Essentials of Pediatric Nursing 4th Edition Study Guide |
Complete Pediatric Nursing Notes, NCLEX Prep, Child
Health Concepts, Practice Questions & Exam Review
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Question 1: Which principle is the foundation of family-centered care in pediatric nursing?
A. The nurse makes all decisions regarding the child's treatment plan.
B. The family is viewed as the constant in the child's life.
C. Medical staff should limit family presence during procedures to reduce anxiety.
D. Care should be delivered in a standardized manner regardless of family dynamics.
CORRECT ANSWER: B. The family is viewed as the constant in the child's life.
Rationale: Family-centered care recognizes that the family is the primary source of strength and
support for the child and views the family as the constant in the child's life, while healthcare
providers and systems fluctuate.
Question 2: A nurse is assessing a 6-month-old infant. Which developmental milestone
should the nurse expect to observe?
A. Walking with assistance
B. Sitting without support
C. Saying two-word phrases
D. Building a tower of two blocks
CORRECT ANSWER: B. Sitting without support
Rationale: By 6 months of age, most infants can sit without support. Walking typically occurs
around 12 months, two-word phrases around 18-24 months, and building blocks around 15-18
months.
Question 3: When administering medication to a preschooler, which technique is most
appropriate to gain cooperation?
A. Tell the child the medicine is candy.
B. Offer a choice between two acceptable options, such as using a cup or a spoon.
C. Restrain the child immediately to ensure safety.
D. Administer the medication while the child is sleeping.
CORRECT ANSWER: B. Offer a choice between two acceptable options, such as using a cup or
a spoon.
Rationale: Preschoolers are developing autonomy. Offering limited choices gives them a sense
of control and encourages cooperation without compromising safety. Calling medicine candy is
dangerous and discouraged.
Question 4: A toddler is hospitalized for dehydration. What is the priority nursing
intervention regarding fluid replacement?
A. Encourage large volumes of fluid immediately.
B. Administer oral rehydration therapy in small, frequent amounts.
C. Restrict fluids until vomiting stops completely.
D. Use only intravenous fluids regardless of severity.
CORRECT ANSWER: B. Administer oral rehydration therapy in small, frequent amounts.
,Rationale: For mild to moderate dehydration, oral rehydration therapy (ORT) given in small,
frequent amounts is effective and less invasive. Large volumes can trigger vomiting, and IVs are
reserved for severe cases or failed ORT.
Question 5: Which finding in a newborn would require immediate notification of the
provider?
A. Acrocyanosis of the hands and feet
B. Respiratory rate of 50 breaths per minute
C. Grunting sounds during expiration
D. Presence of a Mongolian spot on the buttocks
CORRECT ANSWER: C. Grunting sounds during expiration
Rationale: Grunting is a sign of respiratory distress and potential airway obstruction or lung
pathology in a newborn. Acrocyanosis, a respiratory rate of 50, and Mongolian spots are normal
findings.
Question 6: A school-age child is admitted with a fractured femur. Which pain assessment
tool is most appropriate?
A. FLACC scale
B. Wong-Baker FACES Pain Rating Scale
C. CRIES scale
D. Visual Analog Scale with complex descriptors
CORRECT ANSWER: B. Wong-Baker FACES Pain Rating Scale
Rationale: The Wong-Baker FACES scale is validated for children aged 3 years and older who can
point to the face that matches their pain level. The FLACC and CRIES scales are for non-verbal or
infant populations.
Question 7: What is the primary goal of therapeutic play in a pediatric hospital setting?
A. To distract the child from medical procedures only.
B. To allow the child to express feelings and master experiences.
C. To keep the child occupied so nurses can work efficiently.
D. To teach the child complex medical terminology.
CORRECT ANSWER: B. To allow the child to express feelings and master experiences.
Rationale: Therapeutic play helps children process hospitalization, express anxieties, and gain a
sense of control over their environment, aiding in emotional coping and recovery.
Question 8: A parent asks about the recommended age for introducing solid foods to an
infant. What is the nurse's best response?
A. "Solid foods can be introduced at 2 months."
B. "Solid foods should be introduced around 6 months of age."
C. "Solid foods should be delayed until 12 months."
D. "Solid foods can start as soon as the baby loses the tongue extrusion reflex, usually at 4
months."
CORRECT ANSWER: B. "Solid foods should be introduced around 6 months of age."
Rationale: Current guidelines recommend exclusive breastfeeding or formula feeding for the
first 6 months, with solid food introduction beginning around 6 months when the infant shows
developmental readiness.
