NR 328 CMS Pediatric Nursing Exam Mastery Study Guide | Nosebleed
(Epistaxis) Emergency Management, Sickle Cell Disease Crisis & Acute Chest
Syndrome, Hemophilia Bleeding Management & Factor Replacement Therapy,
Pediatric Blood Transfusion Reactions & Circulatory Overload Recognition, Iron-
Deficiency Anemia Treatment & Iron Supplement Administration, Pediatric HIV
Infection & AIDS-Defining Conditions (Cytomegalovirus), Absolute Neutropenia
& Infection Risk (ANC <500), Chemotherapy Complications & Extravasation
Management, Oral Mucositis Care in Pediatric Oncology, Hodgkin Disease
Symptoms (Fever, Night Sweats, Hepatosplenomegaly), Wilms Tumor
Preoperative Nursing Care & Abdominal Palpation Precautions, Leukemia
Treatment & Live-Virus Vaccine Considerations, Steroid Therapy Side Effects in
Children (Behavioral Changes), Tracheostomy Airway Obstruction Assessment &
Suctioning Guidelines, Acute Epiglottitis Emergency Airway Management,
Rotavirus Gastroenteritis Manifestations, Varicella Infection & Airborne-Contact
Isolation Precautions Exam Questions Verified and Provided with Complete A+
Graded Rationales Latest Updated 2026
Which interventions are included in the management of nosebleeds in children? Select all that
apply.
a. Apply warm compresses to the bridge of the nose if bleeding is persistent.
b. Apply continuous pressure to the nose with thumb and forefinger for at least 10 minutes.
c. Have the child sit down and tilt the head backward.
,d. Insert cotton or wadded tissue into each nostril if bleeding persists.
e. Instruct the child to breathe through the mouth.
Answer: B, D, E
Rationale: During a nosebleed, the child should be instructed to breathe through the mouth,
cotton or wadded tissue can be inserted into the nostrils to stop bleeding, and continuous
pressure using the thumb and forefinger should be applied for at least 10 minutes. The child
should be instructed to sit up and lean forward, not tilt the head backward. Ice or cold cloths,
not warm compresses, can be used on the bridge of the nose if bleeding persists.
The nurse is developing a teaching plan for the family of a toddler recently diagnosed with sickle
cell disease. Of which does the nurse include as important for the family to be aware and to
report in order to recognize signs of the major cause of death for children under age 5 with
sickle cell disease?
a. Presence of respiratory problems
b. Signs and symptoms of stroke
c. Localized swelling over joints
d. Presence of fever
Answer: D
,Rationale: The major cause of death for children with sickle cell disease under the age of 5 is
overwhelming infections; thus the family needs to monitor the child closely for presence of
fever. Signs and symptoms of stroke, presence of respiratory problems, and localized swelling
over joints are also symptoms of issues related to sickle cell disease, but are not directly related
to the leading cause of death for children under the age of 5.
Which symptom would the nurse recognize as an acquired immunodeficiency syndrome (AIDS)-
defining condition in an American child with human immunodeficiency virus (HIV)?
a. Parotitis
b. Cytomegalovirus
c. Oral candidiasis
d. Hepatosplenomegaly
Answer: B
Rationale: Cytomegalovirus is a defining condition for AIDS in an HIV-infected American child.
Parotitis, oral candidiasis, and hepatosplenomegaly are common clinical manifestations of HIV
infection in children but not AIDS-defining conditions.
, The nurse is administering a blood transfusion to a child for treatment of hemophilia. Upon
assessment, the nurse notes that the child is cyanotic, has difficulty breathing, and has rales
upon inspiration throughout the lung fields. What is the nurse’s best response to these findings?
a. Stop the transfusion immediately.
b. Administer epinephrine immediately.
c. Insert a urinary catheter and monitor hourly outputs.
d. Reassess the patient again in five minutes.
Answer: A
Rationale: Cyanosis, rales, and difficulty breathing are all potential signs of circulatory overload.
If signs of circulatory overload occur, the transfusion should be stopped immediately.
Reassessing the patient in five minutes would not provide an immediate response to the
situation. Epinephrine is administered for allergic reactions. Insertion of a urinary catheter may
be done to treat an incompatibility reaction.
The nurse is teaching the family of a child diagnosed with iron-deficiency anemia about the
proper administration of iron supplements. Which points should the nurse include in the
education session? Select all that apply.
a. Stop the medication and call the primary care provider if tarry stools are noted.
b. Administer with milk products to alter the taste if taste is an issue.
