NUR106 | NUR106 Pediatric Nursing Exam 4
Version 2 | Questions with Correct Answers and
Expert Explanation for Each Question | Saint Paul’s
School of Nursing
1. A 10-year-old child is diagnosed with Attention Deficit Hyperactivity Disorder
(ADHD). Which intervention should the nurse include in the child’s plan of care to
promote academic success?
A. Encourage the child to work on large projects all at once.
B. Provide a classroom environment with multiple stimulating decorations.
C. Allow the child to choose their own schedule each day.
D. Break tasks into small, manageable steps with frequent breaks.
Correct Answer: D
Expert Explanation: Children with ADHD often struggle with executive functioning
and maintaining focus on lengthy assignments. Breaking tasks into smaller
segments prevents the child from becoming overwhelmed and allows for immediate
reinforcement. Frequent breaks help manage the child’s need for physical
movement and prevent cognitive fatigue. Using complex instructions or busy
environments typically increases distractibility rather than performance.
Consistency and structure are the cornerstones of managing behavioral symptoms
in the school setting.
,2. Which assessment finding is most characteristic of a 4-year-old child with Autism
Spectrum Disorder (ASD)?
A. Frequent seeking of physical comfort from strangers.
B. Preference for changing routines daily to stay engaged.
C. Highly advanced verbal communication skills for their age.
D. Lack of interest in imaginative play or social reciprocity.
Correct Answer: D
Expert Explanation: Autism Spectrum Disorder is primarily characterized by
deficits in social communication and social interaction across multiple contexts. A
common sign in young children is a lack of make-believe play and failure to share
interests with others. These children often struggle with nonverbal behaviors such
as eye contact and social cues. Rather than seeking variety, children with ASD
usually exhibit a strong preference for rigid routines and sameness. Identifying
these social delays early is crucial for implementing effective behavioral therapies.
3. An adolescent patient is admitted to the psychiatric unit with a diagnosis of
Oppositional Defiant Disorder (ODD). What is the nurse’s priority when managing this
patient’s behavior?
A. Ignoring all instances of verbal defiance to avoid conflict.
B. Negotiating rules every time the patient challenges them.
,C. Establishing clear, consistent limits and consequences.
D. Restricting all social contact with peers until behavior improves.
Correct Answer: C
Expert Explanation: Patients with ODD exhibit a pattern of angry, irritable mood
and argumentative behavior toward authority figures. Establishing clear limits
provides the structure necessary for the patient to understand expectations and
boundaries. When consequences are consistent, the adolescent learns that their
choices directly impact their environment. Negotiating or ignoring behavior often
reinforces the defiance and undermines the therapeutic plan. The nurse must
maintain a calm, non-judgmental approach while enforcing the established rules of
the unit.
4. A nurse is assessing a child suspected of having Conduct Disorder. Which behavior
should the nurse identify as a hallmark of this condition?
A. Persistent violation of the basic rights of others and social norms.
B. Repetitive hand-flapping and rocking movements.
C. Excessive shyness and withdrawal in social situations.
D. Difficulty sustaining attention in the classroom.
Correct Answer: A
, Expert Explanation: Conduct Disorder involves more severe behavioral problems
than ODD, including aggression toward people or animals. These individuals often
engage in deceitfulness, theft, or serious violations of rules without remorse. Unlike
simple social withdrawal, this behavior is externalized and harmful to the
community or peers. Hand-flapping is more common in ASD, while attention issues
point toward ADHD. Nursing care focuses on ensuring safety and helping the child
develop empathy and self-control.
5. When assessing an adolescent for signs of depression, which symptom should the
nurse expect to see that differs from adult presentations?
A. Irritability and acting-out behaviors.
B. Persistent feelings of sadness.
C. Changes in sleep patterns.
D. Loss of interest in activities.
Correct Answer: A
Expert Explanation: While adults with depression often appear lethargic or sad,
children and adolescents frequently manifest depression as irritability. This may
lead to behavioral outbursts that are sometimes misinterpreted as mere rebellion or
conduct issues. Somatic complaints like stomachaches or headaches are also more
common in younger populations. Identifying these mood shifts is essential for
Version 2 | Questions with Correct Answers and
Expert Explanation for Each Question | Saint Paul’s
School of Nursing
1. A 10-year-old child is diagnosed with Attention Deficit Hyperactivity Disorder
(ADHD). Which intervention should the nurse include in the child’s plan of care to
promote academic success?
