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

The presentation describes croup. For mild-to-moderate croup with maintained airway, cool mist and racemic epinephrine for moderate cases are the priority interventions. Dexamethasone is also standard.

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

44 lbs divided by 2.2 = 20 kg. Total daily dose = 40 mg/kg x 20 kg = 800 mg/day. Per dose (q8h) = 800/3 = 267 mg. Volume = (267/250) x 5 mL = 5.3 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

Epiglottitis is a life-threatening emergency. Throat examination or any agitation can precipitate complete airway obstruction. The child must be kept calm with the parent while an emergent airway team is assembled.

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

RDS in preterm neonates presents with expiratory grunting, nasal flaring, intercostal/subcostal retractions, and cyanosis — classic signs of surfactant deficiency.

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

Acute chest syndrome is defined by new pulmonary infiltrate on CXR plus fever, chest pain, cough, hypoxia, or wheezing in a sickle cell patient. It is the leading cause of death in sickle cell disease.

ANCC - American Nurses Credentialing Center Practice Test

ANCC - American Nurses Credentialing Center Practice Test

ANCC Pediatric Nursing 2