NURSING*RADTECH*DENTISTRY*CRIMINOLOGY*MIDWIFERY*MEDTECH

LET*PSYCHOMET*RESPIRATORY THERAPY*CIVIL SERVICE*NAPOLCOM

NCLEX*DHA*HAAD* PROMETRIC* UK-CBT
EVALUATIVE EXAMINATION
PEDIATRIC NURSING
Prepared By: Prof. John Octubre,RN
1. A nurse admits a child to the hospital with a diagnosis c. Administer only high protein fluids
of pyloric stenosis. On admission assessment, which d. Warm fluids before administering them
data would the nurse expect to obtain when asking the 9. A newborn develops cephalhematoma. The nurse
mother about the child’s symptoms? should plan to explain to the mother that:
A.Vomiting large amounts of bile a. The swelling may cross the suture line
B.Watery diarrhea b. The soft sac will bulge when the infant cries
C.Increased urine output c. It will resolve spontaneously in 3-6 weeks
D.Projectile vomiting d. This condition is unusual with vaginal delivery

2.A 3-year-old child is hospitalized because of persistent 10.A lumbar puncture is performed on a child suspected
vomiting. A nurse monitors the child closely for: of having bacterial meningitis. Cerebrospinal fluid is
A.Diarrhea obtained for analysis. A nurse reviews the results of the
B.Metabolic acidosis CSF analysis and determines that which of the following
C.Metabolic alkalosis results would verify the diagnosis?
D.Hyperactive bowel sounds A.cloudy CSF, decreased protein, and decreased glucose
B.cloudy CSF, elevated protein, and decreased glucose
3.A nurse provides home care instructions to the parents C.clear CSF, elevated protein, and decreased glucose
of a child with celiac disease. The nurse teaches the D.clear CSF, decreased pressure and elevated protein
parents to include which of the following food items in
the child’s diet? 11.A home care nurse provides instructions to the
A.Rice mother of an infant with cleft palate regarding feeding.
B.Rye toast Which statement if made by the mother indicates a need
C.Oatmeal for further instructions?
D.Wheat bread A.“I will use a nipple with a small hole to prevent
choking.”
4.A sweat test is performed on a child with a suspected B.“I will stimulate sucking by rubbing the nipple on the
diagnosis of cystic fibrosis. (CF). The nurse reviews the lower lip.”
test results and determines that which of the following is C.“I will allow the infant time to swallow.”
a positive result for CF? D.“I will allow the infant to rest frequently to provide
A.Chloride level of 20 mEq/L time for swallowing what has been placed in the mouth.”
B.Chloride level of 30 mEq/L
C.Chloride level of 40 mEq/L 12.A nurse is caring for a newborn infant with a
D.Chloride level of 70 mEq/L suspected diagnosis of imperforate anus. The nurse
monitors the infant, knowing that which of the following
5.Christopher, 2 months-old, is suspected of having is not a clinical manifestation associated with this
coarctation of the aorta. The cardinal sign of this defect disorder?
is A.The presence of stool in the urine
A.clubbing of the digits and circumoral cyanosis B.Failure to pass a rectal thermometer
B.pedal edema and portal congestion C.Failure to pass meconium in the first 24 hours after
C.systolic ejection murmur birth
D.upper extremity hypertension d. The passage of currant jelly-like stools

6. An infants intestines are sterile at birth, therefore 13.A nurse is gathering supplies in preparation to
lacking the bacteria necessary for the synthesis of administer a tepid bath to a child with a fever. The nurse
a. Prothrombin understands that which of the following items would not
b. Bile salts be needed for the bath?
c. Intrinsic factor A.Washcloths and towels
d. Bilirubin B.A bottle of alcohol
C.Toys
7. On April 16 at 3:45pm, a 34 week 1550gm female D.Lightweight pajamas
infant is delivered to Dina. The infant demonstrates
nasal flaring, intercostals retractions, expiratory grunt, 14.A clinic nurse is assessing a child for dehydration.
and slight cyanosis. An umbilical catheter is inserted with The nurse determines that the child is moderately
IV infusion of 5% Dextrose and water 30cc to run over a dehydrated if which symptom is noted on assessment?
ten hour period. Blood gases and electrolyte studies are A.Flat fontanels
ordered immediately. The premature baby is placed in a B.Moist mucous membranes
heated isolette because: C.Pale skin color
a. The premature infant has a small body surface for D.Oliguria
her
weight 15.A nurse interviews the parents of a child recently
b. Heat increases flow of oxygen to extremities diagnosed with glumerulonephritis. The nurse
c. Temperature control mechanism is immature understands that which information collected during the
d. Heat within the isolette facilitates drainage of assessment is most often associated with the diagnosis
mucus of glumerulonephritis?
A.Streptococcal throat infection 2 weeks prior to
8. The premature infant has a difficulty in concentrating diagnosis
urine and may have large amounts of fluid lost. The B.Child fell off a bike onto the handlebars
nurse caring for Dina’s baby would: C.Nausea and vomiting for the last 24 hours
a. Force fluid every half hour D.Urticaria and itching for 1 week prior to diagnosis
b. Observe color and amounts of urine and
check 16.A nurse is assigned to care for child suspected of
its specific gravity having glumerulonephritis. The nurse reviews the child’s
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record and notes that which finding is associated with 24.A test that is done on all neonates to detect PKU is:
the diagnosis of glumerulonephritis? A.Phenistix test
A.Low blood urea nitrogen (BUN) B.Guthrie blood test
B.Hypotension C.Ferric chloride urine test
C.Low urinary specific gravity D.Clinitest serum phosphopyruvic acid
D.Red-brown urine
25.The cardiac defects associated with tetralogy of Fallot
17.A nurse is developing a plan of care for a 7-year-old include:
child diagnosed with acute glumerulonephritis. The A.Right ventricular hypertrophy, atrial and ventricular
nurse includes which priority intervention in the plan of defects, and mitral valve stenosis
care? B.Origin of the aorta from the right ventricle and of the
A.Encourage limited activity and provide safety pulmonary artery from the left ventricle
measures C.Right ventricular hypertrophy, ventricular septal
B.Catheterize the child to strictly monitor intake and defect, stenosis of pulmonary artery, and overriding
output aorta
C.Force oral fluids to prevent hypovolemic shock D.Abnormal connection between the pulmonary artery
D.Encourage classmates to visit and to keep the child and the aorta, right ventricular hypertrophy, and atrial
informed of school events septal defects

