Pediatric Proctor (70/70 Questions) 1. A nurse is preparing to assess a 4-year old child’s visual acuity. Which of the following actions should the nurse plan first? • Use a tumbling E chart for the assessment • Position the child 4.6 meters (15 feet) from the chart • Assess both eyes together first, then each eye separately • Test the child without glasses before testing with glasses 2. A nurse is providing discharge teaching to a parent of a child who has juvenile idiopathic arthritis and a new prescription of prednisone/etarnecept. Which of the following statement should the nurse include in the teaching? • “Discontinue this medication if gastrointestinal upset occurs.” • “Expect that this medication will stimulate a growth spurt.” • “Limit your child’s intake of potassium-rich foods.” • “Monitor your child for indications of infection.” 3. A nurse on a pediatric unit is caring for four children. The nurse should use droplet precautions for which of the following children? • An adolescent who has hepatitis A • A toddler who has seasonal influenza • A preschool-age child who has pediculosis capitis • A school-age child who has viral conjunctivitis 4. A nurse is providing teaching to an adolescent who has vulvovaginitis. Which of the following statements should the nurse include in the teaching? • “Apply a warm, moist compress three times per day.” • “Apply scented baby powder to absorb residual moisture.” • “Wear a feminine deodorant pad for vaginal drainage.” • “Wear nylon underwear at night.” 5. A nurse is creating a plan of care for a school-age child who has nephrotic syndrome. Which of the following interventions should the nurse include? (Select all that apply) • Provide a low-sodium diet • Encourage increased fluid intake • Assess for protein in the urine • Initiate contact precautions • Obtain a daily weight 6. A nurse in a pediatric unit is caring for a school-age child following a cardiac catheterization. Which of the following interventions would the nurse take? • Maintain NPO status for 24 hrs. following the procedure • Administer meperidine for pain every 4 hrs. • Perform a sterile dressing change 8 hrs. after the procedure • Keep the affected extremity straight for 6 hrs. 7. A nurse is teaching a parent of a toddler about administering digoxin. Which of the following statements by the parent indicates understanding of the teaching? • “I should mix the medication with 4 ounces of my child’s favorite juice.” • “I should give my child water after giving the medication.” • “I should give my child another dose if he vomits right after taking the medication.” • “I should give the medication with foods that are high in fiber.” 8. A nurse is caring for a 9-year-old child who has major burns to her face and upper torso. Which of the following actions should the nurse take first? • Administer a tetanus vaccine • Give pain medication • Begin enteral feedings • Initiate a crystalloid IV bolus 9. A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following should the nurse include in the plan of care? • Schedule routine oral care every 8 hrs. • Administer oral viscous lidocaine • Moisten the mucous with lemon glycerin swabs • Cleanse the gums with saline soaked gauze 10. A nurse in a community health clinic is assessing the needs of a single parent who has three young children and works full time. Which of the following resources should the nurse recommend? • 12-step support group • Respite child care • Child home health care • Counseling for depression 11. A nurse is caring for a child who has a prescription for fluticasone and has developed white patches and sores in his mouth. Which of the following is an appropriate action for the nurse to take? • Encourage the use of a spacer • Withhold the medication until the lesions heal • Obtain a prescription for oral prednisone • Collect a culture from the lesions 12. A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching? • Seal soft toys in a plastic bag for 14 days • Apply bactericidal ointment to lesions • Administer acyclovir PO two times per day • Soak hairbrushes in boiling water for 10 min. 13. A nurse in an emergency department is caring for a child who has epiglottis. Which of the following actions should the nurse take? • Provide nebulizer aerosol therapy • Administer IV antibiotics • Inspect the tonsils using a tongue depressor • Collect a throat culture 14. A nurse is planning care for a child who is placed in skin traction. Which of the following is the priority action for the nurse to take? • Increase fluid intake • Maintain proper body alignment • Use an alternate pressure mattress • Monitor pedal pulses 15. A nurse is preparing to administer ondansetron 0.15 mg/kg IV to a child who is receiving chemotherapy and weighs 29.4 kg. Available is ondansetron 4 mg/2 mL solution. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero) • Answer: 2.2 mL 16. A nurse is performing a physical assessment of a school-age child who has acute glomerulonephritis. Which of the following findings should the nurse expect? • Hypotension • Increased urinary output • Flushed skin • Facial edema 17. A nurse in an emergency department is assessing an adolescent who reports inhalation of gasoline. Which of the following findings should the nurse expect? • Hypothermia • Pinpoint pupils • Hyperactive reflexes • Ataxia 18. A nurse in the emergency department is assessing a toddler who has hyperpyrexia, severe dyspnea, and is drooling. Which of the following actions should the nurse take first? • Prepare the toddler for nasotracheal intubation • Insert an IV catheter for the toddler • Obtain a blood culture from the toddler • Administer an antibiotic to the toddler 19. A nurse is caring for an infant who has a patent ductus arteriosus. The nurse should identify that the defect is at which of the following locations of the heart? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your assessment) • Answer: 20. A nurse is caring for an infant who has hydrocephalus and ventriculoperitoneal shunt malfunction. Which of the following assessment findings indicates that the infant is experiencing increased intracranial pressure? • Increased appetite • Irritability • Flat fontanel • Tachycardia 21. A nurse is assessing an infant who has iron deficiency anemia. Which of the following findings should the nurse expect? • Increased hemoglobin level • Hyperactive muscle tone • Bradycardia • Pale conjunctiva 22. A nurse is caring for a child who received partial thickness burns to over 50% of his body 10 days ago and has splints over his joints to prevent contractions. Which of the following actions should the nurse take? (Select all that apply) • Provide a high-calorie diet • Administer analgesics IM • Remove splints during sleep • Change dressings using aseptic technique • Monitor intake and output 23. A school nurse is assessing a 7-year-old student. The nurse should identify which of the following findings as a potential indicator of physical abuse? • Bruising around the wrists • Abrasions on the knees • Weight in 45th percentile • Front deciduous teeth missing 24. A nurse is assessing an 18-month-old child during a well-child visit. Which of the following findings should the nurse report to the provider? • The child crawls to navigate the room • The child has frequent temper tantrums • The child consistently throws items to the floor • The child scribbles on the wall with a crayon 25. A nurse is caring for an infant who has rotavirus. Which of the following findings indicates that the infant is inadequately dehydrated? • Weight loss 7% • Capillary refill 1 second • Bradycardia • Respiratory rate 26/min 26. A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching? • Adjust the water heater temperature to 54° C (129.2° F) • Check clothing for loose buttons • Provide balloons for play • Place screens on all windows 27. A nurse is caring for a school-age child who is in 90°/90° skeletal traction. Which of the following actions should the nurse take? • Release the traction to allow the child to bathe • Place the child on an alternating pressure mattress • Adjust the weights to allow the child to turn • Ensure that the pulley mechanism is attached to the skin 28. A nurse is caring for a child who has increased intracranial pressure and is unconscious due to a closed head injury. Which of the following actions should the nurse take? • Maintain the child’s neck in a flexed position • Turn the child side to side every 2 hrs. • Initiate seizure precautions • Perform chest percussion as needed 29. A nurse is providing teaching to the parents of a school-age child newly diagnosed with a seizure disorder. The nurse should teach the parents to take which of the following actions during a seizure? • Clear the area of hard objects • Minimize movement of the limbs • Insert a tongue blade between the teeth • Place the child in a prone position 30. A nurse is providing teaching to a parent of an infant who has diaper rash. Which of the following statements by the parent indicates an understanding of the teaching? • “I will use antibacterial soap to wash the rash with each diaper change.” • “I will keep the area warm and moist.” • “I will use super-absorbent disposable diapers.” • “I will sprinkle talcum powder over the affected area twice daily.” 31. A nurse in a provider’s office is assessing the vital signs of a 1-year-old toddler. Which of the following findings should the nurse report to the provider? • Blood pressure 88/42 mm Hg • Heart rate 110/min. • Respiratory rate 54/min. • Temperature 37.7° C (99.9° F) 32. A nurse is teaching about growth and development to a parent of a 12-year-old child. The nurse should instruct the parent to expect the child to exhibit which of the following characteristics during early adolescence? • Emotional separation from parents • Mood swings • Increased self-esteem • Decelerating growth rate 33. A nurse is caring for a child who is 2 hrs. postoperative. Which of the following actions should the nurse take first? (Click the “exhibit” button for additional information about the client. There are three tabs that contain separate categories of data) • Recheck the child’s temperature • Determine the child’s sedation level • Assess the child’s pain level • Compare the child’s pedal pulses 34. A nurse is assessing an adolescent who has Cushing’s syndrome. Which of the following findings should the nurse expect? • Potassium 4.2 mEq/L • Blood glucose 320 mg/dL • Advanced bone age • Cachectic appearance 35. A nurse is caring for a preschool-age child who is 2 hrs. postoperative following a tonsillectomy and adenoidectomy. Which of the following manifestations should the nurse report to the provider? • Tachycardia • Blood-tinged mucus • Dark brown emesis • Halitosis 36. A nurse is assessing a 6-month old infant who has respiratory syncytial virus. The nurse should immediately report which of the findings to the provider? • Coughing • Tachypnea • Pharyngitis • Rhinorrhea 37. A nurse is admitting an infant who has GERD. Which of the following is the priority assessment finding? • Weight loss • Excessive crying • Wheezing • Regurgitation 38. A nurse is planning care for a child who is experiencing sickle cell crisis. Which of the following interventions should the nurse include in the plan of care? • Administer meperidine as needed for pain • Initiate bed rest • Limit fluid intake • Apply cold compresses to affected joints 39. A nurse is providing teaching to a parent of a child who has cystic fibrosis and a new prescription for dornase alfa. Which of the following instructions should the nurse include in the teaching? • “Store the medication in the refrigerator.” • “Use a spacer with this medication.” • “Administer every 4 hours as needed for cough.” • “Mix the medication with albuterol solution prior to administration.” 40. A nurse is caring for a preschool-age child who has a terminal illness. Which of the following findings should the nurse expect? • Believes the condition is a punishment • Expresses interests in the funeral arrangements • Accepts death is inevitable • Feels excessive anxiety about physical changes 41. A nurse is reviewing the laboratory values of a school-age child who has nephrotic syndrome. Which of the following laboratory results should the nurse expect? • Serum sodium 144 mg/dL • Serum protein 4.2 g/dL • Hgb 12 g/dL • BUN 15 mg/dL 42. A nurse is planning care for a school-age child who has autism spectrum disorder. Which of the following actions should the nurse include in the plan? • Give the child three options when making choices • Stay with the child for long periods of time • Explain procedures in detail to the child • Introduce the child to new situations slowly 43. A nurse is preparing to administer morphine 0.2 mg/kg IV to a child who is postoperative and in pain. The child weighs 34 kg. Available is morphine 1 mg/mL solution. How many mL should the nurse administer? (round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero) • Answer: 6.8 mL 44. A nurse is providing teaching to a parent of an 11-month-old infant who has acute diarrhea and dehydration. Which of the following fluids should the nurse instruct the parent to provide to the infant? • Chicken broth • Oral electrolyte solution • Glucose water • Half-strength apple juice 45. A nurse is providing teaching to a parent of a child who has HIV. Which of the following statements by the parent indicates an understanding of the teaching? • “The risk of transmission decreases since my child is on zidovudine for 2 weeks.” • “My child will need to repeat his childhood immunizations since he is in remission.” • “My child will need to double his medications for the next 6 months.” • “I will ensure that my child is tested for tuberculosis every year.” 46. A nurse is caring for a school-age child who has diabetes mellitus. Which of the following findings should the nurse recognize as being consistent with hyperglycemia? • Pallor • Thirst • Sweating • Tremors 47. A nurse in an urgent care clinic is prioritizing care for four children. Which of the following children should the nurse assess first? • A preschool-age child who has a muffled voice and no spontaneous cough • An adolescent who has Crohn’s disease and a recent weight loss of 5 kg (11 lbs.) • A toddler who has nephrotic syndrome and facial edema • A school-age child who has diabetes mellitus and a blood glucose of 200 mg/dL 48. A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first? • An adolescent who has sickle cell anemia and slurred speech • A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of nafcillin • An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0 to 10 • A toddler who has a partial-thickness burn on his right hand and requires a dressing change 49. A nurse is preparing to administer immunizations to a 3-month-old infant. Which of the following is an appropriate method to take to deliver atraumatic care? • Use a 20-gauge needle for the injections • Apply eutectic mixture of local anesthetics (EMLA) cream immediately before the injections • Inject the immunizations into the deltoid muscle • Provide a pacifier coated with an oral sucrose solution prior to the injections 50. A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever. The nurse should expect that which of the following laboratory tests can contribute to confirming this diagnosis? (Select all that apply) • Antistreptolysin O (ASO) titer • Blood urea nitrogen (BUN) • Partial thromboplastin (PTT) • Erythrocyte sedimentation rate (ESR) • C-reactive protein (CRP) 51. A nurse is reviewing the laboratory report of a school-age child who has bacterial pneumonia. Which of the following laboratory values should the nurse expect? • WBC 18,000/mm3 • Ph. 7.40 • Hgb 14 g/dL • Creatinine 0.5 mg/dL 52. A nurse is providing teaching about medication administration to the parents of a toddler who has a new prescription for liquid ferrous sulfate. Which of the following instructions should the nurse include in the teaching? • “Report tarry, green stools to the provider.” • “Administer the drops with milk.” • “Dilute the drops with water prior to administration.” • “Provide an antacid prior to administration.” 53. A nurse in an emergency department is caring for a child following an overdose of acetylsalicylic acid. Which of the following medications should the nurse plan to administer? • Flumazenil • Phytonadione • Midazolam • Naloxone 54. A nurse is planning care for a newly admitted child who has rotavirus. Which of the following precautions should be implemented? • Airborne • Contact • Protective • Droplet 55. A nurse is developing a plan of care for a child who is dying. Which of the following measures should the nurse implement to the child and his family? • Maintain consistent nursing staff assignments • Ask the parents to leave the room for procedures • Select one family member to receive information • Limit the number of visitors in the client’s room 56. A nurse is planning to perform tracheostomy care for a toddler. Which of the following is an appropriate action for the nurse to take? • Have the client flex his head when securing the ties • Place the child in Trendelenburg position when performing care • Clean around the stoma with full-strength hydrogen peroxide • Use clean technique to change the tracheostomy tube 57. A nurse in the emergency department is caring for a child who has a temperature of 39.1° C (102.4° F) and a suspected diagnosis of bacterial meningitis. Which of the following actions should the nurse take first? • Prepare the child for a lumbar puncture • Administer an antipyretic to the child • Dim the lights in the child’s room • Implement droplet precautions for the child 58. A nurse is caring for a toddler who has a short leg cast. Which of the following findings should the nurse report to the provider? • Positive pedal pulse in the distal extremity • Pallor of the distal extremity • Mobility of the distal extremity • Warm temperature of the distal extremity 59. A nurse is caring for a newly admitted toddler who has acute diarrhea. Which of the following actions should the nurse take first? • Initiate contact precautions • Administer an antibiotic • Obtain a stool specimen for culture • Give 0.9% sodium chloride IV bolus 60. A nurse is planning to teach an adolescent who is lactose intolerant about dietary guidelines. Which of the following instructions should the nurse include in the teaching? • “You may tolerate plain milk better than chocolate milk.” • “You can drink milk on an empty stomach.” • “You can replace milk with nondairy sources of calcium.” • “You should consume flavored yogurt instead of plain yogurt.” 61. A nurse is providing discharge teaching to the parents of a school-age child following placement of a ventriculoperitoneal shunt. The nurse should determine that the teaching was effective when the parents identify which of the following as an indicator the shunt has been displaced? • Hyperactive bowel sounds • Elevated temperature • Increased sleeping • Decreased urine output 62. A nurse is providing teaching to a parent of a 2-month-old infant about immunization schedules. Which of the following statements by the parent indicates an understanding of the teaching? • “My child needs to get the MMR immunization when she’s 12 months old.” • “My child needs to get the varicella immunization when she’s 6 months old.” • “My child will receive the influenza immunization today.” • “My child will receive the hepatitis A immunization today.” 63. A nurse is performing a cranial nerve assessment on a school-age child. Which of the following findings indicates proper functioning of the child’s trigeminal nerve? • The child maintains balance when standing with eyes closed • The child has symmetrical jaw strength when biting down • The child exhibits a gag reflex when stimulated with a tongue blade • The child correctly identifies specific scents 64. A nurse is planning care for a child immediately following the insertion of a chest tube for continuous suction with a closed drainage system. Which of the following interventions should the nurse include in the plan of care? • Ensure continuous bubbling is present in the suction control chamber • Report the presence of tiddling of fluid in the water seal chamber • Change the chest tube insertion site dressing every 12 hrs. • Record the amount of chest tube drainage every 2 hrs. 65. A nurse is educating an adolescent following the application of an arm cast. Which of the following statements by the client indicates an understanding of the teaching? • “I will sprinkle baby powder into the cast if my arm itches.” • “I should limit the use of the fingers of my broken arm.” • “I will elevate my forearm on pillows at night.” • “I should expect my fingers to be swollen for several days.” 66. A nurse in a community center is providing an in-service for parents about nutritional guidelines. Which of the following guidelines should the nurse include in the teaching? • Encourage a 15-year-old to increase calcium intake • Provide 36 oz. of milk per day to a toddler • Offer 8 to 10 oz. of juice per day to a preschooler • Introduce popcorn as a healthy snack at 12 months of age 67. A nurse is caring for a school-age child who is experiencing pain. Which of the following assessment teachings would be the most accurate information regarding the child’s pain? • Ask the child to use a FACES rating scale • Monitor the child’s involuntary movements • Observe the child’s facial expressions • Assess the child’s pulse and respirations 68. A nurse in an emergency department is assessing a school-age child who has asthma. Which of the following should the nurse identify as the priority? • Decreased breath sounds • Hyperresonance on percussion • Nonproductive cough • Pulse rate 118/min 69. A nurse is caring for a child who is postoperative following surgical correction of tetralogy of Fallot. Which of the following is a manifestation of heart failure? • Exercise intolerance • Bradycardia • Weight loss • Decreased respirations 70. A nurse is caring for a 4-year-old child who has meningitis and is receiving gentamycin. Which of the following laboratory results should the nurse report to the provider? • Creatinine 1.4 mg/dL • BUN 12 mg/dL • BUN 6 mg/dL • Creatinine 0.2 mg/dL