Summer
A 6-year-old with fever, cough, and conjunctivitis develops a red, blotchy rash starting on the face. What is the best immediate nursing intervention?
A. Administer antiviral medication
B. Initiate airborne precautions and notify provider
C. Apply calamine lotion to rash
D. Encourage sun exposure
Answer: B. Initiate airborne precautions and notify provider
What should the nurse monitor for in a male adolescent with mumps?
A. Hepatosplenomegaly
B. Orchitis and testicular pain
C. Visual disturbances
D. Nasal congestion
Answer: B. Orchitis and testicular pain
A child recovering from chickenpox has intense itching. Which nursing intervention is appropriate?
A. Use calamine lotion and oatmeal baths
B. Administer aspirin to reduce inflammation
C. Cover all lesions with antibiotic ointment
D. Avoid any lotion or cream application
Answer: A. Use calamine lotion and oatmeal baths
A school-age child with epilepsy begins having a tonic-clonic seizure that lasts over 5 minutes in the emergency department. What is the nurse’s first action?
A. Notify the child’s neurologist
B. Prepare the child for a CT scan
C. Administer IV lorazepam as prescribed
D. Suction the airway and insert an oral airway
Answer: C. Administer IV lorazepam as prescribed
A child is squinting at the board in class and says objects far away are blurry. What condition does the nurse suspect?
A. Hyperopia
B. Myopia
C. Astigmatism
D. Strabismus
Answer: B. Myopia
Which statement about varicella management is correct?
A. Ibuprofen is preferred to treat fever
B. Children may return to school once vesicles are crusted
C. Aspirin can reduce inflammation
D. Oral antibiotics are needed for rash
Answer: B. Children may return to school once vesicles are crusted
A nurse is caring for an infant diagnosed with pertussis. Which of the following actions is the highest priority?
A. Administering acetaminophen for fever
B. Monitoring oxygen saturation and apnea episodes
C. Teaching the parents about antibiotic side effects
D. Encouraging oral fluid intake
Answer: B. Monitoring oxygen saturation and apnea episodes
Which of the following findings is most concerning for pediatric sepsis?
A. Temperature of 99.5°F
B. Heart rate of 160 bpm in a crying toddler
C. Capillary refill time of 5 seconds
D. BP of 98/60 in a school-aged child
Answer: C. Capillary refill time of 5 seconds
What is the nurse’s priority concern during a prolonged seizure in a child?
A. Electrolyte imbalance
B. Risk of aspiration and impaired breathing
C. Parental anxiety
D. Risk of infection
Answer: B. Risk of aspiration and impaired breathing
Which child is most at risk for acute otitis media?
A. A breastfed 3-month-old
B. A toddler attending daycare with frequent colds
C. A 12-year-old with swimmer’s ear
D. A child with bilateral tympanostomy tubes
Answer: B. A toddler attending daycare with frequent colds
Which of the following correctly orders the stages of infectious disease?
A. Convalescent → Incubation → Illness → Prodromal
B. Incubation → Prodromal → Illness → Convalescent
C. Illness → Convalescent → Prodromal → Incubation
D. Prodromal → Incubation → Illness → Resolution
Answer: B. Incubation → Prodromal → Illness → Convalescent
Which of the following vaccines protects against pertussis?
A. MMR
B. Hib
C. DTaP
D. IPV
Answer: C. DTaP
Which is the most sensitive early indicator of neurologic status in a child with suspected increased intracranial pressure?
A. Change in pupil size
B. Changes in level of consciousness
C. Vomiting
D. Bradycardia
Answer: B. Changes in level of consciousness
A 4-year-old was submerged in water for an unknown time and is now in the ED. The child is conscious but coughing and has mild retractions. What is the nurse’s first priority?
A. Provide warm IV fluids
B. Administer supplemental oxygen
C. Prepare for chest physiotherapy
D. Encourage oral fluids
Answer: B. Administer supplemental oxygen
A child has hearing loss due to chronic otitis media with effusion. What type of hearing loss is this?
A. Conductive
B. Sensorineural
C. Central
D. Functional
Answer: A. Conductive
Which is the correct sequence for using an EpiPen in a child?
A. Inject into upper arm → Hold for 5 seconds
B. Remove safety cap → Inject into outer thigh → Hold for 10 seconds
C. Inject into buttocks → Rub area for 30 seconds
D. Inject into inner thigh → Lie child down immediately
Answer: B. Remove safety cap → Inject into outer thigh → Hold for 10 seconds
A 5-year-old with HIV is being seen for a well-child visit. Which finding would prompt immediate notification of the provider?
A. Low-grade fever and mild cough
B. Recent weight loss and oral lesions
C. Skin rash with no fever
D. Recurrent ear infections
Answer: B. Recent weight loss and oral lesions
Which cranial nerve is being tested when a child is asked to stick out their tongue and move it side to side?
A. CN VII (Facial)
B. CN IX (Glossopharyngeal)
C. CN XII (Hypoglossal)
D. CN X (Vagus)
Answer: C. CN XII (Hypoglossal)
A 10-month-old infant is brought to the emergency department with a fever of 102.9°F, irritability, poor feeding, and a bulging fontanel. The nurse suspects bacterial meningitis. The provider gives the following orders. Which should the nurse do first?
A. Administer IV ceftriaxone
B. Start IV fluids
C. Obtain blood cultures
D. Place the infant in droplet isolation
Answer: D. Place the infant in droplet isolation
The parent of a newborn diagnosed with congenital glaucoma asks what signs they should monitor for. Which response by the nurse is most appropriate?
A. “Watch for yellow discharge and crusting.”
B. “Monitor for excessive blinking and light sensitivity.”
C. “Look for small pupils and rapid eye movements.”
D. “Check for drooping eyelids and dry eyes.”
Answer: B. “Monitor for excessive blinking and light sensitivity.”
Which symptom would lead the nurse to suspect scarlet fever rather than a simple strep throat infection?
A. Enlarged cervical lymph nodes
B. White patches on the tonsils
C. High fever and sore throat
D. Red rash that feels like sandpaper
Answer: D. Red rash that feels like sandpaper
The nurse is caring for a neonate with suspected sepsis. What lab value would be most concerning?
A. Hematocrit of 44%
B. White blood cell count of 3,000/mm³
C. Glucose of 65 mg/dL
D. Platelet count of 250,000
Answer: B. White blood cell count of 3,000/mm³
What is the most important teaching for parents of a child discharged with a minor head injury?
A. “Wake your child every 2 hours for 48 hours.”
B. “Encourage physical activity to assess stamina.”
C. “Give ibuprofen every 4 hours.”
D. “Restrict fluids for the next 24 hours.”
Answer: A. “Wake your child every 2 hours for 48 hours.”
A 4-year-old is diagnosed with amblyopia (lazy eye). Which treatment should the nurse anticipate educating the parent about?
A. Antibiotic eye drops
B. Corrective surgery
C. Patching the stronger eye
D. Eye massage exercises
Answer: C. Patching the stronger eye
The nurse is teaching parents after tympanostomy tube placement. Which statement by the parent indicates a need for further teaching?
A. “If the ear drains fluid, I’ll call the doctor.”
B. “We’ll skip the swim lessons for a few weeks.”
C. “The tubes should be removed at the next checkup.”
D. “This should help prevent future ear infections.”
Answer: C. “The tubes should be removed at the next checkup.”