PEDIATRIC NURSING COMPREHENSIVE EXAM STUDY GUIDE QUESTIONS AND
ANSWERS
STRESS RESPONSES IN TODDLERS
SEPARATION ANXIETY, REGRESSION, AND SLEEP ISSUES
LATEST UPDATED 2025
All Answers are in RED
Major Keywords: Pediatric nursing exam, stress in toddlers, toddler separation anxiety, grief in young children, toddler regression behaviors, refusal to eat in toddlers,
pediatric sleep disturbances, nursing care for stressed toddlers, emotional development in pediatrics, NCLEX pediatric mental health
STUDY GUIDE
Examples of stress experienced by toddlers
1. separation anxiety from parents, grief reactions
2. regression
3. refusal to eat
4. difficulty sleeping
Three phases of separation anxiety and behavioral responses exhibited during each phase
1. protest; clings to parent to force them to stay
2. despair, inactive + withdrawn and regress
3. detachment, denial, after prolonged separation , denies need for parents lvoe, affection to nurses
Nursing interventions to reduce separation anxiety
1. encourage family contact
2. familiar belonging brought from home
3. provide therapeutic play
4. accept regression
5. consistent routine with familiar staff
6. extra cuddling and holding
Example of a coping strategy found amongst toddlers when in stress
throwing games
List the major developmental tasks for toddlers
1. development of autonomy
2. control environment
3. act of movement with no restraining
Identify examples of collaborative efforts to assist toddlers with control and mobility
1. assist child with ambulation within their control
2. throwing games, vent frustrations
,3. child life specialist, modified toys
4. physical therapist, promote strength and flexibility
List nursing interventions used to prepare a toddle for a procedure
1. brief explanations, 5-10 mins, emphasize what the child will see, hear, taste, or feel
2. see age appropriate videos with parents
3. comfort by use of bandages to stop bleeding, avoid deception to gain compliance
Identify the initial step to effective pain management and special considerations made for a toddler
1. assessment, meaning of hurt, what word is used for pain
2. prior pain experience
3. what does your child do when she/he is hurting
4. anything special that need to know about the child in pain
List behavioral cues demonstrated by a a toddler when experiencing pain
1. frowning
2. crying
2. restlessness
List physiological cues demonstrated by a toddler when experiencing pain.
1. rapid pulse
2. rapid respiration
3. perspiration
Identify nursing interventions used for pain management with a toddler
1. form of relaxation, deep breaths
2. form of distraction
3. transport to treatment room for treatments
4. medical personnel restrains, not parents
5. the parents presence
6. explain in a a few simple words
7. administration of pain meds
Provide examples of fostering autonomy and independence when planning for discharge
1. select favoring snacks
2. help with dressing change
3. allow playing if on bed rest ( can play near bed)
4. continue to perform toileting and hygiene skills
5. toys for psychosocial development
6. give independence and allow exploration within safe guidelines
List seven reliable devices for accurately measuring and administering oral meds
*measuring spoon
*plastic syringes
*calibrated nipple
, *plastic medicine cup
*calibrated dropper
*hollow handles medicine spoon
*medicine bottle used to delivery oral meds via syringe
Six methods of med administration that encourage child's acceptance
1. flavored ice pop/small ice cube to suck to numb tongue
2. mix drop with a small about (1tsp) of sweet tasting substance
NO honey until age 1 year
3. give a chase of water, juice, soft drink
4. if n/v is a problem, give a carbonated beverage poured over finely crushed ice before or after
5. when unpleasant tastes pinch the nose and drink med thru a straw
6. have pharmacist prepare drug in a flavored chewable lozenge
7. infants will suck forma needless syringe
What two types of meds should never be crushed and why?
*enteric or protected coating; could irritate the stomach; this type of tables is absorbed by small intestine
*Slow release- could be absorbed more rapidly
If med must be crushed what type of food should never be used?
Honey in infants due to botulism
2 methods of restraining for infant or toddler receiving IM injection in vastus lateralis
1. body of larger infant can be securely held between the nurses arm and body
2. swaddle baby leaving the part of the extremity out that is receiving the injection
List six meds that should be reviewed by 2 profession nurses before administration to infant/child
*digoxin
*chemotherapeutic agents
*insulin
*epinephrine
*opoids
*sedatives
According to Ericksons theory of development why would a toddler view hospitalization as a
punishment?
