Nursing Care of Children (NUR 321): Pediatrics Exam 3 | Questions and Answers Latest Spring 2026 - Coppin State University.

Nursing Care of Children (NUR 321): Pediatrics Exam 3 | Questions and Answers Latest Spring 2026 - Coppin State University. Pediatrics Exam 3 1. A nurse is reviewing the medical history of a 9-year-old child diagnosed with acute rheumatic fever. Which of the following questions should the nurse ask the parent to gather relevant information? a. Has your child experienced any joint or swelling recently? b. Has your child been vaccinated for influenza this year? c. Does your child have any allergies to foods? d. Does your child have a family history of asthma? 2. A child arrives to the emergency department with a dry, barking cough, hoarseness, anxiety, and noisy inspirations, but the symptoms have subsided by the time of arrival. Which of the following home care instructions should the ED nurse provide to the family for the managing future episodes? a. Expose the child to mist by running a hot shower b. Provide oxygen therapy using a nasal cannula c. Treat the child with antipyretics d. Treat the child with antibiotics 3. A nurse is caring for an adolescent who has acute otitis media (AOM) and was prescribed azithromycin 1 week ago. Which of the following manifestations reported by the client should the nurse address first? a. Abdominal discomfort b. Chest palpitations c. Nausea d. Diarrhea 4. What is the correct type of education that would be disclosed to this family of a child with hypoplastic left heart syndrome (HLHS)? a. This is a problem where the right side of the heart did not develop properly b. Initial treatments are palliative staged procedures that can be done to help the child live longer with this defect until heart transplantation occurs c. This is a problem where the left side of the heart is doing all the work and needs to be relieved d. The infant will have immediate surgery and then staged procedures to completely correct the heart defect 5. A nurse is providing teaching to the caregiver of a 5-year-old child who has a new diagnosis of asthma. Which of the following statements by the caregiver indicates an understanding of the teaching? a. “Asthma attacks can be life-threatening, so we need to have an action plan in place” b. “My child will grow out of their asthma problems and any other issues that go along with it” c. “There is one cause of asthma, so we need to address that as soon as possible” d. “Asthma problems only affect the respiratory system”6. A nurse is providing education to the family of a school aged child who has a history of atrial septal defect (ASD) with surgical repair. The child’s caregivers ask the nurse if their child can play sports. Which of the following statements made by the nurse is most appropriate? a. “Your child can participate in team sports as tolerated” b. “Your child can participate in activities like riding a bike, but they should not participate in sports” c. “Your child can participate in only individual sports, no team sports” d. “Your child cannot participate in any sports” 7. A nurse is providing care for an infant who has heart failure and is being discharged from the hospital. When providing discharge education, which of the following clinical manifestations should the nurse ensure caregivers are able to identify as signs of worsening heart failure? a. Tachypnea and diaphoresis with feeding, weigh gain, and irritability b. Abdominal pain, poor appetite, and cough c. Bradycardia, rapid weight-gain, and irritability d. Cough, edema, and increased work of breathing 8. A nurse is providing care to a school-aged child who has uncontrolled asthma. The child’s parent does not seem engaged in the child’s treatment during the hospitalization and states that the child manages their care with little assistance from them. Which of the following nursing interventions is most appropriate? a. Contact child protective services to intervene in the family since the child’s parent does not seem adequately prepared to manage the client’s illness at home b. Empower the child’s parent to help manage the asthma by offering comprehensive education on the condition, treatment plan, and managing potential complications at home c. Write out a detailed schedule of the child’s medication and a list of their healthcare provider’s addresses and phone numbers in case they should need it d. Print out a copy of the asthma action plan and thoroughly review it with the child and the school nurse prior to discharge 9. A nurse is providing care to a 13-year-old who has an atrial septal defect (ASD). Their caregivers raise concerns regarding mood changes, reporting the child seems