MATERNAL AND CHILD NURSING | Prof.

MT Vanguardia

INSTRUCTIONS: Read the questions carefully, answer without hesitation. Shade properly. Do not keep on changing your answer the way you change
your mind when it comes to relationship. If you keep on changing you will just get hurt in the end.

This exam is designed to evaluate the things you have learned in this subject, this is not intended to judge your future whether you’re going to fail in
life or not. Take it easy. Relax. Pause and pray. God loves you, and so do I. I will miss you my dearest nurses. Thank you for inspiring me. Fly high,
do not give up, we will be colleagues soon.

Respiratory Diseases
1. The nurse is teaching the mother of a 5-month-old infant 7. The nurse is assessing a 2 – month old child in the pediatrician’s
diagnosed with bronchiolitis. Which statement by the mother office. Which of the following would indicate an early sign of
indicates that teaching has been effective? respiratory distress?
A."I hope my baby will come home from the hospital." a. The infant is breathing shallowly.
B. "I know that this disease is serious and can lead to asthma." b. The infant has tachypnea.
C. "My baby needs to be cured this time so it won't happen again." c. The infant has tachycardia.
D. "My baby has been sick. This machine helps him breathe d. The infant has bradycardia.

2. Which assessment finding would the nurse identify as abnormal for 8. Which of the following assessments is of greatest concern in a 15
a 4-month-old? – month old that has not been eating well and has had increased
A. The abdominal wall is rising with inspiration. respiratory rate?
B. The respiratory rate is between 30 and 35 breaths/minute a. The patient is lying down and has moderate retractions, low-grade
C. The infant's skin is mottled during examination. fever, and nasal congestion.
D. The spaces between the ribs (intercostal) are delineated during b. The patient is in the tripod position and has diminished breath
inspiration. sounds and a muffled cough.
c. The patient is sitting up and has coarse breath sounds, coughing,
3. Which is the most appropriate nursing diagnosis for a 2-year-old and fussiness.
child with epiglottiditis? d. The patient is restless, crying, has bilateral wheezes and poor
A. Anxiety related to separation from parent feeding.
B. Decreased cardiac output related to bradycardia
C. Ineffective airway clearance related to laryngospasm 9. Which statement is the best response of the nurse to the mother of
D. Impaired gas exchange related to noncompliant lungs a 3 – year old female with drooling, difficulty swallowing and fever of
39C with a suspicion of epiglottitis?
4. A 23-month-old child is brought to the emergency department with a. “A simple blood test will tell us if your daughter has epiglottitis.”
suspected croup. Which assessment finding reflects increasing b. “We will swab your daughter’s throat and send it for culture.”
respiratory distress? c. “We will do a lateral neck x-ray of the soft tissue.”
A. Stridor d. “The diagnosis is made based on your daughter’s signs and
B. Bradycardia symptoms.”
C. Decreased level of consciousness
D. Flushed skin 10. What is the first action of the nurse in the emergency room to a 2
– year old with high fever, dysphagia, drooling, rapid pulse rate and
5. Which laboratory result will provide the health care team with the tachypnea?
most important information regarding the respiratory status of a child a. Prepare for immediate IV placement.
with an acute asthma exacerbation? b. Prepare for immediate respiratory treatment.
a. A CBC. c. Place the child on a stretcher for a thorough physical assessment.
b. An ABG. d. Allow the child to sit in the parent’s lap while awaiting an x-ray.
c. A BUN.
d. A PTT. 11. A nurse is eating in the hospital cafeteria when a toddler at a
nearby table chokes on a piece of food and appears slightly blue.
