NUR 418 Exam 2 Questions With Complete Solutions
A 7-year-old with new onset Type 1 diabetes is admitted. Which
sign is most indicative of diabetic ketoacidosis (DKA)?
A. Weight gain and polyphagia
B. Fruity breath and Kussmaul respirations
C. Hyporeflexia and constipation
D. Hypertension and bradycardia Correct Answers Correct
Answer: B
Rationale: Fruity odor and deep, rapid respirations indicate
metabolic acidosis from DKA.
A child receiving chemotherapy for leukemia develops fever and
neutropenia. Priority nursing action:
A. Administer antipyretic and observe
B. Obtain cultures and start broad-spectrum antibiotics per
protocol
C. Encourage visitors to come support the child
D. Hold chemotherapy and discharge home Correct Answers
Correct Answer: B
Rationale: Febrile neutropenia is an emergency; prompt cultures
and empiric antibiotics are required.
A child receiving vincristine reports numbness in hands and feet.
The nurse recognizes this as:
A. Expected sign of remission
B. A side effect of neurotoxicity from vincristine
C. Evidence of infection
D. An unrelated allergic reaction Correct Answers Correct
Answer: B
,Rationale: Vincristine can cause peripheral neuropathy—assess
and report for dosing considerations.
A child with adrenal insufficiency has poor appetite and
vomiting. Labs show hyponatremia. The nurse recognizes the
need to:
A. Increase oral sodium intake only
B. Give stress-dose IV hydrocortisone and fluids
C. Restrict fluids indefinitely
D. Place on high-salt diet at home only Correct Answers b
A child with adrenal insufficiency is ill with vomiting. What is
the nurse's priority action?
A. Encourage home rest and fluids only
B. Administer stress-dose corticosteroids per protocol
C. Restrict sodium intake
D. Discontinue all medications temporarily Correct Answers
Correct Answer: B
Rationale: Illness may precipitate adrenal crisis; stress dosing of
steroids prevents decompensation.
A child with central DI is prescribed desmopressin (DDAVP).
What teaching should the nurse provide?
A. "You will take this medication only when you feel thirsty."
B. "Monitor output and body weight; report sudden weight
gain."
C. "Increase sodium intake while on this medication."
D. "This medication causes increased urine output." Correct
Answers Correct Answer: B
Rationale: DDAVP reduces urine output—watch for water
retention and hyponatremia; weight gain signals fluid retention.
, A child with epiglottitis sits upright, drooling, and is extremely
anxious. The nurse's best action is:
A. Keep the child calm, avoid oral examinations, and prepare for
emergent airway management
B. Inspect the throat with a tongue depressor immediately
C. Place child supine and start oral fluids
D. Encourage the child to blow out candles to relax airway
Correct Answers Correct Answer: A
Rationale: Manipulation can cause complete airway obstruction;
maintain position, keep calm, and prepare for airway support.
A child with hemophilia A is admitted after a joint bleed. The
nurse anticipates giving:
A. Desmopressin (DDAVP) or factor VIII concentrate per
orders
B. Aspirin for pain control
C. Heparin to prevent clotting
D. No treatment; allow bleed to resolve spontaneously Correct
Answers Correct Answer: ARationale: DDAVP raises factor
VIII in mild disease; replacement with factor VIII concentrate is
indicated for bleeding.
A child with spina bifida is most at risk for:
A. Latex allergy
B. Hypoglycemia
C. Skin dryness
D. Visual impairment Correct Answers A
A 7-year-old with new onset Type 1 diabetes is admitted. Which
sign is most indicative of diabetic ketoacidosis (DKA)?
A. Weight gain and polyphagia
B. Fruity breath and Kussmaul respirations
C. Hyporeflexia and constipation
D. Hypertension and bradycardia Correct Answers Correct
Answer: B
Rationale: Fruity odor and deep, rapid respirations indicate
metabolic acidosis from DKA.
A child receiving chemotherapy for leukemia develops fever and
neutropenia. Priority nursing action:
A. Administer antipyretic and observe
B. Obtain cultures and start broad-spectrum antibiotics per
protocol
C. Encourage visitors to come support the child
D. Hold chemotherapy and discharge home Correct Answers
Correct Answer: B
Rationale: Febrile neutropenia is an emergency; prompt cultures
and empiric antibiotics are required.
A child receiving vincristine reports numbness in hands and feet.
The nurse recognizes this as:
A. Expected sign of remission
B. A side effect of neurotoxicity from vincristine
C. Evidence of infection
D. An unrelated allergic reaction Correct Answers Correct
Answer: B
,Rationale: Vincristine can cause peripheral neuropathy—assess
and report for dosing considerations.
A child with adrenal insufficiency has poor appetite and
vomiting. Labs show hyponatremia. The nurse recognizes the
need to:
A. Increase oral sodium intake only
B. Give stress-dose IV hydrocortisone and fluids
C. Restrict fluids indefinitely
D. Place on high-salt diet at home only Correct Answers b
A child with adrenal insufficiency is ill with vomiting. What is
the nurse's priority action?
A. Encourage home rest and fluids only
B. Administer stress-dose corticosteroids per protocol
C. Restrict sodium intake
D. Discontinue all medications temporarily Correct Answers
Correct Answer: B
Rationale: Illness may precipitate adrenal crisis; stress dosing of
steroids prevents decompensation.
A child with central DI is prescribed desmopressin (DDAVP).
What teaching should the nurse provide?
A. "You will take this medication only when you feel thirsty."
B. "Monitor output and body weight; report sudden weight
gain."
C. "Increase sodium intake while on this medication."
D. "This medication causes increased urine output." Correct
Answers Correct Answer: B
Rationale: DDAVP reduces urine output—watch for water
retention and hyponatremia; weight gain signals fluid retention.
, A child with epiglottitis sits upright, drooling, and is extremely
anxious. The nurse's best action is:
A. Keep the child calm, avoid oral examinations, and prepare for
emergent airway management
B. Inspect the throat with a tongue depressor immediately
C. Place child supine and start oral fluids
D. Encourage the child to blow out candles to relax airway
Correct Answers Correct Answer: A
Rationale: Manipulation can cause complete airway obstruction;
maintain position, keep calm, and prepare for airway support.
A child with hemophilia A is admitted after a joint bleed. The
nurse anticipates giving:
A. Desmopressin (DDAVP) or factor VIII concentrate per
orders
B. Aspirin for pain control
C. Heparin to prevent clotting
D. No treatment; allow bleed to resolve spontaneously Correct
Answers Correct Answer: ARationale: DDAVP raises factor
VIII in mild disease; replacement with factor VIII concentrate is
indicated for bleeding.
A child with spina bifida is most at risk for:
A. Latex allergy
B. Hypoglycemia
C. Skin dryness
D. Visual impairment Correct Answers A