more anxious and worried than usual over the past year. Considering the diagnosis of ASD, which of the following responses is appropriate for the nurse to make? a. “Children with ASD are at greater risk for experiencing anxiety” b. “All children with ASD have mood disorders” c. “Worrying is normal for this age group” d. “Children may become anxious when they have to be in a health care setting”10. How is the diagnoses of respiratory syncytial virus (RSV) accomplished? a. Throat culture b. Collection of a sputum specimen c. Obtaining blood for a complete blood count (CBC) d. Nasal aspiration 11. A nurse is providing teaching for a parent of a preschool-aged child who had a myringotomy with a tympanoplasty tube insertion 4 days ago. Which of the following actions should the nurse identify as an indication that the teaching was effective? (Select All The Apply) a. The child’s parent applies the prescribed medication as instructed b. The parent allows their child to attempt to lift their older sibling above the ground c. The child’s parent enforces nose blowing only when necessary d. The child’s parent states that they developed a plan to have their child use plugs in the shower e. The parent noticed purulent drainage from their child’s ear and immediately reported it to the surgeon 12. A nurse is assessing a 2-year-old toddler who has bronchitis. For which of the following findings should the nurse anticipate a prescription for a chest x-ray? a. Fatigue b. Coryza c. Axillary temperature 40 C (104F) d. Wheezing 13. A nurse is preparing to administer digoxin 8 mcg/kg/day PO to divide equally every 12 hrs. for a preschooler who weighs 33 lbs. Available is digoxin elixir 0.05 mg/mL. How many mL should the nurse administer per dose? (Round to answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) a. 1.2 mL 14. A nurse is providing education to the guardian of a child who has a prescription for palivizumab for respiratory syncytial virus (RSV). Which of the following instructions should the nurse provide to the guardian? a. The risk of becoming infected with RSV will be eliminated if the child receives this medication b. Administration of this injection every 28 days will be required c. Administer this medication once during RSV season d. Administer this after a positive diagnosis of RSV is obtained 15. A toddler with Kawasaki’s disease is ordered to receive IVIG and aspirin therapy. The nurse knows that medication therapy will follow all principles except which of the following? a. IVIG administration may reduce the risk of coronary artery aneurysms in Kawasaki diseaseb. Instruct parents to avoid measles and varicella vaccination for 11 months after high-dose IVIG administration c. Children with prolonged or recurrent fever may require a second dose of IVIG d. The aspirin dose will be increased after the fever is gone 16. A nurse is caring for a 16-year-old adolescent who just received rescue medication for an asthma exacerbation. Prior to the medication administration, nursing assessment revealed tearfulness, a respiratory rate of 32/min, wheezing in all lobes, oxygen saturation level of 91% on room air, inability to speak, and nasal flaring. The nurse should recognize that which of the following manifestations would indicate the client’s condition is improving? a. Is sitting calmly and able to answer questions b. Upward trend in respiratory rate c. Downward trend of oxygen saturation level d. Changed positions frequently 17. A nurse is assessing an infant in the cardiology clinic. Which of the following sets of clinical manifestations is consistent with a large ventricular septal defect? a. Murmur, excessive weight gain, and tachypnea b. Bradypnea, murmur, and fatigue with feeds c. Bradypnea, excessive weight gain, and fatigue with feeds d. Murmur, tachypnea, and fatigue with feeds 18. A nurse is providing education to the family of an infant who has a significant atrial septal defect (ASD). Which of the following is an accurate statement regarding clinical manifestations of ASD? a. “The infant could experience pulmonary hypotension” b. “The infant will experience an excessive weight gain” c. “The infant could experience recurrent respiratory infections” d. “The infant will be more likely to become dehydrated” 19. A nurse is caring for a child who is suspected of having pertussis. The nurse should recognize that the pathophysiology of pertussis includes which of the following? (Select All That Apply). a. The infection mainly affects the nostrils b. The infection is viral in nature c. The toxins released by the bacteria attack epithelial cell cilia d. The lungs and airway become inflamed e. Secretions are produced and are challenging