,Question 9: Which sign is indicative of increased intracranial pressure (ICP) in an infant?
A. Sunken fontanel
B. Bulging anterior fontanel
C. Increased appetite
D. Hyperactivity
CORRECT ANSWER: B. Bulging anterior fontanel
Rationale: A bulging anterior fontanel in an infant is a classic sign of increased intracranial
pressure. A sunken fontanel indicates dehydration.
Question 10: When caring for a child with cystic fibrosis, which dietary modification is
essential?
A. Low-calorie, low-fat diet
B. High-calorie, high-protein, and high-fat diet with enzyme supplements
C. Strict vegetarian diet
D. Fluid restriction to prevent edema
CORRECT ANSWER: B. High-calorie, high-protein, and high-fat diet with enzyme supplements
Rationale: Children with cystic fibrosis have malabsorption due to pancreatic insufficiency. They
require a high-calorie, high-protein diet and pancreatic enzyme replacements to maintain
growth and nutrition.
Question 11: A child with asthma is experiencing an acute exacerbation. Which medication
should the nurse anticipate administering first?
A. Oral corticosteroids
B. Short-acting beta-agonist (SABA) via nebulizer
C. Long-acting beta-agonist (LABA)
D. Antibiotics
CORRECT ANSWER: B. Short-acting beta-agonist (SABA) via nebulizer
Rationale: Short-acting beta-agonists like albuterol are the first-line treatment for acute asthma
exacerbations to provide rapid bronchodilation. Corticosteroids reduce inflammation but take
longer to act.
Question 12: Which vaccination is typically administered at birth?
A. MMR (Measles, Mumps, Rubella)
B. Hepatitis B
C. Varicella
D. Influenza
CORRECT ANSWER: B. Hepatitis B
Rationale: The first dose of the Hepatitis B vaccine is routinely recommended within 24 hours of
birth to prevent vertical transmission and early infection.
Question 13: A toddler is diagnosed with otitis media. What instruction should the nurse give
the parents regarding pain management?
A. Apply ice packs directly to the ear.
B. Administer acetaminophen or ibuprofen as directed.
C. Use cotton swabs to clean the ear canal frequently.
D. Keep the child in a flat supine position.
, CORRECT ANSWER: B. Administer acetaminophen or ibuprofen as directed.
Rationale: Analgesics like acetaminophen or ibuprofen are effective for managing pain
associated with otitis media. Ice can be uncomfortable, and cotton swabs can damage the ear.
Question 14: What is the most common cause of poisoning in toddlers?
A. Carbon monoxide
B. Ingestion of household cleaning products or medications
C. Snake bites
D. Plant ingestion
CORRECT ANSWER: B. Ingestion of household cleaning products or medications
Rationale: Due to their curiosity and oral exploration, toddlers are most frequently poisoned by
ingesting accessible household substances like cleaners and medications.
Question 15: A child with sickle cell anemia is in vaso-occlusive crisis. What is the priority
nursing intervention?
A. Administer cold compresses to painful areas.
B. Ensure adequate hydration and pain management.
C. Restrict movement to prevent fracture.
D. Administer iron supplements immediately.
CORRECT ANSWER: B. Ensure adequate hydration and pain management.
Rationale: Hydration helps reduce blood viscosity and improve flow, while pain management is
critical in vaso-occlusive crisis. Cold compresses can cause vasoconstriction and worsen the
crisis.
Question 16: Which finding suggests a child may be experiencing physical abuse?
A. Bruises on the shins
B. Burns in the shape of an immersion pattern
C. A single fall resulting in a forehead bump
D. Frequent minor scratches from play
CORRECT ANSWER: B. Burns in the shape of an immersion pattern
Rationale: Immersion burns (stocking or glove distribution) are highly suspicious for non-
accidental trauma. Bruises on shins and minor scratches are common in active children.
Question 17: When teaching a parent about car seat safety for a 2-year-old, what is the
recommendation?
A. Forward-facing seat in the front seat.
B. Rear-facing seat in the back seat until at least age 2 or until height/weight limits are reached.
C. Booster seat with a lap belt only.
D. Adult seat belt alone.
CORRECT ANSWER: B. Rear-facing seat in the back seat until at least age 2 or until
height/weight limits are reached.
Rationale: Current safety guidelines recommend keeping children in rear-facing car seats as
long as possible, typically until at least age 2, to protect the head and neck in a crash.
Question 18: A child with type 1 diabetes presents with fruity breath odor and deep, rapid
respirations. What condition does this indicate?
