NR 328 Final Exam: Pediatric Nursing - Chamberlain
University Updated and Latest Questions and Correct
Answers with Rationale
1. A 4-year-old child explains to the nurse that their teddy bear is sad because it has to stay in the hospital.
Which stage of Piaget’s cognitive development is this child demonstrating?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Correct Answer: B
Rationale: The preoperational stage occurs between the ages of two and seven years. During this phase,
children exhibit animism, which is the belief that inanimate objects have feelings. This child’s statement
about the teddy bear is a classic example of this cognitive milestone. Nurses should use this
understanding to provide age-appropriate explanations during care. It is important to remember that
egocentrism is also a hallmark of this developmental stage.
2. An infant’s mother is concerned because her 6-month-old is not yet sitting unsupported. What is the most
appropriate response by the nurse?
A. Most infants sit unsupported by 4 months of age.
B. It is normal for infants to sit unsupported between 6 and 8 months.
C. Sitting unsupported is a milestone typically achieved at 8 months.
D. This is a significant delay that requires immediate referral.
Correct Answer: B
,Rationale: Gross motor development varies slightly among individual infants. Most infants begin to sit
with support at six months and independently by eight months. Telling the mother this is normal helps
alleviate unnecessary parental anxiety. The nurse should continue to monitor milestones at subsequent
well-child visits. Understanding these windows of development is crucial for accurate pediatric
assessment.
3. A toddler is admitted with a diagnosis of laryngotracheobronchitis (Croup). Which clinical manifestation
should the nurse expect to observe?
A. Drooling and high fever
B. Silent chest and cyanosis
C. Wheezing and productive cough
D. Barking cough and inspiratory stridor
Correct Answer: D
Rationale: Laryngotracheobronchitis is characterized by inflammation of the larynx and trachea. This
inflammation leads to the hallmark barking cough and inspiratory stridor. Drooling and high fever are
more indicative of epiglottitis, which is a medical emergency. The nurse must monitor for signs of
increased respiratory effort in the toddler. Cool mist therapy is often used to help soothe the airway and
reduce swelling.
4. The nurse is caring for an infant with Tetralogy of Fallot who suddenly becomes cyanotic and dyspneic.
Which action should the nurse take first?
A. Administer 100% oxygen via mask.
B. Administer a dose of morphine sulfate.
C. Prepare for immediate endotracheal intubation.
, D. Place the infant in a knee-chest position.
Correct Answer: D
Rationale: A hypercyanotic episode, or ‘tet spell,’ requires immediate intervention to improve
oxygenation. Placing the infant in a knee-chest position increases systemic vascular resistance. This
change in pressure helps reduce the right-to-left shunt in the heart. While oxygen and morphine may be
used later, the physical positioning is the priority action. This maneuver is a standard evidence-based
practice for managing acute cyanosis in these patients.
5. A child with Cystic Fibrosis is prescribed pancreatic enzymes. How should the nurse instruct the parents to
administer this medication?
A. Give the enzymes once daily in the morning.
B. Administer the enzymes only when the child has a fatty meal.
C. Give the enzymes with every meal and every snack.
D. Mix the enzymes into a large bowl of hot oatmeal.
Correct Answer: C
Rationale: Pancreatic enzymes are essential for the digestion of fats, proteins, and carbohydrates in CF
patients. Because the child’s pancreas cannot release these enzymes, they must be replaced orally. Taking
them with every meal and snack ensures that nutrients are properly absorbed. The enzymes should not
be mixed with hot food as heat can deactivate them. Effective management is reflected by a decrease in
the number of bulky, foul-smelling stools.
6. Which of the following is the most reliable indicator of fluid loss or gain in a 2-year-old child?
A. Daily weights at the same time each day
B. The number of wet diapers in 24 hours
University Updated and Latest Questions and Correct
Answers with Rationale
1. A 4-year-old child explains to the nurse that their teddy bear is sad because it has to stay in the hospital.
Which stage of Piaget’s cognitive development is this child demonstrating?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Correct Answer: B
Rationale: The preoperational stage occurs between the ages of two and seven years. During this phase,
children exhibit animism, which is the belief that inanimate objects have feelings. This child’s statement
about the teddy bear is a classic example of this cognitive milestone. Nurses should use this
understanding to provide age-appropriate explanations during care. It is important to remember that
egocentrism is also a hallmark of this developmental stage.
2. An infant’s mother is concerned because her 6-month-old is not yet sitting unsupported. What is the most
appropriate response by the nurse?
A. Most infants sit unsupported by 4 months of age.
B. It is normal for infants to sit unsupported between 6 and 8 months.
C. Sitting unsupported is a milestone typically achieved at 8 months.
D. This is a significant delay that requires immediate referral.
Correct Answer: B
,Rationale: Gross motor development varies slightly among individual infants. Most infants begin to sit
with support at six months and independently by eight months. Telling the mother this is normal helps
alleviate unnecessary parental anxiety. The nurse should continue to monitor milestones at subsequent
well-child visits. Understanding these windows of development is crucial for accurate pediatric
assessment.
3. A toddler is admitted with a diagnosis of laryngotracheobronchitis (Croup). Which clinical manifestation
should the nurse expect to observe?
A. Drooling and high fever
B. Silent chest and cyanosis
C. Wheezing and productive cough
D. Barking cough and inspiratory stridor
Correct Answer: D
Rationale: Laryngotracheobronchitis is characterized by inflammation of the larynx and trachea. This
inflammation leads to the hallmark barking cough and inspiratory stridor. Drooling and high fever are
more indicative of epiglottitis, which is a medical emergency. The nurse must monitor for signs of
increased respiratory effort in the toddler. Cool mist therapy is often used to help soothe the airway and
reduce swelling.
4. The nurse is caring for an infant with Tetralogy of Fallot who suddenly becomes cyanotic and dyspneic.
Which action should the nurse take first?
A. Administer 100% oxygen via mask.
B. Administer a dose of morphine sulfate.
C. Prepare for immediate endotracheal intubation.
, D. Place the infant in a knee-chest position.
Correct Answer: D
Rationale: A hypercyanotic episode, or ‘tet spell,’ requires immediate intervention to improve
oxygenation. Placing the infant in a knee-chest position increases systemic vascular resistance. This
change in pressure helps reduce the right-to-left shunt in the heart. While oxygen and morphine may be
used later, the physical positioning is the priority action. This maneuver is a standard evidence-based
practice for managing acute cyanosis in these patients.
5. A child with Cystic Fibrosis is prescribed pancreatic enzymes. How should the nurse instruct the parents to
administer this medication?
A. Give the enzymes once daily in the morning.
B. Administer the enzymes only when the child has a fatty meal.
C. Give the enzymes with every meal and every snack.
D. Mix the enzymes into a large bowl of hot oatmeal.
Correct Answer: C
Rationale: Pancreatic enzymes are essential for the digestion of fats, proteins, and carbohydrates in CF
patients. Because the child’s pancreas cannot release these enzymes, they must be replaced orally. Taking
them with every meal and snack ensures that nutrients are properly absorbed. The enzymes should not
be mixed with hot food as heat can deactivate them. Effective management is reflected by a decrease in
the number of bulky, foul-smelling stools.
6. Which of the following is the most reliable indicator of fluid loss or gain in a 2-year-old child?
A. Daily weights at the same time each day
B. The number of wet diapers in 24 hours