6. What is the best response of the nurse who were ask by the The appropriate initial action should be to
parents of a 2 – year old child with asthma on the impact of asthma A. Begin mouth to mouth resuscitation
on the child’s future in sports? B. Give the child water to help in swallowing
a. “As long as your child takes prescribed asthma medication, the C. Perform 5 abdominal thrusts
child will be fine.” D. Call for the emergency response team
b. “The earlier a child is diagnosed with asthma, the more significant
the symptoms.” 12. Betty is a 9-year-old girl diagnosed with cystic fibrosis. Which of
c. “The earlier a child is diagnosed with asthma, the better the the following must Nurse Archie keep in mind when developing a
chance the child has of growing out of the disease.” care plan for the child?
d. “Your child should avoid playing contact sports and sports that A. Pulmonary secretions are abnormally thick.
require a lot of running.” B. Elevated levels of potassium are found in the sweat.
C. CF is an autosomal dominant hereditary disorder.
D. Obstruction of the endocrine glands occurs.
 C. "Offer the infant a bottle of formula."
13. Veronica’s parents were told that their daughter needs ribavirin D. "Take the infant for a ride in the car."
(Virazole). This drug is used to treat which of the following?
A. Cystic fibrosis 21. During newborn assessment, the nurse auscultates a
B. Otitis media machinelike heart murmur, wide pulse pressure, periods of apnea,
C. Respiratory syncytial virus (RSV) increased PaCO2, and decreased PO2. You would suspect:
D. Bronchitis a. Pulmonary hypertension
b. Patent Ductus Arteriosus
14. Beta-adrenergic agonists such as albuterol are given to Reggie, a c. Ventricular Septal Defect
child with asthma. Such drugs are administered primarily to do which d. Bronchopulmonary dysplasia.
of the following?
A. Dilate the bronchioles 22. The best response of the nurse to the student nurse who asks if
B. Reduce secondary infections there are medications to treat Kawasaki Disease is:
C. Decrease postnasal drip a. Immunoglobulin G and aspirin.
D. Reduce airway inflammation b. Immunoglobulin G and ACE inhibitors.
c. Immunoglobulin E and heparin.
15. Alice is rushed to the emergency department during an acute, d. Immunoglobulin E and ibuprofen.
severe prolonged asthma attack and is unresponsive to usual
treatment. The condition is referred to as which of the following? 23. The first nursing action to a 2 – month old with Tetralogy of Fallot
A. Status asthmaticus (TOF) who develops severe respiratory distress and becomes
B. Reactive airway disease cyanotic should be to:
C. Intrinsic asthma a. Lay the child flat to promote hemostasis.
D. Extrinsic asthma b. Lay the child flat with legs elevated to increase blood flow to the
heart.
Cardiovascular Diseases c. Sit the child on the parent’s lap, with legs dangling, to promote
venous pooling.
16. Which action should the nurse include in the plan of care for a 2- d. Hold the child in knee-chest position to decrease venous blood
month-old with heart failure? return
A. Allow the infant to rest before feeding.
B. Bathe the infant and administer medications before feeding. 24. The nurse would expect which laboratory finding to an infant with
C. Weigh and bathe the infant before feeding. congestive heart disease of decreased pulmonary blood flow?
D. Feed the infant when he cries. a. Decreased platelet count
b. Polycythemia
17. A 10-month-old infant with tetralogy of Fallot (TOF) experiences a c. Decreased ferritin level
cyanotic episode. To improve oxygenation during such an episode, d. Shift to the left
the nurse should place the infant in which position?
A. Knee-to-chest 25. Which nursing plan would be appropriate in helping to control
B. Fowler's congestive heart failure in a 2 – month old child treated with
C. Trendelenburg's furosemide?
D. Prone a. Promoting fluid restriction.
b. Feeding a low-salt formula.
18. 2During assessment to a child with rheumatic fever, the nurse c. Feeding in semi-Fowler position.
should expect which of the following signs and symptoms? d. Encouraging breast milk.
a. Joint pain in ankles and knees.
b. Negative group A beta streptococcal culture.
c. Large red “bulls eye”–appearing rash. 26. Which statement if made by the mother of male toddler with
d. Stiff neck with photophobia. Rheumatic Fever shows he has good understanding of the care of
the child?