Complete Pediatric Nursing Notes, NCLEX Prep, Child
Health Concepts, Practice Questions & Exam Review
Bundle
Question 1: Which principle is the foundation of family-centered care in pediatric nursing?
A. The nurse makes all decisions regarding the child's treatment plan.
B. The family is viewed as the constant in the child's life.
C. Medical staff should limit family presence during procedures to reduce anxiety.
D. Care should be delivered in a standardized manner regardless of family dynamics.
CORRECT ANSWER: B. The family is viewed as the constant in the child's life.
Rationale: Family-centered care recognizes that the family is the primary source of strength and
support for the child and views the family as the constant in the child's life, while healthcare
providers and systems fluctuate.
Question 2: A nurse is assessing a 6-month-old infant. Which developmental milestone
should the nurse expect to observe?
A. Walking with assistance
B. Sitting without support
C. Saying two-word phrases
D. Building a tower of two blocks
CORRECT ANSWER: B. Sitting without support
Rationale: By 6 months of age, most infants can sit without support. Walking typically occurs
around 12 months, two-word phrases around 18-24 months, and building blocks around 15-18
months.
Question 3: When administering medication to a preschooler, which technique is most
appropriate to gain cooperation?
A. Tell the child the medicine is candy.
B. Offer a choice between two acceptable options, such as using a cup or a spoon.
C. Restrain the child immediately to ensure safety.
D. Administer the medication while the child is sleeping.
CORRECT ANSWER: B. Offer a choice between two acceptable options, such as using a cup or
a spoon.
Rationale: Preschoolers are developing autonomy. Offering limited choices gives them a sense
of control and encourages cooperation without compromising safety. Calling medicine candy is
dangerous and discouraged.
Question 4: A toddler is hospitalized for dehydration. What is the priority nursing
intervention regarding fluid replacement?
A. Encourage large volumes of fluid immediately.
B. Administer oral rehydration therapy in small, frequent amounts.
C. Restrict fluids until vomiting stops completely.
D. Use only intravenous fluids regardless of severity.
CORRECT ANSWER: B. Administer oral rehydration therapy in small, frequent amounts.
,Rationale: For mild to moderate dehydration, oral rehydration therapy (ORT) given in small,
frequent amounts is effective and less invasive. Large volumes can trigger vomiting, and IVs are
reserved for severe cases or failed ORT.
Question 5: Which finding in a newborn would require immediate notification of the
provider?
A. Acrocyanosis of the hands and feet
B. Respiratory rate of 50 breaths per minute
C. Grunting sounds during expiration
D. Presence of a Mongolian spot on the buttocks
CORRECT ANSWER: C. Grunting sounds during expiration
Rationale: Grunting is a sign of respiratory distress and potential airway obstruction or lung
pathology in a newborn. Acrocyanosis, a respiratory rate of 50, and Mongolian spots are normal
findings.
Question 6: A school-age child is admitted with a fractured femur. Which pain assessment
tool is most appropriate?
A. FLACC scale
B. Wong-Baker FACES Pain Rating Scale
C. CRIES scale
D. Visual Analog Scale with complex descriptors
CORRECT ANSWER: B. Wong-Baker FACES Pain Rating Scale
Rationale: The Wong-Baker FACES scale is validated for children aged 3 years and older who can
point to the face that matches their pain level. The FLACC and CRIES scales are for non-verbal or
infant populations.
Question 7: What is the primary goal of therapeutic play in a pediatric hospital setting?
A. To distract the child from medical procedures only.
B. To allow the child to express feelings and master experiences.
C. To keep the child occupied so nurses can work efficiently.
D. To teach the child complex medical terminology.
CORRECT ANSWER: B. To allow the child to express feelings and master experiences.
Rationale: Therapeutic play helps children process hospitalization, express anxieties, and gain a
sense of control over their environment, aiding in emotional coping and recovery.
Question 8: A parent asks about the recommended age for introducing solid foods to an
infant. What is the nurse's best response?
A. "Solid foods can be introduced at 2 months."
B. "Solid foods should be introduced around 6 months of age."
C. "Solid foods should be delayed until 12 months."
D. "Solid foods can start as soon as the baby loses the tongue extrusion reflex, usually at 4
months."
CORRECT ANSWER: B. "Solid foods should be introduced around 6 months of age."
Rationale: Current guidelines recommend exclusive breastfeeding or formula feeding for the
first 6 months, with solid food introduction beginning around 6 months when the infant shows
developmental readiness.
