1. Andrea with suspected rheumatic fever is admitted to the pediatric unit. When obtaining the child’s
history, the nurse considers which information to be most important?
a. A fever that started 3 days ago
b. Lack of interest in food
c. A recent episode of pharyngitis
d. Vomiting for 2 days
2. Nurse Liza is administering a medication via the intraosseous route to a child. Intraosseous drug
administration is typically used when a child is:
a. Under age 3
b. Over age 3
c. Critically ill and under age 3
d. Critically ill and over age 3
3. When assessing a child’s cultural background, the nurse in charge should keep in mind that:
a. Cultural background usually has little bearing on a family’s health practices
b. Physical characteristics mark the child as part of a particular culture
c. Heritage dictates a group’s shared values
d. Behavioral patterns are passed from one generation to the next
4. While examining a 2-year-old child, the nurse in charge sees that the anterior fontanel is open. The
a. Notify the doctor
b. Look for other signs of abuse
c. Recognize this as a normal finding
d. Ask about a family history of Tay-Sachs disease
5. The nurse is aware that the most common assessment finding in a child with ulcerative colitis is:
a. Intense abdominal cramps
b. Profuse diarrhea
c. Anal fissures
d. Abdominal distention
6. When administering an I.M. injection to an infant, the nurse in charge should use which site?
d. Vastus lateralis
7. A child with a poor nutritional status and weight loss is at risk for a negative nitrogen balance. To help
diagnose this problem, the nurse in charge anticipates that the doctor will order which laboratory test?
a. Total iron-binding capacity
c. Total protein
d. Serum transferring
8. When developing a plan of care for a male adolescent, the nurse considers the child’s psychosocial
needs. During adolescence, psychosocial development focuses on:
a. Becoming industrious
b. Establishing an identity
c. Achieving intimacy
d. Developing initiative
9. When developing a plan care for a hospitalized child, nurse Mica knows that children in which age
group are most likely to view illness as a punishment for misdeeds?
b. Preschool age
c. Scholl age
10. Nurse Taylor suspects that a child, age 4, is being neglected physically. To best assess the child’s
nutritional status, the nurse should ask the parents which question?
a. “Has your child always been so thin?”
b. “Is your child a picky eater?”
c. “What did your child eat for breakfast?”
d. “Do you think your child eats enough?”
11. A female child, age 2, is brought to the emergency department after ingesting an unknown number
of aspirin tablets about 30 minutes earlier. On entering the examination room, the child is crying and
clinging to the mother. Which data should the nurse obtain first?
a. Heart rate, respiratory rate, and blood pressure
b. Recent exposure to communicable diseases
c. Number of immunizations received
d. Height and weight
12. A mother asks the nurse how to handle her 5-year-old child, who recently started wetting the pants
after being completely toilet trained. The child just started attending nursery school 2 days a week. Which
principle should guide the nurse’s response?
a. The child forgets previously learned skills
b. The child experiences growth while regressing, regrouping, and then progressing
c. The parents may refer less mature behaviors
d. The child returns to a level of behavior that increases the sense of security.
13. A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child’s
vision, the nurse should ask:
a. “Do you have any problems seeing different colors?”
b. “Do you have trouble seeing at night?”
c. “Do you have problems with glare?”
d. “How are you doing in school?”
14. During a well-baby visit, Jenny asks the nurse when she should start giving her infant solid foods.
The nurse should instruct her to introduce which solid food first?
b. Egg whites
c. Rice cereal
15. To decrease the likelihood of bradyarrhythmias in children during endotracheal intubation,
succinylcholine (Anectine) is used with which of the following agents?
a. Epinephrine (Adrenalin)
b. Isoproterenol (Isuprel)
c. Atropine sulfate
d. Lidocaine hydrochloride (Xylocaine)
16. A 1 year and 2-month-old child weighing 26 lb (11.8 kg) is admitted for traction to treat congenital
hip dislocation. When preparing the patient’s room, the nurse anticipates using which traction system?
a. Bryant’s traction
b. Buck’s extension traction
c. Overhead suspension traction
d. 90-90 traction
17. Mandy, age 12, is 7 months pregnant. When teaching parenting skills to an adolescent, the nurse
knows that which teaching strategy is least effective?
