NUR106 | NUR106 Pediatric Nursing Exam 2
Version 1 | Questions with Correct Answers and
Expert Explanation for Each Question | Saint Paul’s
School of Nursing
1. A 10-month-old infant is admitted with bronchiolitis caused by RSV. Which nursing
intervention should the nurse prioritize?
A. Administering oral antibiotics as prescribed
B. Suctioning the nares to clear thick secretions
C. Maintaining a strictly supine position
D. Encouraging a high-fiber diet
Correct Answer: B
Expert Explanation: Bronchiolitis in infants often leads to significant mucus
production which can obstruct the small airways and nasal passages. Since infants
are obligate nose breathers, clearing the nares with a bulb syringe is essential for
maintaining a patent airway. The nurse should perform suctioning especially before
feedings and sleep to improve comfort and intake. Supportive care including
hydration and oxygenation is the mainstay of treatment for viral RSV. This
prioritization directly addresses the infant’s immediate respiratory stability and
ability to feed.
,2. A child with asthma is experiencing a severe exacerbation. Which assessment
finding is most indicative of impending respiratory failure?
A. Loud expiratory wheezing heard without a stethoscope
B. Increased heart rate of 110 beats per minute
C. An oxygen saturation of 94% on room air
D. A sudden decrease in wheezing with diminished breath sounds
Correct Answer: D
Expert Explanation: A sudden decrease in wheezing or a ‘silent chest’ indicates
that air movement is so restricted that no sound is produced. This is a critical
finding signaling that the child is no longer able to move enough air to create a
wheeze. Immediate emergency intervention including advanced airway
management may be necessary to prevent arrest. While tachycardia and wheezing
are common in asthma, the absence of breath sounds is the most ominous sign. The
nurse must recognize this change immediately to initiate life-saving protocols.
3. The nurse is teaching a school-aged child how to use a Peak Flow Meter. Which
instruction should the nurse include?
A. Inhale as deeply as possible through the meter
B. Record the average of three consecutive attempts
C. Perform the test while sitting in a slouched position
,D. Record the highest of three readings obtained
Correct Answer: D
Expert Explanation: Peak flow monitoring is used to measure the maximum speed
of expiration to monitor asthma control. The child should stand up, take a deep
breath, and blow out as hard and fast as possible. Three attempts should be
performed to ensure accuracy and the highest value is recorded in the asthma action
plan. This ‘personal best’ helps determine which zone (Green, Yellow, or Red) the
child is currently in. Consistently recording the highest reading ensures that
treatment adjustments are based on the child’s optimal lung function.
4. A toddler is suspected of having epiglottitis. Which action should the nurse avoid
during the physical assessment?
A. Using a tongue blade to visualize the posterior pharynx
B. Monitoring the child’s oxygen saturation levels
C. Assessing for a muffled voice or ‘frog-like’ croaking
D. Observing for the presence of the ‘tripod’ position
Correct Answer: A
Expert Explanation: Epiglottitis is a medical emergency characterized by sudden
swelling of the epiglottis that can cause total airway obstruction. Using a tongue
blade or performing a throat swab can trigger a laryngospasm that completely
, closes the airway. The nurse should keep the child calm and avoid any invasive
procedures until an artificial airway can be established. Assessment should rely on
observation of symptoms like drooling, dysphagia, and distress. Providing
humidified oxygen via a blow-by method is often the safest way to deliver therapy
without causing agitation.
5. A child is prescribed Albuterol via a metered-dose inhaler (MDI) for acute asthma
symptoms. What side effect should the nurse monitor for?
A. Bradycardia and lethargy
B. Constipation and urinary retention
C. Hypoglycemia and dizziness
D. Tachycardia and nervousness
Correct Answer: D
Expert Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that works
by relaxing bronchial smooth muscle to improve airflow. Because it stimulates beta
receptors, it often results in systemic sympathetic effects such as an increased heart
rate and tremors. Parents and children should be educated that feeling ‘jittery’ or
having a racing heart is a common but temporary side effect. The nurse must
monitor the pulse rate before and after administration to ensure it remains within a
Version 1 | Questions with Correct Answers and
Expert Explanation for Each Question | Saint Paul’s
School of Nursing
1. A 10-month-old infant is admitted with bronchiolitis caused by RSV. Which nursing
intervention should the nurse prioritize?