to expel 20. A 4-year-old boy is having difficulty using a metered-dose inhaler due to lack of coordination. What should the nurse suggest to improve the effectiveness of his asthma treatment? a. Use a spacer with the inhaler b. Utilize a peak expiratory flow meter c. Try chest physiotherapy d. Switch to a nebulizer21. Parents of a child admitted with respiratory distress are concerned because the child won’t lie down and wants to sit in a chair leaning forward. The nurse tells the parents that: a. This position helps keep the airway open b. This helps the child feel in control of his situation c. This confirms the child has asthma d. The child needs to be encouraged to lie flat in the bed 22. A nurse is providing education to the parent of a 13-year-old adolescent who has a prescription for oseltamivir for influenza. The nurse should instruct the parent to monitor the adolescent for which of the following findings during treatment? a. Hallucinations b. Constipation c. Headache d. Hyperglycemia 23. A nurse is caring for a 2-year-old child in the emergency department who was diagnosed with foreign body aspiration. Which of the following clinical manifestations should the nurse expect to see when assessing the child? (Select All That Apply) a. Choking b. Excessive coughing c. Wheezing d. Abdominal pain e. Nausea 24. Child’s weight: 33 lb Medication order: intravenous immunoglobulin 6,000 mg IV today A child weighing 33 lbs is prescribed 6,000 mg of intravenous immunoglobulin. Considering the recommended dose is 300 to 600 mg/dose IV every 3 to 4 weeks, is the ordered dose safe? a. True, the ordered dose exceeds the range but is still considered safe b. False, the ordered dose exceeds the recommended maximum c. False, the ordered dose is within the range but needs adjustment based on patient tolerance d. True, the ordered dose is within the recommended range 25. A nurse is caring for an 11-year-old child who presents to the emergency department with a mild cough and malaise that have been present for 1 week and an oral temperature of 38.1 C (100.6F). After gathering s history, the nurse suspects pertussis. Which of the following should the nurse anticipate the healthcare provider to prescribe to aid in the rapid diagnosis of pertussis? a. Pulmonary function testing (PFT) b. CT scan c. Chest x-rayd. Polymerase chain reaction test 26. A nurse is assessing a 5-day-old newborn. Which of the following findings should the nurse expect? a. Erythema toxicum b. Bulging anterior fontanel c. Heart rate 166/min d. Respiratory rate 24/min 27. A nurse has just received hand-off communication at the start of their shift. After reviewing each client’s status, which of the following clients should the nurse see first? a. A 15-year-old adolescent who had a laparoscopic appendectomy 30 hours ago, rates their pain a 3 on a scale of 1 to 10, and is preparing for discharge this morning b. An 18-month-old admitted for dehydration 2 days ago who has had six wet diapers in the last 24 hours and ate 90% of their meals c. A 6-year-old child admitted with asthma exacerbation who used a rescue inhaler 16 hours ago d. A 3-year-old toddler who aspirated several sunflower seeds and continues to cough with an O2 saturation of 91% 28. Which treatment would the nurse expect to administer to a child with acute rheumatic fever if ordered? a. Digoxin b. Penicillin c. Antihistamines d. Intravenous immunoglobulin 29. A nurse demonstrates understanding of congenital heart conditions associated with Tetralogy of Fallot by identifying which of the following anomalies? a. Patent ductus arteriosus b. Coarctation of the aorta c. Atrial septal defect d. Overriding aorta 30. A nurse reviewing the medical record of a child who has autism spectrum disorder (ASD) and notes the child has missed several appointments. When the nurse calls the parent, they state that visits to the healthcare provider’s office are difficult because of the loud environment, the bright lights, and the overstimulation, which leads to meltdowns. Which of the following actions should the nurse take to facilitate compliance with appointments? (Select All That Apply) a. Ensure the healthcare staff are staff that the child is familiar with b. Schedule the child’s appointment at a less busy time of day c. Place the child in a room further away from other clients d. Dim the lights in the child’s roome. Schedule the child’s appointment for after-hours so no other clients are there 31. A nurse is caring for a toddler who was diagnosed with acute otitis media (AOM) 2 weeks ago and prescribed 2 different antibiotics for treatment. Which of the following findings by the nurse requires further assessment? a. The toddler’s