NUR 254 Exam 2: Pediatrics - Galen College of Nursing
Updated and Latest Questions and Correct Answers with
Rationale
1. A 2-year-old child is admitted with a suspected diagnosis of epiglottitis. Which clinical manifestation
should the nurse recognize as a priority assessment?
A. Barking cough and loud stridor
B. Low-grade fever and clear nasal drainage
C. Drooling, agitation, and absence of cough
D. Wheezing and productive cough
Correct Answer: C
Rationale: Epiglottitis is a life-threatening bacterial infection of the epiglottis. Classic signs include the
‘four Ds’: drooling, dysphagia, dysphonia, and distressed inspiratory efforts. Unlike croup, a cough is
typically absent in patients with epiglottitis. The child often sits in a tripod position to help maintain an
open airway. Immediate medical intervention is required because the airway can become completely
obstructed rapidly.
2. When caring for a child with Respiratory Syncytial Virus (RSV) bronchiolitis, which precaution should the
nurse implement?
A. Standard and Contact precautions
B. Airborne and Contact precautions
C. Droplet and Airborne precautions
D. Standard precautions only
Correct Answer: A
,Rationale: RSV is primarily transmitted through direct contact with respiratory secretions. Standard and
Contact precautions are necessary to prevent the spread of the virus in the hospital setting. This includes
wearing a gown and gloves when entering the patient’s room. Some facilities may also utilize droplet
precautions due to the risk of large droplets during suctioning. Hand hygiene remains the most effective
way to prevent transmission to other vulnerable patients.
3. A child with Cystic Fibrosis is receiving pancreatic enzymes. The nurse should instruct the parents to
administer the enzymes at which time?
A. Between meals on an empty stomach
B. With every meal and snack
C. Once daily in the morning
D. Immediately before bedtime
Correct Answer: B
Rationale: Pancreatic enzymes are required for children with cystic fibrosis to assist in the digestion and
absorption of fats and proteins. These enzymes must be taken with all meals and snacks to be effective. If
the child is not eating, the enzymes should not be given. Proper dosing is determined by the number of
stools and the child’s weight gain. Failure to take enzymes results in steatorrhea and malnutrition.
4. The nurse is educating a parent about the schedule for the Measles, Mumps, and Rubella (MMR) vaccine.
At what age should the first dose be administered?
A. 2 months
B. 12 to 15 months
C. 6 months
D. 4 to 6 years
,Correct Answer: B
Rationale: The MMR vaccine is a live attenuated vaccine typically given in two doses. The first dose is
recommended between 12 and 15 months of age. The second dose is usually administered between 4 and
6 years of age. Vaccinating too early may result in a decreased immune response due to maternal
antibodies. Live vaccines are generally avoided in children who are severely immunocompromised.
5. Which of the following is a classic clinical manifestation of Pertussis (whooping cough) during the
paroxysmal stage?
A. Bursts of rapid coughs followed by a high-pitched intake of breath
B. High fever and generalized rash
C. Dry, hacking cough that is worse at night
D. Stridor and a muffled voice
Correct Answer: A
Rationale: Pertussis progresses through several stages, with the paroxysmal stage being the most
distinct. During this stage, the child experiences violent coughing fits that can lead to cyanosis. The
characteristic ‘whoop’ occurs when the child attempts to inhale deeply after a coughing paroxysm. This
stage can last for several weeks and is very exhausting for the child. Droplet precautions are essential
during the early contagious phases.
6. A 6-year-old child is recovering from a tonsillectomy. Which sign would most likely indicate postoperative
hemorrhage?
A. Frequent swallowing
B. Occasional barking cough
C. Complaints of a sore throat
, D. Small amount of dried blood on the pillow
Correct Answer: A
Rationale: Frequent swallowing is a primary sign of silent bleeding in a child who has had a
tonsillectomy. Blood trickling down the back of the throat triggers the swallowing reflex even while the
child is asleep. The nurse should also monitor for tachycardia, restlessness, and bright red emesis. It is
vital to assess the throat with a flashlight if hemorrhage is suspected. Parents should be educated to
monitor for these signs for up to two ages post-surgery.
7. What is the gold standard diagnostic test for Cystic Fibrosis?
A. Chest X-ray
B. Sputum culture
C. Fecal fat analysis
D. Sweat chloride test
Correct Answer: D
Rationale: The sweat chloride test is the definitive diagnostic tool for cystic fibrosis. It measures the
amount of chloride in the child’s sweat, which is abnormally high in CF patients. A chloride level greater
than 60 mEq/L is considered positive for the diagnosis. This test is non-invasive and uses a process called
pilocarpine iontophoresis to stimulate sweating. Newborn screening also helps in early detection, but the
sweat test remains the standard.
8. A child is admitted with a diagnosis of croup. Which intervention is most appropriate for a child
experiencing mild laryngeal spasms?