18.A mother brings her 2-week-old infant to a clinic for 26.When observing a newborn with Down syndrome, the
treatment following a diagnosis of clubfoot made at the nurse should be aware that a common defect associated
time of birth. Which of the following statements, if made with this condition is:
by the mother, indicates a need for further education A.Deafness
regarding this disorder? B.Hydrocephaly
A.“I need to bring my infant back to the clinic in 1 C.Muscular hypertonicity
month for a new cast.” D.Congenital heart defect
B.“Treatment needs to be started as soon as possible.”
C.“I need to come to the clinic every week with my 27.The nurse analyzes the laboratory values of a child
infant for the casting.” with leukemia who is receiving chemotherapy. The nurse
D.“I realize my infant will require follow-up care until full notes that the platelet count is 20,000/mm³. On the
grown.” basis of this laboratory result, which intervention will the
nurse document in the plan of care?
19.When performing a physical assessment of a A.Initiative protective isolation precautions
newborn with Down syndrome, the nurse should B.Monitor the temperature every 4 hours
carefully evaluate the infant’s: C.Monitor closely for signs of infection
A.Heart sounds D.Use Toothettes for mouth care
B.Anterior fontanel
C.Pupillary reaction 28.Which of the following definitions best describes the
D. Lower extremities form of clubfoot called talipes equino varus?
A.inversion of the foot
20.A 12-year-old is diagnosed as having idiopathic B.eversion of the foot
scoliosis. Because proper exercise and avoidance of C.plantar flexion
fatigue are essential components of care, the nurse is D.dorsiflexion
aware that the most therapeutic sport for this child
would be: 29.A cleft lip predisposes an infant to infections primarily
A.Golf because of:
B.Bowling A.poor nutrition from disturbed feeding
C.Swimming B.poor circulation of the defective area
D.Badminton C.waste products that accumulate along the defect
D.mouth breathing, which dries the oropharyngeal
21.A 3-month-old infant has been diagnosed as having mucous membranes
congenital hypothyroidism. If care is not instituted until
after early infancy, the child will probably have: 30.The nurse should carefully observe the infant with a
A.Myxedema tentative diagnosis of pyloric stenosis for:
B.Thyrotoxicosis A.quality of cry
C.Some mental retardation B.quality of stool
D.Abnormal deep tendon reflexes C.signs of dehydration
D.coughing and gagging after feeding
22.A 6-year-old has received partial-thickness burns of
the face and chest in a house fire. For the first 24 hours 31. Children with nasal infection usually may have
after hospitalization, the nurse should primarily observe problems of developing otitis media because?
this child for: Eustachian tubes are shorter, narrower
A.Wound sepsis A.The tympanic membranes are more prone to adhere
B.Separation anxiety B.microorganisms
C.Pulmonary distress C.The eustachian tubes in children are shorter and
D.Fluid and electrolyte imbalance horizontal
D.The eustachian tubes in children are longer and sloped
23.An infant is diagnosed a having pyloric stenosis. compared to adults
When palpating this infant’s abdomen, the nurse would
expect to find: 32. Tonya a 6 year-old child is rushed to the ER due to
A.An impacted and distended colon cyanosis after playing with her older sister. She is
B.Marked tenderness around the umbilicus known to have Tetralogy of Fallot since birth. Three of
C.An olive-sized mass in the right upper quadrant the following are congenital defects associated with
D.Rhythmic peristaltic waves in the lower abdomen Tetralogy of Fallot. Which ONE is NOT included?
a. Deviation of the aorta
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b. Stenosis of the mitral valve delivery and not exceed it because of the possibility of
c. Stenosis of the pulmonary artery the child to develop:
d. Intraventricularseptal defect a. ChoanalAtresia
b. RetrolentalFibroplasia
33. A mother arrives at an ER with her 5-year-old child. c. Hypospadias
The mother states that the child fell off a bunk bed. A d. Phenylketonuria
head injury is suspected, and a nurse is assessing the
child continuously for signs of increased intracranial 42. This kind of immunity is acquired resulting form
pressure (ICP). Which of the following would indicate a previous effect of a disease or repeated exposure to
late sign of increased ICP in this child? doses of an organism?
A.Nausea a. Anaphylactic
B.Dilated scalp veins b. Active
C.Bulging fontanel c. Passive
D.Widened pulse pressure d. artificial

