ANCC Pediatric Nursing 2

Question 1

A 6-year-old presents with barking cough, inspiratory stridor, and low-grade fever. The child is alert and not drooling. Which nursing intervention is the priority?

Accepted Answer

Place in cool mist environment and administer racemic epinephrine per order

Answer

Prepare for immediate intubation at bedside

Answer

Position the child supine for airway assessment

Answer

Obtain throat swab culture before initiating any treatment

Question 2

A child weighing 44 lbs requires amoxicillin 40 mg/kg/day divided every 8 hours. Available suspension is 250 mg/5 mL. How many mL per dose?

Accepted Answer

5.3 mL

Answer

10.7 mL

Answer

3.0 mL

Answer

8.0 mL

Question 3

A 3-year-old presents with suspected epiglottitis. Which nursing action is the absolute priority?

Accepted Answer

Avoid any agitation; keep child calm with parent; do NOT examine the throat

Answer

Obtain a throat culture to identify the causative organism

Answer

Place child supine and prepare for bag-mask ventilation

Answer

Administer ibuprofen to reduce fever immediately

Question 4

A 28-week gestation newborn in the NICU — which finding is most consistent with respiratory distress syndrome (RDS)?

Accepted Answer

Expiratory grunting, nasal flaring, subcostal retractions, and cyanosis on room air

Answer

Unilateral absent breath sounds with mediastinal shift

Answer

Coarse crackles with productive cough and purulent secretions

Answer

Apnea episodes lasting 15 seconds with rapid spontaneous resolution

Question 5

A 10-year-old with sickle cell disease has fever 38.9 C, SpO2 94%, chest pain, and bilateral pulmonary infiltrates. Which complication does this represent?

Accepted Answer

Acute chest syndrome (ACS)

Answer

Aplastic crisis due to parvovirus B19 infection

Answer

Vaso-occlusive pain crisis isolated to chest wall

Answer

Pulmonary embolism from hypercoagulable state

Question 6

A 2-year-old weighing 13 kg needs acetaminophen 15 mg/kg every 4-6 hours. Available concentration is 160 mg/5 mL. How many mL per dose?

Accepted Answer

6.1 mL

Answer

4.1 mL

Answer

3.0 mL

Answer

2.5 mL