NR 328 Exam 2: Pediatric Nursing - Chamberlain
University Updated and Latest Questions and Correct
Answers with Rationale
1. A 4-year-old child is brought to the emergency department with a high fever, muffled voice, and drooling.
What is the priority nursing intervention?
A. Inspect the throat with a tongue blade
B. Keep the child calm and prepare for intubation
C. Obtain a throat culture
D. Administer an oral antipyretic
Correct Answer: B
Rationale: The clinical manifestations suggest epiglottitis, which is a medical emergency that can lead to
complete airway obstruction. Nursing management focuses on maintaining a patent airway and avoiding
any stimulation that could cause laryngospasm. Inspecting the throat or taking a culture can trigger an
immediate airway closure. The nurse should have emergency airway equipment ready and keep the child
as calm as possible in a position of comfort. This approach ensures safety while preparing for definitive
airway management by specialized staff.
2. A nurse is teaching the parents of a child with cystic fibrosis about pancreatic enzyme replacement.
Which statement indicates the parents understand the teaching?
A. We will administer the enzymes with all meals and snacks.
B. We will skip the enzymes if he is not hungry.
C. We will give the enzymes once daily in the morning.
D. We will mix the enzymes with his hot oatmeal.
,Correct Answer: A
Rationale: Children with cystic fibrosis require pancreatic enzymes to aid in the digestion and
absorption of fats, proteins, and carbohydrates. These enzymes must be taken every time the child
consumes food to be effective throughout the digestive process. They should not be mixed with hot foods
because heat can deactivate the enzymes. If a meal is skipped, the dose is usually omitted, but consistency
with all intake is vital for growth. This intervention directly addresses the malabsorption issues
associated with the thick mucus characteristic of the disease.
3. Which clinical manifestation is most characteristic of a child diagnosed with Laryngotracheobronchitis
(Croup)?
A. Productive cough with thick yellow sputum
B. Wheezing on expiration with a silent chest
C. Barking, brassy cough and inspiratory stridor
D. High-pitched crackles at the lung bases
Correct Answer: C
Rationale: Croup is characterized by edema and inflammation of the larynx, trachea, and bronchi. The
hallmark sign is a barking or ‘seal-like’ cough caused by the narrowed airway. Inspiratory stridor occurs
as air is pulled through the swollen subglottic area. Symptoms often worsen at night or when the child
becomes agitated or upset. Management typically includes cool mist, hydration, and sometimes
corticosteroids to reduce airway inflammation.
4. A child is admitted with Respiratory Syncytial Virus (RSV). What type of precautions should the nurse
implement?
A. Contact and Droplet precautions
, B. Airborne precautions
C. Standard precautions only
D. Protective environment
Correct Answer: A
Rationale: RSV is primarily transmitted through direct contact with respiratory secretions or
contaminated surfaces. It can also be spread through large droplets when an infected person coughs or
sneezes nearby. Implementing both contact and droplet precautions is the standard of care to prevent
nosocomial transmission. Nurses should wear gowns and gloves when entering the room and a mask
when within three feet of the patient. Diligent hand hygiene remains the most effective way to prevent
the spread of this highly contagious virus.
5. A nurse is evaluating a child’s response to an albuterol nebulizer treatment during an acute asthma
attack. Which finding indicates the treatment was effective?
A. Increased heart rate
B. Slowed respiratory rate with retractions
C. Decreased wheezing and improved breath sounds
D. The child becomes more somnolent
Correct Answer: C
Rationale: Albuterol is a short-acting beta-agonist used to rescue the patient by dilating the bronchioles.
Effectiveness is measured by a decrease in respiratory distress, including reduced wheezing and
improved air entry. While tachycardia is a common side effect of the medication, it does not indicate
therapeutic effectiveness. A decrease in respiratory rate is positive only if it is accompanied by a
University Updated and Latest Questions and Correct
Answers with Rationale
1. A 4-year-old child is brought to the emergency department with a high fever, muffled voice, and drooling.
What is the priority nursing intervention?
A. Inspect the throat with a tongue blade
B. Keep the child calm and prepare for intubation
C. Obtain a throat culture
D. Administer an oral antipyretic
Correct Answer: B
Rationale: The clinical manifestations suggest epiglottitis, which is a medical emergency that can lead to
complete airway obstruction. Nursing management focuses on maintaining a patent airway and avoiding
any stimulation that could cause laryngospasm. Inspecting the throat or taking a culture can trigger an
immediate airway closure. The nurse should have emergency airway equipment ready and keep the child
as calm as possible in a position of comfort. This approach ensures safety while preparing for definitive
airway management by specialized staff.
2. A nurse is teaching the parents of a child with cystic fibrosis about pancreatic enzyme replacement.
Which statement indicates the parents understand the teaching?
A. We will administer the enzymes with all meals and snacks.
B. We will skip the enzymes if he is not hungry.
C. We will give the enzymes once daily in the morning.
D. We will mix the enzymes with his hot oatmeal.
,Correct Answer: A
Rationale: Children with cystic fibrosis require pancreatic enzymes to aid in the digestion and
absorption of fats, proteins, and carbohydrates. These enzymes must be taken every time the child
consumes food to be effective throughout the digestive process. They should not be mixed with hot foods
because heat can deactivate the enzymes. If a meal is skipped, the dose is usually omitted, but consistency
with all intake is vital for growth. This intervention directly addresses the malabsorption issues
associated with the thick mucus characteristic of the disease.
3. Which clinical manifestation is most characteristic of a child diagnosed with Laryngotracheobronchitis
(Croup)?
A. Productive cough with thick yellow sputum
B. Wheezing on expiration with a silent chest
C. Barking, brassy cough and inspiratory stridor
D. High-pitched crackles at the lung bases
Correct Answer: C
Rationale: Croup is characterized by edema and inflammation of the larynx, trachea, and bronchi. The
hallmark sign is a barking or ‘seal-like’ cough caused by the narrowed airway. Inspiratory stridor occurs
as air is pulled through the swollen subglottic area. Symptoms often worsen at night or when the child
becomes agitated or upset. Management typically includes cool mist, hydration, and sometimes
corticosteroids to reduce airway inflammation.
4. A child is admitted with Respiratory Syncytial Virus (RSV). What type of precautions should the nurse
implement?
A. Contact and Droplet precautions
, B. Airborne precautions
C. Standard precautions only
D. Protective environment
Correct Answer: A
Rationale: RSV is primarily transmitted through direct contact with respiratory secretions or
contaminated surfaces. It can also be spread through large droplets when an infected person coughs or
sneezes nearby. Implementing both contact and droplet precautions is the standard of care to prevent
nosocomial transmission. Nurses should wear gowns and gloves when entering the room and a mask
when within three feet of the patient. Diligent hand hygiene remains the most effective way to prevent
the spread of this highly contagious virus.
5. A nurse is evaluating a child’s response to an albuterol nebulizer treatment during an acute asthma
attack. Which finding indicates the treatment was effective?
A. Increased heart rate
B. Slowed respiratory rate with retractions
C. Decreased wheezing and improved breath sounds
D. The child becomes more somnolent
Correct Answer: C
Rationale: Albuterol is a short-acting beta-agonist used to rescue the patient by dilating the bronchioles.
Effectiveness is measured by a decrease in respiratory distress, including reduced wheezing and
improved air entry. While tachycardia is a common side effect of the medication, it does not indicate
therapeutic effectiveness. A decrease in respiratory rate is positive only if it is accompanied by a