A. Administering intravenous antibiotics
B. Administering a sedative to help the child sleep
Updated and Latest Questions and Correct Answers with
Rationale
1. A 2-year-old child is admitted with a suspected diagnosis of epiglottitis. Which clinical manifestation
should the nurse recognize as a priority assessment?
A. Barking cough and loud stridor
B. Low-grade fever and clear nasal drainage
C. Drooling, agitation, and absence of cough
D. Wheezing and productive cough
Correct Answer: C
Rationale: Epiglottitis is a life-threatening bacterial infection of the epiglottis. Classic signs include the
‘four Ds’: drooling, dysphagia, dysphonia, and distressed inspiratory efforts. Unlike croup, a cough is
typically absent in patients with epiglottitis. The child often sits in a tripod position to help maintain an
open airway. Immediate medical intervention is required because the airway can become completely
obstructed rapidly.
2. When caring for a child with Respiratory Syncytial Virus (RSV) bronchiolitis, which precaution should the
nurse implement?
A. Standard and Contact precautions
B. Airborne and Contact precautions
C. Droplet and Airborne precautions
D. Standard precautions only
Correct Answer: A
,Rationale: RSV is primarily transmitted through direct contact with respiratory secretions. Standard and
Contact precautions are necessary to prevent the spread of the virus in the hospital setting. This includes
wearing a gown and gloves when entering the patient’s room. Some facilities may also utilize droplet
precautions due to the risk of large droplets during suctioning. Hand hygiene remains the most effective
way to prevent transmission to other vulnerable patients.
3. A child with Cystic Fibrosis is receiving pancreatic enzymes. The nurse should instruct the parents to
administer the enzymes at which time?
A. Between meals on an empty stomach
B. With every meal and snack
C. Once daily in the morning
D. Immediately before bedtime
Correct Answer: B
Rationale: Pancreatic enzymes are required for children with cystic fibrosis to assist in the digestion and
absorption of fats and proteins. These enzymes must be taken with all meals and snacks to be effective. If
the child is not eating, the enzymes should not be given. Proper dosing is determined by the number of
stools and the child’s weight gain. Failure to take enzymes results in steatorrhea and malnutrition.
4. The nurse is educating a parent about the schedule for the Measles, Mumps, and Rubella (MMR) vaccine.
At what age should the first dose be administered?
A. 2 months
B. 12 to 15 months
C. 6 months
D. 4 to 6 years
,Correct Answer: B
Rationale: The MMR vaccine is a live attenuated vaccine typically given in two doses. The first dose is
recommended between 12 and 15 months of age. The second dose is usually administered between 4 and
6 years of age. Vaccinating too early may result in a decreased immune response due to maternal
antibodies. Live vaccines are generally avoided in children who are severely immunocompromised.
5. Which of the following is a classic clinical manifestation of Pertussis (whooping cough) during the
paroxysmal stage?
A. Bursts of rapid coughs followed by a high-pitched intake of breath
B. High fever and generalized rash
C. Dry, hacking cough that is worse at night
D. Stridor and a muffled voice
Correct Answer: A
Rationale: Pertussis progresses through several stages, with the paroxysmal stage being the most
distinct. During this stage, the child experiences violent coughing fits that can lead to cyanosis. The
characteristic ‘whoop’ occurs when the child attempts to inhale deeply after a coughing paroxysm. This
stage can last for several weeks and is very exhausting for the child. Droplet precautions are essential
during the early contagious phases.
6. A 6-year-old child is recovering from a tonsillectomy. Which sign would most likely indicate postoperative
hemorrhage?
A. Frequent swallowing
B. Occasional barking cough
C. Complaints of a sore throat
, D. Small amount of dried blood on the pillow
Correct Answer: A
Rationale: Frequent swallowing is a primary sign of silent bleeding in a child who has had a
tonsillectomy. Blood trickling down the back of the throat triggers the swallowing reflex even while the
child is asleep. The nurse should also monitor for tachycardia, restlessness, and bright red emesis. It is
vital to assess the throat with a flashlight if hemorrhage is suspected. Parents should be educated to
monitor for these signs for up to two ages post-surgery.
7. What is the gold standard diagnostic test for Cystic Fibrosis?
A. Chest X-ray
B. Sputum culture
C. Fecal fat analysis
D. Sweat chloride test
Correct Answer: D
Rationale: The sweat chloride test is the definitive diagnostic tool for cystic fibrosis. It measures the
amount of chloride in the child’s sweat, which is abnormally high in CF patients. A chloride level greater
than 60 mEq/L is considered positive for the diagnosis. This test is non-invasive and uses a process called
pilocarpine iontophoresis to stimulate sweating. Newborn screening also helps in early detection, but the
sweat test remains the standard.
8. A child is admitted with a diagnosis of croup. Which intervention is most appropriate for a child
experiencing mild laryngeal spasms?
A. Administering intravenous antibiotics
B. Administering a sedative to help the child sleep