A. Administering oral antibiotics as prescribed
B. Suctioning the nares to clear thick secretions
C. Maintaining a strictly supine position
D. Encouraging a high-fiber diet
Correct Answer: B
Expert Explanation: Bronchiolitis in infants often leads to significant mucus
production which can obstruct the small airways and nasal passages. Since infants
are obligate nose breathers, clearing the nares with a bulb syringe is essential for
maintaining a patent airway. The nurse should perform suctioning especially before
feedings and sleep to improve comfort and intake. Supportive care including
hydration and oxygenation is the mainstay of treatment for viral RSV. This
prioritization directly addresses the infant’s immediate respiratory stability and
ability to feed.
,2. A child with asthma is experiencing a severe exacerbation. Which assessment
finding is most indicative of impending respiratory failure?
A. Loud expiratory wheezing heard without a stethoscope
B. Increased heart rate of 110 beats per minute
C. An oxygen saturation of 94% on room air
D. A sudden decrease in wheezing with diminished breath sounds
Correct Answer: D
Expert Explanation: A sudden decrease in wheezing or a ‘silent chest’ indicates
that air movement is so restricted that no sound is produced. This is a critical
finding signaling that the child is no longer able to move enough air to create a
wheeze. Immediate emergency intervention including advanced airway
management may be necessary to prevent arrest. While tachycardia and wheezing
are common in asthma, the absence of breath sounds is the most ominous sign. The
nurse must recognize this change immediately to initiate life-saving protocols.
3. The nurse is teaching a school-aged child how to use a Peak Flow Meter. Which
instruction should the nurse include?
A. Inhale as deeply as possible through the meter
B. Record the average of three consecutive attempts
C. Perform the test while sitting in a slouched position
,D. Record the highest of three readings obtained
Correct Answer: D
Expert Explanation: Peak flow monitoring is used to measure the maximum speed
of expiration to monitor asthma control. The child should stand up, take a deep
breath, and blow out as hard and fast as possible. Three attempts should be
performed to ensure accuracy and the highest value is recorded in the asthma action
plan. This ‘personal best’ helps determine which zone (Green, Yellow, or Red) the
child is currently in. Consistently recording the highest reading ensures that
treatment adjustments are based on the child’s optimal lung function.
4. A toddler is suspected of having epiglottitis. Which action should the nurse avoid
during the physical assessment?
A. Using a tongue blade to visualize the posterior pharynx
B. Monitoring the child’s oxygen saturation levels
C. Assessing for a muffled voice or ‘frog-like’ croaking
D. Observing for the presence of the ‘tripod’ position
Correct Answer: A
Expert Explanation: Epiglottitis is a medical emergency characterized by sudden
swelling of the epiglottis that can cause total airway obstruction. Using a tongue
blade or performing a throat swab can trigger a laryngospasm that completely
, closes the airway. The nurse should keep the child calm and avoid any invasive
procedures until an artificial airway can be established. Assessment should rely on
observation of symptoms like drooling, dysphagia, and distress. Providing
humidified oxygen via a blow-by method is often the safest way to deliver therapy
without causing agitation.
5. A child is prescribed Albuterol via a metered-dose inhaler (MDI) for acute asthma
symptoms. What side effect should the nurse monitor for?
A. Bradycardia and lethargy
B. Constipation and urinary retention
C. Hypoglycemia and dizziness
D. Tachycardia and nervousness
Correct Answer: D
Expert Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that works
by relaxing bronchial smooth muscle to improve airflow. Because it stimulates beta
receptors, it often results in systemic sympathetic effects such as an increased heart
rate and tremors. Parents and children should be educated that feeling ‘jittery’ or
having a racing heart is a common but temporary side effect. The nurse must
monitor the pulse rate before and after administration to ensure it remains within a