tympanic membrane is intact b. The toddler eats 80% of their meals and drinks 100% of their fluids c. The toddler is experiencing a new onset of migraines d. The toddler has an axillary temperature of 36.5C (97.4F) 32. A nurse is caring for a 6-year-old child who is experiencing an asthma exacerbation. The nurse is preparing to administer the prescribed aerosol rescue medication. Which of the following items would the nurse need to administer the medication? (Select All That Apply) a. Nebulizer b. Mask c. Syringe d. Spacer e. Intravenous access 33. Why is it important to limit the feeding time for a child with congestive heart failure? a. To ensure the child does not develop a feeding aversion b. To allow more time for the child to rest, which is crucial for recovery c. To prevent the child from overhydration, which can worsen heart failure d. To ensure the child gains weight efficiently by conserving calories 34. A nurse is providing discharge teaching to a 10-year-old client with status asthmaticus who has been prescribed Cromolyn sodium (Intal) via MDI and albuterol (Proventil) via MDI with a spacer. Which statement by the client indicates a need for additional teaching? a. “If my breathing begins to feel tight, I will use the Proventil immediately” b. “It may take 2 to 3 weeks before the Intal will make a difference in my manifestations” c. “If I miss s dose of Intal and it is not yet time for the next dose, I will take it as soon as I remember” d. “I will be sure to take the Intal four times a day before using the Proventil” 35. A home health nurse is assessing an adolescent who has cystic fibrosis. The child expresses concern about experiencing increasing episodes of respiratory distress and asks the nurse for insight into the possible reasons. Which of the following responses should the nurse make?a. “If you are experiencing worsening respiratory distress, we must get you to the emergency department immediately” b. “It sounds like you may be concerned that your condition could be getting worse. That can be scary, tell me more about what you have been experiencing” c. “As you know, cystic fibrosis is a respiratory disease, increased respiratory distress is a characteristic symptom of this disorder” d. “As a nurse, I can’t diagnose what is causing you to have worsening symptoms. However, I will relay this information to your healthcare provider so they can determine what should happen next” 36. 37. After teaching the parents of a young child with cystic fibrosis about how to administer pancreatic enzymes, which statement by the parents indicate correct understanding? a. “We can open the capsule and sprinkle it on his cereal” b. “We need to dissolve the capsule in water” c. “We can puncture the capsule and pour the liquid on his tongue” d. “We should crush the capsule to make it smaller” 38. A child has been prescribed spironolactone. Which laboratory value is most important to monitor following this medication? a. Serum potassium levels b. Serum magnesium levels c. Serum chloride levels d. Serum calcium levels 39. 40. 41. Which of the following indicates that the demands on the heart are successfully decreased in an infant with congestive heart failure (CHF)? a. Positioned in High Fowler position to maintain oxygen saturation at 90% b. Irritability when awake c. Capillary refill of more than 5 seconds d. Appropriate weight gain for age 42. 43. A nurse is providing care to an infant who has tetralogy of Fallot. The infant’s caregiver reports increased irritability and a bluish discoloration of the infant’s oral mucous membranes. Which of the following interventions is the nurse’s priority? a. Providing supplemental oxygen b. Consoling the child c. Administering morphine d. Placing the child in a knee-to-chest position 44.45. A nurse is planning care for a child who has chronic otitis media (COM). Which of the following interprofessional team members should the nurse plan to consult? (Select All That Apply) a. Ophthalmologist b. Speech therapist c. Audiologist d. Pediatrician e. Ear, nose, and throat (ENT) provider 46. A nurse is providing education to a family of a child who has Kawasaki disease. Which of the following statements made by the caregiver indicates an understanding of the education provided? a. “Kawasaki disease is an abnormal immune response that only affects the liver” b. “Kawasaki disease is an abnormal immune response in which the body attacks the skin only” c. “Kawasaki disease is an abnormal immune response that causes injury to the body’s muscles” d. “Kawasaki disease is an abnormal immune system response that can weaken the coronary arteries” 47. A nurse is teaching a parent of a school-aged child who has chronic otitis media (COM) about their condition. Which of the following statements made by the parent indicates an understanding of the teaching? a. “The doctor will screen my child for COM every 6 months” b. “My child could fall more easily with COM” c. “Children experiencing COM rarely have complications” d. “COM causes fluid to drain too rapidly from the ears” 48. 