NR 328 Pediatric Nursing Week 6 Study Guide 2026/2027 Chamberlain
College
1. A school-age child with Type 1 Diabetes Mellitus presents with diaphoresis,
pallor, and tachycardia. What is the priority nursing action?
A. Administer a bolus of IV normal saline
B. Check the blood glucose level immediately
C. Administer 10 units of regular insulin
D. Provide a high-fiber snack
Answer: B
Rationale: The symptoms of diaphoresis, pallor, and tachycardia indicate hypoglycemia.
The priority is to confirm the blood glucose level before providing a simple carbohydrate.
2. When teaching a parent how to mix NPH and Regular insulin, which
instruction is correct?
A. Draw up the NPH (cloudy) insulin first
B. Shake the NPH vial vigorously before drawing
C. Draw up the Regular (clear) insulin first
D. Inject air into the Regular vial first, then the NPH vial
Answer: C
Rationale: To prevent contaminating the short-acting (clear) insulin with the
intermediate-acting (cloudy) insulin, the clear insulin is drawn into the syringe first.
,3. A child is admitted with Diabetic Ketoacidosis (DKA). Which clinical finding
should the nurse expect?
A. Slow, shallow respirations
B. Hypotension and bradycardia
C. Weight gain and edema
D. Kussmaul respirations and fruity breath
Answer: D
Rationale: DKA results in metabolic acidosis; the body attempts to compensate by blowing
off CO2 via deep, rapid Kussmaul respirations. Fruity breath is caused by ketones.
4. A child with Growth Hormone (GH) deficiency is prescribed Somatropin
injections. When should the nurse instruct the parents to administer the
medication?
A. At bedtime
B. Before lunch each day
C. Immediately upon waking in the morning
D. Every other day after exercise
Answer: A
Rationale: Growth hormone is naturally secreted in the highest concentrations during
sleep; therefore, injections are most effective when given at bedtime.
5. A nurse is caring for an infant with suspected Congenital Hypothyroidism.
Which assessment finding is characteristic of this condition?
A. Hyperactivity and diarrhea
B. High-pitched, shrill cry
C. Increased heart rate and weight loss
D. Large protruding tongue and hypotonia
Answer: D
, Rationale: Congenital hypothyroidism typically manifests with a large tongue, hypotonia
(floppiness), lethargy, and constipation due to slowed metabolism.
6. Which teaching point is most important for a child newly diagnosed with
Diabetes Insipidus (DI)?
A. The child must strictly restrict fluid intake
B. The child should avoid high-protein foods
C. The child must have unrestricted access to water
D. Blood glucose should be checked every 4 hours
Answer: C
Rationale: DI is characterized by the inability to concentrate urine, leading to massive
polyuria. To prevent dehydration, children must have free access to water.
7. A child with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is at
risk for which electrolyte imbalance?
A. Hyponatremia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: A
Rationale: SIADH involves excessive ADH, causing water retention and dilution of the
blood, which results in dilutional hyponatremia.
8. A toddler with Phenylketonuria (PKU) is being discharged. Which food choice
should the nurse advise the parents to avoid?
A. Orange juice
B. Steamed carrots
C. Chicken breast
D. Rice cereal
Answer: C
College
1. A school-age child with Type 1 Diabetes Mellitus presents with diaphoresis,
pallor, and tachycardia. What is the priority nursing action?
A. Administer a bolus of IV normal saline
B. Check the blood glucose level immediately
C. Administer 10 units of regular insulin
D. Provide a high-fiber snack
Answer: B
Rationale: The symptoms of diaphoresis, pallor, and tachycardia indicate hypoglycemia.
The priority is to confirm the blood glucose level before providing a simple carbohydrate.
2. When teaching a parent how to mix NPH and Regular insulin, which
instruction is correct?
A. Draw up the NPH (cloudy) insulin first
B. Shake the NPH vial vigorously before drawing
C. Draw up the Regular (clear) insulin first
D. Inject air into the Regular vial first, then the NPH vial
Answer: C
Rationale: To prevent contaminating the short-acting (clear) insulin with the
intermediate-acting (cloudy) insulin, the clear insulin is drawn into the syringe first.
,3. A child is admitted with Diabetic Ketoacidosis (DKA). Which clinical finding
should the nurse expect?
A. Slow, shallow respirations
B. Hypotension and bradycardia
C. Weight gain and edema
D. Kussmaul respirations and fruity breath
Answer: D
Rationale: DKA results in metabolic acidosis; the body attempts to compensate by blowing
off CO2 via deep, rapid Kussmaul respirations. Fruity breath is caused by ketones.
4. A child with Growth Hormone (GH) deficiency is prescribed Somatropin
injections. When should the nurse instruct the parents to administer the
medication?
A. At bedtime
B. Before lunch each day
C. Immediately upon waking in the morning
D. Every other day after exercise
Answer: A
Rationale: Growth hormone is naturally secreted in the highest concentrations during
sleep; therefore, injections are most effective when given at bedtime.
5. A nurse is caring for an infant with suspected Congenital Hypothyroidism.
Which assessment finding is characteristic of this condition?
A. Hyperactivity and diarrhea
B. High-pitched, shrill cry
C. Increased heart rate and weight loss
D. Large protruding tongue and hypotonia
Answer: D
, Rationale: Congenital hypothyroidism typically manifests with a large tongue, hypotonia
(floppiness), lethargy, and constipation due to slowed metabolism.
6. Which teaching point is most important for a child newly diagnosed with
Diabetes Insipidus (DI)?
A. The child must strictly restrict fluid intake
B. The child should avoid high-protein foods
C. The child must have unrestricted access to water
D. Blood glucose should be checked every 4 hours
Answer: C
Rationale: DI is characterized by the inability to concentrate urine, leading to massive
polyuria. To prevent dehydration, children must have free access to water.
7. A child with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is at
risk for which electrolyte imbalance?
A. Hyponatremia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: A
Rationale: SIADH involves excessive ADH, causing water retention and dilution of the
blood, which results in dilutional hyponatremia.
8. A toddler with Phenylketonuria (PKU) is being discharged. Which food choice
should the nurse advise the parents to avoid?
A. Orange juice
B. Steamed carrots
C. Chicken breast
D. Rice cereal
Answer: C