(Epistaxis) Emergency Management, Sickle Cell Disease Crisis & Acute Chest
Syndrome, Hemophilia Bleeding Management & Factor Replacement Therapy,
Pediatric Blood Transfusion Reactions & Circulatory Overload Recognition, Iron-
Deficiency Anemia Treatment & Iron Supplement Administration, Pediatric HIV
Infection & AIDS-Defining Conditions (Cytomegalovirus), Absolute Neutropenia
& Infection Risk (ANC <500), Chemotherapy Complications & Extravasation
Management, Oral Mucositis Care in Pediatric Oncology, Hodgkin Disease
Symptoms (Fever, Night Sweats, Hepatosplenomegaly), Wilms Tumor
Preoperative Nursing Care & Abdominal Palpation Precautions, Leukemia
Treatment & Live-Virus Vaccine Considerations, Steroid Therapy Side Effects in
Children (Behavioral Changes), Tracheostomy Airway Obstruction Assessment &
Suctioning Guidelines, Acute Epiglottitis Emergency Airway Management,
Rotavirus Gastroenteritis Manifestations, Varicella Infection & Airborne-Contact
Isolation Precautions Exam Questions Verified and Provided with Complete A+
Graded Rationales Latest Updated 2026
Which interventions are included in the management of nosebleeds in children? Select all that
apply.
a. Apply warm compresses to the bridge of the nose if bleeding is persistent.
b. Apply continuous pressure to the nose with thumb and forefinger for at least 10 minutes.
c. Have the child sit down and tilt the head backward.
,d. Insert cotton or wadded tissue into each nostril if bleeding persists.
e. Instruct the child to breathe through the mouth.
Answer: B, D, E
Rationale: During a nosebleed, the child should be instructed to breathe through the mouth,
cotton or wadded tissue can be inserted into the nostrils to stop bleeding, and continuous
pressure using the thumb and forefinger should be applied for at least 10 minutes. The child
should be instructed to sit up and lean forward, not tilt the head backward. Ice or cold cloths,
not warm compresses, can be used on the bridge of the nose if bleeding persists.
The nurse is developing a teaching plan for the family of a toddler recently diagnosed with sickle
cell disease. Of which does the nurse include as important for the family to be aware and to
report in order to recognize signs of the major cause of death for children under age 5 with
sickle cell disease?
a. Presence of respiratory problems
b. Signs and symptoms of stroke
c. Localized swelling over joints
d. Presence of fever
Answer: D
,Rationale: The major cause of death for children with sickle cell disease under the age of 5 is
overwhelming infections; thus the family needs to monitor the child closely for presence of
fever. Signs and symptoms of stroke, presence of respiratory problems, and localized swelling
over joints are also symptoms of issues related to sickle cell disease, but are not directly related
to the leading cause of death for children under the age of 5.
Which symptom would the nurse recognize as an acquired immunodeficiency syndrome (AIDS)-
defining condition in an American child with human immunodeficiency virus (HIV)?
a. Parotitis
b. Cytomegalovirus
c. Oral candidiasis
d. Hepatosplenomegaly
Answer: B
Rationale: Cytomegalovirus is a defining condition for AIDS in an HIV-infected American child.
Parotitis, oral candidiasis, and hepatosplenomegaly are common clinical manifestations of HIV
infection in children but not AIDS-defining conditions.
, The nurse is administering a blood transfusion to a child for treatment of hemophilia. Upon
assessment, the nurse notes that the child is cyanotic, has difficulty breathing, and has rales
upon inspiration throughout the lung fields. What is the nurse’s best response to these findings?
a. Stop the transfusion immediately.
b. Administer epinephrine immediately.
c. Insert a urinary catheter and monitor hourly outputs.
d. Reassess the patient again in five minutes.
Answer: A
Rationale: Cyanosis, rales, and difficulty breathing are all potential signs of circulatory overload.
If signs of circulatory overload occur, the transfusion should be stopped immediately.
Reassessing the patient in five minutes would not provide an immediate response to the
situation. Epinephrine is administered for allergic reactions. Insertion of a urinary catheter may
be done to treat an incompatibility reaction.
The nurse is teaching the family of a child diagnosed with iron-deficiency anemia about the
proper administration of iron supplements. Which points should the nurse include in the
education session? Select all that apply.
a. Stop the medication and call the primary care provider if tarry stools are noted.
b. Administer with milk products to alter the taste if taste is an issue.
