NURS 307 | NURS307 Exam 2: Pediatrics - WCU
Updated and Latest Questions and Correct
Answers with Rationale
1. A 4-year-old child is brought to the emergency department with symptoms of a high fever,
muffled voice, and is sitting in a ‘tripod’ position. What should be the nurse’s priority action?
A. Inspect the throat using a tongue depressor to check for inflammation.
B. Obtain a throat culture to identify the causative organism.
C. Start an IV line immediately to administer antibiotics.
D. Avoid any throat examination and keep the child as calm as possible.
Correct Answer: D
Rationale: The child is showing classic signs of epiglottitis, which is a medical emergency
that can lead to airway obstruction. Manipulating the throat with a tongue blade or swab
can cause a sudden laryngospasm and complete airway closure. The nurse must focus on
maintaining airway patency and keeping the child comfortable until an airway specialist
arrives. Diagnosis is typically confirmed via lateral neck x-ray rather than physical
inspection of the throat. Immediate preparation for intubation or tracheostomy should be
prioritized if respiratory distress increases.
2. A nurse is providing discharge education to the parents of a child who just had a
tonsillectomy. Which finding should the nurse instruct the parents to report immediately?
A. Occasional dried blood on the surgical site.
B. Frequent swallowing or clearing of the throat.
C. Complaints of mild ear pain when drinking fluids.
D. Halitosis or bad breath following the procedure.
Correct Answer: B
Rationale: Frequent swallowing is the most significant early sign of postoperative
hemorrhage following a tonsillectomy. This occurs because the child is swallowing the
blood trickling down the back of the throat. Early detection is vital because hemorrhage
can occur up to 10 days post-surgery when scabs slough off. Other symptoms like mild ear
pain and bad breath are common and expected during the healing process. Parents should
be taught to monitor for signs of bleeding at all times during the recovery period.
3. A nurse is caring for an infant diagnosed with Respiratory Syncytial Virus (RSV) and
bronchiolitis. What isolation precautions are most appropriate for this patient?
A. Airborne precautions only.
B. Standard precautions only.
,C. Droplet and Contact precautions.
D. Protective environment precautions.
Correct Answer: C
Rationale: RSV is primarily transmitted through direct contact with respiratory secretions
or contaminated surfaces. While it is spread by large droplets, these droplets do not travel
far, necessitating both contact and droplet precautions. Nurses must wear gowns and
gloves when entering the room and potentially masks if splashing is likely. Hand hygiene is
the most effective way to prevent the nosocomial spread of RSV among pediatric patients.
Isolating the infant in a private room or cohorting with other RSV patients is also a
standard practice.
4. A child with Cystic Fibrosis (CF) is prescribed pancreatic enzymes. When should the nurse
instruct the parents to administer this medication?
A. Once daily in the morning before breakfast.
B. Immediately before bed to prevent nighttime indigestion.
C. Only when the child experiences fatty stools.
D. Before every meal and every snack.
Correct Answer: D
Rationale: Pancreatic enzymes are essential for children with CF to ensure proper
digestion and absorption of nutrients, especially fats and proteins. These enzymes must be
taken with every meal and snack to replace the ones the pancreas cannot produce. Missing
a dose can lead to malabsorption and the presence of steatorrhea, which are bulky, foul-
smelling stools. The dosage is typically adjusted based on the child’s growth and the
consistency of their bowel movements. Proper administration helps prevent malnutrition
and promotes healthy weight gain in these patients.
5. A nurse is teaching a parent about the management of a 7-year-old child with asthma.
Which statement by the parent indicates a need for further teaching?
A. ‘I will give the albuterol inhaler when my child starts wheezing.’
B. ‘The fluticasone inhaler should be used every day even if he feels fine.’
C. ‘I should stop the daily steroid inhaler once his breathing improves for a week.’
D. ‘I will use the albuterol inhaler to prevent an attack before he goes to soccer practice.’
Correct Answer: C
Rationale: Asthma management requires a combination of rescue medications and long-
term controller medications. Fluticasone is an inhaled corticosteroid used for daily control
and should not be stopped without medical consultation. Stopping the controller
medication abruptly can lead to an increase in airway inflammation and a higher risk of
, severe exacerbations. Albuterol is correctly used as a rescue medication for acute
symptoms or pre-exercise prevention. Education must emphasize that the lack of
symptoms does not mean the underlying inflammation has vanished.
6. The nurse is reviewing the immunization record of a 12-month-old child. Which of the
following vaccines should the child receive at this visit?
A. MMR (Measles, Mumps, Rubella) and Varicella.
B. Rotavirus and Tetanus (Tdap).
C. Human Papillomavirus (HPV) and Meningococcal.
D. Hepatitis B and Inactivated Poliovirus (IPV) only.
Correct Answer: A
Rationale: According to the standard CDC pediatric immunization schedule, the first dose
of the MMR and Varicella vaccines is typically given between 12 and 15 months of age.
These are live attenuated vaccines that provide critical protection against common
childhood viral infections. The 12-month visit also usually includes the Hib and PCV13
boosters. Nurses must verify that the child does not have contraindications, such as severe
immunodeficiency, before administration. Proper documentation of the site and
manufacturer is required for all immunizations given.
7. A 5-year-old child is diagnosed with Pertussis (whooping cough). What is the primary
nursing intervention during the paroxysmal stage?
A. Administering cough suppressants to promote sleep.
B. Encouraging vigorous physical activity to clear lung secretions.
C. Ensuring a quiet environment and monitoring for respiratory distress.
D. Providing large meals to increase caloric intake.
Correct Answer: C
Rationale: The paroxysmal stage of pertussis is characterized by severe coughing fits that
can lead to cyanosis and exhaustion. Maintaining a quiet, calm environment helps minimize
triggers that may induce a coughing spell. The nurse must monitor airway patency and
oxygen saturation levels closely during these episodes. Cough suppressants are generally
ineffective and are not recommended for children with pertussis. Small, frequent meals are
preferred over large ones to prevent vomiting caused by the intense coughing.
8. A nurse is evaluating a child with suspected Mononucleosis. Which clinical manifestation is
most associated with this condition?
A. Significant splenomegaly and cervical lymphadenopathy.
B. A ‘slapped-cheek’ appearance on the face.
C. Red, peeling skin on the palms and soles of the feet.
Updated and Latest Questions and Correct
Answers with Rationale
1. A 4-year-old child is brought to the emergency department with symptoms of a high fever,
muffled voice, and is sitting in a ‘tripod’ position. What should be the nurse’s priority action?
A. Inspect the throat using a tongue depressor to check for inflammation.
B. Obtain a throat culture to identify the causative organism.
C. Start an IV line immediately to administer antibiotics.
D. Avoid any throat examination and keep the child as calm as possible.
Correct Answer: D
Rationale: The child is showing classic signs of epiglottitis, which is a medical emergency
that can lead to airway obstruction. Manipulating the throat with a tongue blade or swab
can cause a sudden laryngospasm and complete airway closure. The nurse must focus on
maintaining airway patency and keeping the child comfortable until an airway specialist
arrives. Diagnosis is typically confirmed via lateral neck x-ray rather than physical
inspection of the throat. Immediate preparation for intubation or tracheostomy should be
prioritized if respiratory distress increases.
2. A nurse is providing discharge education to the parents of a child who just had a
tonsillectomy. Which finding should the nurse instruct the parents to report immediately?
A. Occasional dried blood on the surgical site.
B. Frequent swallowing or clearing of the throat.
C. Complaints of mild ear pain when drinking fluids.
D. Halitosis or bad breath following the procedure.
Correct Answer: B
Rationale: Frequent swallowing is the most significant early sign of postoperative
hemorrhage following a tonsillectomy. This occurs because the child is swallowing the
blood trickling down the back of the throat. Early detection is vital because hemorrhage
can occur up to 10 days post-surgery when scabs slough off. Other symptoms like mild ear
pain and bad breath are common and expected during the healing process. Parents should
be taught to monitor for signs of bleeding at all times during the recovery period.
3. A nurse is caring for an infant diagnosed with Respiratory Syncytial Virus (RSV) and
bronchiolitis. What isolation precautions are most appropriate for this patient?
A. Airborne precautions only.
B. Standard precautions only.
,C. Droplet and Contact precautions.
