NUR106 | NUR106 Pediatric Nursing Exam 3
Version 3 Questions with Correct Answers and
Expert Explanation for Each Question
1. A 10-year-old child with sickle cell anemia is admitted for a vaso-occlusive crisis.
Which nursing intervention should be prioritized?
A. Administering oxygen via nasal cannula
B. Increasing intravenous and oral fluid intake
C. Applying cold compresses to the painful joints
D. Administering meperidine for pain management
Correct Answer: B
Expert Explanation: Vaso-occlusive crisis is caused by sickle-shaped cells
obstructing blood flow and causing tissue ischemia. Hydration is the priority
intervention because it reduces blood viscosity and helps prevent further sickling.
While oxygen may be used, it does not reverse the sickling that has already occurred
in the absence of respiratory distress. Cold compresses should be avoided as they
cause vasoconstriction and worsen the occlusion. Effective hydration remains the
cornerstone of pediatric management for these acute hematologic episodes.
2. A nurse is teaching the parents of a toddler diagnosed with iron-deficiency anemia
about dietary changes. Which statement indicates a need for further teaching?
A. “I will give my child a bottle of milk to help them fall asleep.”
,B. “I will provide iron-fortified cereals for breakfast.”
C. “I will limit my child’s milk intake to 24 ounces per day.”
D. “I will offer lean meats and green leafy vegetables.”
Correct Answer: A
Expert Explanation: Iron-deficiency anemia in toddlers is frequently caused by
excessive cow’s milk consumption which lacks iron. Giving a bottle of milk at
bedtime can lead to increased intake and potential dental caries. Parents should be
taught to limit milk to encourage the consumption of iron-rich solid foods. The goal
is to ensure a balanced diet that supports adequate hemoglobin production. Proper
education prevents nutritional deficiencies that can impact a child’s long-term
growth and development.
3. A child is undergoing induction therapy for Acute Lymphoblastic Leukemia (ALL).
Which assessment finding is most concerning for the nurse?
A. Alopecia and scalp sensitivity
B. A temperature of 101.2°F (38.4°C)
C. Nausea and vomiting after treatment
D. Poor appetite and weight loss
Correct Answer: B
,Expert Explanation: Children undergoing chemotherapy for leukemia are at
extremely high risk for life-threatening infections due to neutropenia. A fever in a
neutropenic patient is considered a medical emergency and requires immediate
intervention. While alopecia and nausea are common side effects of treatment, they
are not immediately life-threatening. Nurses must monitor absolute neutrophil
counts and implement strict infection control measures. Early detection of sepsis is
critical for improving survival rates in pediatric oncology patients.
4. Which instruction should the nurse include when teaching the parents of a child
with Hemophilia A?
A. “Encourage the child to participate in contact sports.”
B. “Practice RICE (Rest, Ice, Compression, Elevation) for joint injuries.”
C. “Apply heat to joints if the child experiences swelling.”
D. “Administer aspirin for minor aches and pains.”
Correct Answer: B
Expert Explanation: Hemophilia A is a genetic bleeding disorder characterized by a
deficiency in clotting factor VIII. The RICE method is the standard of care for
managing acute joint bleeding to minimize damage. Contact sports and aspirin are
strictly contraindicated as they significantly increase the risk of internal
hemorrhage. Ice causes vasoconstriction which helps control bleeding, whereas heat
, would increase blood flow to the area. Ensuring family compliance with safety
protocols is vital for preventing long-term joint deformity.
5. A nurse is preparing to assess a child with a suspected Wilms tumor. Which action is
strictly contraindicated?
A. Measuring the child’s blood pressure
B. Palpating the abdomen for mass margins
C. Obtaining a urine sample for analysis
D. Assessing the child’s lung sounds
Correct Answer: B
Expert Explanation: Wilms tumor, or nephroblastoma, is a common pediatric renal
cancer often presenting as an abdominal mass. Palpation of the abdomen must be
avoided to prevent accidental rupture of the tumor capsule. Rupture can lead to the
seeding of cancer cells throughout the peritoneal cavity and worsen the prognosis.
The nurse should place a sign over the bed stating that the abdomen should not be
palpated. This precaution is a fundamental safety standard in the management of
suspected pediatric renal tumors.
6. A child with Thalassemia major is receiving chronic blood transfusions. What
complication should the nurse monitor for most closely?