19. Prior to administration of digoxin to an infant with congestive a. “I will apply heat to his swollen joints to promote circulation.”
heart failure to enhance myocardial function, the nurse should assess b. “I will have him do gentle stretching exercises to prevent
which of the following? contractures.”
a. Yellow sclera. c. “I will give him the aspirin that is ordered for pain and
b. Apical pulse rate. inflammation.”
c. Cough. d. “I will apply cold packs to his swollen joints to reduce pain.”
d. Liver function test.
27 In which congenital heart disease would the nurse need to take
20. The nurse is teaching the mother of an infant with tetralogy of upper and lower extremity blood pressure (BP)?
Fallot. The mother asks what to do when her infant becomes very a. Transposition of the great vessels.
blue and has trouble breathing after crying. The nurse should tell the b. Aortic stenosis (AS)
mother: c. Coarctation of the aorta (COA)
A. "Leave the infant alone until the crying stops." d. Tetralogy of fallot (TOF)
B. "Put the infant in the knee-chest position." .
28. During patient teaching to a school – aged female diagnosed with 5. Apply oxygen per nasal cannula to keep oxygen saturations above
valvular disease following Rheumatic Fever, you discuss the child’s 94%.
long-term prophylactic therapy with antibiotics for dental procedures, a. 1, 2, 3 c. 3, 4, 5
surgery, and childbirth. The parents indicate they understand when b. 2, 3, 4 d. 3, 4
they say:
a. “She will need to take the antibiotics until she is 18 years old.” 34. Which of the following actions should be taken to stop the
b. “She will need to take the antibiotics for 5 years after the last bleeding of a child with Hemophilia A who fell and injured a knee
attack.” while playing outside?
c. “She will need to take the antibiotics for 10 years after the last 1. The extremity should be immobilized.
attack.” 2. The extremity should be elevated.
d. “She will need to take the antibiotics for the rest of her life.” 3. Warm moist compresses should be applied to decrease pain.
4. Passive range-of-motion exercises should be administered to the
29. A child born with Down syndrome should be evaluated for what extremity.
associated cardiac manifestation? 5. Factor VIII should be administered.
a. CHD a. 1, 2, 3 c. 3, 4, 5
b. Systemic hypertension b. 2, 3, 4 d. 1, 2, 5
c. Hyperlipidemia
d. Cardiomyopathy 35. Which of the following describe(s) Idiopathic Thrombocytopenic
Purpura (ITP)?
30. During assessment of a 9 – year old female child, the parents 1. ITP is a congenital hematological disorder.
verbalized she has developed spastic movements of extremities and 2. ITP causes excessive destruction of platelets.
trunk and facial grimace and speech disturbance which seems worse 3. Children with ITP have normal bone marrow.
when the child is anxious and does not occur when she is sleeping. 4. Platelets are small in ITP.
The nurse should asks the parents of the child about what recent 5. Purpura is observed in ITP.
illness? a. 1, 2, 3 c. 1, 3, 5
a. Kawasaki Disease b. 2, 3, 4 d. 2, 3, 5
b. Rheumatic Fever
c. Malignant hypertension. 36. Which of the following is/are reason/s to do a spinal tap on a child
d. Atrial fibrillation. with a diagnosis of leukemia?
1. Rule out meningitis.
Hematologic Diseases 2. Assess the central nervous system for infiltration.
3. Give intrathecal chemotherapy.
31. The mother of a 2 – year old boy who has admitted for anemia 4. Determine increased intracranial pressure.
asks the nurse what are to foods to include in his diet to improve his 5. Stage the leukemia.
nutritional status. Which of the following will the nurse recommends? a. 1, 2, 3 c. 1, 2, 4
a. Increase the child’s intake of whole cow’s milk to 32 ounces a day. b. 1, 3, 5 d. 2, 3
b. Increase the child’s intake of meats, eggs, and green vegetables.
c. Increase the child’s intake of fruits, whole grains, and rice. 37. Which interventions should improve the tissue perfusion to a child
d. Increase the number of snacks the child eats during the day. with sickle cell anemia who experience vaso – occlusive crisis?
a. Limiting oral fluids.
