Any topic
Multiple Choice (Priority)
A nurse is caring for a newborn with myelomeningocele. The sac is intact. Which action is the nurse’s priority?
A. Place the infant supine for bonding
B. Cover the sac with sterile dry gauze
C. Apply sterile saline-moistened dressing to the sac
D. Begin range of motion exercises
C. Apply sterile saline-moistened dressing to the sac
This is a myelomeningocele → spinal cord + meninges protruding → HIGH risk for infection and rupture
👉 Priority = PROTECT THE SAC + PREVENT INFECTION
✔️ Why C is Correct:
MC
A child with tonsillitis is prescribed antibiotics. What is the most important teaching?
A. Stop medication once symptoms improve
B. Take full course of antibiotics
C. Avoid fluids
D. Stay on bed rest for 2 weeks
B. Take full course of antibiotics
NCLEX Priority = Prevent complications + ensure infection is fully treated
Tonsillitis is often caused by bacterial infection (like strep), and incomplete treatment can lead to serious complications.
✔️ Why B is Correct:
Delegation
Which task can the nurse delegate to a UAP?
A. Assess a child with stridor
B. Administer nebulized medication
C. Record intake and output
D. Teach parents about RSV
C. Record intake and output
👉 UAP = Stable patients + Non-assessment + Non-teaching + Non-medication
Recording intake and output (I&O) is:
Priority (RSV)
A child with RSV bronchiolitis has increased work of breathing. What is the nurse’s priority action?
A. Administer antibiotics
B. Provide oxygen therapy
C. Encourage fluids
D. Perform chest percussion
B. Provide oxygen therapy
A child with RSV Bronchiolitis and increased work of breathing is at risk for:
👉 Hypoxia
What is the nurse’s priority action before suctioning a tracheostomy patient?
A. Apply suction while inserting catheter
B. Hyperoxygenate the patient
C. Insert catheter quickly
D. Limit suction time to 20 seconds
B. Hyperoxygenate the patient
Hyperoxygenation before suctioning:
Multiple Choice (Airway Priority)
A 3-year-old with epiglottitis is sitting upright, drooling, and has stridor. What is the nurse’s priority action?
A. Examine the throat with a tongue blade
B. Place the child supine
C. Prepare for emergency airway management
D. Offer oral fluids
C. Prepare for emergency airway management
Multiple Choice (Failure to Thrive)
A nurse is caring for an infant with failure to thrive (FTT). Which intervention is most appropriate?
A. Feed only when the infant cries
B. Establish a structured feeding schedule
C. Limit calorie intake
D. Avoid daily weights
B. Establish a structured feeding schedule
NCLEX Priority = Promote consistent growth + adequate nutrition
Infants with Failure to Thrive need:
👉 Regular, predictable nutrition to support weight gain
✔️ Why B is Correct:
Multiple Choice (FTT)
A nurse is caring for an infant with failure to thrive. Which finding requires immediate intervention?
A. Weight gain of 10 g/day
B. Refusal to eat during feeding
C. Parent reports irregular feeding schedule
D. Output of 6 wet diapers/day
B. Refusal to eat during feeding
In an infant with Failure to Thrive, the most urgent concern is:
👉 Not taking in enough calories RIGHT NOW
Multiple Choice (Tracheostomy Care)
During tracheostomy care, which action is CORRECT?
A. Cut gauze to fit around trach
B. Use clean technique at all times
C. Use sterile precut gauze
D. Remove ties before applying new ones
C. Use sterile precut gauze
Sterile precut gauze:
Multiple Choice (Suctioning Technique)
Which action is correct during suctioning?
A. Apply continuous suction during insertion
B. Suction longer than 15 seconds
C. Apply intermittent suction while withdrawing
D. Skip oxygenation before procedure
C. Apply intermittent suction while withdrawing
True or False
Children have a higher risk of respiratory distress because their airways are larger than adults.
False ❌
Children have SMALLER airways → higher risk of obstruction
Priority (Croup)
A toddler with croup suddenly becomes quiet with minimal air movement. What is the nurse’s priority interpretation?
A. Child is improving
B. Child is tired from crying
C. Airway obstruction is worsening
D. Medication is effective
C. Airway obstruction is worsening
In croup, a sudden change from:
👉 loud stridor → QUIET with minimal air movement
= VERY BAD SIGN
Patient Teaching (Multiple Choice)
The nurse is teaching a parent about asthma medications. Which statement indicates correct understanding?
