1. The mother of a 6-year-old boy is concerned that her child is much
smaller than the other children in the class. Despite adequate appetite he
seems to lose weight and often indicates abdominal pain. His mother reports
foul smelling stools. Which health problem is most likely causing
these symptoms?
A Type 1 diabetes mellitus.
B Cushing syndrome.
C Celiac disease.
D Hypothyroidism.
2. After assessing a newborn the nurse decides to notify the health care
provider to report dislocated hips. What did the nurse assess in this client?
A A shortened leg.
B Flexed extremities.
C Lack of leg movement.
D Legs shorter than arms.
3. The nurse is making a home visit to a family with an 18-month-old
toddler. Which observation should the nurse consider as expected
development for the toddler?
A Talks in 1 to 2 sentences.
B Draws a circle.
C Turns book pages one at a time.
D Eats with a spoon.
4. The nurse is caring for a newborn with a bulging anterior fontanel. Which
statement regarding this observation is correct?
A The bulging is due to physiological compression of the skull during the
delivery.
B The baby is most likely delivered through vacuum extraction.
C The mother of the baby experienced diabetes during pregnancy.
D The baby has abnormal fluid accumulation in the skull.
5. The school nurse is planning disease prevention strategies for the
upcoming school year. Which strategy should be included for female
students between the ages of 10 and 13?
A Screen for scoliosis.
B Instructions on menstruation.
C Instructions on birth control measurements.
D Importance of obtaining vaccination with IPV (Inactivated Poliovirus).
6. A child with cystic fibrosis needs chest physiotherapy at home. After
teaching the parents the procedure which statement indicates that
instruction has been effective?
A “We should do chest physiotherapy after meals.”
B “We should do chest physiotherapy before meals.”
C “We should do chest physiotherapy every 2 hours.”
D “We should do chest physiotherapy before bedtime.”
7. The nurse is reassessing an infant with plagiocephaly. Which
observation indicates that this disorder is improving?
A The infant’s head is less flat.
B The infant’s neck is less twisted.
C The infant’s neurological symptoms are improving.
D The infant’s upper lip has healed.
8. During a routine health visit the nurse suspects a 2-month-old infant is
experiencing hypothyroidism. What did the nurse assess in the infant?
A Constant crying.
B Rapid heart rate.
C Cool extremities.
D Rapid arm and leg movements.
9. The mother of a toddler is concerned that the child is becoming
antisocial because the child does not play with other children but will sit
next to another child and play alone. What should the nurse respond to this
mother’s concern?
A This is called parallel play and is expected.
B This is called creative play and should be limited.
C This is called isolated play and should be investigated.
D This is called independent play and should be discouraged.
10. A toddler is diagnosed with amblyopia. What should the nurse plan to
instruct the parents about the care of the toddler with this health problem?
A Teach the child to limit eye movements.
B Schedule for surgery to correct the problem.
C Plan to use an eye patch for 2 to 6 hours every day.
D Treatment does not begin until the child is 7 years old.
11. The nurse is instructing the parents of an infant with congenital hip
dysplasia on the use of a Pavlik harness. Which statement indicates
teaching has been effective?
A “Each morning, I should soak the harness in warm water and let it air dry.”
B “I can only take off the harness to change the baby’s diaper.”
C “I should put on the harness every night before the baby goes to sleep.”
D “I should dress the baby in a bodysuit underneath the harness.”
12. The nurse is concerned that a preschool age child is demonstrating
signs of cerebral palsy. What did the nurse assess in this client?
A Scissor gait.
B Hops on 1 foot.
C Balances on 1 foot.
D Catches a ball with 2 hands.
13. A school-age child is prescribed phenytoin (Dilantin) to control
seizures. What should the nurse instruct the parents regarding this
medication?
A Avoid sunlight.
B Monitor vision because of night blindness.
C Take the child for frequent dental checkups.
D Restrict food products with calcium and vitamin D.
14. An infant with pyloric stenosis is prescribed potassium in 0.9% normal
saline infusion. The nurse is providing this infusion to prevent
complications related to which health problem?
A Spasticity.
B Polyuria.
C Few stools.
D Repeated vomiting.
15. A school-age child receiving chemotherapy for acute lymphocytic
leukemia (ALL) is placed in protective isolation. What should the nurse
explain as the purpose of the isolation to the client and family?
A Protect the client from developing an infection.
B Reduce the need for more chemotherapy medication.
C Facilitate the body’s use of the chemotherapy medication.
D Protect the staff and visitors from contracting ALL.
16. The nurse is instructing the parents of a 12-year-old girl diagnosed with
asthma on the use of inhaled corticosteroids. Which statement indicates
teaching has been effective?
A “This medication should be used only in case of an exacerbation.”
B “This medication may be addictive if used for long periods in a row.”
C “The steroids in this medication may cause acne.”
D “This medication may cause oral yeast infections.”
17. A preschool-age child recovering from rheumatic heart disease
develops pulmonary venous congestion. What will the nurse most likely
assess in this client?
A Weight gain and ascites.
B Tachypnea and wheezing.
C Tachycardia and weak pulses.
D Slow weight gain and diaphoresis.
18. The nurse is counseling the parents of a newborn with bilateral
cryptorchidism on the need for orchiopexy surgery. Which statement
regarding this condition is correct?
A It is recommended to wait 4 to 6 months and see if this condition resolves
spontaneously.
B The surgery will reverse the risk of reduced fertility completely.
C The baby needs surgery immediately to prevent testicular cancer later in
life.
D The baby will need hormonal replacement therapy until the surgery.
19. The nurse is preparing to assess a 3-month-old infant who is currently
asleep. Which part of the assessment should the nurse complete at this
time?
A Eyes and ears.
B Nose and throat.
C Heart and lung sounds.
D Musculoskeletal system.
20. A 6-year-old child is diagnosed with the 5th disease. Which statement
made by the mother indicates teaching about this infection has been
effective?
A “The infection is the aftermath of a recent vaccination and will resolve
spontaneously.”
B “I cannot bring my child to day care until the rash has completely
dissolved.”
C “My child needs antibiotics for 7 days.”
D “I should not be surprised if the rash lasts weeks to months.”
21. The nurse is instructing the mother of a child diagnosed with
chickenpox. Which complication should be discussed with the mother?
A Risk of the scarring of the mitral and aortic valve.
B Risk of secondary bacterial infection.
C Risk of anaplastic anemia.
D Risk of Guillain-Barré disease.
22. During a home visit the nurse is concerned that a school-age child with
type 1 diabetes mellitus is at risk for hypoglycemic episodes. What did the
nurse observe in the home environment?
A The child was eating large portions of potato chips.
B The child was having dinner one hour after an afternoon snack.
C The child was outside playing for several hours without a snack.
D The child was watching television and playing on the computer for several
hours.
23. The nurse is instructing about cow milk allergy to the parents of a 3-
month-old infant diagnosed with this condition. Which statement should
the nurse include while teaching these parents?
A “Exclusively breast feeding the infant will solve the problem.”
B “Soy based formula is a good alternative for the child.”
C “Lactase supplements will help the infant digest milk products better.”
D “The child is likely to outgrow the allergy in the next couple of years.”
24. The nurse is providing postoperative care to a child with a perforated
appendix. What should be included in the client’s plan of care?
A Provide plenty of fluids to promote hydration.
B Administer parenteral antibiotics for 7 days as prescribed.
C Start with clear liquids and progress to low residue diet.
D Promote activity and prepare for discharge in 2 days.
25. The mother of a one-year-old boy tells the nurse that her child gets very
upset whenever she leaves the house to go to work. The nurse explains
this is part of normal behavior and will change gradually as the boy
develops which developmental behavior(s)?
A Sense of object permanence.
B Sense of purpose and guilt.
C Language and vocabulary skills.
D Ability to walk independently.
26. The nurse is caring for an infant with a patent ductus arteriosus (PDA).
Which statement regarding this condition is incorrect?
A This is an acyanotic congenital heart condition.
B The infant’s caloric requirements are higher than normal.
C Prostaglandin E1 therapy is indicated.
D A machine like murmur can be heard over the heart.
27. A newborn is diagnosed with respiratory distress syndrome. Which
assessment findings are consistent with this diagnosis? Select all that
apply.
A Edema.
B Jaundice.
C Retractions.
D Normal heart rate.
E Respiratory rate 30.
28. A six-year-old client is recovering from a cardiac catheterization and
will be returning home in a few hours. What should the nurse instruct the
parents about the client’s care?
A Restrict oral fluids for 5 days.
B Encourage quiet play for 24 hours.
C Expect bleeding at the site for 3 days.
D Keep on bed rest for 48 hours at home.
29. A 1-year-old child drowns in the backyard wading pool. Which action
should be performed first to help this child?
A Defibrillation.
B Gradually rewarm the child.
C Apply 100% oxygen via face mask.
D Initiate cardiopulmonary resuscitation.
30. While auscultating heart sounds of a 4-year-old client the nurse notes a
faster rate with inspiration than expiration. What should the nurse
document as the finding from this assessment?
A Murmur.
B Sinus arrhythmia.
C Split heart sound.
D Third heart sound.
