BSN Pediatric Nursing 2 — Questions and Answers
Question 1: A 4-year-old is admitted with epiglottitis. Which nursing intervention is the highest priority?
- Obtain a throat culture using a tongue blade
- Prepare for emergency airway management (Correct answer)
- Administer antipyretics and monitor temperature
- Place the child in a supine position for comfort
Correct answer: Prepare for emergency airway management
Epiglottitis can cause rapid airway obstruction; preparing for emergency airway management (intubation or tracheostomy) is the top priority to prevent respiratory arrest.
Question 2: A child is diagnosed with Tetralogy of Fallot and experiences a hypercyanotic ('Tet') spell. Which position should the nurse place the child in?
- Supine with legs elevated
- Semi-Fowler's position
- Knee-chest position (Correct answer)
- Left lateral decubitus position
Correct answer: Knee-chest position
The knee-chest position increases systemic vascular resistance, reduces right-to-left shunting, and improves pulmonary blood flow, thereby relieving the hypercyanotic spell.
Question 3: The nurse is teaching a parent about celiac disease dietary management. Which grain is SAFE for a child with celiac disease?
- Barley
- Rye
- Rice (Correct answer)
- Wheat
Correct answer: Rice
Rice is naturally gluten-free and safe for children with celiac disease; barley, rye, and wheat all contain gluten and must be avoided.
Question 4: A nurse is assessing a child with bacterial meningitis. Which triad of symptoms is classic for this condition?
- Fever, rash, and joint pain
- Fever, severe headache, and nuchal rigidity (Correct answer)
- Photophobia, vomiting, and bradycardia
- Altered consciousness, seizures, and hypotension
Correct answer: Fever, severe headache, and nuchal rigidity
The classic triad of bacterial meningitis is fever, severe headache, and nuchal rigidity (stiff neck), reflecting meningeal inflammation.
Question 5: A child with sickle cell disease is admitted in vaso-occlusive crisis. Which intervention has the highest priority?
- Restrict oral fluid intake
- Administer IV fluids and analgesics (Correct answer)
- Apply ice packs to painful areas
- Prepare the child for an exchange transfusion
Correct answer: Administer IV fluids and analgesics
IV hydration reduces blood viscosity and promotes sickling reversal, while adequate analgesia addresses the severe pain of vaso-occlusive crisis; these are the primary interventions.
Question 6: A 2-year-old is brought to the ED after ingesting an unknown substance. The poison control center advises against inducing emesis. Which substance most likely contraindicates emesis induction?
- Acetaminophen tablets
- Caustic cleaning solution (Correct answer)
- Gummy vitamins
- Non-toxic crayon
Correct answer: Caustic cleaning solution
Caustic substances cause chemical burns; inducing emesis re-exposes the esophagus and mouth to the caustic material, worsening injury.
Question 7: The nurse is caring for a child with nephrotic syndrome. Which assessment finding is most expected with this diagnosis?
- Hypertension and hematuria
- Massive proteinuria and dependent edema (Correct answer)
- Oliguria and elevated BUN/creatinine
- Polyuria and polydipsia
Correct answer: Massive proteinuria and dependent edema
Nephrotic syndrome is characterized by massive proteinuria (>3.5 g/day in adults, >40 mg/m²/hr in children), which leads to hypoalbuminemia and dependent edema.
BSN Pediatric Nursing 2
A 4-year-old is admitted with epiglottitis.
Which nursing intervention is the highest priority?