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    Exam Review

    1. A nurse is caring for an infant experiencing a hypercyanotic, or "tet spell.”. Which interventions are appropriate for this condition?
      (SATA)
      A)
      Administer oxygen.
      B)
      Encourage oral fluids.
      C)
      Administer morphine.
      D)
      Lay the child flat.
      E)
      Place in knee-chest position.
    2. A nurse is assessing a 2-month-old infant with a patent ductus arteriosus. Which finding is most concerning?
      A)
      Oxygen saturation of 88
      B)
      Bounding peripheral pulses.
      C)
      Machinery-like murmur.
      D)
      Respiratory rate of 60 breaths per minute.
    3. After administering furosemide to a school-aged child with congestive heart failure secondary to a ventricular septal defect, which finding indicates improvement?
      A)
      Urine output decreased to 0.5 mL/kg/hr.
      B)
      Weight increased by 1.5 kg.
      C)
      Respiratory rate decreased from 50 to 32 breaths per minute.
      D)
      Heart rate increased to 160 bpm.
    4. A child is experiencing a tonic-clonic seizure. Which nursing action is most appropriate during the seizure?
      A)
      Turn the child to the side to prevent aspiration.
      B)
      Give an oral benzodiazepine medication to stop the seizure.
      C)
      Insert a tongue blade to prevent airway obstruction.
      D)
      Restrain the child to minimize injury.
    Page 1 of 11

    Exam Review

    1. A nurse is administering digoxin to an infant. The apical pulse is 88 bpm. What should the nurse do?
      A)
      Administer half the dose.
      B)
      Administer the dose.
      C)
      Administer double the dose.
      D)
      Hold the dose and notify the provider.
    2. A nurse is preparing to administer a fluid bolus to a child in septic shock. What type of fluid and over what duration should the nurse expect the provider to order?
      A)
      20 mL/kg of hypotonic saline over 10 minutes.
      B)
      5 mL/kg of Ringer's lactate (LR) over 30 minutes.
      C)
      10 mL/kg of D5W over 1 hour.
      D)
      20 mL/kg of 0.9% NaCl (normal saline) over 5-30 minutes.
    3. Which symptom would warrant immediate reevaluation in a child with a concussion?
      A)
      Mild headache.
      B)
      Vomiting.
      C)
      Alertness.
      D)
      Normal gait.
    4. Which of the following are expected clinical manifestations of viral croup?
      (SATA)
      A)
      Stridor.
      B)
      Barking cough.
      C)
      Hoarseness.
      D)
      Tripod positioning.
      E)
      Drooling.
    Page 2 of 11

    Exam Review

    1. Match the respiratory condition with its hallmark symptom.
      (SATA)
      A)
      Viral croup: Barking cough and stridor.
      B)
      Asthma: Polyphonic wheezing and chest tightness.
      C)
      Epiglottitis: Drooling and muffled voice.
      D)
      Bronchiolitis: Wheezing and crackles.
    2. Which of the following is the most concerning sign of increased intracranial pressure in an infant?
      A)
      High-pitched cry.
      B)
      Poor feeding.
      C)
      Separated cranial sutures.
      D)
      Bradycardia.
    3. Which diagnostic test confirms cystic fibrosis?
      A)
      Sweat chloride test.
      B)
      Pulmonary function test.
      C)
      Chest X-ray.
      D)
      Sputum culture.
    4. Which of the following are appropriate nursing interventions for a child with viral meningitis?
      A)
      Restrict fluids to prevent cerebral edema.
      B)
      Monitor for signs of increased intracranial pressure.
      C)
      Administer acetaminophen for fever and pain.
      D)
      Administer IV antibiotics immediately.
      E)
      Encourage rest and hydration.
      F)
      Provide a quiet, dimly lit environment.
    Page 3 of 11

    Exam Review

    1. A nurse is assessing a child with suspected infective endocarditis. Which finding is most indicative of this condition?
      A)
      Periorbital edema.
      B)
      Bounding pulses in lower extremities.
      C)
      High-pitched cry.
      D)
      Splinter hemorrhages under nails.
    2. A nurse is assessing a child with coarctation of the aorta. The nurse expects to find weaker pulses in the lower extremities compared to the upper extremities.
      A)
      True
      B)
      False
    3. A nurse is preparing to suction a 5-year-old child with a severe traumatic brain injury who is intubated. Which of the following actions is most appropriate to prevent a rise in intracranial pressure (ICP)?
      A)
      Administer sedation prior to suctioning.
      B)
      Lower the head of the bed to increase venous return.
      C)
      Perform suctioning as quickly as possible.
      D)
      Delay suctioning until ICP rises.
    4. Which symptoms are commonly seen in bacterial meningitis?
      A)
      Photophobia.
      B)
      Petechial rash.
      C)
      Nuchal rigidity.
      D)
      High-pitched cry.
      E)
      Seizures.
    Page 4 of 11

    Exam Review

    1. Which symptoms are most consistent for a school-age patient who presents with mild to moderate asthma?
      A)
      Cyanosis.
      B)
      Chest tightness.
      C)
      A cough that is always productive.
      D)
      Wheezing.
      E)
      Prolonged expiration.
    2. Which of the following criteria must be met for a seizure to be classified as a febrile seizure?
      A)
      Occurs with a temperature less than 38°C.
      B)
      Occurs with a temperature greater than 38°C in a child 6 months to 5 years of age.
      C)
      Occurs in a child older than 6 years.
      D)
      Occurs with a central nervous system infection.
    3. Which of the following signs is most indicative of hydrocephalus in an infant?
      A)
      Setting-sun sign.
      B)
      High-pitched cry.
      C)
      Sunken fontanel.
      D)
      Normal head circumference.
    4. A child weighing 12.6 kg requires a 20 mL/kg fluid bolus to be administered over 25 minutes. What is the infusion rate in milliliters per hour (mL/hr) that the nurse should set on the IV pump? Round your answer to the nearest tenth and enter only digits (not units).
    Page 5 of 11

    Exam Review

    1. Which nursing diagnoses are appropriate for an infant with a large patent ductus arteriosus (PDA)?
      A)
      Risk for infection.
      B)
      Decreased cardiac output.
      C)
      Fluid volume deficit.
      D)
      Risk for impaired gas exchange.
      E)
      Activity intolerance.
    2. Which symptoms are associated with focal impaired awareness seizures?
      A)
      Generalized muscle stiffening.
      B)
      Loss of consciousness.
      C)
      Dreamlike state.
      D)
      Emotional changes.
      E)
      Automatisms.
    3. Which of the following is the most critical initial nursing action for a child suspected of epiglottitis?
      A)
      Prepare for airway management.
      B)
      Give racemic epinephrine.
      C)
      Administer intravenous antibiotics.
      D)
      Obtain a throat culture.
    4. Which of the following are nursing priorities for a child with severe traumatic brain injury (TBI)?
      A)
      Elevate the head of bed to 15-30°.
      B)
      Maintain a quiet environment.
      C)
      Monitor for changes in level of consciousness.
      D)
      Use seizure precautions.
      E)
      Administer D5W maintenance intravenous fluids for hydration.
    Page 6 of 11