Growth/Developmental
Infection/Immunity
Oxygenation
Spinal Bifida
Failure To Thrive
100

A nurse is explaining growth vs development to a parent. Which statement is correct?

A. Growth refers to emotional maturity
B. Development refers to increase in height
C. Growth refers to physical changes in the body
D. Development refers only to cognitive skills

C.Growth refers to physical changes in the body 

Growth = physical changes (height, weight). Development = skills (cognitive, motor, social).

100

A child has a barking cough and stridor. Which condition is MOST likely?

A. Pneumonia
B. Asthma
C. Croup
D. Bronchiolitis

C. Croup

Rationale:
Croup = barking cough + stridor (hallmark).

100

A patient has severe hypoxia that does NOT improve with oxygen therapy. What condition?

A. Asthma
B. COPD
C. ARDS
D. Bronchitis

C. ARDS

Rationale:
ARDS = severe, refractory hypoxia

100

A newborn is diagnosed with myelomeningocele. Which is the nurse’s priority intervention immediately after birth?

A. Place the infant supine and dry thoroughly
B. Apply sterile moist dressing over the sac
C. Initiate oral feeding
D. Perform passive range of motion

B. Apply sterile moist dressing over the sac 

Why B is correct:

  • A sterile, moist (saline) dressing keeps the sac:
    • From drying out and cracking
    • Protected from infection (meningitis risk 🚨)
  • This is the PRIORITY immediately after birth
100

Multiple Choice

A nurse is assessing a 6-month-old infant suspected of failure to thrive. Which finding is the most significant indicator?

A. Occasional vomiting after feeding
B. Weight below the 5th percentile
C. Sleeping 12 hours per night
D. Mild diaper rash

B. Weight below the 5th percentile 

Rationale:
The most important indicator of FTT is poor weight gain, especially below the 5th percentile or falling percentiles. Other findings are less specific.

200

SATA

Which are examples of development? Select all that apply.

A. Learning to walk
B. Increase in head circumference
C. Speaking first words
D. Emotional bonding
E. Weight gain

A. Learning to walk

C. Speaking first words

D. Emotional bonding

Rationale:
Development = skills (motor, language, emotional). Growth = physical (B, E).


200

 (SATA)

Which are components of innate immunity? Select all that apply.

A. Skin
B. White blood cells
C. Antibodies from vaccines
D. Mucous membranes
E. T lymphocytes memory

A. Skin

B. White blood cells

D. Mucous membranes

Rationale:
Innate = natural defenses (skin, WBCs). Adaptive = antibodies (C, E).

200

MC

Which teaching is MOST important for SIDS prevention?

A. Sleep with parents
B. Place infant on stomach
C. Place infant on back to sleep
D. Use soft blankets

C. Place infant on back to sleep

β€œBack to sleep” = #1 prevention for SIDS.

200

SATA

Which findings are commonly associated with spina bifida?

A. Hydrocephalus
B. Flaccid paralysis of lower extremities
C. Increased bowel and bladder control
D. Clubfoot deformities
E. Latex allergy risk

A. Hydrocephalus

B. Flaccid paralysis of lower extremities

D. Clubfoot deformities

E. Latex allergy risk

βœ” A. Hydrocephalus β€” CORRECT

  • Very common due to Chiari II malformation
  • Leads to ↑ CSF β†’ increased ICP
  • Watch for:
    • Bulging fontanelle 🚨
    • Increasing head circumference

βœ” B. Flaccid paralysis of lower extremities β€” CORRECT

  • Nerve damage β†’ loss of motor function
  • Severity depends on level of lesion

❌ C. Increased bowel and bladder control β€” WRONG

  • It’s the opposite!

πŸ‘‰ These children have:

  • Neurogenic bladder
  • Loss of bowel control
  • High risk for UTIs

βœ” D. Clubfoot deformities β€” CORRECT

  • Due to muscle imbalance + immobility
  • Also may see hip dislocation

βœ” E. Latex allergy risk β€” CORRECT 🚨

  • VERY HIGH-YIELD NCLEX POINT
  • Repeated exposure β†’ sensitivity

πŸ‘‰ Always use:

  • Latex-free gloves, catheters, supplies 
200

True or False

Failure to thrive is always caused by a medical condition.

FALSE 

FTT can be:

  • Organic (medical)
  • Non-organic (environmental) β†’ MOST COMMON
300

Which behavior is expected in a hospitalized toddler?

A. Logical thinking
B. Regression (bedwetting)
C. Concern about body image
D. Desire for independence in schoolwork

B. Regression (bedwetting) 

Rationale:
Toddlers β†’ regression + tantrums under stress.

300

A nurse hears wheezing and thick mucus in an infant. Which condition?

A. Croup
B. RSV (bronchiolitis)
C. Pneumonia
D. Tuberculosis

B. RSV (bronchiolitis)

Rationale:
RSV = wheezing + mucus + infants.

