PNLE Pediatric Nursing

A. PEDIATRICS (20 Questions)

SITUATION: Kawasaki disease is a common disease of the children especially in the Asia
Pacific region like in Japan and Korea. The following questions apply:

1. The following observations are noted in a child under the acute phase of Kawasaki disease
except:
A. Fever
B. Vascular aneurysm
C. Increased WBC
D. Conjunctivitis

2. A child is diagnosed with Kawasaki Disease. Which of the following manifestations is seen
during the subacute phase of the disease?
A. Strawberry tongue
B. Polymorphous rashes
C. Increased ESR
D. Desquamation of palms and soles

3. A mother of a very ill child with Kawasaki disease is asking why his child is transferred in
the ICU. You, as a knowledgeable nurse would answer her correctly by saying:
A. “Your child can rest well in the ICU since there are few patients there”
B. “Your child’s WBC is high so he needs to be in the ICU”
C. “Your child may have develop cardiac problems and he needs to be closely
monitored”

4. When developing the plan of care for a newly admitted 2-year old child with the diagnosis
od Kawasaki Disease, which of the following should be the priority?
a. Taking vital signs every 6 hours
b. Monitoring input and output every hour
c. Minimize skin discomfort
d. Providing passive range of motion exercises.

5. A 16-month old child diagnosed with Kawasaki Disease is very irritable, refuses to eat, and
exhibits peeling skin on hands and feet. The nurse should do which of the following first?
a. Apply lotion to the hands and feet
b. Offer foods that the toddler likes
c. Place the toddler in a quiet environment
d. Ask the parents to comfort the child for you to give her meals
PNLE Pediatric Nursing

SITUATION: Neurologic problems in children are caused by several reasons. As a

competent nurse, he or she should be well-versed and knowledgeable with managing
neurologic problems in children. The following questions apply:

6. Parents bring a 10-month old boy born with myelomeningocele and hydrocephalus with a
ventriculoperitoneal shunt to the ER department. His symptoms include vomiting, poor
feeding, lethargy, and irritability. What interventions by the nurse are the most appropriate?
I. Weigh the child
II. Listen to bowel sound
III. Palpate anterior fontanel
IV. Obtain vital signs
V. Assess pitch and quality of child’s cry

a. I and III
b. II and IV
c. II, III, IV
d. II,III,IV, V

7. The nurse reports to the doctor the signs of increased intracranial pressure in an infant with a
myelomeningocele who has which of the following?
a. Minimal lower-extremity movement
b. High-pitched cry
c. Overflowing voiding
d. Fontanel that bulges with crying

8. The parents of an infant with myelomeningocele ask the nurse about their child’s future
mental ability. What is the nurse’s best response ?
a. “About one-third have an intellectual disability, but it’s too early to tell about your child”
b. ”About two-thirds have an intellectual disability significantly retarded, and you’ll know
soon if this will occur.”
c. “Your child will probably be of normal intelligence since he demonstrates signs of it
now”
d. “You’ll need to talk with the doctor about that, but you can ask later.”

9. A nurse evaluates discharge teaching as successful when the parents of a school-age child
with a ventriculoperitoneal shunt insertion identify which sign as signaling a blocked shunt?
a. Decreased urine output with stable intake
b. Tense fontanel and increased head circumference
c. Elevated temperature and reddened incisional site
d. Irritability and difficulty with eating
PNLE Pediatric Nursing

10. A nurse is developing a plan of care with the parents of a 6-year-old girl diagnosed with a
seizure disorder. To promote growth and development, the nurse should instruct the parents
that:
a. The child will need activity limitation and will be unstable to perform as well as her
peers.
b. There is potential for a learning disability and the child may need tutoring to reach her
grade level.
c. The child will likely have normal intelligence and be able to attend regular school
d. There will be problems associated with social stigma and parents should consider home
schooling

11. When teaching an adolescent with a seizure disorder who is receiving valproic acid
(Depakene), which sign or symptom should the nurse instruct the client to report to the
health care provider?
a. Several episodes of diarrhea
b. Loss of appetite
c. Jaundice
d. Sore throat

12. When interviewing the parents of a 2-yo child, a history of which of the following illnesses
should lead the nurse to suspect pneumococcal meningitis?
a. Bladder infection
b. Middle ear infection
c. Fractured clavicle
d. Upper respiratory tract infection

13. Which of the following actions should be the priority when caring for a school-age child
admitted to the pediatric unit with the diagnosis of Guillain-Barre syndrome?
a. Assessing child’s ability to follow simple commands
b. Evaluating the child’s bilateral muscle strength
c. Making a game of the range-of-motion exercises
d. Providing the child with diversional activity

14. A 3- year old is recovering from a concussion. The persistence of which finding is LEAST
concerning?
a. Lack of interest in favorite toys
b. Change in eating habits
c. Inability to hop
d. Increased temper tantrums
PNLE Pediatric Nursing

15. A nasogastric tube is prescribed to be inserted for a child with severe head trauma.
Diagnostic testing reveals that the child has a basilar skull fracture. What should the nurse
do next?

a. Use extra lubrication when inserting the nasogastric tube

b. Attempt to place the tube into the duodenum.
c. Collaborate with the primary health care to make confirmatory assessment by MRI
d. Ask for the prescription to be changed to oral gastric tube
e. Test the gastric aspirate for blood

16. After a child undergoes a craniotomy for an infratentorial brain tumor, the nurse should
place the child in which of the following positions
a. Prone
b. Semi-fowler’s
c. Side-lying
d. Tendelenburg

17. During assessment of an adolescent who has sustained a recent thoracic spinal injury, the
nurse auscultates the adolescent’s abdomen. The nurse explains to the parents that this is
necessary because clients with spinal cord injury often develop which of the following?
a. Hyperactive bowel sounds
b. Paralytic ileus
c. Profuse diarrhea
d. Increased flatulence

18. Which of the following findings should lead the nurse to decide that spinal shock was
resolving in the adolescent with a spinal cord injury?
a. Normal urinary bladder activity
b. Flaccid Paralysis
c. Hyperactive reflexes
d. Widened pulse pressure

19. A school-age boy with a spinal cord injury is moved to the rehabilitation unit. The nurse
notes that the child tends to refuse to cooperate in care and to be hostile. The nurse interprets
this behavior as indicative of which of the following?
a. A stage of grief reaction
b. A phase of rebellion
c. A phase of fatigue and over-exhaustion
d. A response to too much attention
PNLE Pediatric Nursing

20. A nurse is assessing a child who has a mild intellectual disability. The best indication of how
this child is progressing can be obtained by observing him
a. At school with teacher
b. At home with family members
c. In the clinic with his mother
d. Playing with his friends