32. The nurse is taking care of a child with sickle cell disease. The b. Administering oxygen.
nurse is aware that which of the following problems is (are) c. Administering antibiotics.
associated with sickle cell disease? d. Administrating analgesics.
1. Polycythemia.
2. Hemarthrosis. 38. What information should the nurse explain to the parents of a
3. Aplastic crisis. child with sickle cell disease regarding the reason for a splenectomy?
4. Thrombocytopenia. a. To decrease potential for infection.
5. Splenic sequestration. b. To prevent splenic sequestration.
6. Vaso-occlusive crisis. c. To prevent sickling of red blood cells.
a. 1, 2, 3 c. 3, 4, 5 d. To prevent sickle cell crisis.
b. 2, 3, 5 d. 3, 5, 6
39. Which of the following analgesics is most effective for a child with
33. Which of the following interventions/orders should the nurse sickle cell pain crisis?
question in caring for a 6 – year old child with sickle cell vaso – a. Demerol. c. Morphine.
occlusive crisis? b. Aspirin. d. Excedrin
1. Position the child for comfort.
2. Apply hot packs to painful areas. 40. What information should the nurse teach the family of a child with
3. Give Demerol 25 mg intravenously every 4 hours as needed for sickle cell anemia who is scheduled to have exchange transfusion?
pain. a. The procedure is done to prevent further sickling during a vaso-
4. Restrict oral fluids. occlusive crisis.
b. The procedure reduces side effects from blood transfusions.
c. The procedure is a routine treatment for sickle cell crisis.
d. Once the child’s spleen is removed, it is necessary to do exchange d. This malformation will be corrected with a nonoperative rectal pull-
transfusions. through.

41. Which factors identified by the parent of a child with sickle cell 49. The nurse is providing discharge instructions to the parents of an
anemia as being able to cause a pain crisis indicates a need for infant who has had surgery to open a low imperforate anus. The
further instruction? nurse knows that the discharge instructions have been understood
a. Infection. c. Stress at school. when the child’s parents say:
b. Overhydration. d. Cold environment. a. “We will use an oral thermometer because we cannot use a rectal
one.”
42. Which activity should the nurse suggests to the parent as a safe b. “We will call the physician if the stools change in consistency.”
activity for a child diagnosed with hemophilia? c. “Our infant will never be toilet-trained.”
a. Baseball. c. Soccer. d. “We understand that it is not unusual for our infant’s urine to
b. Swimming. d. Football. contain stool.”

43. Which of the following measures should the nurse teach the 50. Which statement by the parent would be typical for a child being
parent of a child with hemophilia to do first if the child sustains an evaluated for pyloric stenosis?
injury to a joint causing bleeding? a. “The baby is a very fussy eater and just does not want to eat.”
a. Give the child a dose of Tylenol. b. “The baby tends to have a very forceful vomiting episodes at night
b. Immobilize the joint, and elevate the extremity. only.”
c. Apply heat to the area. c. “The baby is always hungry after vomiting so I refeed.”
d. Administer factor per the home care protocol. d. “The baby is happy in spite of getting really upset after spitting up.”

44. A nurse is doing discharge education with a parent who has a 51. What should be included in the plan of care to the parents of an
child with beta-thalassemia (Cooley anemia). The nurse informs the infant with an umbilical hernia?
parent that the child is at risk for which of the following conditions? a. If the hernia has not resolved on its own by the age of 12 months,
a. Hypertrophy of the thyroid. surgery is generally recommended.
b. Polycythemia vera. b. If the hernia appears to be more swollen or tender, seek medical
c. Thrombocytopenia. care immediately.
d. Chronic hypoxia and iron overload. c. To help the hernia resolve, place a pressure dressing over the
area gently.