A. Polycythemia
Version 3 Questions with Correct Answers and
Expert Explanation for Each Question
1. A 10-year-old child with sickle cell anemia is admitted for a vaso-occlusive crisis.
Which nursing intervention should be prioritized?
A. Administering oxygen via nasal cannula
B. Increasing intravenous and oral fluid intake
C. Applying cold compresses to the painful joints
D. Administering meperidine for pain management
Correct Answer: B
Expert Explanation: Vaso-occlusive crisis is caused by sickle-shaped cells
obstructing blood flow and causing tissue ischemia. Hydration is the priority
intervention because it reduces blood viscosity and helps prevent further sickling.
While oxygen may be used, it does not reverse the sickling that has already occurred
in the absence of respiratory distress. Cold compresses should be avoided as they
cause vasoconstriction and worsen the occlusion. Effective hydration remains the
cornerstone of pediatric management for these acute hematologic episodes.
2. A nurse is teaching the parents of a toddler diagnosed with iron-deficiency anemia
about dietary changes. Which statement indicates a need for further teaching?
A. “I will give my child a bottle of milk to help them fall asleep.”
,B. “I will provide iron-fortified cereals for breakfast.”
C. “I will limit my child’s milk intake to 24 ounces per day.”
D. “I will offer lean meats and green leafy vegetables.”
Correct Answer: A
Expert Explanation: Iron-deficiency anemia in toddlers is frequently caused by
excessive cow’s milk consumption which lacks iron. Giving a bottle of milk at
bedtime can lead to increased intake and potential dental caries. Parents should be
taught to limit milk to encourage the consumption of iron-rich solid foods. The goal
is to ensure a balanced diet that supports adequate hemoglobin production. Proper
education prevents nutritional deficiencies that can impact a child’s long-term
growth and development.
3. A child is undergoing induction therapy for Acute Lymphoblastic Leukemia (ALL).
Which assessment finding is most concerning for the nurse?
A. Alopecia and scalp sensitivity
B. A temperature of 101.2°F (38.4°C)
C. Nausea and vomiting after treatment
D. Poor appetite and weight loss
Correct Answer: B
,Expert Explanation: Children undergoing chemotherapy for leukemia are at
extremely high risk for life-threatening infections due to neutropenia. A fever in a
neutropenic patient is considered a medical emergency and requires immediate
intervention. While alopecia and nausea are common side effects of treatment, they
are not immediately life-threatening. Nurses must monitor absolute neutrophil
counts and implement strict infection control measures. Early detection of sepsis is
critical for improving survival rates in pediatric oncology patients.
4. Which instruction should the nurse include when teaching the parents of a child
with Hemophilia A?
A. “Encourage the child to participate in contact sports.”
B. “Practice RICE (Rest, Ice, Compression, Elevation) for joint injuries.”
C. “Apply heat to joints if the child experiences swelling.”
D. “Administer aspirin for minor aches and pains.”
Correct Answer: B
Expert Explanation: Hemophilia A is a genetic bleeding disorder characterized by a
deficiency in clotting factor VIII. The RICE method is the standard of care for
managing acute joint bleeding to minimize damage. Contact sports and aspirin are
strictly contraindicated as they significantly increase the risk of internal
hemorrhage. Ice causes vasoconstriction which helps control bleeding, whereas heat
, would increase blood flow to the area. Ensuring family compliance with safety
protocols is vital for preventing long-term joint deformity.
5. A nurse is preparing to assess a child with a suspected Wilms tumor. Which action is
strictly contraindicated?
A. Measuring the child’s blood pressure
B. Palpating the abdomen for mass margins
C. Obtaining a urine sample for analysis
D. Assessing the child’s lung sounds
Correct Answer: B
Expert Explanation: Wilms tumor, or nephroblastoma, is a common pediatric renal
cancer often presenting as an abdominal mass. Palpation of the abdomen must be
avoided to prevent accidental rupture of the tumor capsule. Rupture can lead to the
seeding of cancer cells throughout the peritoneal cavity and worsen the prognosis.
The nurse should place a sign over the bed stating that the abdomen should not be
palpated. This precaution is a fundamental safety standard in the management of
suspected pediatric renal tumors.
6. A child with Thalassemia major is receiving chronic blood transfusions. What
complication should the nurse monitor for most closely?
A. Polycythemia