49. A nurse is caring for a 2-year-old child who has pneumonia. The child’s parents are unable to be with the child in the hospital during the day due to work schedules. While the child is alone during the day, they have several crying episodes which cause increased periods of respiratory distress, exhibiting manifestations such as tachypnea and decreased oxygen saturation levels. Which of the following interdisciplinary care team members would be beneficial to include in the child’s plan of care? a. Respiratory therapist b. Case manager c. Child life specialist d. Social worker 50. A nurse is providing discharge teaching to the parent of a child who is prescribed diphenhydramine 25 mg elixir every 4 hr as needed. The amount available is diphenhydramine elixir 12.5mg/5mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)a. 10mL 51. 52. A nurse is assessing a 2-month-old infant who has an acute respiratory tract infection. Which of the following findings should the nurse identify as requiring intervention? (Select All That Apply) a. Cyanotic skin b. Nasal flaring c. Productive cough d. Crying during feeding e. Intercostal retractions f. Head bobbing 53. A nursing is caring for an adolescent client who has pneumonia and a prescription for cefpodoxime 5mg/kg PO every 12 hrs for 5 days. The client weighs 88 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) a. 200 mg 54. A child is administered a dose of digoxin and subsequently vomits the medication. What should the nurse do next? a. Administer next dose as prescribed in 12 hours b. Administer another dose c. Contact the health care provider d. Offer a snack and administer another dose 55. A school nurse is caring for a child with a severe sore throat and fever. What should the nurse recommend to the parent as the next step? a. Take the child to the emergency room immediately b. Schedule an appointment with the primary care provider for further evaluation c. Administer acetaminophen for fever and pain management, and ensure the child gets plenty of rest d. Encourage the child to drink fluids that contain electrolytes to stay hydrated 56. A nurse is providing anticipatory guidance to parents who are introducing their child to more solid foods. Which of the following foods should the nurse educate the parents about that increases the risk of foreign body aspiration? (Select All That Apply) a. Popcorn b. Bread c. Grapes d. Hot dogs e. Cheese 57. 58. Nursing care of the child with Kawasaki disease is challenging because of: a. Predictable disease courseb. The child’s irritability c. The child’s ongoing requests for food d. Complex antibiotic therapy 59. A nurse is providing care to a 2-year-old who has a strong family history of hypertension. At the clinic visit, the child’s caregiver asks when it would be appropriate to monitor blood pressure. Which of the following statements made by the nurse is accurate? a. “Your child should have their blood pressure checked every time they are seen for a health care visit” b. “Your child should have blood pressure screening annually, starting at 3 years of age” c. “Your child should have blood pressure screenings every 6 months, starting at 2 years of age” d. “Your child will not have blood pressure screening until they are in high school” 60. A nurse is teaching a newly hired nurse about cystic fibrosis (CF). Which of the following statements should the nurse make? a. “Heart failure will occur at some point during the progression of CF” b. “This disorder is most common in individuals of Northern European descent” c. “The life expectancy for an individual who has this disorder is 25 years of age” d. “This disorder occurs when the mother has a mutation of the 7th chromosome’ 61. A nurse is caring for a full-term newborn diagnosed with persistent/patent ductus arteriosus (PDA). The newborn’s caregiver asks the nurse, “What causes a PDA?” Which of the following statements should the nurse respond with? a. “This cardiac defect is due to a folic acid deficiency in your diet when you are pregnant” b. “PDAs are more commonly seen in male newborns” c. “There is a 25% chance your next baby will also have a PDA” d. “A risk factor for having a newborn who has a PDA is a family history of heart disorders” 62. A child with cystic fibrosis is being discharged from the hospital. Which