45. Which test provides a definitive diagnosis of aplastic anemia? d. If the hernia is repaired surgically, there is a strong likelihood that it
a. Complete blood count with differential. will return
b. Bone marrow aspiration.
c. Serum IgG levels. 52. What is the best response of the nurse to an expectant mother
d. Basic metabolic panel. who asks if her new baby will have an umbilical hernia?
a. More often in large infants.
Gastrointestinal Diseases b. In white infants more than in African American infants.
c. Twice as often in male infants.
46. Which intervention takes priority when admitting an infant with d. More often in premature infants.
acute gastroenteritis?
A. Obtaining a stool specimen 53. The nurse is giving discharge instructions to the parent of a 1-
B. Weighing the infant month-old infant with tracheoesophageal fistula and a gastrostomy
C. Offering the infant clear liquids tube. The nurse knows the mother understands the discharge
D. Obtaining a history of the illness teaching when she states:
a. “I will give my baby feedings through the GT but place liquid
47. Which of the following statement indicates understanding about medications in the corner of the mouth to be absorbed.”
the Hirschsprung’s disease? b. “I will flush the GT with 2 ounces of water after each feeding to
a. There is a lack of peristalsis in the large intestine and an prevent the GT from clogging.”
accumulation of bowel contents, leading to abdominal distention. c. “I will clean the area around the GT with every day.”
b. There is excessive peristalsis throughout the intestine, resulting in d. “I will place petroleum jelly around the GT if any redness and
abdominal distention. bleeding develop.”
c. There is a small-bowel obstruction leading to ribbon-like stools.
54. The nurse is caring for a newborn who has just been diagnosed
d. There is inflammation throughout the large intestine, leading to
with trachea-esophageal fistula and is scheduled for surgery. Which
accumulation of intestinal contents and abdominal distention.
should the nurse expect to do in the pre-operative period?
a. Keep the child in a monitored crib, obtain frequent vital signs, and
48. The nurse is caring for a neonate with an anorectal malformation.
allow the parents to visit but not hold their infant.
The nurse notes that the infant has not passed any stool per rectum
b. Administer intravenous fluids and antibiotics.
but the infant’s urine contains meconium. The nurse can make which
c. Place the infant on 100% oxygen via a non-rebreather mask.
assumption?
d. Have the mother feed the infant slowly in a monitored area,
a. The child likely has a low anorectal malformation.
stopping all feedings 4 to 6 hours before surgery.
b. The child likely has a high anorectal malformation.
c. The child will not need a colostomy.
55. Which should be the nurse’s immediate action when a newborn d. “The lip is repaired in the first few weeks of life, but the palate is
begins to cough and choke and becomes cyanotic while feeding? not usually repaired until the child is 18 months old.”
a. Inform the physician of the situation.
b. Have the mother stop feeding the infant, and observe to see if the Genitourinary Diseases
choking episode resolves on its own.
c. Immediately determine the infant’s oxygen saturation, and have 61. 7-year-old Damon has cystitis; which of the following would Nurse
the mother stop feeding the infant. Elena expect when assessing the child?
d. Take the infant from the mother, and administer blow-by oxygen A. Dysuria
while obtaining the infant’s oxygen saturation. B. Costovertebral tenderness
C. Flank pain
56. The nurse is caring for a newborn with esophageal atresia. When D. High fever
reviewing the mother’s history, which would the nurse expect to find?
a. Maternal polyhydramnios. 62. Niklaus was born with hypospadias; which of the following should
b. Pregnancy lasting more than 38 weeks. be avoided when a child has such condition?
c. Poor nutrition during pregnancy. A. Surgery
d. Alcohol consumption during pregnancy. B. Circumcision
C. Intravenous pyelography (IVP)
57. Which of the following nursing actions should be included in the D. Catheterization
plan of care for a 14-month-old whose cleft palate was repaired 12
hours ago? 63. Stefan was diagnosed with secondary vesicoureteral reflux; such
1. Allow the infant to have familiar items of comfort such as a favorite condition usually results from which of the following?
stuffed animal and a “sippy” cup. A. Acidic urine
2. Once liquids have been tolerated, encourage a bland diet such as B. Congenital defects
soup, Jell-O, and saltine crackers. C. Hydronephrosis
3. Administer pain medication on a regular schedule, as opposed to D. Infection
an as-needed schedule.
