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    Exam Review

    1. A newborn is admitted to the pediatric unit to rule out congenital hypothyroidism. Which of the following findings would the nurse expect if this diagnosis is confirmed?
      A)
      Bradycardia, constipation, and hypotonia
      B)
      Elevated serum T3 and T4
      C)
      Tachycardia, diarrhea, and tremors
      D)
      Decreased thyroid stimulating hormone (TSH)
    2. A nurse is performing a developmental assessment on a 4-year-old client. What assessment finding would warrant further investigation?
      A)
      The client has urinary and bowel continence.
      B)
      The client is unable to tie their shoes.
      C)
      The client introduces their "friend" who is not visible to the nurse.
      D)
      The client speaks in 2-3 word sentences.
    3. The nurse is reviewing the record of a pediatric client diagnosed with pyloric stenosis. Which assessment finding would the nurse expect to find in the electronic health record?
      A)
      Projectile vomiting
      B)
      Large amounts of bilious emesis
      C)
      Watery diarrhea
      D)
      Steatorrhea
    4. An infant has been admitted to the pediatric unit with a diagnosis of pyloric stenosis. What would the nurse expect in the plan of care for this client?
      A)
      Administration of analgesic medication
      B)
      Preparation for surgical correction
      C)
      Assistance in doing a barium enema on infant
      D)
      Beginning thickened feedings with rice cereal
    Page 1 of 16

    Exam Review

    1. A nurse is providing teaching to the parents of a toddler who has iron-deficiency anemia and is taking iron supplements. Which statement by the parents indicates an understanding of the teaching?
      A)
      "Restricting fiber from our child's diet will help absorption of the iron."
      B)
      “The medication may cause blood in the stools."
      C)
      "Our child's blood count will need to be monitored routinely for several weeks."
      D)
      "The medication will be more effective if it is administered with meals."
    2. During the assessment of a pediatric client with celiac disease, the nurse would most likely note which physical finding?
      A)
      Tender inguinal lymph nodes
      B)
      Enlarged liver
      C)
      Protuberant abdomen
      D)
      Periorbital edema
    3. A nurse is closely monitoring a pediatric client following a tonsillectomy. Which finding would alert the nurse to a postoperative complication?
      A)
      Dry mouth
      B)
      Reports of mild to moderate pain
      C)
      Dried flecks of blood in oral secretions
      D)
      Frequent swallowing
    4. A 4-year-old client presents to the emergency department with drooling, agitation, and inability to cough. The nurse should recognize these findings are associated with which diagnosis?
      A)
      Bronchiolitis
      B)
      Asthma
      C)
      Nasopharyngitis
      D)
      Bacterial epiglottitis
    Page 2 of 16

    Exam Review

    1. A 5-year-old girl presents to the clinic with a urinary tract infection (UTI). After educating the family on preventing recurrent infections, what statement by the family indicates further teaching is needed?
      A)
      "We will increase our child's fiber intake."
      B)
      "We will teach our child to wipe from front to back."
      C)
      "My child may need a follow-up to a specialist due to recurrent infections."
      D)
      "No additional testing is required after the course of antibiotics are complete."
    2. A nurse is caring for an infant in the post-anesthesia care unit following cleft lip and palate repair. What is an appropriate action for the nurse to take?
      A)
      Offer a pacifier with sucrose for pain relief.
      B)
      Maintain elbow restraints in the postoperative period.
      C)
      Place infant in trendelenburg position in the immediate postoperative period.
      D)
      Provide an ice collar for pain.
    3. The mother of a 4-year-old client tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment, the mother tells the nurse that their child is eating well and that their activity level is unchanged. The nurse, suspecting the possibility of Wilms tumor, should avoid which action during the physical assessment?
      A)
      Monitoring the temperature for the presence of fever
      B)
      Monitoring the blood pressure for the presence of hypertension
      C)
      Assessing the urine for the presence of hematuria
      D)
      Palpating the abdomen for a mass
    4. In caring for a pediatric client with nephrotic syndrome, which intervention should be included in the plan of care?
      A)
      Testing the urine for glucose levels regularly
      B)
      Weighing on the same scale each day
      C)
      Increasing oral fluid intake
      D)
      Following a low-potassium diet while on furosemide therapy
    Page 3 of 16