D. Protective environment precautions.
Correct Answer: C
Rationale: RSV is primarily transmitted through direct contact with respiratory secretions
or contaminated surfaces. While it is spread by large droplets, these droplets do not travel
far, necessitating both contact and droplet precautions. Nurses must wear gowns and
gloves when entering the room and potentially masks if splashing is likely. Hand hygiene is
the most effective way to prevent the nosocomial spread of RSV among pediatric patients.
Isolating the infant in a private room or cohorting with other RSV patients is also a
standard practice.
4. A child with Cystic Fibrosis (CF) is prescribed pancreatic enzymes. When should the nurse
instruct the parents to administer this medication?
A. Once daily in the morning before breakfast.
B. Immediately before bed to prevent nighttime indigestion.
C. Only when the child experiences fatty stools.
D. Before every meal and every snack.
Correct Answer: D
Rationale: Pancreatic enzymes are essential for children with CF to ensure proper
digestion and absorption of nutrients, especially fats and proteins. These enzymes must be
taken with every meal and snack to replace the ones the pancreas cannot produce. Missing
a dose can lead to malabsorption and the presence of steatorrhea, which are bulky, foul-
smelling stools. The dosage is typically adjusted based on the child’s growth and the
consistency of their bowel movements. Proper administration helps prevent malnutrition
and promotes healthy weight gain in these patients.
5. A nurse is teaching a parent about the management of a 7-year-old child with asthma.
Which statement by the parent indicates a need for further teaching?
A. ‘I will give the albuterol inhaler when my child starts wheezing.’
B. ‘The fluticasone inhaler should be used every day even if he feels fine.’
C. ‘I should stop the daily steroid inhaler once his breathing improves for a week.’
D. ‘I will use the albuterol inhaler to prevent an attack before he goes to soccer practice.’
Correct Answer: C
Rationale: Asthma management requires a combination of rescue medications and long-
term controller medications. Fluticasone is an inhaled corticosteroid used for daily control
and should not be stopped without medical consultation. Stopping the controller
medication abruptly can lead to an increase in airway inflammation and a higher risk of
, severe exacerbations. Albuterol is correctly used as a rescue medication for acute
symptoms or pre-exercise prevention. Education must emphasize that the lack of
symptoms does not mean the underlying inflammation has vanished.
6. The nurse is reviewing the immunization record of a 12-month-old child. Which of the
following vaccines should the child receive at this visit?
A. MMR (Measles, Mumps, Rubella) and Varicella.
B. Rotavirus and Tetanus (Tdap).
C. Human Papillomavirus (HPV) and Meningococcal.
D. Hepatitis B and Inactivated Poliovirus (IPV) only.
Correct Answer: A
Rationale: According to the standard CDC pediatric immunization schedule, the first dose
of the MMR and Varicella vaccines is typically given between 12 and 15 months of age.
These are live attenuated vaccines that provide critical protection against common
childhood viral infections. The 12-month visit also usually includes the Hib and PCV13
boosters. Nurses must verify that the child does not have contraindications, such as severe
immunodeficiency, before administration. Proper documentation of the site and
manufacturer is required for all immunizations given.
7. A 5-year-old child is diagnosed with Pertussis (whooping cough). What is the primary
nursing intervention during the paroxysmal stage?
A. Administering cough suppressants to promote sleep.
B. Encouraging vigorous physical activity to clear lung secretions.
C. Ensuring a quiet environment and monitoring for respiratory distress.
D. Providing large meals to increase caloric intake.
Correct Answer: C
Rationale: The paroxysmal stage of pertussis is characterized by severe coughing fits that
can lead to cyanosis and exhaustion. Maintaining a quiet, calm environment helps minimize
triggers that may induce a coughing spell. The nurse must monitor airway patency and
oxygen saturation levels closely during these episodes. Cough suppressants are generally
ineffective and are not recommended for children with pertussis. Small, frequent meals are
preferred over large ones to prevent vomiting caused by the intense coughing.
8. A nurse is evaluating a child with suspected Mononucleosis. Which clinical manifestation is
most associated with this condition?
A. Significant splenomegaly and cervical lymphadenopathy.
B. A ‘slapped-cheek’ appearance on the face.
C. Red, peeling skin on the palms and soles of the feet.