a. Providing a one-on-one demonstration and requesting a return demonstration, using a live infant
b. Initiating a teenage parent support group with first – and – second-time mothers
c. Using audiovisual aids that show discussions of feelings and skills
d. Providing age-appropriate reading materials
18. When performing a physical examination on an infant, the nurse in charge notes abnormally low-set
ears. This findings is associated with:
a. Otogenous tetanus
b. Tracheoesophageal fistula
c. Congenital heart defects
d. Renal anomalies
19. Nurse Raven should expect a 3-year-old child to be able to perform which action?
a. Ride a tricycle
b. Tie the shoelaces
d. Jump rope
20. Nurse Betina is teaching a group of parents about otitis media. When discussing why children are
predisposed to this disorder, the nurse should mention the significance of which anatomical feature?
a. Eustachian tubes
c. Tympanic membrane
d. External ear canal
21. The nurse is evaluating a female child with acute poststreptoccocal glomerulonephritis for signs
of improvement. Which finding typically is the earliest sign of improvement?
a. Increased urine output
b. Increased appetite
c. Increased energy level
d. Decreased diarrhea
22. Dr. Smith prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose
of administering corticosteroids to this child?
a. To increase blood pressure
b. To reduce inflammation
c. To decrease proteinuria
d. To prevent infection
23. Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for
2 days. On assessment, the nurse in charge detects dry mucous membranes and lethargy. What other
findings suggests a fluid volume deficit?
a. A sunken fontanel
b. Decreased pulse rate
c. Increased blood pressure
d. Low urine specific gravity
24. How should the nurse May prepare a suspension before administration?
a. By diluting it with normal saline solution
b. By diluting it with 5% dextrose solution
c. By shaking it so that all the drug particles are dispersed uniformly
d. By crushing remaining particles with a mortar and pestle
25. What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shock?
a. 20 ml/kg
b. 10 ml/kg
c. 30 ml/kg
d. 15 ml/kg
26. Becky, age 5, with intelligence quotient of 65 is admitted to the hospital for evaluation. When
planning care, the nurse should keep in mind that this child is:
a. Within the lower range of normal intelligence
b. Mildly retarded but educable
c. Moderately retarded but trainable
d. Completely dependent on others for care
27. Maureen, age 12, is brought to the clinic for evaluation for a suspected eating disorder. To best
assess the effects of role and relationship patterns on the child’s nutritional intake, the nurse should ask:
a. “What activities do you engage in during the day?”
b. “Do you have any allergies to foods?”
c. “Do you like yourself physically?”
d. “What kinds of food do you like to eat?”
28. Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At
what age is the diagnosis of SIDS most likely?
a. At 1 to 2 years of age
b. At I week to 1 year of age, peaking at 2 to 4 months
c. At 6 months to 1 year of age, peaking at 10 months
d. At 6 to 8 weeks of age
29. When evaluating a severely depressed adolescent, the nurse knows that one indicator of a high risk
for suicide is:
b. Excessive sleepiness
c. A history of cocaine use
d. A preoccupation with death
30. A child is diagnosed with Wilms’ tumor. During assessment, the nurse in charge expects to detect:
a. Gross hematuria
c. Nausea and vomiting
d. An abdominal mass
31. The parents of a child, age 5, who will begin school in the fall ask the nurse for anticipatory
guidance. The nurse should explain that a child of this age:
a. Still depends on the parents
b. Rebels against scheduled activities
c. Is highly sensitive to criticism
d. Loves to tattle
32. While preparing to discharge an 8-month-old infant who is recovering from gastroenteritis and
dehydration, the nurse teaches the parents about their infant’s dietary and fluid requirements. The nurse
should include which other topic in the teaching session?
a. Nursery schools
b. Toilet Training
c. Safety guidelines
d. Preparation for surgery
33. Nurse Betina should begin screening for lead poisoning when a child reaches which age?
a. 6 months
b. 12 months
c. 18 months
d. 24 months
34. When caring for an 11-month-old infant with dehydration and metabolic acidosis, the nurse expects
to see which of the following?
a. A reduced white blood cell count
b. A decreased platelet count
c. Shallow respirations
35. After the nurse provides dietary restrictions to the parents of a child with celiac disease, which
statement by the parents indicates effective teaching?
a. “Well follow these instructions until our child’s symptoms disappear.”
b. “Our child must maintain these dietary restrictions until adulthood.”
c. “Our child must maintain these dietary restrictions lifelong.”
d. “We’ll follow these instructions until our child has completely grown and developed.”
