communicable
disease
hearing and vision
vaccines
neuro
extra
100

 The nurse is caring for four children. Which child has the highest priority for immediate airway assessment?

A. A child with measles and conjunctivitis
B. A child with diphtheria and a thick gray pharyngeal membrane
C. A child with mumps and bilateral parotid swelling
D. A child with fifth disease and a slapped-cheek rash

B. A child with diphtheria and a thick gray pharyngeal membrane

100

A 7-year-old swimmer presents with severe ear pain and drainage. The nurse gently presses on the tragus and the child reports significant pain. Which diagnosis is most likely

Otitis externa

100

A nurse is preparing discharge teaching for parents of a healthy newborn. Which statement by the parents requires correction?

A. “Our baby should receive Hepatitis B vaccine within the first 12 hours of life.”
B. “Our baby may receive RSV preventive antibody if appropriate for RSV season.”
C. “The first routine DTaP vaccine is given at birth.”
D. “We should keep an accurate record of all vaccines.”

C. “The first routine DTaP vaccine is given at birth.”

100
  1. A child with bacterial meningitis suddenly develops a seizure. Which action should the nurse take first?

A. Place a tongue blade in the child's mouth.
B. Restrain the child's extremities.
C. Protect the airway and place the child on the side.
D. Leave the room to notify the provider.

C. Protect the airway and place the child on the side.

100

A 9-year-old has begun avoiding school and reports headaches and abdominal pain every Monday morning. The physical examination is normal. Which nursing action is the priority?


Assess for bullying, academic difficulties, anxiety, or other school-related stressors

200

A child with mumps has fever, headache, and significant swelling of the parotid glands. Which complication should the nurse specifically monitor for in a male child?

Orchitis

200

A newborn has an abnormal red reflex in the left eye. Which condition should the nurse suspect?

Congenital cataract

200

. A 16-year-old adolescent arrives at the clinic. The medical record shows that the adolescent received Tdap and MenACWY at age 11. The adolescent has completed the appropriate HPV series. Which vaccine should the nurse anticipate administering today?

A. Tdap
B. MenACWY booster
C. MenB routinely
D. DTaP

B. MenACWY booster

200
  1. The nurse is caring for a child with increased ICP. Which new assessment finding represents the most severe deterioration?

A. Headache
B. Projectile vomiting
C. Unequal pupils
D. Fixed and dilated pupils with decerebrate posturing

D. Fixed and dilated pupils with decerebrate posturing

200

A parent asks why vaccination is repeatedly emphasized when discussing childhood infections. Which response by the nurse is most accurate based on the chapter?

A. "Vaccines completely eliminate all childhood infections."
B. "Immunization is an important prevention strategy for many childhood infections."
C. "Vaccines are primarily used after the child develops symptoms."
D. "Vaccination is only important for bacterial infections."

B. "Immunization is an important prevention strategy for many childhood infections."

300

A 2-year-old develops a sudden high fever. Two days later, the fever resolves and a generalized rash appears. The child is otherwise improving. Which condition is most likely

Roseola

300

A 7-year-old child repeatedly squints when attempting to read the classroom board but reports no difficulty reading books held close to the face. Which refractive error does the nurse suspect?

Myopia

300

A healthy 16-month-old child has received DTaP doses at 2, 4, and 6 months. Which vaccine should the nurse anticipate administering at this visit based on the recommended schedule?

A. DTaP dose 4
B. Tdap booster
C. IPV booster
D. MenACWY

A. DTaP dose 4

300
  1. A 3-year-old has a seizure associated with a rapid increase in temperature. The seizure lasts 2 minutes, and the child returns to baseline afterward. Which interpretation is most appropriate?

A. This is most consistent with a typical febrile seizure.
B. This is status epilepticus.
C. This is an absence seizure.
D. This is an epidural hematoma.

A. This is most consistent with a typical febrile seizure.

300

A nurse is assessing a nonverbal 4-year-old child with developmental delay who is postoperative. The child is grimacing, has rigid legs, is crying intermittently, and cannot answer questions about pain. Which assessment tool is most appropriate?

FLACC

400

A 12-year-old presents with fever, severe headache, and a rash that initially appeared on the wrists and ankles before spreading toward the trunk. The parent reports finding a tick attached to the child several days ago. Which prescription should the nurse anticipate?

Doxycycline


400

A 10-month-old has fever, irritability, and repeatedly pulls at the right ear. Otoscopic examination reveals a bulging, erythematous tympanic membrane. Which condition is most likely?

Acute otitis media

400

A 12-year-old received the first HPV vaccine dose 8 months ago. The parent asks whether the second dose can be given today. Which response is most appropriate?

A. “No. The second dose must be given exactly 12 months after the first.”
B. “Yes. The recommended interval is 6–12 months.”
C. “No. A third dose must be given because your child is older than 11.”
D. “Yes, but the child must restart the series because too much time has passed.”


Answer: B

400
  1. A nurse is caring for five children. Which child should be seen first?

A. A 2-year-old with hydrocephalus who has sunset eyes
B. A 9-year-old with meningitis who has photophobia
C. A 6-year-old with a febrile seizure who is now alert
D. A 13-year-old with TBI who develops bradycardia, hypertension, and irregular respirations

D. A 13-year-old with TBI who develops bradycardia, hypertension, and irregular respirations

400

A child describes pain as "burning, shooting, and like electricity running through my leg" following a nerve injury. Which type of pain should the nurse recognize?

Neuropathic

500

The nurse is given the following report:

  • Child 1: fever, parotid swelling, headache
  • Child 2: severe headache, fever, rash beginning at wrists and ankles after a tick bite
  • Child 3: high fever followed by a rash after the fever resolves
  • Child 4: thick gray membrane in the pharynx with increasing difficulty breathing

Which child should the nurse assess first, second, third, and fourth?

A. 4 → 2 → 1 → 3
B. 2 → 4 → 1 → 3
C. 4 → 1 → 2 → 3
D. 3 → 4 → 2 → 1

A. 4 → 2 → 1 → 3

500

A nurse is differentiating AOM from OME. Which findings are most consistent with OME rather than AOM? Select all that apply.

A. No fever

B. Dull, opaque tympanic membrane

C. Middle-ear fluid

D. Severe acute ear pain

E. Bulging erythematous tympanic membrane

F. Possible hearing difficulty

A, B, C, F

500

A 4-month-old infant has a documented history of intussusception. The parent asks why the infant cannot receive the vaccine that other infants commonly receive at this age. Which vaccine is the nurse referring to?

A. Hib
B. IPV
C. Rotavirus
D. PCV

Answer: C

Answer: C

500
  1. A child with suspected increased ICP is being evaluated. Which finding should the nurse recognize as a late manifestation rather than an early manifestation?

A. Headache
B. Vomiting
C. Diplopia
D. Cushing triad

D. Cushing triad

500

A nurse is caring for a 5-year-old who has recently developed nighttime fears. Which intervention is most appropriate?

Establish a consistent bedtime routine and offer a night-light

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