CPNRE - Canadian Practical Nurse Registration Examination Pediatric and Child Health Nursing Questions and Answers Flashcards

A 3-week-old presents with projectile vomiting after every feeding, visible gastric waves, and an olive-shaped mass in the epigastrium. The nurse suspects:

Answer: Pyloric stenosis

Projectile non-bilious vomiting, visible peristaltic waves, and an olive-shaped mass in the epigastrium are the classic triad of pyloric stenosis.

Which developmental milestone would the nurse expect in a healthy 9-month-old infant?

Answer: Pincer grasp and object permanence

By 9 months, infants develop the pincer grasp and begin to understand object permanence (knowing an object exists when out of sight).

A 6-year-old is recovering from tonsillectomy. Which finding requires IMMEDIATE nursing intervention?

Answer: Frequent swallowing and restlessness

Frequent swallowing in a post-tonsillectomy child is a sign of hemorrhage as the child swallows blood, requiring immediate assessment.

A nurse is assessing a 4-year-old child's pain. Which tool is MOST appropriate?

Answer: FACES Pain Rating Scale

The FACES Pain Rating Scale is validated for children aged 3 and older who can self-report pain using pictures of facial expressions.

An 8-month-old is diagnosed with RSV bronchiolitis. Which clinical feature is MOST concerning and warrants immediate intervention?

Answer: Oxygen saturation of 88% on room air

An oxygen saturation of 88% indicates significant hypoxemia requiring immediate supplemental oxygen and possible escalation of care.

A nurse is preparing to administer digoxin to a 2-year-old with heart failure. The child's apical pulse is 88 bpm. What is the appropriate action?

Answer: Withhold the dose and notify the physician

The threshold for withholding digoxin in children under 2 years is an apical pulse below 90 bpm; 88 bpm means the dose should be held and the physician notified.

Parents of a child with a newly placed gastrostomy tube (G-tube) ask what to do if the tube falls out at home. What is the CORRECT nurse teaching?

Answer: Cover the stoma with a clean cloth and come to the hospital within 4-6 hours

A gastrostomy stoma can close within hours, so parents should cover it to prevent closure and bring the child promptly to hospital for replacement.