NR 328 Pediatric Nursing Exam 4 Study Guide 2026 |Chamberlain
College
1. A nurse is caring for a child with a suspected diagnosis of bacterial meningitis.
Which of the following is the priority nursing action?
A. Administer prescribed analgesics
B. Monitor head circumference
C. Perform a lumbar puncture
D. Initiate droplet precautions
Answer: D
Rationale: Bacterial meningitis is highly contagious. Initiating droplet precautions is the
priority to prevent the spread of infection to others before other procedures are
performed.
2. A child with increased intracranial pressure (ICP) is being monitored. Which of
the following is an early sign of increased ICP in an infant?
A. Projectile vomiting
B. Cheyne-Stokes respirations
C. Bradycardia
D. Bulging fontanels
Answer: D
Rationale: In infants, whose cranial sutures are not yet fused, a bulging fontanel is a classic
early sign of increased intracranial pressure.
,3. A child is admitted with a diagnosis of Reye Syndrome. Which of the following
should the nurse investigate in the child’s recent medical history?
A. Influenza treated with aspirin
B. Exposure to lead-based paint
C. A recent streptococcal infection
D. History of gluten intolerance
Answer: A
Rationale: Reye Syndrome is associated with the administration of aspirin (salicylates)
during a viral illness such as influenza or varicella.
4. Which of the following is a key assessment finding in a child with Duchenne
Muscular Dystrophy?
A. Positive Brudzinski sign
B. Gowers sign
C. Barlow maneuver
D. Trendelenburg sign
Answer: B
Rationale: The Gowers sign, where a child uses their hands to ‘walk’ up their legs to stand,
is indicative of pelvic girdle weakness seen in Duchenne Muscular Dystrophy.
5. A nurse is teaching parents of a child with a new ventriculoperitoneal (VP)
shunt. Which symptom should they report immediately as it indicates shunt
malfunction?
A. Increased appetite
B. Dry mucous membranes
C. Sleepiness and irritability
D. A weight gain of 1 pound
Answer: C
, Rationale: Irritability, lethargy, and sleepiness are signs of increased ICP, which suggests
the shunt may be blocked or malfunctioning.
6. A nurse is providing discharge teaching for a child who had a tonsillectomy.
Which of the following is a sign of post-operative hemorrhage?
A. Low-grade fever
B. Refusal to drink citrus juice
C. Complaint of a sore throat
D. Frequent swallowing
Answer: D
Rationale: Frequent swallowing is a classic sign of bleeding in the throat post-
tonsillectomy, even if the child is asleep.
7. A child with scoliosis is prescribed a Milwaukee brace. How many hours a day
should the nurse instruct the child to wear the brace?
A. 8 hours
B. 12 hours
C. 23 hours
D. Only while sleeping
Answer: C
Rationale: For maximum effectiveness in correcting the spinal curve, scoliosis braces are
typically worn 23 hours a day, removed only for hygiene.
8. Which clinical manifestation is expected in a child with Nephrotic Syndrome?
A. Gross hematuria
B. Severe generalized edema
C. Elevated blood pressure
D. Weight loss
Answer: B
College
1. A nurse is caring for a child with a suspected diagnosis of bacterial meningitis.
Which of the following is the priority nursing action?
A. Administer prescribed analgesics
B. Monitor head circumference
C. Perform a lumbar puncture
D. Initiate droplet precautions
Answer: D
Rationale: Bacterial meningitis is highly contagious. Initiating droplet precautions is the
priority to prevent the spread of infection to others before other procedures are
performed.
2. A child with increased intracranial pressure (ICP) is being monitored. Which of
the following is an early sign of increased ICP in an infant?
A. Projectile vomiting
B. Cheyne-Stokes respirations
C. Bradycardia
D. Bulging fontanels
Answer: D
Rationale: In infants, whose cranial sutures are not yet fused, a bulging fontanel is a classic
early sign of increased intracranial pressure.
,3. A child is admitted with a diagnosis of Reye Syndrome. Which of the following
should the nurse investigate in the child’s recent medical history?
A. Influenza treated with aspirin
B. Exposure to lead-based paint
C. A recent streptococcal infection
D. History of gluten intolerance
Answer: A
Rationale: Reye Syndrome is associated with the administration of aspirin (salicylates)
during a viral illness such as influenza or varicella.
4. Which of the following is a key assessment finding in a child with Duchenne
Muscular Dystrophy?
A. Positive Brudzinski sign
B. Gowers sign
C. Barlow maneuver
D. Trendelenburg sign
Answer: B
Rationale: The Gowers sign, where a child uses their hands to ‘walk’ up their legs to stand,
is indicative of pelvic girdle weakness seen in Duchenne Muscular Dystrophy.
5. A nurse is teaching parents of a child with a new ventriculoperitoneal (VP)
shunt. Which symptom should they report immediately as it indicates shunt
malfunction?
A. Increased appetite
B. Dry mucous membranes
C. Sleepiness and irritability
D. A weight gain of 1 pound
Answer: C
, Rationale: Irritability, lethargy, and sleepiness are signs of increased ICP, which suggests
the shunt may be blocked or malfunctioning.
6. A nurse is providing discharge teaching for a child who had a tonsillectomy.
Which of the following is a sign of post-operative hemorrhage?
A. Low-grade fever
B. Refusal to drink citrus juice
C. Complaint of a sore throat
D. Frequent swallowing
Answer: D
Rationale: Frequent swallowing is a classic sign of bleeding in the throat post-
tonsillectomy, even if the child is asleep.
7. A child with scoliosis is prescribed a Milwaukee brace. How many hours a day
should the nurse instruct the child to wear the brace?
A. 8 hours
B. 12 hours
C. 23 hours
D. Only while sleeping
Answer: C
Rationale: For maximum effectiveness in correcting the spinal curve, scoliosis braces are
typically worn 23 hours a day, removed only for hygiene.
8. Which clinical manifestation is expected in a child with Nephrotic Syndrome?
A. Gross hematuria
B. Severe generalized edema
C. Elevated blood pressure
D. Weight loss
Answer: B
