abdomen is necessary to assess the size and position of the tumor to be

surgically removed.

e) A nephrectomy will be part of the treatment plan: a) Palpation of the abdomen is to be avoided

and then the tumor and the effected kidney will be removed in surgery. e) A nephrectomy will be part of the treatment plan

44. Which condition in a child should alert a nurse for increased fluid require- ments?

a) Fever

b) Increased intracranial pressure (ICP)

c) Hypothermia

d) Congestive heart failure: a) Fever

45. A nurse caring for a child being treated for ALL (Acute Lymphoblastic Leukemia) reviews

this child's most recent lab results? WBC = 5000. Neu- trophils = 8%. Which of the following analysis by the nurse is correct?

a) The absolute neutrophil count is 800 and the child is neutropenic

b) The absolute neutrophil count is 4000 and the child is not neutropenic

c) The absolute neutrophil count is 8000 and the child is not neutropenic

d) The absolute neutrophil count is 400 and the child is neutropenic.: d) The absolute neutrophil

count is 400 and the child is neutropenic.

46. Which of the following is/are (a) major consequence(s) of ALL? (Select all that apply)

a) Hyperbilirubinemia

b) Hemophilia

c) Thrombocytopenia

d) Astrocytoma

e) Anemia

f) Neutropenia: a) Hyperbilirubinemia

e) Anemia

f) Neutropenia

47. A 5 year old is diagnosed with Legg-Calve-Perthes Disease: The USF senior 1 nursing student

demonstrates a good understanding of this disease by stating all of the following: (Select all that apply)

a) The onset is insidious with the child limping

b) This is a self-limiting disease

c) The child will have a positive Gower's sign

d) The use of NSAIDS can provide relief of pain

e) The Pavlik harness is worn for 3-6 weeks to provide adduction positioning-

: a) The onset is insidious with the child limping b) This is a self-limiting disease d) The use of NSAIDS can provide relief of pain

48. Which of the following is part of the preoperative care for a child with scoliosis who is going to

have spinal surgery and the placement of Harrington rods? Select all that apply.

a) Preparation for replacement of potential loss of blood volume

b) Instructions on the use of a PCA

c) Central venous access device (CVAD) placement (Broviac, Portacath, PICC)

d) The use of a thoracolumbosacral orthotic (TLSO) brace (Boston brace is an example of a TLSO

brace.): a) Preparation for replacement of potential loss of blood volume b) Instructions on the use of a PCA d) The use of a thoracolumbosacral orthotic (TLSO) brace (Boston brace is an example of a TLSO brace.)

49. The pathophysiology of a Slipped Capital Femoral Epiphysis is:

a) An inflammatory process that is usually treated with NSAIDs

b) The capital femoral epiphysis is trapped in the acetabulum

c) The movement of the femoral neck stretches the blood vessels of the epiphysis

d) It begins with avascular necrosis: c) The movement of the femoral neck stretches the

blood vessels of the epiphysis

50. Characteristics of the emesis and pattern of vomiting help determine the cause. The color and

consistency of the emesis vary according to the cause. Green bilious vomiting suggests:

a) Bowel obstruction

b) GERD

c) AGE

d) Appendicitis: a) Bowel obstruction

51. What are priorities for a child undergoing abdominal surgery? Select all that apply.

A) Prevent infection

b) Manage pain

c) Assess bowel function

d) Support the child and family with apprepriate teaching

e) Maintain fluid balance

f) Monitor vital signs and interpret them correctly: all of them

52. Daisy weighed 45.5 pounds last week. After 3 days of vomiting and diarrhea she weighs 19.6 kg

today. What is her percent of dehydration?

a) 9%

b) 7%

c) 3%

d) 5%: d) 5%

53. Oscar weighs 12 kg and is assessed to be moderately (6%)

dehydrated after 1 day of vomiting and diarrhea.You as the nurse would instruct his parent that he should take oral rehydration solution (ORS) in the next 4 hours:

a) 800 mL

b) 1200 mL

c) 600 mL

d) 400 mL: b) 1200 mL

54. The first priority for parents immediately following accidental ingestion of a toxic substance by a

child at home is:

a) Administer syrup of Ipecac to induce vomiting.

b) Have the child drink water.

c) Have the child drink milk.

d) Call the poison control hot line.

e) Go to the emergency department.: d) Call the poison control hot line.