    Exam Review

    1. A nurse has developed a plan of care for a family whose 7-year-old has been experiencing enuresis. Which of the following statements by the parents indicates that further teaching is needed?
      A)
      "We will limit our child's caffeinated beverages"
      B)
      "We will limit fluid during the day."
      C)
      "We will wake our child at scheduled intervals at night to void."
      D)
      "We will need to administer anticholinergics if behavioral strategies are ineffective."
    2. The nurse is reviewing the medical record of a pediatric client suspected to have acute glomerulonephritis. What finding should the nurse expect to note in a client with this diagnosis?
      A)
      Decreased urine specific gravity
      B)
      Hypotension
      C)
      Positive antistreptolysin O titer
      D)
      Low blood urea nitrogen and creatinine
    3. While assessing a preadolescent client, the nurse notes curvature of the client's spine. Which statement by the parent supports this observation?
      A)
      “I've wondered why my child won't let me in the room when changing clothes."
      B)
      "My child has such a hard time finding pants that fit right. They never seem to fit evenly over the hips."
      C)
      "My child has been reporting back pain for the last 2 or 3 months."
      D)
      "My child has been taking ibuprofen daily for the last few weeks because of hip pain after walking so much at school."
    4. A child allergic to insect stings presents to the school nurse stating, "A bee stung me on the playground." Which action by the school nurse should be prioritized?
      A)
      Apply topical diphenhydramine to affected site.
      B)
      Apply a cool pack to reduce the swelling.
      C)
      Position the child in a supine position with legs elevated.
      D)
      Assess the client's airway and breathing rate.
    Page 4 of 16

    Exam Review

    1. A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?
      A)
      The infant has passed several tar-like stools.
      B)
      The infant has not gained weight and has stooled once.
      C)
      The infant has not stooled.
      D)
      The infant has passed hard, pellet-like stools.
    2. A nurse is planning care for a client who has acute glomerulonephritis. Which intervention should the nurse include in the plan when caring for this client?
      A)
      Encourage increased fluid intake.
      B)
      Administer antibiotics.
      C)
      Encourage frequent ambulation.
      D)
      Obtain weight weekly.
    3. A nurse is caring for a 3-year-old child who has had 160 mL of urine output over the past 8 hour period. The child weighs 33 lb. After calculating the client's urinary output, which action is appropriate?
      A)
      Notify the provider.
      B)
      Provide oral rehydration fluids.
      C)
      Perform a bladder scan at the bedside.
      D)
      Continue to monitor the client.
    4. The nurse has taught the parents of a school-aged child with a newly placed ventriculoperitoneal (VP) shunt to monitor for early signs of shunt malfunction. The nurse determines the parents understand the instructions if they understand they should notify the provider if the child develops which early manifestation?
      A)
      Lethargy
      B)
      Seizure activity
      C)
      Rapid weight gain
      D)
      Disinterest in attending school
    Page 5 of 16

    Exam Review

    1. A pediatric client is admitted to the unit with failure to thrive. The mother states that the child has been "spitting up" and excessively crying immediately after every bottle. What diagnostic test will the nurse anticipate to confirm a diagnosis?
      A)
      Upper gastrointestinal series to determine structural abnormalities from gastroesophageal reflux
      B)
      Biopsy of small intestine mucosa to rule out celiac disease
      C)
      Ultrasound to assess for presence of pyloric stenosis
      D)
      Lower gastrointestinal series to assess for an intestinal blockage
    2. A nurse is caring for an infant who has diaper dermatitis. What is an appropriate action for the nurse to take when caring for this client?
      A)
      Wash off the barrier cream with each diaper change.
      B)
      Cloth diapers are recommended to manage this disorder.
      C)
      Apply a light layer of talcum powder with each diaper change.
      D)
      Expose the excoriated area to air frequently.
    3. A nurse is caring for a newborn who was recently delivered. Which of the following clinical signs would cause the nurse to suspect tricuspid atresia?
      A)
      Profound cyanosis
      B)
      Periorbital edema
      C)
      Absent femoral pulses
      D)
      Decreased blood pressure to lower extremities
    4. A nurse is caring for a 4-year-old who was admitted with acute diarrhea and dehydration. Which finding indicates that oral rehydration therapy has been effective?
      A)
      Capillary refill greater than 3 seconds
      B)
      Respiratory rate 24/min
      C)
      Urine specific gravity 1.015 (nl. 1.005-1.030)
      D)
      Heart rate 130/bpm
    Page 6 of 16