CPNRE CPNRE - Canadian Practical Nurse Registration Examination Pediatric and Child Health Nursing Questions and Answers 4 — Questions and Answers
Question 1: A 4-year-old is admitted with epiglottitis. Which nursing intervention is the HIGHEST priority?
- Initiate IV access immediately
- Keep the child calm and avoid agitating procedures (Correct answer)
- Administer humidified oxygen by face mask
- Obtain a throat culture using a tongue depressor
Correct answer: Keep the child calm and avoid agitating procedures
Agitation can cause complete airway obstruction in epiglottitis, so maintaining calm and avoiding invasive procedures until airway is secured is the priority.
Question 2: A nurse is caring for a neonate with suspected hypoglycemia. Which finding would MOST support this diagnosis?
- Blood glucose of 3.0 mmol/L
- Jitteriness and poor feeding (Correct answer)
- Ruddy skin color
- Respiratory rate of 45 breaths/min
Correct answer: Jitteriness and poor feeding
Jitteriness, tremors, and poor feeding are classic clinical signs of neonatal hypoglycemia.
Question 3: A child with sickle cell disease is in vaso-occlusive crisis. Which intervention takes priority?
- Restrict fluid intake to prevent overload
- Apply cold compresses to painful areas
- Administer prescribed analgesics and IV fluids (Correct answer)
- Encourage ambulation to prevent sickling
Correct answer: Administer prescribed analgesics and IV fluids
Pain management with analgesics and IV hydration to reduce blood viscosity are the primary interventions during vaso-occlusive crisis.
Question 4: The nurse is teaching parents about fever management in a 2-year-old. Which statement by the parent indicates correct understanding?
- I will give ASA (aspirin) because it works fastest
- I will dress my child warmly to help sweat out the fever
- I will give acetaminophen or ibuprofen and ensure adequate fluids (Correct answer)
- I should bring my child in immediately for any fever above 37.5°C
Correct answer: I will give acetaminophen or ibuprofen and ensure adequate fluids
Acetaminophen or ibuprofen with adequate hydration is the correct approach; ASA is contraindicated in children due to Reye syndrome risk.
Question 5: A 7-year-old is brought in after ingesting an unknown number of iron tablets. Which early sign of iron toxicity should the nurse assess for?
- Bradycardia and hypertension
- Nausea, vomiting, and bloody diarrhea (Correct answer)
- Jaundice and dark urine
- Respiratory depression
Correct answer: Nausea, vomiting, and bloody diarrhea
Early iron toxicity manifests as severe GI symptoms including nausea, vomiting, abdominal pain, and bloody diarrhea within the first 6 hours.
Question 6: A nurse is preparing to administer a vaccine to an 18-month-old. Which site is MOST appropriate for intramuscular injection?
- Deltoid muscle
- Dorsogluteal site
- Vastus lateralis muscle (Correct answer)
- Ventrogluteal site
Correct answer: Vastus lateralis muscle
The vastus lateralis (anterolateral thigh) is the preferred IM injection site for children under 3 years due to its large muscle mass and absence of major nerves.
Question 7: A 10-year-old with type 1 diabetes presents with rapid deep breathing, fruity breath odor, and blood glucose of 28 mmol/L. The nurse recognizes this as:
- Hypoglycemic episode requiring dextrose
- Diabetic ketoacidosis requiring insulin and fluids (Correct answer)
- Hyperglycemic hyperosmolar state requiring oral fluids
- Respiratory acidosis requiring sodium bicarbonate
Correct answer: Diabetic ketoacidosis requiring insulin and fluids
Kussmaul respirations, fruity breath, and severe hyperglycemia are hallmarks of diabetic ketoacidosis, treated with IV insulin and fluid replacement.
CPNRE CPNRE - Canadian Practical Nurse Registration Examination Pediatric and Child Health Nursing Questions and Answers 4
A 4-year-old is admitted with epiglottitis.
Which nursing intervention is the HIGHEST priority?