Module 1 - Basic Concepts of Pediatrics

Sample Questions
Read each question carefully. Select the statement, word or sentence that most
appropriately completes the phrase or answers the question.
1.

You are discussing toddler development with a parent. Which of the following
interventions will foster the achievement of autonomy?
a. Help the toddler complete tasks.
b. Provide opportunities for toddler to play with other children.
c. Help the toddler learn the difference between right and wrong.
d. Encourage the toddler to do things for self when capable of doing them.

2. You observe parents playing with their 10-month-old daughter. Which of the
following do you recognize as an example that the child is developing object
permanency? The child:
a. Looks for the toy that the parents hide under the blanket.
b. Returns the blocks to the same spot on the table.
c. Recognizes that a ball of clay is the same when flattened out.
d. Bangs two cubes held in her hands.
3. Effective communication with families is essential. Which of the following is
considered a block to effective communication?
a. Using silence
b. Using clichs
c. Defining the problem
d. Using judgmental statements
4. What is the single most important factor to consider when communicating with
children?
a. The childs physical condition
b. Presence or absence of the childs parent
c. Developmental level of the child
d. Nonverbal behaviors of the child.
5. You are meeting a 5-year-old child for the first time and need the child to
cooperate. You decide to do a simple magic trick using gauze. This should be
interpreted as:
a. Inappropriate because of the childs age.
b. A way to establish rapport
c. Too distracting, when cooperation is important
d. Acceptable, if there is adequate time.

6.

You are taking a health history on an adolescent. How would you best describe
how the chief complaint should be determined?
a. Ask for a detailed listing of symptoms

b. Ask the adolescent, Why did you come here today?

c. Use what the adolescent says to determine, in correct medical terminology, to
identify the problem.
d. Interview the parents away from the adolescent to determine the chief
complaint.
7.

During an examination of a toddler. You note that the child is bowlegged. You
should recognize this finding is:
a. Abnormal and requires further investigation.
b. Abnormal unless it occurs in conjunction with knock-knee.
c. Normal if the condition is unilateral or asymmetric.
d. Normal because the lower back and leg muscles are not yet well-developed.

8.. You are assessing a 3-day-old, breast fed newborn who weighed 7 lbs, 8 oz at birth.
The infants mother is now very concerned that the infant weighs 6 lbs, 15 oz.
The most appropriate nursing intervention is:
a. Recommend supplemental feedings.
b. Explain that this weight loss is within normal limits.
c. Assess the child further to determine cause of excessive weight loss.
d. Encourage the mother to express breast milk for bottle-feeding the infant.
9. The parents of a 9 month-old tells you hey have noticed foods such as peas and
corn are not completely digested and come out in the childs stool. You should
provide an explanation based on the fact that :
a. The child should not be given fibrous foods such as these until digestive tract
matures at about age four.
b. The child should not be given solid foods until this digestive tract problem is
resolved.
c. This is normal and requires further investigation.
d. This is normal because of the immaturity of the digestive processes at this age.
10. Which of the following is an appropriate play activity for a 7-month old infant to
encourage visual stimulation?
a. Playing peekaboo
b. Playing pat-a-cake
c. Imitating animal sounds
d. Showing how to clap hands

11. You are teaching a parent about the introduction of solid foods during infancy.
You should instruct the parent that:
a. Solid foods should not be introduced until the extrusion reflex disappears
completely.
b. Foods should be introduced one at a time at intervals of 4 to 7 days.

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c. Solid foods can be mixed in a special container with a nipple to make the
transition easier for the infant.
d. Fruits and vegetables should be the first solids to be introduced.
12. A mother then asks you if a 2 year-old child can eat hot dogs. Your reply should
be:
a. This child is too young to digest hot dogs.
b. Hot dogs should be cut into small pieces to prevent aspiration.
c. The child is too young to eat hot dogs safely.
d. Hot dogs should be cut into small, irregular pieces to prevent aspiration.
13. You are explaining the Food Guide Pyramid to a group of fourth graders.
Which of the following should be included in your explanation?
a. Fats and oils should be limited to three servings per day.
b. The most number of services per day should come from the milk, yogurt and
cheese group.
c. At least two services per day from the milk group is recommended.
d. At least four services per day from the bread, cereal, rice and pasta group are
recommended.
14.

The parent of an 18-month old tells you that he says no to everything, has
rapid mood swings and if scolded, immediately wants to be held. Your best
interpretation of this behavior is:
a. This is normal behavior for his age.
b. This is unusual behavior for his age.
c. He is not effectively coping with stress
d. He is demonstrating that he needs more attention.

15.

Although a 14-month old girl recently received a shock from an electrical

outlet, her parents find her about to place a paper clip in another outlet. They
discuss this with you as they are frustrated about how to handle these kind of
situations. You should advise them that:
a. Her cognitive level must be delayed.
b. This is typical behavior because toddlers are not well developed.
c. This is typical behavior because at this age, there is an inability to transfer past
experiences to new situations.
d. This is not typical behavior because toddlers should know better than to repeat
an act that caused them pain.

Module 1 - Basic Concepts of Pediatrics

Answer Key:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

d
a
d
c
b
b
d
b
d
a
b
d
c
a
c

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Module 2 - Children with Alterations in Oxygenation
Sample Questions
1.

When preparing parents of an infant with apnea for discharge, it is essential that the
parents learn:
a. Infant massage techniques.
b. Nasogastric feeding techniques.
c. Cardiopulmonary resuscitation.
d. Administration of oral steroids.

2.

One of the characteristic signs of cystic fibrosis is the presence of:

a. Hemoptysis
b. .Increased appetite.
c. Steatorrhea
d. Recurrent urinary tract infection.

3.

To facilitate breathing and ease respiratory effort, the nurse places the child with
asthma symptoms in the following position:
a. Low-Fowler's.
b. Prone.
c. Semi-Fowler's
d. Side-lying

4. The most appropriate nursing intervention when caring for an infant with an upper
respiratory infection an elevated temperature would be to:
a. Give tepid baths to reduce the fever
b. Encourage food intake to maintain caloric needs.
c. Have child wear heavy clothing to prevent chilling.
d. Give small amounts of favorite fluids frequently to prevent dehydration.
5. When caring for a child following a tonsillectomy, you should:
a. Watch for continuous swallowing.
b. Encourage gargling to reduce discomfort
c. Position the child on the back for sleeping.
d. Apply warm compresses to the throat for comfort.
6. An 18 month old child is seen in the clinic with acute otitis media. Trimethoprimsulfamethoxazole (Bactrim) is prescribed. Instructions to the parent should include
which of the following?
a. Administer all of the prescribed medication
b. Continue medication until all symptoms subside.
c. Immediately stop giving medication if hearing loss develops.
d. Stop giving medication and come to the clinic if fever is still present in 24 hours.

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7 A 4-year-old girl is brought to the emergency room. She has a Afroglike@ croaking
sound on inspiration, is agitated, and is drooling. She insists on sitting upright. You
should do which of the following?
a. Examine her oral pharynx and report findings to the physician.
b. Make her lie down and rest quietly.
c. Auscultate her lungs and make preparations for placement in a mist tent.
d. Notify the physician immediately and be prepared to assist with a tracheostomy or
intubation.
8. You are assessing a child with croup. Examining the child=s throat using a tongue
depressor might precipitate which of the following?
a. Inspiratory stridor
b. Complete obstruction
c. Sore throat
d. Respiratory tract infection
9. You are assigned to the outpatient clinic. The mother of a 20-month-old boy tells you
that he has a barking cough at night. His temperature is 370 C. You suspect the child
has croup and therefore would recommend that the mother:
a. Control fever with acetaminophen and call if the cough gets worse tonight.
b. Try a cool-mist vaporizer at night and watch for signs of difficulty breathing.
c. Try over the counter cough medicine and come to the clinic tomorrow if there is no
improvement.
d. Tell her that the doctor will admit the child to the hospital to observe for impending
epiglottis.
10. You are assigned to care for a toddler with acute laryngotracheobronchitis. You
encourage the mother to remain at the bedside as much as possible. The rationale for
this action is primarily:
a. Mothers of hospitalized toddlers often experience guilt.
b. The mother=s presence will reduce anxiety and ease the child=s respiratory effort.
c. Separation from the mother is a major developmental threat at this age.
d. The mother can provide constant observations of the child=s respiratory efforts.
11. An important nursing consideration when caring for a 10-month-old infant with
respiratory syncytial virus/bronchiolitis would be which of the following?
a.
Place in a mist tent
b.
Administer antibiotics
c.
Administer cough syrup
d.
Encourage drinking 8 ounces of formula every four hours.

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12. A parent whose two school-age children have asthma asks you what sports, if any, they
can participate. You should recommend which of the following sports?
a. Soccer
b. Running
c. Swimming
d. Basketball
13. Which of the following drugs is usually given first in the emergency treatment of an
acute, severe asthma episode in a young child?
a.
Ephedrine
b.
Epinephrine
c.
Antibiotics
d.
Cough syrup with codeine
14. Cystic fibrosis may affect singular or multiple systems of the body. The primary
factor responsible for possible multiple clinical manifestations is:
a. Atrophic changes in mucosal wall of intestines.
b. Hypoactivity of autonomic nervous system
c. Hyperactivity of sweat glands.
d. Mechanical obstruction caused by increased viscosity of mucous gland secretions.
15. Which of the following tests aid in the diagnosis of cystic fibrosis?
a. Sweat test, stool for fat, chest x-ray.
b. Stool for fat, gastric contents for HCL, chest x-ray.
c. Sweat test, bronchoscopy, dudodenal fluid analysis.
d. Sweat test, stool for trypsin, biopsy of intestinal mucosa.

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Module 2 - Children with Alterations in Oxygenation
Answer Key

1. c
2. c
3. c
4. d
5. a
6. a
7. d
8. b
9. b
10. b
11. a
12. c
13. b
14. d
15. a

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Module 3 Children with Alterations in Nutrition/Elimination
Sample Questions
1. A 5-1/2 month-old infant is admitted to the hospital with a fever and a history of
vomiting for 48 hours. In view of this infants responses, the assessment by the nurse that
would initially influence the childs care is:
a. Inspecting the babys skin for poor turgor
b. Determining the babys vital signs and weight
c. Checking the babys neurologic status and urinary output
d. Asking the mother whether the baby is breast- fed or bottle-fed
2. To best ascertain the magnitude of fluid loss in an infant with gastroenteritis and
diarrhea, the nurse should:
a. Evaluate the infants skin turgor carefully
b. Note the elevation of the infants hematocrit value
c. Assess the moistness of the infants mucous membranes
d. Compare the infants pre-illness weight with the current weight
3. An initial nursing assessment of an infant with severe dehydration will most likely
reveal:
a. Stools that are frothy
b. A weak, decreased pulse
c. Bulging of the occipital fontanel
d. An elevated urine specific gravity
4. When assessing a 4-month-old infant with gastroenteritis and dehydration, the nurse
would expect to find a:
a. Specific gravity of 1.014
b. Urinary output of 50 mi/hr
c. Depressed anterior fontanel
d. History of allergies to various foods

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5. A 5-month-old with a history of frequent bouts of diarrhea is to be discharged. A
priority concern that the nurse should include in the teaching plan for the mother is
the:
a. Effects of antibiotics on viral gastroenterins
b. Potential hazards of fluid loss in young children
c. Importance of a well-balanced diet for the infant
d. Need for cleanliness of foods and feeding utensils
6. A mother asks why her 1-year-old toddlers cleft palate was not repaired at the time
the cleft lip was repaired at 3 months of age. The nurses best response would be:
a. Waiting leaves time for other birth defects to be detected and corrected.
b.

The cleft lip was so disfiguring that plastic surgery was done as quickly as
possible.

c. Your surgeon prefers to separate the operations to minimize and prevent

complications.
d. The palate is corrected after teething and before your child talks so that correct
speech may be learned.
7. After the repair of a cleft lip, the nurse will provide nutrition for the baby via:
a. A plastic teaspoon
b. Intravenous feedings
c. A rubber-tipped syringe
d. Nasogastric tube feedings
8. When assessing an infant with a suspected diagnosis of hypertrophic pyloric stenosis,
the nurse would expect to find:
a. Visible peristaltic waves across the lower abdomen
b. A palpable mass in the epigastrium to the right of the umbilicus
c. Tenderness over the epigastric region not relieved by heat application
d. Lower abdominal distention with vomiting of bile-stained gastric contents

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9. A 25-day-old infant is admitted to the hospital after 3 days of vomiting, and pyloric
stenosis is diagnosed. The most important nursing assessment at the time of admission
is the:
a. Character, amount, and times when the baby vomited
b. Time of last feeding, type of formula, and amount taken
c. Presence of an olive-shaped mass in the lower abdomen
d. Amount and color of last voiding, skin turgor, and respiratory status
10. To help a child retain tube feedings and avoid aspiration, the nurse should place the
child in the:
a. Prone position
b. Left side-lying position
c. Semi-Fowlers position
d. Supine position with head turned

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Module 3 Caring for Children with Alterations in Nutrition/Elimination
Sample Question Answer Key

1. a
2. b
3. b
4. c
5. b
6. d
7. d
8. a
9. b
10. c

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4 Module 4 Caring for Children with Alterations in Immunologic Function
Sample Questions

1. What is the priority nursing diagnosis for an infant admitted to the hospital with severe
combined immunodeficiency disease?
a. Alteration in nutrition
b. Impaired airway clearance
c. Risk for fluid volume deficit.
d. Risk for infection
2. Which of the following would be an expected nursing goal for the child with AIDS?
a. The childs viral load will decrease to normal limits.
b. The child will have nutritional intake that supports growth.
c. The child will be educated at home with a tutor.
d. The child will have activities limited.
3. The inflammation, pain, and swelling of the joints of a child with juvenile rheumatoid
arthritis (JRA) can result in:
a. Skin atrophy
b. Facial rash
c. Buildup of scar tissue in the joint.
d. Systemic rash and itching

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Module 4 Caring for Children with Alterations in Immunologic Function

Answer Sheet
1. d
2. b
3. c

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Module 5 Caring for Children with Alterations in Circulation
Sample Questions
1.

Which of the following newborns is at risk for developing a thromboembolism?

a. A newborn with a hematocrit of 60%.
b. A newborn with respiratory failure.
c. A newborn with mild hypoxemia.
d. A newborn with a hemoglobin of 12 mg/dl.

2.

An infant with an unrepaired congenital heart defect is not gaining weight and is
admitted to the hospital. To improve weight gain, the nurse can expect to:
a. Increase the time of feedings to 45 minutes each feed.
b. Increase the caloric density of the formula
c. Feed the infant hourly.
d. Prepare the infant for cardiac surgery.

3.

The parents of a child hospitalized with acute rheumatic fever are asking for
appropriate ideas for play at home. The nurse would correctly suggest:
a. Soccer.
b. Swimming.
c. Quiet board games
d. Yoga.

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Module 5 Caring for Children with Alterations in Circulation
Sample Questions Answer Key

1.

2.

3.

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6 Module Caring for Children with Alterations in Neurosensory Functions
Sample Review Questions
1.

A young child with hydrocephalus was admitted to the pediatric unit following the
placement of a ventriculoperitoneal shunt. Which of the following is a necessary
nursing intervention?
a. Daily x-rays to evaluate the shunt.
b. Measure head circumference daily.
c. Palpate fontanels frequently.
d. Keep the child prone.

2.

A young child has a seizure disorder and is on medication. The side effect of gingival
hyperplasia is caused by which anticonvulsant?
a. Phenobarbital.
b. Phenytoin (Dilantin).
c. Carbamazepine (Tegretol).
d. Valproic acid (Depakene).

3.

When an adolescent is admitted to the hospital with viral meningitis, the nurse would
include which intervention in the plan of care?
a. Keep the room dark and quiet.
b. Administer intravenous antibiotics.
c. Follow serum sodium levels daily.
d. Administer oral steroids.

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Module 6 Answer Key

1.
2.
3.

b
b
a

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Module 7 - Caring for Children with Alterations in Metabolism - Endocrine
Sample Review Questions
1. A child is receiving propylthiouracil for the treatment of hyperthyroidism(Graves
Disease). The parents and child should be taught to recognize and report adverse
symptoms immediately. They should report:
a. Coughing
b. Ear pain
c. Fever, sore throat
d. Upper respiratory infection
2. You are caring for an adolescent who has just returned to his room after a
thyroidectomy. Which of the following indicated complications that should be
reported immediately?
a. Lethargy
b. Facial edema
c. Acute neck pain, hoarseness
d. Severe stridor, hoarseness, feeling of tightness in the throat.
3. Which of the following is categorized by catabolism and development of ketosis in the
absence of insulin replacement therapy?
a. Type I diabetes
b. Type II diabetes
c. Impaired glucose tolerance
d. Gestational diabetes
4.The mother of a child with Type I diabetes asks why her child can=t avoid all those
Ashots@ and take pills like her uncle does. Your best reply is:
a. The pills work with adult pancreas only.
b. The drugs affect fat and protein metabolism but not sugar.
c. Your child needs insulin replacement and the oral hypoglycemics only add to an
existing supply of insulin.
d. Perhaps when your child is older, the pancreas will produce its own insulin and then
your child will take oral hypoglycemics.
5. The parent of a child asks why home blood glucose monitoring is being recommended
for her child with diabetes. You should base the explanation on the fact that:
a. It is a less expensive method of testing.
b. It is an easier method of testing.
c. It allows better management of the diabetes
d. Children have a greater sense of control over the diabetes when they do the testing.

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Module 7 - Caring for Children with Alterations in Metabolism - Endocrine
Sample Answers

1.

2.

3.

4.

5.

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