55. The nurse's primary legal responsibility when suspecting abuse (NAT) is:

a) Document the child's physical assessment finding accurately b )Refer the family to the hospital support group

c) Report the case to the appropriate authorities

d) Identify family resources for support: c) Report the case to the appropriate authorities

56. Hypoglycemeia is an acute danger in children with Type 1 diabetes melli- tus. What are the

signs of hypoglycemia in children? Select all that apply

a) Polyuria

b) Slurred speech

c) Polydipsia

d) Hunger

e) Sweating

f) Confusion: b) Slurred speech

d) Hunger

e) Sweating

f) Confusion

57. In Hemolytic Uremic Syndrome the nurse would expect which of these lab results: select all that

apply.

a) Hemoglobin and hematocrit low

b) BUN low. Serum creatinine low

c) Platelet count low

d) INR elevated: a) Hemoglobin and hematocrit low

c) Platelet count low

58. Which of the following is a treatment for a child with Hemolytic Uremic Syndrome who has

been anuric (no urine output) for 24 hours:

a) Platelet transfusion

b) IV antibiotics

c) Dialysis

d) IVIG infusion: c) Dialysis

59. Which of the following are clinical manifestations of Anorexia Nervosa: (Select all that apply)

a) Severe and profound weight loss

b) Sinus bradycardia

c) Low body temperature

d) Hypertension: a) Severe and profound weight loss

b) Sinus bradycardia

c) Low body temperature

60. Which of the following questions are used when assessing for Anorexia Nervosa: (Select all

that apply)

a) Do you worry that you have lost control over how much you eat?

b) Do thought and fears about food and weight dominate your life?

c) Do you make yourself sick because you feel uncomfortably full?

d) Do you believe yourself to be too thin when others say you are not?: a) Do you worry that you

have lost control over how much you eat?

b) Do thought and fears about food and weight dominate your life?

c) Do you make yourself sick because you feel uncomfortably full?

61. Which of the following is characteristic of Attention-Deficit-Hyperactivity Disorder (ADHD)

a) Distractibility to external stimuli

b) Seeing one task through to completion

c) Overachievement in school performance

d) Developmentally appropriate at following instructions: a) Distractibility to external stimuli

62. Which drug kills 6.5 times more children than any other illicit drug?

a) Alcohol

b) Cocaine

c) Tobacco

d) Narcotics: a) Alcohol

63. During long-term management of substance abuse in adolescence, which of the following are

goals: (Select all that apply)

a) Punitive treatment towards correction

b) Determine the function that the drug plays in the adolescent's life

c) Exploring factors that influence drug use

d) Establish feelings of self-worth and a commitment to self-help.: b) Determine the function that

the drug plays in the adolescent's life

c) Exploring factors that influence drug use

d) Establish feelings of self-worth and a commitment to self-help.

64. Which of the following is the most common serious opportunistic infection in children with

human immunodeficiency virus (HIV)?

a) Pneumocystis carinii pneumonia

b) Endocarditis

c) Encephalitis

d) Meningitis: a) Pneumocystis carinii pneumonia

65.An inguinal hernia occurs when protrude through the inguinal canal and into

the .: - abdominal contents

• groin area

66. A 4 month old comes to the ED. The heart rate is 204 and her blood pressure is 58/38. The

anterior fontanel is sunken. The USF nursing student notes that this baby does not cry when the IV is inserted. The child's parents state she has not "held anything down" for 18 hours. A finger-stick shows a blood glucose of 84. What should the nursing student expect will be the immediate intervention?

a) Administer a 20 mL/kg bolus of D10W

b) Offer the child an oral rehydrating solution

c) Administer a 10 mL/kg bolus of D5Normal Saline (D5NS)

c) Administer a 20 mL/kg bolus of Normal Saline: c) Administer a 20 mL/kg bolus of Normal Saline

67. The weakest point of long bones in children is the growth plate (physis). Consequently this is a

frequent site of damage in childhood trauma. Factures involving the growth plate and the epiphysis are classified with:

a) The Salter-Harris classification system

b) The Periosteal classification system

c) The Greenstick classification system

d) The Buckle/Torus classification system: a) The Salter-Harris classification system

68. A USF Senior 1 nursing student is caring for 6 year old Lizelle, an ALL patient with fever and

neutropenia. The student is telling Lizelle how much she is studying for the pediatric exam when Lizelle asks "Which of the following are part of neutropenic precautions? Please select all that apply. That is my favorite type of question."

a) Fresh flowers are not allowed in the room

b) Private negative pressure room

c) Limiting the number of peripheral blood draws or IV starts

d) No raw foods allowed in the room

e) Visits from elementary school siblings: a) Fresh flowers are not allowed in the room

c) Limiting the number of peripheral blood draws or IV starts

d) No raw foods allowed in the room

69. A 7-year-old child presents to the pediatric clinic, with her mother, com- plaining of

progressively worsening headache and clumsiness. Her mother complains that her daughter has been "tripping over her own feet". She has also been complaining that "her head really hurts". Her mother states that she has been more lethargic lately. She has been nauseous and has been vomiting, more so in the mornings. This presentation could indicate:

a) a brain tumor in the prefrontal cortex

b) a brain tumor in the parietal region

c) a brain tumor in the cerebellum

d) a brain tumor in the temporal region: c) a brain tumor in the cerebellum

70. After the surgical removal of a brain tumor, what position should the child be placed in?

a) always in the prone position

b) operative side of the skull down

c) operative side of the skull up

d) child's postion of comfort: c) operative side of the skull up

71. When caring for children in the spirit of the Jesuit Tradition the nurse should be conscious

of: select all that apply

a) Trying to be a healing presence

b) How prestigious their position is

c) Being a person for and with others.

d) Cura Personalis: a) Trying to be a healing presence

c) Being a person for and with others.

d) Cura Personalis