,Question 9: Which sign is indicative of increased intracranial pressure (ICP) in an infant?
A. Sunken fontanel
B. Bulging anterior fontanel
C. Increased appetite
D. Hyperactivity
CORRECT ANSWER: B. Bulging anterior fontanel
Rationale: A bulging anterior fontanel in an infant is a classic sign of increased intracranial
pressure. A sunken fontanel indicates dehydration.
Question 10: When caring for a child with cystic fibrosis, which dietary modification is
essential?
A. Low-calorie, low-fat diet
B. High-calorie, high-protein, and high-fat diet with enzyme supplements
C. Strict vegetarian diet
D. Fluid restriction to prevent edema
CORRECT ANSWER: B. High-calorie, high-protein, and high-fat diet with enzyme supplements
Rationale: Children with cystic fibrosis have malabsorption due to pancreatic insufficiency. They
require a high-calorie, high-protein diet and pancreatic enzyme replacements to maintain
growth and nutrition.
Question 11: A child with asthma is experiencing an acute exacerbation. Which medication
should the nurse anticipate administering first?
A. Oral corticosteroids
B. Short-acting beta-agonist (SABA) via nebulizer
C. Long-acting beta-agonist (LABA)
D. Antibiotics
CORRECT ANSWER: B. Short-acting beta-agonist (SABA) via nebulizer
Rationale: Short-acting beta-agonists like albuterol are the first-line treatment for acute asthma
exacerbations to provide rapid bronchodilation. Corticosteroids reduce inflammation but take
longer to act.
Question 12: Which vaccination is typically administered at birth?
A. MMR (Measles, Mumps, Rubella)
B. Hepatitis B
C. Varicella
D. Influenza
CORRECT ANSWER: B. Hepatitis B
Rationale: The first dose of the Hepatitis B vaccine is routinely recommended within 24 hours of
birth to prevent vertical transmission and early infection.
Question 13: A toddler is diagnosed with otitis media. What instruction should the nurse give
the parents regarding pain management?
A. Apply ice packs directly to the ear.
B. Administer acetaminophen or ibuprofen as directed.
C. Use cotton swabs to clean the ear canal frequently.
D. Keep the child in a flat supine position.
, CORRECT ANSWER: B. Administer acetaminophen or ibuprofen as directed.
Rationale: Analgesics like acetaminophen or ibuprofen are effective for managing pain
associated with otitis media. Ice can be uncomfortable, and cotton swabs can damage the ear.
Question 14: What is the most common cause of poisoning in toddlers?
A. Carbon monoxide
B. Ingestion of household cleaning products or medications
C. Snake bites
D. Plant ingestion
CORRECT ANSWER: B. Ingestion of household cleaning products or medications
Rationale: Due to their curiosity and oral exploration, toddlers are most frequently poisoned by
ingesting accessible household substances like cleaners and medications.
Question 15: A child with sickle cell anemia is in vaso-occlusive crisis. What is the priority
nursing intervention?
A. Administer cold compresses to painful areas.
B. Ensure adequate hydration and pain management.
C. Restrict movement to prevent fracture.
D. Administer iron supplements immediately.
CORRECT ANSWER: B. Ensure adequate hydration and pain management.
Rationale: Hydration helps reduce blood viscosity and improve flow, while pain management is
critical in vaso-occlusive crisis. Cold compresses can cause vasoconstriction and worsen the
crisis.
Question 16: Which finding suggests a child may be experiencing physical abuse?
A. Bruises on the shins
B. Burns in the shape of an immersion pattern
C. A single fall resulting in a forehead bump
D. Frequent minor scratches from play
CORRECT ANSWER: B. Burns in the shape of an immersion pattern
Rationale: Immersion burns (stocking or glove distribution) are highly suspicious for non-
accidental trauma. Bruises on shins and minor scratches are common in active children.
Question 17: When teaching a parent about car seat safety for a 2-year-old, what is the
recommendation?
A. Forward-facing seat in the front seat.
B. Rear-facing seat in the back seat until at least age 2 or until height/weight limits are reached.
C. Booster seat with a lap belt only.
D. Adult seat belt alone.
CORRECT ANSWER: B. Rear-facing seat in the back seat until at least age 2 or until
height/weight limits are reached.
Rationale: Current safety guidelines recommend keeping children in rear-facing car seats as
long as possible, typically until at least age 2, to protect the head and neck in a crash.
Question 18: A child with type 1 diabetes presents with fruity breath odor and deep, rapid
respirations. What condition does this indicate?