A. Encourage the child to work on large projects all at once.
B. Provide a classroom environment with multiple stimulating decorations.
C. Allow the child to choose their own schedule each day.
D. Break tasks into small, manageable steps with frequent breaks.
Correct Answer: D
Expert Explanation: Children with ADHD often struggle with executive functioning
and maintaining focus on lengthy assignments. Breaking tasks into smaller
segments prevents the child from becoming overwhelmed and allows for immediate
reinforcement. Frequent breaks help manage the child’s need for physical
movement and prevent cognitive fatigue. Using complex instructions or busy
environments typically increases distractibility rather than performance.
Consistency and structure are the cornerstones of managing behavioral symptoms
in the school setting.
,2. Which assessment finding is most characteristic of a 4-year-old child with Autism
Spectrum Disorder (ASD)?
A. Frequent seeking of physical comfort from strangers.
B. Preference for changing routines daily to stay engaged.
C. Highly advanced verbal communication skills for their age.
D. Lack of interest in imaginative play or social reciprocity.
Correct Answer: D
Expert Explanation: Autism Spectrum Disorder is primarily characterized by
deficits in social communication and social interaction across multiple contexts. A
common sign in young children is a lack of make-believe play and failure to share
interests with others. These children often struggle with nonverbal behaviors such
as eye contact and social cues. Rather than seeking variety, children with ASD
usually exhibit a strong preference for rigid routines and sameness. Identifying
these social delays early is crucial for implementing effective behavioral therapies.
3. An adolescent patient is admitted to the psychiatric unit with a diagnosis of
Oppositional Defiant Disorder (ODD). What is the nurse’s priority when managing this
patient’s behavior?
A. Ignoring all instances of verbal defiance to avoid conflict.
B. Negotiating rules every time the patient challenges them.
,C. Establishing clear, consistent limits and consequences.
D. Restricting all social contact with peers until behavior improves.
Correct Answer: C
Expert Explanation: Patients with ODD exhibit a pattern of angry, irritable mood
and argumentative behavior toward authority figures. Establishing clear limits
provides the structure necessary for the patient to understand expectations and
boundaries. When consequences are consistent, the adolescent learns that their
choices directly impact their environment. Negotiating or ignoring behavior often
reinforces the defiance and undermines the therapeutic plan. The nurse must
maintain a calm, non-judgmental approach while enforcing the established rules of
the unit.
4. A nurse is assessing a child suspected of having Conduct Disorder. Which behavior
should the nurse identify as a hallmark of this condition?
A. Persistent violation of the basic rights of others and social norms.
B. Repetitive hand-flapping and rocking movements.
C. Excessive shyness and withdrawal in social situations.
D. Difficulty sustaining attention in the classroom.
Correct Answer: A
, Expert Explanation: Conduct Disorder involves more severe behavioral problems
than ODD, including aggression toward people or animals. These individuals often
engage in deceitfulness, theft, or serious violations of rules without remorse. Unlike
simple social withdrawal, this behavior is externalized and harmful to the
community or peers. Hand-flapping is more common in ASD, while attention issues
point toward ADHD. Nursing care focuses on ensuring safety and helping the child
develop empathy and self-control.
5. When assessing an adolescent for signs of depression, which symptom should the
nurse expect to see that differs from adult presentations?
A. Irritability and acting-out behaviors.
B. Persistent feelings of sadness.
C. Changes in sleep patterns.
D. Loss of interest in activities.
Correct Answer: A
Expert Explanation: While adults with depression often appear lethargic or sad,
children and adolescents frequently manifest depression as irritability. This may
lead to behavioral outbursts that are sometimes misinterpreted as mere rebellion or
conduct issues. Somatic complaints like stomachaches or headaches are also more
common in younger populations. Identifying these mood shifts is essential for
