DOH Nursing Pediatric Nursing 3 — Questions and Answers
Question 1: A nurse is administering an intramuscular injection to a 6-month-old infant. Which muscle is preferred?
- Vastus lateralis (anterolateral thigh) (Correct answer)
- Deltoid
- Dorsogluteal
- Rectus femoris
Correct answer: Vastus lateralis (anterolateral thigh)
The vastus lateralis is the preferred IM injection site for infants <1 year because the deltoid is too small and the dorsogluteal carries sciatic nerve risk. The anterolateral thigh has well-developed muscle mass in infants.
Question 2: What is the normal blood pressure range for a healthy 5-year-old child?
- 95–110/60–70 mmHg (Correct answer)
- 120/80 mmHg
- 80/50 mmHg
- 140/90 mmHg
Correct answer: 95–110/60–70 mmHg
Normal BP for a 5-year-old is approximately 95–110/60–70 mmHg. Blood pressure increases gradually with age. A value of 120/80 mmHg is normal for adults. Hypertension in children is defined as BP ≥95th percentile for age, sex, and height.
Question 3: A child with sickle cell disease presents with severe bone pain, fever, and chest infiltrates on X-ray. What complication has occurred?
- Acute chest syndrome (Correct answer)
- Vaso-occlusive crisis without chest involvement
- Sequestration crisis
- Aplastic crisis
Correct answer: Acute chest syndrome
Acute chest syndrome (ACS) in sickle cell disease is defined by new pulmonary infiltrates on chest X-ray plus at least one symptom (fever, chest pain, decreased O2 saturation, or respiratory symptoms). It is the leading cause of death in SCD patients.
Question 4: Which behavior is a developmental milestone for a 12-month-old infant?
- Standing independently and saying 1–2 words with meaning (Correct answer)
- Walking unaided for long distances
- Speaking in 2-word phrases
- Stacking 6 blocks
Correct answer: Standing independently and saying 1–2 words with meaning
At 12 months, infants typically pull to stand and may stand briefly alone, and begin using 1–2 meaningful words (e.g., 'mama,' 'dada'). Walking independently typically occurs at 12–15 months. Two-word phrases appear around 18–24 months.
Question 5: A child is admitted with suspected bacterial meningitis. Which intervention should occur first?
- Administer prescribed IV antibiotics immediately, even before LP if there will be any delay (Correct answer)
- Perform lumbar puncture before any antibiotics
- Isolate the patient and call the family
- Order CT scan before any treatment
Correct answer: Administer prescribed IV antibiotics immediately, even before LP if there will be any delay
In suspected bacterial meningitis, antibiotics must not be delayed. If lumbar puncture will be delayed (e.g., waiting for CT), IV antibiotics should be started immediately. Every hour of delay in antibiotic therapy worsens outcomes and increases mortality.
Question 6: What is the appropriate needle length for IM injection in a 2-year-old child?
- 5/8 to 1 inch (16–25 mm) (Correct answer)
- 1.5 inches (38 mm)
- 2 inches (50 mm)
- 0.25 inch (6 mm) intradermal
Correct answer: 5/8 to 1 inch (16–25 mm)
For toddlers (1–2 years), a needle length of 5/8 to 1 inch is recommended for IM injection into the vastus lateralis, ensuring penetration into muscle without striking bone. Longer needles are used for larger muscle masses in older children and adults.
DOH Nursing Pediatric Nursing 3
A nurse is administering an intramuscular injection to a 6-month-old infant.
Which muscle is preferred?