NUR 230 Exam 4: OB/Peds - Galen College of Nursing
Updated and Latest Questions and Correct Answers with
Rationale
1. A 10-month-old infant is admitted with respiratory syncytial virus (RSV) bronchiolitis. Which nursing
intervention should be prioritized in the care plan?
A. Administering prophylactic antibiotics as ordered
B. Maintaining the infant in a prone position for better drainage
C. Encouraging the intake of high-calorie solid foods
D. Performing frequent nasopharyngeal suctioning to maintain airway patency
Correct Answer: D
Rationale: RSV causes significant mucus production which can easily obstruct the small airways of an
infant. Suctioning is essential to keep the airway clear and improve oxygenation. Since RSV is viral,
antibiotics are not indicated unless a secondary bacterial infection occurs. Infants in respiratory distress
should not be forced to eat solids due to aspiration risk. Contact and droplet precautions are also
necessary to prevent the spread of the virus to other patients.
2. A school-aged child with asthma is being discharged with a prescription for an albuterol inhaler. What
should the nurse include in the discharge teaching?
A. Use this medication daily even if no symptoms are present
B. This medication should be used as a rescue therapy for acute symptoms
C. Rinse the mouth with water only after using steroid inhalers
D. Wait at least five minutes between puffs of the same medication
Correct Answer: B
,Rationale: Albuterol is a short-acting beta-agonist used to provide immediate relief during an asthma
exacerbation. It is not intended for long-term maintenance or daily control unless prescribed for
exercise-induced bronchospasm. Patients should be taught to wait approximately one minute between
puffs for maximum efficacy. Side effects often include tachycardia, tremors, and nervousness. Using a
spacer can help ensure more medication reaches the lungs instead of the back of the throat.
3. At what age should a healthy child typically receive their first dose of the Measles, Mumps, and Rubella
(MMR) vaccine according to the CDC schedule?
A. 2 months
B. 12 to 15 months
C. 6 months
D. 4 to 6 years
Correct Answer: B
Rationale: The first dose of the MMR vaccine is recommended between 12 and 15 months of age. A
second dose is usually administered before the child enters school between 4 and 6 years. Because MMR
is a live attenuated vaccine, it is generally not given to infants under 12 months due to maternal antibody
interference. It is also contraindicated in pregnant women or individuals who are severely
immunocompromised. Nurses must monitor for a low-grade fever or mild rash that may occur 1-2 weeks
post-vaccination.
4. A pediatric patient weighs 44 lbs. The physician orders a medication at 15 mg/kg/dose. How many
milligrams should the nurse administer?
A. 150 mg
B. 660 mg
, C. 300 mg
D. 440 mg
Correct Answer: C
Rationale: First, the nurse must convert the child’s weight from pounds to kilograms by dividing 44 by
2.2, which equals 20 kg. Next, multiply the weight in kilograms by the ordered dose (20 kg x 15 mg/kg),
resulting in 300 mg. Double-checking pediatric dosages is a critical safety step to prevent medication
errors. Dosage should always be based on the most recent weight recorded in the chart. For liquid
medications, the nurse should use an oral syringe rather than a household spoon for accuracy.
5. A 4-year-old is brought to the emergency department with a high fever, muffled voice, and drooling.
What action by the nurse is contraindicated?
A. Using a tongue blade to visualize the throat
B. Allowing the child to sit in a position of comfort
C. Applying humidified oxygen via blow-by
D. Preparing for emergency intubation
Correct Answer: A
Rationale: Drooling, dysphonia, and distress are classic signs of epiglottitis, a medical emergency.
Attempting to visualize the throat with a tongue blade can cause immediate laryngospasm and complete
airway obstruction. The child should be kept calm and allowed to sit in a tripod position to facilitate
breathing. Medical staff should have an emergency airway kit and tracheostomy set ready at the bedside.
Antibiotics and corticosteroids will eventually be administered once the airway is secured.