A. “Salmeterol can be used alone for quick relief”
B. “Albuterol is used for acute attacks”
C. “Ipratropium has no side effects”
D. “Steroids are only used in emergencies”
B. “Albuterol is used for acute attacks”
Rescue vs. Controller Meds in Asthma
✔️ Why B is Correct:
Priority (Ostomy Complication)
A patient with an ostomy reports leakage around the pouch. What is the nurse’s best action?
A. Apply skin barrier paste
B. Change pouch more frequently
C. Clean area with alcohol
D. Tighten pouch clamp
A. Apply skin barrier paste
Skin barrier paste:
SATA (Parent Teaching)
Which instructions should the nurse include when teaching parents about SIDS prevention?
A. Place infant on back to sleep
B. Use firm mattress
C. Use soft blankets for comfort
D. Avoid overheating
E. Allow co-sleeping
Multiple Choice (Developmental Care)
A nurse is caring for a hospitalized school-age child. Which intervention best supports development?
A. Allow unlimited parental control
B. Encourage participation in care decisions
C. Provide strict bed rest
D. Avoid explaining procedures
B. Encourage participation in care decisions
Developmental Stage Insight (School-Age = Industry vs. Inferiority)
School-age children (≈6–12 years) want to:
👉 Feel capable, involved, and in control
✔️ Why B is Correct:
SATA (Assessment)
Which findings are expected in a child experiencing an acute asthma attack?
A. Wheezing
B. Use of accessory muscles
C. Bradycardia
D. Chest tightness
E. Silent chest
Asthma = airway narrowing + inflammation + mucus
👉 Leads to difficulty moving air IN and OUT
✔️ Expected Findings:
SATA (Assessment)
Which findings are expected in a patient with COPD?
A. Barrel chest
B. Digital clubbing
C. Productive cough
D. Bradypnea
E. Tripod positioning
COPD (chronic bronchitis + emphysema) leads to:
👉 Air trapping + chronic hypoxia + increased work of breathing
SATA (Ostomy Care)
Which actions are appropriate when caring for a patient with an ostomy?
A. Cut wafer 1/16–1/8 inch larger than stoma
B. Empty pouch when completely full
C. Clean skin with warm water
D. Use moisturizing soap
E. Change appliance before meals
SATA (Risk Factors)
Which factors increase the risk of SIDS?
A. Secondhand smoke exposure
B. Prone sleeping position
C. Firm mattress
D. Soft bedding
E. Overheating
SATA (Patient-Centered Care)
A toddler is hospitalized and exhibiting separation anxiety (protest stage). Which behaviors should the nurse expect?
A. Crying and screaming for parents
B. Quiet withdrawal and apathy
C. Rejecting strangers
D. Clinging to parents
E. Showing interest in toys
A. Crying and screaming for parents
C. Rejecting strangers
D. Clinging to parents
The protest stage is the FIRST stage of separation anxiety. The child is basically saying:
👉 “Where are my parents?! I don’t like this!!”
✔️ Expected Behaviors (PROTEST stage)
SATA (Spina Bifida Care)
Which nursing interventions are appropriate for an infant with spina bifida (pre-op)?
A. Place infant in prone position
B. Apply moist sterile dressing to sac
C. Cover sac with diaper
D. Use latex-free supplies
E. Keep sac dry
A. Place infant in prone position
B. Apply moist sterile dressing to sac
D. Use latex-free supplies
NCLEX Priority = Protect the sac + Prevent infection
Infant with Spina Bifida (especially myelomeningocele):
👉 BIG risks: rupture + infection (meningitis)
✔️ Correct Interventions:
SATA (Respiratory Assessment)
A nurse is assessing a child for hypoxia. Which findings are expected?
A. Tachycardia
B. Bradycardia
C. Nasal flaring
D. Retractions
E. Lethargy
NCLEX Priority = Early signs of hypoxia first!
When a child has Hypoxia, the body tries to compensate → then decompensates if untreated.
✔️ Expected Findings:
SATA (Croup Management)
A child with croup is admitted. Which interventions should the nurse implement?
A. Provide cool mist humidification
B. Administer racemic epinephrine
C. Keep child calm
D. Encourage excessive crying
E. Give antibiotics immediately
Croup = airway inflammation → reduce swelling + keep airway open
Croup (laryngotracheobronchitis) causes:
👉 Barking cough + stridor + airway narrowing
✔️ Appropriate Interventions:
SATA (Hospitalized Toddler)
A hospitalized toddler is showing regression. Which behaviors would the nurse expect?
A. Bedwetting
B. Loss of language skills
C. Increased independence
D. Clinginess
E. Thumb sucking
Hospitalization is stressful → toddlers often regress to earlier behaviors for comfort and security.
✔️ Expected Regression Behaviors: