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Which statement by the nurse reflects correct understanding of sensorineural hearing loss in children?
A. “It’s caused by fluid or blockage in the ear canal.”
B. “It is commonly treated with antibiotics.”
C. “It involves damage to the inner ear or auditory nerve.”
D. “It is often temporary and resolves with time.”
Answer: C. “It involves damage to the inner ear or auditory nerve.”
Which best describes a “vesicle”?
A. A flat, discolored spot less than 1 cm
B. A small, raised solid lesion
C. A fluid-filled lesion less than 1 cm
D. A thickened area of flaky skin
Answer: C. A fluid-filled lesion less than 1 cm
Which finding in a 15-year-old is most concerning for risk of suicide?
A. Irritability after school
B. Spending more time on their phone
C. Giving away personal belongings
D. Sleeping in on weekends
Answer: C. Giving away personal belongings
Which condition is the most common cause of shock in pediatric patients?
A. Cardiogenic shock from congenital heart defects
B. Hypovolemic shock from dehydration or bleeding
C. Neurogenic shock after spinal cord injury
D. Septic shock from bacterial infections
Answer: B. Hypovolemic shock from dehydration or bleeding
Which medication is commonly used as a first-line vasoactive drug for pediatric septic shock?
A. Epinephrine
B. Dopamine
C. Norepinephrine
D. Atropine
Answer: B. Dopamine
A nurse is caring for a 3-year-old with spastic cerebral palsy who has muscle rigidity and poor motor control. Which is the priority nursing action?
A. Encourage passive range-of-motion exercises
B. Teach child to self-administer baclofen
C. Provide high-protein snacks between meals
D. Limit the use of mobility aids to promote walking
Answer: A. Encourage passive range-of-motion exercises
A school-age child develops sudden red, itchy welts on her arms after eating strawberries. What is the priority nursing action?
A. Administer diphenhydramine as ordered
B. Apply hydrocortisone cream
C. Encourage the child to scratch to reduce itching
D. Have the child lie flat with legs elevated
Answer: A. Administer diphenhydramine as ordered
A nurse is conducting a well-child assessment for an 18-month-old toddler. Which of the following findings would prompt the nurse to recommend further screening for autism spectrum disorder (ASD)?
A. Runs with a wide-based gait
B. Points to ask for a snack
C. Engages in pretend play with a toy phone
D. Avoids eye contact and has not begun to speak
Answer: D. Avoids eye contact and has not begun to speak
A child in hypovolemic shock arrives at the emergency room. What is the nurse's priority action?
A. Administer IV fluids rapidly
B. Give oxygen via nasal cannula
C. Obtain blood cultures
D. Monitor urine output
Answer: A. Administer IV fluids rapidly
Which of the following drugs can be administered via the endotracheal tube in emergencies? (Select all that apply)
A. Lidocaine
B. Epinephrine
C. Atropine
D. Naloxone
Answer: A, B, C, D (LEAN acronym)
A 7-year-old child presents with a fractured radius after falling off the monkey bars. The x-ray shows a partial break through the bone. What type of fracture does the nurse suspect?
A. Comminuted
B. Spiral
C. Greenstick
D. Compound
Answer: C. Greenstick
A hospitalized child with MRSA has a draining wound. Which action by the nurse is most important to prevent transmission?
A. Keep the wound moist
B. Use contact precautions
C. Restrict oral intake
D. Limit use of gloves to wound care
Answer: B. Use contact precautions
A nurse is teaching the parent of a child with ADHD about stimulant medication. Which statement indicates a need for further teaching?
A. "We'll give the medication in the morning to avoid sleep problems."
B. "I'll make sure my child eats before taking the medication."
C. "We’ll ask about once-daily dosing to avoid school doses."
D. "I’ll give the medication at bedtime so it lasts through school."
Answer: D. "I’ll give the medication at bedtime so it lasts through school."
Which clinical sign would the nurse expect to observe in a child with metabolic acidosis?