6. Which clinical manifestation is most characteristic of Laryngotracheobronchitis (Croup)?
A. High-pitched expiratory wheezing
Updated and Latest Questions and Correct Answers with
Rationale
1. A 10-month-old infant is admitted with respiratory syncytial virus (RSV) bronchiolitis. Which nursing
intervention should be prioritized in the care plan?
A. Administering prophylactic antibiotics as ordered
B. Maintaining the infant in a prone position for better drainage
C. Encouraging the intake of high-calorie solid foods
D. Performing frequent nasopharyngeal suctioning to maintain airway patency
Correct Answer: D
Rationale: RSV causes significant mucus production which can easily obstruct the small airways of an
infant. Suctioning is essential to keep the airway clear and improve oxygenation. Since RSV is viral,
antibiotics are not indicated unless a secondary bacterial infection occurs. Infants in respiratory distress
should not be forced to eat solids due to aspiration risk. Contact and droplet precautions are also
necessary to prevent the spread of the virus to other patients.
2. A school-aged child with asthma is being discharged with a prescription for an albuterol inhaler. What
should the nurse include in the discharge teaching?
A. Use this medication daily even if no symptoms are present
B. This medication should be used as a rescue therapy for acute symptoms
C. Rinse the mouth with water only after using steroid inhalers
D. Wait at least five minutes between puffs of the same medication
Correct Answer: B
,Rationale: Albuterol is a short-acting beta-agonist used to provide immediate relief during an asthma
exacerbation. It is not intended for long-term maintenance or daily control unless prescribed for
exercise-induced bronchospasm. Patients should be taught to wait approximately one minute between
puffs for maximum efficacy. Side effects often include tachycardia, tremors, and nervousness. Using a
spacer can help ensure more medication reaches the lungs instead of the back of the throat.
3. At what age should a healthy child typically receive their first dose of the Measles, Mumps, and Rubella
(MMR) vaccine according to the CDC schedule?
A. 2 months
B. 12 to 15 months
C. 6 months
D. 4 to 6 years
Correct Answer: B
Rationale: The first dose of the MMR vaccine is recommended between 12 and 15 months of age. A
second dose is usually administered before the child enters school between 4 and 6 years. Because MMR
is a live attenuated vaccine, it is generally not given to infants under 12 months due to maternal antibody
interference. It is also contraindicated in pregnant women or individuals who are severely
immunocompromised. Nurses must monitor for a low-grade fever or mild rash that may occur 1-2 weeks
post-vaccination.
4. A pediatric patient weighs 44 lbs. The physician orders a medication at 15 mg/kg/dose. How many
milligrams should the nurse administer?
A. 150 mg
B. 660 mg
, C. 300 mg
D. 440 mg
Correct Answer: C
Rationale: First, the nurse must convert the child’s weight from pounds to kilograms by dividing 44 by
2.2, which equals 20 kg. Next, multiply the weight in kilograms by the ordered dose (20 kg x 15 mg/kg),
resulting in 300 mg. Double-checking pediatric dosages is a critical safety step to prevent medication
errors. Dosage should always be based on the most recent weight recorded in the chart. For liquid
medications, the nurse should use an oral syringe rather than a household spoon for accuracy.
5. A 4-year-old is brought to the emergency department with a high fever, muffled voice, and drooling.
What action by the nurse is contraindicated?
A. Using a tongue blade to visualize the throat
B. Allowing the child to sit in a position of comfort
C. Applying humidified oxygen via blow-by
D. Preparing for emergency intubation
Correct Answer: A
Rationale: Drooling, dysphonia, and distress are classic signs of epiglottitis, a medical emergency.
Attempting to visualize the throat with a tongue blade can cause immediate laryngospasm and complete
airway obstruction. The child should be kept calm and allowed to sit in a tripod position to facilitate
breathing. Medical staff should have an emergency airway kit and tracheostomy set ready at the bedside.
Antibiotics and corticosteroids will eventually be administered once the airway is secured.
6. Which clinical manifestation is most characteristic of Laryngotracheobronchitis (Croup)?
A. High-pitched expiratory wheezing