31. After a barium enema an infant’s intussusception is resolved. What
should the nurse explain to the parents regarding this outcome?
A The procedure decompressed the stomach.
B The anesthesia for the procedure relaxed the bowel.
C The enema corrected the location of the bowel in the abdominal cavity.
D Hydrostatic pressure from the contrast moved the bowel back into place.
32. A school-age child with a sore throat has a positive throat culture for
streptococcus. The parents do not want the child to have antibiotics. What
should the nurse respond to the parents?
A Provide the child with aspirin if a fever occurs.
B Keep the child out of school until the sore throat heals.
C Ensure the child drinks plenty of fluids and gets adequate rest.
D Untreated streptococcal infection can lead to rheumatic heart fever.
33. The nurse is caring for a child recovering from surgery to correct
pyloric stenosis. Which nursing diagnoses has the highest priority at this
time?
A Altered nutrition.
B Risk for aspiration.
C Increased body temperature.
D Fluid volume deficit.
34. A school-age child recovering from a lumbar puncture wants to know
why bedrest is needed for several hours after the procedure. What should
the nurse explain to the client?
A Bedrest will prevent the development of a spinal headache.
B Bedrest ensures that the blood pressure stays within normal limits.
C Bedrest is needed until the anesthesia from the procedure wears off.
D Bedrest will reduce the need for medication to control pain at the lumbar
insertion site.
35. During the assessment of a preschool-age child whose parents are
from China the nurse notes perfectly round red circles on the entire
abdominal region. What should the nurse do about this finding?
A Document the findings as an abnormal rash.
B Discuss the markings with the child’s parents.
C Ask the child how long physical abuse has been occurring.
D Photograph the markings for submission with a police report.
36. During a home visit the nurse is concerned that a family with two
preschool-age children could be at risk for Lyme disease. What did the
nurse observe during the visit?
A Squirrels climbing up and down the trees.
B Red birds and wild canaries made nests in the backyard trees.
C Wild deer walking through the yard and drinking from the birdbath.
D Children wearing long sleeved shirts and long pants outdoors while
playing.
37. The nurse is instructing a newly graduate nurse on the care of a child
diagnosed with sickle cell anemia and admitted for vaso-occlusive crisis.
What should not be included in the teaching?
A “Never palpate the child’s abdomen during a crisis.”
B “Promoting tissue oxygenation is the main nursing objective during the
crisis.”
C “Long term oxygen supply is needed to reduce sickling of the red blood
cells.”
D “Prophylactic antibiotics are indicated until the child turns 5 years old.”
38. During a home visit the nurse learns that a school-age child has head
lice. What should the nurse instruct the parents on the treatment that the
child will need for this infestation?
A An insecticide should be sprayed inside of the home.
B Bed linen should be washed in cold water and permitted to air dry.
C The best treatment is to shave all of the hair off of the child’s head.
D A pediculicide shampoo is needed immediately and again in 7 to 10 days.
39. The nurse is preparing to administer gentamicin sulfate (Garamycin) to
a school-age child who weighs 77 lbs. The prescription is for 7 mg/kg/day
in 3 divided doses. How many milligrams of the medication will the nurse
provide for each dose?
40. The mother of a 6-month-old baby with an inguinal hernia is concerned
because the baby continues to vomit. The baby’s abdomen is getting large
and hard and stools are streaked with blood. What should the nurse
instruct the mother at this time?
A Place a warm towel on the baby’s abdomen.
B Roll the baby on the tummy and rub the back.
C Take the child to the nearest emergency room.
D Give the baby small sips of a carbonated beverage.
41. While visiting a school-age child recovering from acute
glomerulonephritis in the home the nurse decides to talk with the mother
about the child’s fluid intake. What did the nurse assess in the child?
A General malaise.
B Open sore over the left elbow region.
C Periorbital edema and expiratory crackles.
D Half eaten fresh orange and a glass of milk.
42. During an assessment the nurse is concerned that an 8 month old
infant being treated for gastroesophageal reflux disease is experiencing a
side effect from the prescribed medication ranitidine (Zantac). What did the
nurse assess in the infant?
A Rash.
B Runny diarrhea.
C Swollen tongue.
D Tea-colored urine.
43. The parents of a 5-year-old child diagnosed with acute postinfectious
glomerulonephritis ask the nurse how a throat infection caused a problem
with the kidneys. What should the nurse explain to the parents?
A The infection reduced the child’s intake of fluid and caused kidney damage.
B The infection caused an immune response that changed the kidney’s ability
to function.
C The infection attacked the tissue of the kidneys altering the way water and
salt is filtered.
D The infection started in the kidneys and traveled to the throat region where
it was identified.
