CPNRE CPNRE - Canadian Practical Nurse Registration Examination Pediatric and Child Health Nursing Questions and Answers 5 — Questions and Answers
Question 1: 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:
- Intussusception
- Pyloric stenosis (Correct answer)
- Gastroesophageal reflux
- Hirschsprung disease
Correct 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.
Question 2: Which developmental milestone would the nurse expect in a healthy 9-month-old infant?
- Walking independently
- Speaking 2-word phrases
- Pincer grasp and object permanence (Correct answer)
- Copying geometric shapes
Correct 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).
Question 3: A 6-year-old is recovering from tonsillectomy. Which finding requires IMMEDIATE nursing intervention?
- Complaint of a sore throat
- Frequent swallowing and restlessness (Correct answer)
- Temperature of 37.8°C
- Preference for cool liquids
Correct 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.
Question 4: A nurse is assessing a 4-year-old child's pain. Which tool is MOST appropriate?
- Numeric Rating Scale (0-10)
- FLACC scale
- FACES Pain Rating Scale (Correct answer)
- Visual Analogue Scale
Correct 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.
Question 5: An 8-month-old is diagnosed with RSV bronchiolitis. Which clinical feature is MOST concerning and warrants immediate intervention?
- Mild nasal congestion
- Oxygen saturation of 88% on room air (Correct answer)
- Low-grade fever of 38.2°C
- Decreased appetite
Correct 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.
Question 6: 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?
- Administer the dose and document the heart rate
- Withhold the dose and notify the physician (Correct answer)
- Administer half the dose as a precaution
- Recheck the pulse in 30 minutes before giving
Correct 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.
Question 7: 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?
- Bring the child to the ER immediately and apply a sterile dressing
- Insert the tube back in themselves using a clean technique
- Cover the stoma with a clean cloth and come to the hospital within 4-6 hours (Correct answer)
- Do nothing; the stoma will close naturally within 24 hours
Correct 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.
CPNRE CPNRE - Canadian Practical Nurse Registration Examination Pediatric and Child Health Nursing Questions and Answers 5
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: