Pediatric disorders
A child with Kawasaki disease is at highest risk for which complication if treatment is delayed?
A. Pulmonary embolism
B. Coronary artery aneurysm
C. Acute renal failure
D. Stroke
Answer: B
Rationale: Coronary artery damage is the hallmark high-risk complication.
A child with Pertussis is most contagious during which stage?
A. Convalescent
B. Paroxysmal
C. Catarrhal
D. Recovery
C. Catarrhal
why: Early cold-like stage → highest transmission
Which child is at highest risk for long-term toxic stress effects?
A. Child with strong school support but low income
B. Child exposed to chronic abuse without stable caregiver support
C. Child experiencing a single traumatic event with counseling
D. Child with occasional academic stress
B. Child exposed to chronic abuse without stable caregiver support
Which finding after a head injury requires immediate intervention?
A. Mild headache
B. Drowsiness that improves with rest
C. Clear fluid draining from the nose
D. Irritability
C. Clear fluid draining from the nose
Why: Suggests CSF leak → possible skull fracture
You’re assessing your patient’s morning labs. The metabolic panel shows the following results below. Which results are abnormal? Select all that apply:
A. Potassium 2 mEq/L
B. Sodium 110 mEq/L
C. BUN 10
D. Magnesium 2.3 mg/dL
E. Phosphorus 1 mg/dL
F. Glucose 96 mg/dL
G. Creatinine 5 mg/dL
A. Potassium 2 mEq/L
B. Sodium 110 mEq/L
E. Phosphorus 1 mg/dL
G. Creatinine 5 mg/dL
normal potassium level is 3.5-5 mEq/L, Sodium 135-145 mEq/L, phosphorus 2.5-4.5 mg/dL, and creatinine 0.6-1.2 mg/dL
A child with Cystic Fibrosis has worsening respiratory status. Which finding requires immediate intervention?
A. Thick green sputum
B. Barrel chest
C. Decreased breath sounds with asymmetry
D. Chronic cough
Answer: C
Why: Suggests pneumothorax or severe obstruction
A nurse is caring for a child with Down syndrome. Which associated conditions should the nurse monitor for?
Select all that apply:
A. Congenital heart defects
B. Hyperthyroidism
C. Leukemia
D. Hypotonia
E. Cystic fibrosis
F. Atlantoaxial instability
A. Congenital heart defects
C. Leukemia
D. Hypotonia
F. Atlantoaxial instability
Which statement best explains the relationship between ACEs and adult disease?
A. ACEs only affect mental health outcomes
B. ACEs increase risk for chronic diseases via prolonged stress response
C. ACEs effects are reversible without intervention
D. ACEs primarily impact short-term development only
B. ACEs increase risk for chronic diseases via prolonged stress response
A child has a suspected Compartment Syndrome after a fracture. Which findings should the nurse recognize?
Select all that apply:
A. Severe pain unrelieved by analgesics
B. Pallor of the extremity
C. Bounding distal pulses
D. Paresthesia
E. Paralysis (late sign)
F. Warm skin
A. Severe pain unrelieved by analgesics
B. Pallor of the extremity
D. Paresthesia
E. Paralysis (late sign)
A patient with liver failure has jaundice. What lab result provides evidence of this finding in the patient?
A. Bilirubin 5 mg/dL
B. Creatinine 1 mg/dL
C. Hemoglobin 18 g/dL
D. RBC 3.8 million
A. Bilirubin 5 mg/dL
A bilirubin level should be 0.1-1 mg/dL (remember less than 1 mg/dL). It forms with the breakdown of red blood cells, and creates an orange/yellowish color, which leaks into the mucous membranes/skin and creates “pumpkin” like hue to the patient’s features.
Which lab value in a child receiving chemotherapy requires immediate intervention?
A. Hemoglobin 10 g/dL
B. Platelets 150,000/mm³
C. Absolute neutrophil count (ANC) 400
D. WBC 6,000/mm³
C: absolute neutrophil count (ANC) 400
why? suggests neutropenia which increases infection risk
Which finding in an infant suggests Phenylketonuria is poorly controlled?
A. Musty body odor
B. Weight gain
C. Increased muscle tone
D. Hyperpigmentation
A. Musty body odor
A school-age child with high ACE exposure may exhibit which findings?
Select all that apply:
A. Hypervigilance
B. Developmental regression
C. Advanced emotional regulation
D. Somatic complaints (headaches, abdominal pain)
E. Impulsivity
F. Consistent academic excellence
A. Hypervigilance
B. Developmental regression
D. Somatic complaints (headaches, abdominal pain)
E. Impulsivity
During the emergent phase of burn care, what is the priority?
A. Wound debridement
B. Pain management only
C. Fluid resuscitation
D. Physical therapy
C. Fluid resuscitation
A 6 year-old is admitted with sickle cell crisis. The patient has a FACE scale rating of 10 and the following vital signs: HR 115, BP 120/82, RR 18, oxygen saturation 91%, temperature 101.4’F. Select all the appropriate nursing interventions for this patient at this time?
A. Administer IV Morphine per MD order
B. Administer oxygen per MD order
C. Keep NPO
D. Apply cold compresses
E. Start intravenous fluids per MD order
F. Administer iron supplement per MD order
G. Keep patient on bed rest
H. Remove restrictive clothing or objects from the patient
A, B, E, G, and H. When a patient is in sickle cell crisis, the abnormal RBCs are sickling and sticking together, which blocks blood flow. To help alleviate the RBCs from clumping together and sickling, oxygen and hydration are priority. This will help dilute the blood (hence decrease the sticking of RBCs) and help supply oxygen to the RBCs
A nurse is caring for a child with Tetralogy of Fallot experiencing a hypercyanotic ("tet") spell. Which interventions should the nurse implement?
Select all that apply:
A. Place the child in a knee-chest position
B. Administer oxygen via face mask
C. Encourage the child to ambulate
D. Administer morphine as prescribed
E. Provide a high-flow IV fluid bolus rapidly
F. Calm and comfort the child
A. Place the child in a knee-chest position
B. Administer oxygen via face mask
D. Administer morphine as prescribed
F. Calm and comfort the child
child presents with Stevens-Johnson syndrome. Which findings require immediate intervention?
Select all that apply:
A. Skin sloughing
B. Mucosal involvement
C. Fever
D. Target lesions
E. Eye redness
F. Dry skin only
A. Skin sloughing
B. Mucosal involvement
E. Eye redness
Which behavior in a child with ACE exposure requires immediate intervention?
A. Occasional irritability
B. Difficulty concentrating
C. Suicidal ideation
D. Mild separation anxiety
C. Suicidal ideation
A child is rescued from a near-drowning event. Which findings indicate respiratory compromise?
Select all that apply:
A. Crackles in lungs
B. Pink frothy sputum
C. Bradycardia
D. Hypoxia
E. Hypertension
F. Altered level of consciousness
A. Crackles in lungs
B. Pink frothy sputum
C. Bradycardia
D. Hypoxia
F. Altered level of consciousness
You are providing diet teaching to a patient with low iron levels. Which foods would you encourage the patient to eat regularly?
A. herbal tea, apples, and watermelon
B. Sweet potatoes, artichokes, and packaged meat
C. Egg yolks, beef, and legumes
D. Chocolate, cornbread, and cabbage
C. Egg yolks, beef, and legumes
A toddler diagnosed with Epiglottitis is admitted. Which nursing actions are appropriate?
Select all that apply:
A. Keep the child in an upright position
B. Inspect the throat with a tongue depressor
C. Prepare for intubation
D. Keep emergency airway equipment at bedside
E. Encourage oral fluids
F. Minimize agitation
Answer:
A. Keep the child in an upright position
C. Prepare for intubation
D. Keep emergency airway equipment at bedside
F. Minimize agitation
Trap: NEVER visualize throat → risk of airway collapse
A child is diagnosed with Measles. Which findings should the nurse expect?
Select all that apply:
A. Koplik spots
B. Strawberry tongue
C. High fever
D. Maculopapular rash starting on face
E. Vesicular lesions in various stages
F. Photophobia
A. Koplik spots
C. High fever
D. Maculopapular rash starting on face
F. Photophobia
When screening for ACEs, which nursing actions are appropriate?
Select all that apply:
A. Ensure privacy and confidentiality
B. Use a validated screening tool
C. Ask leading questions to obtain disclosure
D. Build rapport before sensitive questions
E. Document findings objectively
F. Promise secrecy to gain trust
A. Ensure privacy and confidentiality
B. Use a validated screening tool
D. Build rapport before sensitive questions
E. Document findings objectively
A nurse is assessing a toddler with suspected Concussion. Which findings are expected?
Select all that apply:
A. Brief loss of consciousness
B. Persistent vomiting
C. Amnesia surrounding the event
D. Unequal pupils
E. Headache
F. Seizures immediately
A. Brief loss of consciousness
C. Amnesia surrounding the event
E. Headache
A patient’s anion gap is 15 mEq/L. Which condition below can cause this lab result?
A. Diabetic Ketoacidosis
B. Hypokalemia
C. Over usage of antacids
D. Vomiting
A. Diabetic Ketoacidosis
A normal anion gap is 3-10 mEq/L. An anion gap assesses for an acid-base imbalance by looking at certain electrolytes from the metabolic panel (sodium, chloride, bicarbonate) and if there is a gap or difference between positively and negatively charge electrolytes. A HIGH gap or difference demonstrates metabolic acidosis such as Diabetic Ketoacidosis. All the other options actually cause alkalosis.