34.Most newborns void in the first 24 hrs after birth. 43.The nurse is caring for a child with tetralogy of Fallot
Which of the following may cause a reddish stain 4Aho experiences an episode of acute cyanosis. Which
sometimes called as “red brick dust” on the diaper? of the following is the primary clinical manifestation the
a. Uric acid crystals in the urine nurse will assess?
b. Mucus and urate in the urine a. Loss of consciousness
c. Bilirubin in the urine B.Anxiousness and irritability
d. Excess iron in the urine c. Decreased respiratory rate
d.Decreased pulse rate and blood pressure
35. The nurse is performing a newborn assessment,
which of the following is considered normal? 44.When preparing discharge teaching for a family of a
a. presence of 2 veins and 1 artery in umbilical cord child recovering from rheumatic fever, the nurse’s
b. presence of tuft of hair at the lumbar area of priority instruction is
baby’s A.Parents should inform the school nurse of the child’s
back illness
c. presence of “witch milk” in the breast B.Parents should monitor the child for poor appetite and
d. presence of ortolani’s click growth
C.The child should resume school activities as soon as
36. A nurse assigned in a newborn nursery receives a tolerated
telephone call from the delivery room and is told that a D.The child needs to take prophylactic antibiotics to
newborn with spina bifida (meningomyelocele type) will prevent endocrditis
be transported to the nursery. Which of the following
priority items would the nurse prepares at the newborn’s 45. Wendy, a pediatric nurse gives lecture on
bedside? appropriate games/toys for children among mothers and
A.A specific gravity urinometer. caregivers in the pediatric ward. For 2-year old Raphael,
B.A bottle of sterile normal saline. what kind of toy will she prescribe most likely?
C.A rectal thermometer. a. Colorful and attractive
D.A blood pressure cuff. b. Safe to play by himself
c. Competetive
37. A nurse is reviewing the laboratory results for a child d. Can share with his siblings
scheduled for tonsillectomy. The nurse determines that
which of the following laboratory values is the most 46. Which of the following interventions is a priority for
significant to review? the nurse to implement in the postoperative care of a
A.Creatinine child with a cleft lip repair?
B.BUN A.Encourage the parents to limit their visits to allow the
C.Sedimentation rate child to rest
D.Prothrombin time B.Restrain the child’s arms with blankets to prevent the
rubbing the suture line
38. While assessing a child with coarctation of the aorta, C.Place the child prone to facilitate drainage
the nurse would expect to find which of the following? D.Assess for edema of the tongue, lips and mucus
a. Absent or diminished femoral pulses membranes
b. Cyanotic (“tet”) episodes
c. Squatting posture 47. Which of the following activities will enhance the
d. Severe cyanosis at birth growth and development of a 6-year-old child?
39. The nurse is assessing an 11-month old infant. a. Allow her to explore her surroundings
Which of the following is a normal assessment? b. Allow ample time when toileting
a. tonic-neck reflex c. Have her take care of his sister
b. babinski reflex d. Let her choose the clothes she wants to wear
c. moro reflex
d. rooting reflex 48. Which of the following is the first intervention to
include in the initial postoperative care of an infant
40. The nurse knows which of the following is a normal following a bilateral cleft lip and palate repair?
assessment for an 9-month old infant? A.Maintain nothing by mouth until the incision is sealed
A.infant able to roll over B.Restrain all extremities to prevent rubbing of the face
B.infant crawls and lip
C.infant able to stand alone C.Clean the suture line to prevent formation of crusts
D.infant able to walks with support D.Administer sedation to prevent picking at the incision
site
41. A neonate after delivery is having routine newborn
care. When administering oxygenation to the infant, the 49. The nurse seeks to provide appropriate diversional
nurse knows to take caution with the level of oxygen activities for a school-age child with chorea associated
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with rheumatic fever. The best activity for the nurse to
select would be:
a. Cutting out paper dolls
b. Watching educational television
c. String beads to make necklace
d. Assembling a puzzle

50.A priority nursing diagnosis in the care of a child with

pyloromyotomy is
Ineffective breathing
Trauma
Fluid deficit Imbalanced nutrition: less than body
requirements
Acute pain

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