A. Shallow, slow respirations
B. Deep, rapid respirations (Kussmaul breathing)
C. Bradycardia
D. Hypoventilation
Answer: B. Deep, rapid respirations (Kussmaul breathing)
What is the most important nursing care after an animal bite?
A. Apply ice directly to the wound
B. Thoroughly clean and irrigate the wound and monitor for infection
C. Cover the wound with a tight bandage
D. Delay tetanus vaccine if the wound is minor
Answer: B. Thoroughly clean and irrigate the wound and monitor for infection
A 12-year-old with idiopathic scoliosis is fitted for a Boston brace. What statement by the child indicates correct understanding of the treatment plan?
A. “I only need to wear the brace at night.”
B. “The brace will fix my spine completely.”
C. “I should wear it for 18 hours a day.”
D. “Once I start wearing the brace, I won’t need any follow-ups.”
Answer: C. “I should wear it for 18 hours a day.”
A 7-month-old has a persistent red diaper rash with satellite lesions. Which is the most appropriate action by the nurse?
A. Recommend frequent diaper changes and zinc oxide cream
B. Clean with baby wipes containing fragrance and alcohol
C. Apply a topical antifungal such as nystatin
D. Suggest talcum powder with each diaper change
Answer: C. Apply a topical antifungal such as nystatin
A nurse is assessing a 16-year-old girl suspected of having anorexia nervosa. Which physical finding would the nurse expect to observe?
A. Elevated body temperature and tachycardia
B. BMI greater than 18 and thick scalp hair
C. Dry, sallow skin with bradycardia and nail pitting
D. Hypertension and bounding pulses
Answer: C. Dry, sallow skin with bradycardia and nail pitting
Which nursing action is most important when caring for a comatose child?
A. Encourage oral intake
B. Maintain airway patency and suction as needed
C. Provide high-protein snacks
D. Promote mobility exercises
Answer: B. Maintain airway patency and suction as needed
Which action best reflects the first step in the American Heart Association’s Pediatric Chain of Survival?
A. Provide early CPR immediately after cardiac arrest occurs
B. Prevent cardiac arrest and injuries through safety education
C. Call emergency medical services (EMS) as soon as possible
D. Begin pediatric advanced life support (PALS) interventions
B. Prevent cardiac arrest and injuries through safety education
A nurse is caring for a 6-month-old diagnosed with spinal muscular atrophy type 1 (Werdnig-Hoffmann disease). Which finding is most consistent with this condition?
A. Hyperreflexia and spastic movements
B. Normal motor development until age 2
C. Progressive weakness and poor head control
D. Muscle pain and joint swelling
Answer: C. Progressive weakness and poor head control
A mother asks how she can prevent flare-ups of her child’s eczema. Which statement by the nurse is most appropriate?
A. “Use hot water baths to remove dry skin.”
B. “Avoid moisturizers with perfumes or dyes.”
C. “Apply moisturizer only if the skin cracks.”
D. “Dress the child in wool clothing for warmth.”
Answer: B. “Avoid moisturizers with perfumes or dyes.”
Which statement best describes a child with a severe intellectual disability?
A. Able to perform ADLs with minimal help
B. May communicate through single words or gestures
C. Able to read at a 6th-grade level
D. Capable of living alone with job coaching
Answer: B. May communicate through single words or gestures
Atropine is administered in pediatric patients primarily to:
A. Treat bradycardia and reduce secretions before intubation
B. Lower blood pressure
C. Manage seizures
D. Reduce fever
Answer: A. Treat bradycardia and reduce secretions before intubation
Which action should the nurse perform first to maintain an open airway in an unconscious child?
A. Position the child on the side (recovery position)
B. Use a head tilt–chin lift maneuver if no spinal injury is suspected
C. Insert an oral airway without assessing airway patency
D. Suction the mouth before positioning the head
Answer: B. Use a head tilt–chin lift maneuver if no spinal injury is suspected