4. Use a Yankauer suction catheter on the infant’s mouth to decrease 64. When educating parents regarding known antecedent infections
the risk of aspiration of oral secretions. in acute glomerulonephritis, which of the following should the nurse
5. When discharged, remove elbow restraints. cover?
a. 1, 2 c. 1, 4 A. Scabies
b. 1, 3 d. 1, 5 B. Impetigo
C. Herpes simplex
58. What is the best position for a 5 – month old child who had D. Varicella
isolated cleft palate repaired in the immediate post – operative
period? 65. Alaric was diagnosed with minimal-change nephrotic syndrome;
a. Right side-lying. which of the following signs and symptoms are characteristics of the
b. Left side-lying. said disorder?
c. Supine. A. Hypertension, edema, hematuria
d. Prone. B. Hypertension, edema, proteinuria
C. Gross hematuria, fever, proteinuria
59. The nurse is caring for a newborn with a cleft lip and palate. The D. Poor appetite, edema, proteinuria
mother states, “I will not be able to breastfeed my baby.” What is the
best response of the nurse? 66. Preferred nurses at the Nurseslabs Medical Center are about to
a. “It sounds like you are feeling discouraged. Would you like to talk perform a procedure related to a genitourinary (GU) problem to a
about it?” group of pediatric patients. Which of the following groups would find it
b. “Sometimes breastfeeding is still an option for babies with a cleft especially extra stressful?
lip and palate. Would you like more information?” A. Infants
c. “Although breastfeeding is not an option, you have the option of B. Toddlers
pumping your milk and then feeding it to your baby with a special C. Preschoolers
nipple.” D. School-age children
d. “We usually discourage breastfeeding babies with cleft lip and
palate as it puts them at an increased risk for aspiration.” 67. Which of the following organisms is the most common cause of
urinary tract infection (UTI) in children?
60. The best response of the nurse to the parents of a newborn A. Klebsiella
diagnosed with a cleft lip and palate who ask the nurse when will B. Staphylococcus
child’s lip and palate will most likely be repaired? C. Escherichia coli
a. “The palate and the lip are usually repaired in the first few weeks D. Pseudomonas
of life so that the baby can grow and gain weight.”
b. “The palate and the lip are usually not repaired until the baby is 68. Patient S is a sexually active adolescent; which of the following
approximately 6 months old so that the mouth has had enough time instructions would be included in the preventive teaching plan about
to grow.” urinary tract infections?
c. “The lip is repaired in the first few months of life, but the palate is A. Drinking acidic juices
not usually repaired until the child is 3 years old.”
B. Avoiding urinating before intercourse
C. Wearing nylon underwear 77. Which assessment finding would be the nurse’s priority to a child
D. Wiping back to front with a newly applied leg casts who initially feels fine, then starts to
cry and tells the mother that his leg hurts?
69. What is most likely the underlying physiology of primary a. Cast integrity. c. Musculoskeletal integrity.
enuresis? b. Neurovascular integrity. d. Soft-tissue integrity.
A. Psychogenic stress
B. Delayed bladder maturation 78. A spica cast was put on Baby Betty after an unfortunate incident
C. Urinary tract infection to immobilize her hips and thighs; which of the following is the priority
D. Vesicoureteral reflux nursing action immediately after application?
A. Keep the cast dry and clean.
70. Which of the following should be included when developing a B. Cover the perineal area.
teaching plan to prevent urinary tract infection? Select all that apply. C. Elevate the cast.
A. Maintaining adequate fluid intake D. Perform neurovascular checks.
B. Avoiding urination before and after intercourse
C. Emptying bladder with urination 79. Veronica is a 14-year-old girl who wears a brace for structural
D. Wearing underwear made of synthetic material such as nylon scoliosis; which of the following statements indicate effective use of
E. Keeping urine alkaline by avoiding acidic beverages the brace?
F. Avoiding bubble baths and tight clothing A. “I sure am glad that I only have to wear this awful thing at night.”
B. “I’m really glad that I can take this thing off whenever I get tired.”
A. A, C, D C. C, D, F C. “I wonder if I can take the brace off when I go to the homecoming
B. A, C, F D. A, B, C dance.”
D. “I’ll look forward to taking this thing off to take my bath every day.”
71. 12-year-old Caroline has recurring nephrotic syndrome; which of
the following areas of potential disturbances should be a prime 80. Which of the following is the most common permanent disability
consideration when planning ongoing nursing care? in childhood?
A. Body image C. Muscle coordination A. Scoliosis
B. Sexual maturation D. Intellectual development B. Muscular dystrophy
D. Developmental dysplasia of the hip (DDH)
72. The nurse is aware that the following laboratory values support a
diagnosis of pyelonephritis? 81. Among toddlers and children up to age five, femur fractures
A. Myoglobinuria C. Pyuria usually result from a low energy fall. In most cases, the orthopedic
B. Ketonuria D. Low white blood cell (WBC) count surgeon realigns the fracture using fluoroscopy or x-ray imaging as a
guide and immobilizes the leg in a type of cast called a spica cast.
73. Nurse Jeremy is evaluating a client’s fluid intake and output Approximately how many weeks does it take for a fractured femur to
record. Fluid intake and urine output should relate in which way? heal in a 3-year-old?
A. Fluid intake should be double the urine output. A. 2 weeks C. 8 weeks
B. Fluid intake should be approximately equal to the urine output. B. 4 weeks D. 10 weeks
C. Fluid intake should be half the urine output.
D. Fluid intake should be inversely proportional to the urine output. 82. Nurse Cheryl is assessing Fred, a 14-year-old boy who had
scoliosis; besides checking neurologic status directly after Harrington
74. The following are considered functions of the Urinary System rod instrumentation and spinal fusion, she should be regarded with
EXCEPT: which of the following factors?
A. Vitamin D synthesis A. Comfort level C. Physical therapy needs
B. Regulation of red blood cell synthesis B. Dietary tolerance D. Understanding of the procedure
C. Excretion
D. Absorption of digested molecules 83. When a child injures the epiphyseal plate from a fracture, the
damage may result in which of the following?
75. Nurse Kai is evaluating a female child with acute post- A. Rheumatoid arthritis C. Osteomyelitis
streptococcal glomerulonephritis for signs of improvement. Which B. Permanent nerve damage D. Bone growth disruption
finding typically is the earliest sign of improvement?
A. Increased urine output C. Increased energy level 84. Mrs. Lodge’s child requires the use of Pavlik harness; which of
B. Increased appetite D. Decreased diarrhea the following would Nurse Betty do to best assess the mother‘s ability
to care for her child?
Muscular Diseases A. Demonstrate to the mother how to remove and reapply the device.
B. Have the mother remove and reapply the harness before
76. An infant is diagnosed with a congenital hip dislocation. On discharge.
assessment, the nurse expects to note: C. Have the mother verbalize the purpose for using the device.
A. symmetrical thigh and gluteal folds. D. Request a home health care nurse visit after discharge.
B. Ortolani's sign.
C. increased hip abduction. 85. Nurse Kevin is assessing a newborn for developmental dysplasia
D. femoral lengthening. of the hip (DDH); he would expect to assess which of the following?
A. Characteristic limp C. Symmetrical gluteal folds 94. The most common complication associated with
B. Ortolani’s sign D. Trendelenburg‘s signs myelomeningocele is:
a. Learning disability.
86. You have learned that in babies and children with developmental b. Urinary tract infection.
dysplasia (dislocation) of the hip (DDH), the hip joint has not formed c. Hydrocephalus.
normally. Which of the following is the most common form of DDH? d. Decubitus ulcers and skin breakdown.