300

Which is the MOST important risk factor for COPD?

A. Genetics
B. Smoking
C. Exercise
D. Infection

B. Smoking

Rationale:
Smoking = #1 cause of COPD

300

 True or False

Children with spina bifida often have normal motor and sensory function

False 

They usually have motor & sensory deficits

300

SATA

Which nursing interventions are appropriate for a child with failure to thrive?

A. Daily weight monitoring
B. Small frequent feedings
C. Restrict fluids
D. High-calorie diet
E. Monitor intake and output

A. Daily weight monitoring

B. Small frequent feedings

D. High-calorie diet

E. Monitor intake and output

Rationale:

  • Daily weights = best indicator
  • High-calorie + frequent feeds = improve growth
  • I&O = monitor nutrition
    ❌ Fluids should NOT be restricted
400

SATA

Which are appropriate nursing interventions for hospitalized children?

A. Allow parents to stay
B. Maintain routine
C. Restrict family visits
D. Use age-appropriate communication
E. Ignore emotional needs

A.  Allow parents to stay

B. Maitain routine

D. Use age-appropriate communication

Rationale:
Family-centered + routine + age-appropriate care reduces stress.

400

(SATA)

Which diagnostic tests are used for respiratory infections?

(SATA)

Which diagnostic tests are used for respiratory infections?

A. Pulse oximetry
B. Chest X-ray
C. CBC
D. MRI of brain
E. Nasopharyngeal swab


A. Pulse oximetry

B. Chest X-ray

C. CBC

E. Nasopharyngeal swab

Rationale:
MRI not used. Others assess oxygenation + infection

400

(SATA)

Which medications are used for asthma?

A. Albuterol
B. Inhaled corticosteroids
C. Mucolytics
D. Bronchodilators
E. Insulin

A. Albuterol

B. Inhaled corticosteroids

D. Bronchodilators

Asthma β†’ bronchodilators + steroids. Mucolytics mostly COPD.

400

A parent asks why their child with spina bifida needs frequent repositioning. What is the best response?

A. To prevent infection
B. To improve circulation
C. To prevent pressure ulcers
D. To strengthen muscle

C. To prevent pressure ulcers

Prevents pressure ulcers due to immobility

400

Which statement by a parent indicates correct understanding of feeding instructions?

A. β€œI will dilute the formula to make it last longer.”
B. β€œI will follow the exact mixing instructions for formula.”
C. β€œI will feed only when the baby cries.”
D. β€œI will skip night feedings.”

B. β€œI will follow the exact mixing instructions for formula.”

Rationale:
Correct formula preparation is critical.
❌ Diluting formula β†’ worsens FTT
❌ Inconsistent feeding β†’ inadequate intake

500

SATA

Which factors affect growth and development?

A. Genetics
B. Nutrition
C. Family support
D. Stress
E. Oxygen therapy

A. Genetics
B. Nutrition
C. Family support
D. Stress

Rationale:
Biological, environmental, emotional factors all affect development.

500

SATA

Which are signs of respiratory distress in a child?

A. Nasal flaring
B. Retractions
C. Grunting
D. Bradycardia
E. Tachypnea

A. Nasal flaring

B. Retractions

C. Grunting

E. Tachypnea

Rationale:
Classic distress signs = flaring, retractions, grunting, ↑ RR.

500

(SATA)

Which nursing interventions are appropriate for COPD?

A. High-flow oxygen
B. Low-flow oxygen (2L NC)
C. Pursed-lip breathing
D. Encourage smoking
E. Monitor SpOβ‚‚

B. Low-flow oxygen (2L NC)

C. Pursed-lip breathing

E. Monitor SpOβ‚‚

Rationale:
COPD = low Oβ‚‚, breathing techniques, monitoring.


500

SATA

Which complications should the nurse anticipate in a child with spina bifida?

A. Urinary retention
B. Recurrent UTIs
C. Constipation
D. Hypertension
E. Skin breakdown

A. Urinary retention

B. Recurrent UTIs

C. Constipation

E. Skin breakdown

Recurrent UTIs β€” CORRECT 🚨

  • Urine stays in bladder β†’ bacteria grow
  • VERY common complication

πŸ‘‰ Many need intermittent catheterization

Constipation β€” CORRECT

  • Nerve damage β†’ ↓ bowel motility
  • Leads to chronic constipation
  • Skin breakdown β€” CORRECT 🚨
    • ↓ sensation + immobility β†’ pressure injuries
    • Especially on:
      • Heels
      • Sacrum
      • Buttocks
500

 SATA (Select All That Apply)

Which findings are commonly seen in a child with failure to thrive?

A. Delayed development
B. Irritability
C. Rapid weight gain
D. Poor feeding
E. Lethargy


A. Delayed development

B. Irritability

D. Poor feeding

E. Lethargy

 

Rationale:
FTT presents with:

  • Delayed milestones
  • Irritability or lethargy
  • Poor feeding
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