36. A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the
toddler’s fontanels, what should the nurse expects to find?
a. Closed anterior fontanel and open posterior fontanel
b. Open anterior and fontanel and closed posterior fontanel
c. Closed anterior and posterior fontanels
d. Open anterior and posterior fontanels
37. Patrick, a healthy adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should
monitor this client’s fluid intake because fluid overload may cause:
a. Cerebral edema
c. Heart failure
d. Hypovolemic shock
38. An infant is hospitalized for treatment of nonorganic failure to thrive. Whichnursing action is most
appropriate for this infant?
a. Encouraging the infant to hold a bottle
b. Keeping the infant on bed rest to conserve energy
c. Rotating caregivers to provide more stimulation
d. Maintaining a consistent, structured environment
39. The mother of Gian, a preschooler with spina bifida tells the nurse that her daughter sneezes and
gets a rash when playing with brightly colored balloons, and that she recently had an allergic reaction
after eating kiwifruit and bananas. The nurse would suspect that the child may have an allergy to:
d. Color dyes
40. Cristina, a mother of a 4-year-old child tells the nurse that her child is a very poor eater. What’s the
nurse’s best recommendation for helping the mother increase her child’s nutritional intake?
a. Allow the child to feed herself
b. Use specially designed dishes for children – for example, a plate with the child’s favorite cartoon
c. Only serve the child’s favorite foods
d. Allow the child to eat at a small table and chair by herself
41. Nurse Roy is administering total parental nutrition (TPN) through a peripheral I.V. line to a school-
age child. What’s the smallest amount of glucose that’s considered safe and not caustic to small veins,
while also providing adequate TPN?
a. 5% glucose
b. 10% glucose
c. 15% glucose
d. 17% glucose
42. David, age 15 months, is recovering from surgery to remove Wilms’ tumor. Which findings best
indicates that the child is free from pain?
a. Decreased appetite
b. Increased heart rate
c. Decreased urine output
d. Increased interest in play
43. When planning care for a 8-year-old boy with Down syndrome, the nurse should:
a. Plan interventions according to the developmental level of a 7-year-old child because that’s the
b. Plan interventions according to the developmental levels of a 5-year-old because the child will have
c. Assess the child’s current developmental level and plan care accordingly
d. Direct all teaching to the parents because the child can’t understand
44. Nurse Victoria is teaching the parents of a school-age child. Which teaching topic should take
a. Prevent accidents
b. Keeping a night light on to allay fears
c. Explaining normalcy of fears about body integrity
d. Encouraging the child to dress without help
45. The nurse is finishing her shift on the pediatric unit. Because her shift is ending, which intervention
takes top priority?
a. Changing the linens on the clients’ beds
b. Restocking the bedside supplies needed for a dressing change on the upcoming shift
c. Documenting the care provided during her shift
d. Emptying the trash cans in the assigned client room
46. Nurse Alice is providing cardiopulmonary resuscitation (CPR) to a child, age 4. the nurse should:
a. Compress the sternum with both hands at a depth of 1½ to 2” (4 to 5 cm)
b. Deliver 12 breaths/minute
c. Perform only two-person CPR
d. Use the heel of one hand for sternal compressions
47. A 4-month-old with meningococcal meningitis has just been admitted to the pediatric unit. Which
nursing intervention has the highest priority?
a. Instituting droplet precautions
b. Administering acetaminophen (Tylenol)
c. Obtaining history information from the parents
d. Orienting the parents to the pediatric unit
48. Sheena, tells the nurse that she wants to begin toilet training her 22-month-old child. The most
important factor for the nurse to stress to the mother is:
a. Developmental readiness of the child
b. Consistency in approach
c. The mother’s positive attitude
d. Developmental level of the child’s peers
49. An infant who has been in foster care since birth requires a blood transfusion. Who is authorized to
give written, informed consent for the procedure?
a. The foster mother
b. The social worker who placed the infant in the foster home
c. The registered nurse caring for the infant
d. The nurse-manager
50. A child is undergoing remission induction therapy to treat leukemia. Allopurinol is included in the
regimen. The main reason for administering allopurinol as part of the client’s chemotherapy regimen is to:
a. Prevent metabolic breakdown of xanthine to uric acid
b. Prevent uric acid from precipitating in the ureters
c. Enhance the production of uric acid to ensure adequate excretion of urine
d. Ensure that the chemotherapy doesn’t adversely affect the bone marrow
51. A psychotic client reports to the evening nurse that the day nurse put something suspicious in his
water with his medication. The nurse replies, "You're worried about your medication?" The nurse's