A. Acetabular dysplasia C. Preluxation
B. Dislocation D. Subluxation 95. The emergency room nurse admits a child who experienced a
seizure at school. The father comments that this is the first
Neurologic Diseases occurrence, and denies any family history of epilepsy. What is the
best response by the nurse?
87. An infant has undergone surgery to remove a myelomeningocele. A. “Do not worry. Epilepsy can be treated with medications.”
To detect increased intracranial pressure (ICP) as early as possible, B. “The seizure may or may not mean your child has epilepsy.”
the nurse should be alert for which of the following postoperative C. “Since this was the first convulsion, it may not happen again.”
findings? D. “Long-term treatment will prevent future seizures.”
A. Decreased urine output C. Bulging fontanels
B. Increased heart rate D. Sunken eyeballs 96. A 4-year-old hospitalized child begins to have a seizure while
playing with hard plastic toys in the hallway. Of the following nursing
88. A 3-month-old with meningococcal meningitis has just been actions, which one should the nurse do first?
admitted to the pediatric unit. Which nursing intervention has the A. Place the child in the nearest bed
highest priority? B. Administer IV medication to slow down the seizure
A. Instituting droplet precautions C. Place a padded tongue blade in the child’s mouth
B. Administering acetaminophen (Tylenol) D. Remove the child’s toys from the immediate area
C. Obtaining history information from the parents
D. Orienting the parents to the pediatric unit 97. Daya’s child is scheduled for surgery due to myelomeningocele;
the primary reason for surgical repair is which of the following?
89. When developing a plan of care for a toddler with a seizure A. To prevent hydrocephalus
disorder, which of the following would be inappropriate? B. To reduce the risk of infection
A. Padded side rails C. To correct the neurologic defect
B. Oxygen mask and bag system at bedside D. To prevent seizure disorders
C. Arm restraints while asleep
D. Cardiopulmonary monitoring 98. Tiffany is diagnosed with increased intracranial pressure (ICP);
which of the following if stated by her parents would indicate a need
90. Which questions if made by the nurse determines orientation to a for Nurse Charlie to reexplain the purpose for elevating the head of
3 – year old female with an altered state of consciousness? the bed at a 10 to 20-degree angle?
a. Name the president of the Philippines. A. Help alleviate headache
b. Identify her parents and state her own name. B. Increase intrathoracic pressure
c. State her full name and phone number. C. Maintain neutral position
d. Identify the current month but not the date. D. Reduce intra-abdominal pressure.

91. Which of the following assessment findings best indicates 99. In diagnosing seizure disorder, which of the following is the most
increased ICP to a 6 – month old infant diagnosed with beneficial?
hydrocephalus? A. Skull radiographs C. Brain scan
a. Sunken anterior fontanel. B. EEG D. Lumbar puncture
b. Complaints of blurred vision.
c. High-pitched cry. 100. The nurse is caring for a toddler with Down syndrome. To help
d. Increased appetite. the toddler cope with painful procedures, the nurse can:
A. prepare the child by positive self-talk.
92. The nurse is aware that cloudy CSF to a child for possible B. establish a time limit to get ready for the procedure.
diagnosis of meningitis most like indicates which of the following? C. hold and rock him and give him a security object.
a. Viral meningitis. D. count and sing with the child.
b. Bacterial meningitis.
c. No infection, as CSF is usually cloudy.
d. Sepsis.
Trust in the Lord with all your heart, and do not lean on your own
93. An infant is born with a sac protruding through the spine. The sac understanding. In all your ways acknowledge him, and he will make
contains CSF, a portion of the meninges, and nerve roots. The nurse straight your paths. Proverbs 3:5-6
knows that this is referred to as:
a. Meningocele. c. Spina bifida occulta. Love you all nurses, but JESUS loves you the most.
b. Myelomeningocele. d. Anencephaly.