44. A school-age child will be hospitalized for several weeks for
chemotherapy to treat leukemia. What should the nurse encourage that will
support the child’s developmental stage?
A Explain that the child is not responsible for the illness.
B Give both written and verbal instructions about the treatment.
C Suggest parents visit frequently to reduce the onset of stranger anxiety.
D Have school work brought to the hospital for the child to complete while
hospitalized.
45. The nurse suspects that a 4-year-old child might be suffering from
growth hormone deficiency. Which finding is most consistent with this
diagnosis?
A Child’s weight and height have dropped below the 5th percentile.
B Radiographic examination shows retarded bone maturation.
C Child has short stature and developmental delays.
D Child’s height has dropped 3 percentile points.
46. The school nurse is discussing health issues with a female adolescent
student with von Willebrand’s disease. What complaint should the nurse
expect the student to make about the disorder?
A Back pain.
B Trunk obesity.
C Short in stature.
D Excessive menstrual bleeding.
47. A school-age child with osteomyelitis is in transmission-based
precautions and wants to see his family. The child’s younger brother
arrives to visit the client. What should the nurse do?
A Instruct the younger brother to call the client on the telephone.
B Assist the younger brother to apply personal protective equipment.
C Bring the client out to the family lounge to meet with the younger brother.
D Place a chair at the doorway for the younger brother to sit and talk with the
client.
48. The nurse is concerned that a 1-year-old child is experiencing repeated
impetigo infections. What should the nurse do?
A Apply zinc oxide to the lesions twice a day.
B Instruct the mother to gently pick off the crusted lesion.
C Assess the mother as a nasal carrier of Staphylococcus aureus.
D Wash all of the child’s clothing and bed linen in cold water and air dry.
49. A 9-year old child weighing 88 lbs. is prescribed doxycycline hyclate
(Vibramycin) 4 mg/kg/day in 2 divided doses. The medication available is 50
mg/mL. How many mL of the medication will the nurse provide the client
for each dose?
50. A 4-month-old baby has seborrheic dermatitis lesions on the axillae and
antecubital fossa. How should the nurse instruct the child’s mother to care
for these lesions?
A Wash the areas with baby shampoo.
B Wash the areas with soap and hot water.
C Wash the areas with selenium sulfide shampoo.
D Wash the areas with cool water and cover with gauze dressings.
51. The nurse is instructing the parents of a toddler on positive discipline
techniques. What will the nurse include in this teaching?
A Discuss the use of paddling as a form of discipline.
B Provide structure that encourages positive behaviors.
C Identify which parent is the most threatening to the child.
D Explain how discipline is not healthy and should be avoided.
52. While visiting a family with a newborn the nurse notes the activity of
another child who is 4 years old. The nurse suggests that the parents have
the child evaluated for muscular dystrophy. What did the nurse observe?
A Child performed Gowers’ maneuver.
B Child has genu valgum.
C Child pushed a table chair with both arms.
D Child bended over when fixing socks and tying shoes.
53. The nurse learns that a 7-year-old child with asthma uses a short-acting
beta2-agonist every morning before leaving the home to go to school. What
does this finding suggest to the nurse?
A Asthma is well-controlled.
B Asthma is not well-controlled.
C The client needs to take more of the medication.
D The medication should be taken after arriving to school.
54. The parents of a preschool-age child are concerned that the child is
dehydrated after having diarrhea for several days. The emergency room
nurse notes that the child is pale and breathing rapidly. What does this
finding indicate to the nurse?
A The child also suffers from a respiratory infection.
B The child is developing metabolic alkalosis.
C The child is scared and uncomfortable in the new environment.
D The child has lost too much bicarbonate because of the diarrhea.
55. The mother of a toddler asks the nurse when it would be appropriate to
begin toilet training. What should the nurse suggest to the mother?
A Toilet training should never be attempted before the age of 4.
B The best time for toilet training is right before starting kindergarten.
C Toilet training can begin when the child walks well and can pull pants up
and down.
D Most children learn potty training by the age of 2 so it is best to begin as
soon as possible.
ANSWERS:
1. C
2. A
3. D
4. D
5. A
6. B
7. A
8. C
9. A
10. C
11. D
12. A
13. C
14. D
15. A
16. D
17. B
18. A
19. C
20. D
21. B
22. C
23. D
24. B
25. C
26. C
27. A,D
28. B
29. D
30. B
31. D
32. D
33. B
34. A
35. B
36. C
37. C
38. D
39. 82mg
40. C
41. C
42. A
43. B
44. D
45. D
46. D
47. B
48. C
49. 1.6mL
50. C
51. B
52. A
53. B
54. D
55. C
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