A. an example of presenting reality.
B. reinforcing the client's delusions.
C. focusing on emotional content.
D. a nontherapeutic technique called mind reading.
52. A client receiving haloperidol (Haldol) complains of a stiff jaw and difficulty swallowing. The nurse's
first action is to:
A. reassure the client and administer as needed lorazepam (Ativan) I.M.
B. administer as needed dose of benztropine (Cogentin) I.M. as ordered.
C. administer as needed dose of benztropine (Cogentin) by mouth as ordered.
D. administer as needed dose of haloperidol (Haldol) by mouth.
53.Yesterday,aclientwithschizophreniabegantreatmentwithhaloperidol(Haldol). Today,thenurse notices that the
client is holding his head to one side and complaining of neck and jaw spasms. What should the nurse
A. Assume that the client is posturing.
B. Tell the client to lie down and relax.
C. Evaluate the client for adverse reactions to haloperidol.
D. Put the client on the list for the physician to see tomorrow.
54. The nurse knows that the physician has ordered the liquid form of the drug chlorpromazine
(Thorazine) rather than the tablet form because the liquid :
A. has a more predictable onset of action.
B. produces fewer anticholinergic effects.
C. produces fewer drug interactions.
D. has a longer duration of action.
55. Benztropine (Cogentin) is used to treat the extrapyramidal effects induced by antipsychotics. This
drug exerts its effect by:
A. decreasing the anxiety causing muscle rigidity.
B. blocking the cholinergic activity in the central nervous system (CNS).
C. increasing the level of acetylcholine in the CNS.
D. increasing norepinephrine in the CNS.
56. A dopamine receptor agonist such as bromocriptine (Parlodel) relieves muscle rigidity caused by
antipsychotic medication by:
A. blocking dopamine receptors in the central nervous system (CNS).
B. blocking acetylcholine in the CNS.
C. activating norepinephrine in the CNS.
D. activating dopamine receptors in the CNS.
57. Most antipsychotic medications exert which of following effects on the central nervous system (CNS)?
A. Stimulate the CNS by blocking postsynaptic dopamine, norepinephrine, and serotonin receptors.
B. Sedate the CNS by stimulating serotonin at the synaptic cleft.
C. Depress the CNS by blocking the postsynaptic transmission of dopamine, serotonin, and
D. Depress the CNS by stimulating the release of acetylcholine.
58. Which of the following medications would the nurse expect the physician to order to reverse
a dystonic reaction?
A. prochlorperazine (Compazine)
B. diphenhydramine (Benadryl)
C. haloperidol (Haldol)
59. A client has been receiving chlorpromazine (Thorazine), an antipsychotic, to treat his psychosis.
Whichfindings should alert the nurse that the client is experiencing pseudoparkinsonism?
A. Restlessness, difficulty sitting still, and pacing
B. Involuntary rolling of the eyes
C. Tremors, shuffling gait, and masklike face
D. Extremity and neck spasms, facial grimacing, and jerky movements.
60. What medication would probably be ordered for the acutely aggressive schizophrenic client?
A. chlorpromazine (Thorazine)
B. haloperidol (Haldol)
C. lithium carbonate (Lithonate)
D. amitriptyline (Elavil)
61. The nurse must administer a medication to reverse or prevent Parkinson-type symptoms in a client
receiving an antipsychotic. The medication the client will likely receive is:
A. Benztropine (Cogentin).
B. diphenhydramine (Benadryl).
C. propranolol (Inderal).
D. haloperidol (Haldol).
62. A client with paranoid type schizophrenia becomes angry and tells the nurse to leave him alone. The
A. tell him that she'll leave for now but will return soon.
B. ask him if it's okay if she sits quietly with him.
C. ask him why he wants to be left alone.
D. tell him that she won't let anything happen to him.
63. A male patient has a sucking stab wound to the chest. Which action should the nurse take first?
a. Drawing blood for a hematocrit and hemoglobin level
b. Applying a dressing over the wound and taping it on three sides
c. Preparing a chest tube insertion tray
d. Preparing to start an I.V. line
64. For a patient with advance chronic obstructive pulmonary disease (COPD), which nursing action
best promotes adequate gas exchange?
a. Encouraging the patient to drink three glasses of fluid daily
b. Keeping the patient in semi-fowler’s position
c. Using a high-flow venture mask to deliver oxygen as prescribe
d. Administering a sedative, as prescribe
65. A male patient’s X-ray result reveals bilateral white-outs, indicating adult respiratory distress
syndrome (ARDS). This syndrome results from:
a. Cardiogenic pulmonary edema
b. Respiratory alkalosis
c. Increased pulmonary capillary permeability
d. Renal failure