statement by the parent indicates a need for further teaching about their child’s care? a. My child should not get an annual influenza vaccine because of increased risk b. We will encourage our child to use the Flutter mucus clearing device c. I will not encourage my child to cough and deep breathe during chest physiotherapy d. Our child will use a metered dose inhaler to administer a bronchodilator63. An infant with a congenital heart defect is receiving palivizumab (Synagis). What is the primary purpose of this medication? a. Prevent respiratory syncytial virus (RSV) infection b. Prevent secondary bacterial infection c. Decrease toxicity of antiviral agents d. Make isolation of the infant with RSV unnecessary 64. A nurse is caring for an infant who weighs 12 lb and is prescribed cefuroxime sodium 15mg/kg PO every 12 hr. Available is cefuroxime sodium oral solution 125mg/5mL. How many mL should the nurse administer per dose? (Round to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) a. 3.3 mL 65. A nurse is providing education to the family of a client who has infectious endocarditis. Which of the following statements made by the nurse is accurate regarding this condition? a. “Only children with congenital heart disease are at risk for endocarditis, so your child likely has an underlying condition” b. “Endocarditis only occurs in children who are immunocompromised, because they are not able to fight off the bacterial infection in the heart” c. “Endocarditis is an infection of the endocardium resulting from a bloodborne pathogen that adheres to an injured part of the endocardium” d. “Endocarditis and its sequalae are localized to the heart and do not typically impact other parts of the body” 66. A nurse is providing education to the family of a child who has Kawasaki disease without an aneurysm. The caregivers ask how soon their child should be able to return to normal activity. Which of the following statements made by the nurse is appropriate? a. “Your child should be able to return to their usual level of activity within 6 months, without restriction” b. “Your child should be able to return to their usual level of activity in 3 to weeks” c. “Your child should not return to usual activities and should maintain bedrest for at least 6 to 8 weeks” d. “Your child should be able to immediately return to normal activity, without restriction” 67. A nurse is speaking with the parents of a newborn diagnosed with an atrial septal defect (ASD). The parents are concerned and ask “Will our child be okay?” What is the nurse’s best response? a. “Since there are no symptoms being exhibited right now, your child will likely not require surgery until the age of 3 years” b. “While each care is different, the majority of these defects correct on their own. Let’s see what the tests show, then speak with the doctor” c. “Most children have no symptoms of this defect”d. “If the defect isn’t treated it can cause problems such as pulmonary hypertension, heart failure, atrial arrhythmias, or stroke” 68. A nurse at an emergency department is caring for a child who was admitted with cystic fibrosis. The child's parent is given the following laboratory results: sodium 128 mg/dL (136 to 145 mEq/dL), blood glucose 268 g/dL (70 to 100 g/dL), potassium 4.2 mq/L (3.4 to 4.7 mEq/L), and oxygen saturation 88% on 2 L/min via nasal canula (95% to 100%). The parent ask how the values relate to cystic fibrosis. Which of the following statements by the nurse is accurate? a. “Oxygen saturation levels elevate due to scaring of lung tissue and impairment of gas exchange” b. “The condition affects the movement of sodium and water, lowering sodium levels” c. “The condition impairs the function of the intestines, therefore affecting blood glucose levels” d. “The condition produces mucus in the lungs, affecting potassium levels” 69. 70. A nurse is caring for an infant who has acute otitis media (AOM). The provider’s plan of care mentions “watchful-waiting” and the child’s parent asks the nurse what the term means. Which of the following responses should the nurse make? a. “Watchful-waiting involves monitoring how your child responds their prescribed medication for a 5-day period” b. “Watchful-waiting is when your child’s condition is being monitored closely and without prescribing treatment for an average of 3 days. If there is a change in your child’s condition, then the provider will update the plan of care to better accommodate your child’s needs” c. “Watchful-waiting involves monitoring how your child does within 3 months” d. “Watchful-waiting is when the provider monitors your child’s condition until a myringotomy with tympanoplasty tubes procedure can be scheduled”