NR 328 Pediatric Nursing Week 5 Study Guide 2026 |Chamberlain
College
1. A nurse is teaching the parents of a child with Growth Hormone (GH)
deficiency about the administration of recombinant human GH. What is the best
time for the injection?
A. Immediately upon waking in the morning
B. Right before the child goes to bed at night
C. Thirty minutes before the largest meal of the day
D. After vigorous physical exercise
Answer: B
Rationale: Growth hormone is naturally secreted in the highest concentrations during the
early stages of sleep; therefore, administering the injection at bedtime mimics the body’s
natural physiological surge.
2. A child is diagnosed with Diabetes Insipidus (DI). Which clinical manifestation
should the nurse expect to observe?
A. Fluid retention and weight gain
B. Excessive thirst and high urine output
C. High urine specific gravity and low sodium
D. Bradycardia and hypertension
Answer: B
Rationale: DI is characterized by a deficiency of ADH, leading to massive polyuria and
polydipsia. Urine will have a very low specific gravity.
,3. Which laboratory finding is consistent with a diagnosis of Syndrome of
Inappropriate Antidiuretic Hormone (SIADH)?
A. Serum sodium of 150 mEq/L
B. Serum sodium of 125 mEq/L
C. Urine specific gravity of 1.002
D. Low urine osmolality
Answer: B
Rationale: In SIADH, excessive ADH causes water retention, which leads to dilutional
hyponatremia (low serum sodium) and highly concentrated urine.
4. A child with Type 1 Diabetes Mellitus presents with diaphoresis, shakiness,
and pallor. What should be the nurse’s first action?
A. Administer 10 units of Regular insulin
B. Give 15 grams of rapid-acting carbohydrates
C. Check the urine for ketones
D. Contact the provider for an order of normal saline
Answer: B
Rationale: The child is showing signs of hypoglycemia. The standard treatment is the 15-
15 rule: 15g of simple carbs, wait 15 minutes, and recheck blood glucose.
5. Which teaching point is most important for a child wearing a Pavlik harness
for Developmental Dysplasia of the Hip (DDH)?
A. Keep the harness on for 23 hours a day, checking skin for redness
B. Apply lotions or powders under the straps to prevent friction
C. Adjust the straps every 2 hours to ensure a tight fit
D. The harness should only be worn while the child is sleeping
Answer: A
, Rationale: The Pavlik harness must be worn continuously (usually 23-24 hours) to
maintain hip abduction. Straps should only be adjusted by a professional, and skin integrity
is a priority.
6. A nurse is assessing a child for scoliosis. Which instruction should the nurse
provide to the child?
A. Bend forward at the waist with arms hanging down
B. Lie flat on your back and lift your legs
C. Sit on the edge of the table and cough
D. Walk across the room and turn around quickly
Answer: A
Rationale: The Adams Forward Bend test is used to identify rib asymmetry or a ‘rib hump,’
which is a classic sign of scoliosis.
7. In a child with Duchenne Muscular Dystrophy (DMD), the nurse notes the
child uses their hands to ‘walk up’ their legs to stand. This is known as:
A. Trendelenburg sign
B. Ortolani maneuver
C. Gower’s sign
D. Babinski reflex
Answer: C
Rationale: Gower’s sign is a classic compensatory maneuver in DMD where the child uses
their upper body strength to stand up due to pelvic and lower limb muscle weakness.
College
1. A nurse is teaching the parents of a child with Growth Hormone (GH)
deficiency about the administration of recombinant human GH. What is the best
time for the injection?
A. Immediately upon waking in the morning
B. Right before the child goes to bed at night
C. Thirty minutes before the largest meal of the day
D. After vigorous physical exercise
Answer: B
Rationale: Growth hormone is naturally secreted in the highest concentrations during the
early stages of sleep; therefore, administering the injection at bedtime mimics the body’s
natural physiological surge.
2. A child is diagnosed with Diabetes Insipidus (DI). Which clinical manifestation
should the nurse expect to observe?
A. Fluid retention and weight gain
B. Excessive thirst and high urine output
C. High urine specific gravity and low sodium
D. Bradycardia and hypertension
Answer: B
Rationale: DI is characterized by a deficiency of ADH, leading to massive polyuria and
polydipsia. Urine will have a very low specific gravity.
,3. Which laboratory finding is consistent with a diagnosis of Syndrome of
Inappropriate Antidiuretic Hormone (SIADH)?
A. Serum sodium of 150 mEq/L
B. Serum sodium of 125 mEq/L
C. Urine specific gravity of 1.002
D. Low urine osmolality
Answer: B
Rationale: In SIADH, excessive ADH causes water retention, which leads to dilutional
hyponatremia (low serum sodium) and highly concentrated urine.
4. A child with Type 1 Diabetes Mellitus presents with diaphoresis, shakiness,
and pallor. What should be the nurse’s first action?
A. Administer 10 units of Regular insulin
B. Give 15 grams of rapid-acting carbohydrates
C. Check the urine for ketones
D. Contact the provider for an order of normal saline
Answer: B
Rationale: The child is showing signs of hypoglycemia. The standard treatment is the 15-
15 rule: 15g of simple carbs, wait 15 minutes, and recheck blood glucose.
5. Which teaching point is most important for a child wearing a Pavlik harness
for Developmental Dysplasia of the Hip (DDH)?
A. Keep the harness on for 23 hours a day, checking skin for redness
B. Apply lotions or powders under the straps to prevent friction
C. Adjust the straps every 2 hours to ensure a tight fit
D. The harness should only be worn while the child is sleeping
Answer: A
, Rationale: The Pavlik harness must be worn continuously (usually 23-24 hours) to
maintain hip abduction. Straps should only be adjusted by a professional, and skin integrity
is a priority.
6. A nurse is assessing a child for scoliosis. Which instruction should the nurse
provide to the child?
A. Bend forward at the waist with arms hanging down
B. Lie flat on your back and lift your legs
C. Sit on the edge of the table and cough
D. Walk across the room and turn around quickly
Answer: A
Rationale: The Adams Forward Bend test is used to identify rib asymmetry or a ‘rib hump,’
which is a classic sign of scoliosis.
7. In a child with Duchenne Muscular Dystrophy (DMD), the nurse notes the
child uses their hands to ‘walk up’ their legs to stand. This is known as:
A. Trendelenburg sign
B. Ortolani maneuver
C. Gower’s sign
D. Babinski reflex
Answer: C
Rationale: Gower’s sign is a classic compensatory maneuver in DMD where the child uses
their upper body strength to stand up due to pelvic and lower limb muscle weakness.