Ritualism the need to maintain sameness and reliability provides sense of comfort. without ritu8als little
opportunity to exert autonomy. consequently regression and dependency occurs
Hearing test for newborn
OAE- Otoacoustive Emission measures intensity sound from the cochlear hair cells in response to clicks from a
probe placed in the ear canal
does not detect neural damage
Detects inner hearing loss
does not detect damage to cranial nerve
ANSWERS
STRESS RESPONSES IN TODDLERS
SEPARATION ANXIETY, REGRESSION, AND SLEEP ISSUES
LATEST UPDATED 2025
All Answers are in RED
Major Keywords: Pediatric nursing exam, stress in toddlers, toddler separation anxiety, grief in young children, toddler regression behaviors, refusal to eat in toddlers,
pediatric sleep disturbances, nursing care for stressed toddlers, emotional development in pediatrics, NCLEX pediatric mental health
STUDY GUIDE
Examples of stress experienced by toddlers
1. separation anxiety from parents, grief reactions
2. regression
3. refusal to eat
4. difficulty sleeping
Three phases of separation anxiety and behavioral responses exhibited during each phase
1. protest; clings to parent to force them to stay
2. despair, inactive + withdrawn and regress
3. detachment, denial, after prolonged separation , denies need for parents lvoe, affection to nurses
Nursing interventions to reduce separation anxiety
1. encourage family contact
2. familiar belonging brought from home
3. provide therapeutic play
4. accept regression
5. consistent routine with familiar staff
6. extra cuddling and holding
Example of a coping strategy found amongst toddlers when in stress
throwing games
List the major developmental tasks for toddlers
1. development of autonomy
2. control environment
3. act of movement with no restraining
Identify examples of collaborative efforts to assist toddlers with control and mobility
1. assist child with ambulation within their control
2. throwing games, vent frustrations
,3. child life specialist, modified toys
4. physical therapist, promote strength and flexibility
List nursing interventions used to prepare a toddle for a procedure
1. brief explanations, 5-10 mins, emphasize what the child will see, hear, taste, or feel
2. see age appropriate videos with parents
3. comfort by use of bandages to stop bleeding, avoid deception to gain compliance
Identify the initial step to effective pain management and special considerations made for a toddler
1. assessment, meaning of hurt, what word is used for pain
2. prior pain experience
3. what does your child do when she/he is hurting
4. anything special that need to know about the child in pain
List behavioral cues demonstrated by a a toddler when experiencing pain
1. frowning
2. crying
2. restlessness
List physiological cues demonstrated by a toddler when experiencing pain.
1. rapid pulse
2. rapid respiration
3. perspiration
Identify nursing interventions used for pain management with a toddler
1. form of relaxation, deep breaths
2. form of distraction
3. transport to treatment room for treatments
4. medical personnel restrains, not parents
5. the parents presence
6. explain in a a few simple words
7. administration of pain meds
Provide examples of fostering autonomy and independence when planning for discharge
1. select favoring snacks
2. help with dressing change
3. allow playing if on bed rest ( can play near bed)
4. continue to perform toileting and hygiene skills
5. toys for psychosocial development
6. give independence and allow exploration within safe guidelines
List seven reliable devices for accurately measuring and administering oral meds
*measuring spoon
*plastic syringes
*calibrated nipple
, *plastic medicine cup
*calibrated dropper
*hollow handles medicine spoon
*medicine bottle used to delivery oral meds via syringe
Six methods of med administration that encourage child's acceptance
1. flavored ice pop/small ice cube to suck to numb tongue
2. mix drop with a small about (1tsp) of sweet tasting substance
NO honey until age 1 year
3. give a chase of water, juice, soft drink
4. if n/v is a problem, give a carbonated beverage poured over finely crushed ice before or after
5. when unpleasant tastes pinch the nose and drink med thru a straw
6. have pharmacist prepare drug in a flavored chewable lozenge
7. infants will suck forma needless syringe
What two types of meds should never be crushed and why?
*enteric or protected coating; could irritate the stomach; this type of tables is absorbed by small intestine
*Slow release- could be absorbed more rapidly
If med must be crushed what type of food should never be used?
Honey in infants due to botulism
2 methods of restraining for infant or toddler receiving IM injection in vastus lateralis
1. body of larger infant can be securely held between the nurses arm and body
2. swaddle baby leaving the part of the extremity out that is receiving the injection
List six meds that should be reviewed by 2 profession nurses before administration to infant/child
*digoxin
*chemotherapeutic agents
*insulin
*epinephrine
*opoids
*sedatives
According to Ericksons theory of development why would a toddler view hospitalization as a
punishment?
Ritualism the need to maintain sameness and reliability provides sense of comfort. without ritu8als little
opportunity to exert autonomy. consequently regression and dependency occurs
Hearing test for newborn
OAE- Otoacoustive Emission measures intensity sound from the cochlear hair cells in response to clicks from a
probe placed in the ear canal
does not detect neural damage
Detects inner hearing loss
does not detect damage to cranial nerve
