DOH Nursing Pediatric Nursing 4 — Questions and Answers
Question 1: A 4-year-old is admitted with Kawasaki disease. Which clinical sign is NOT part of the diagnostic criteria?
- Generalized vesicular rash (Correct answer)
- Fever lasting >5 days
- Bilateral non-exudative conjunctivitis
- Cervical lymphadenopathy >1.5 cm
Correct answer: Generalized vesicular rash
Kawasaki disease diagnostic criteria include: fever >5 days plus 4 of: bilateral conjunctivitis, rash (maculopapular or erythematous, not vesicular), oral changes (strawberry tongue, red cracked lips), extremity changes, and cervical lymphadenopathy. Vesicular rash suggests varicella, not Kawasaki.
Question 2: Which intervention is priority when a 2-year-old child has a foreign body in the airway and is still coughing forcefully?
- Encourage continued coughing; do not interfere (Correct answer)
- Perform 5 back blows followed by 5 chest thrusts
- Begin CPR immediately
- Perform a blind finger sweep of the mouth
Correct answer: Encourage continued coughing; do not interfere
If a child with airway foreign body has effective cough (can cry, speak, or cough forcefully), the cough is clearing the airway better than any manual intervention. Interfering can dislodge the object further. Only intervene if the cough becomes ineffective or child becomes silent.
Question 3: A neonate is born at 34 weeks gestation. What is the primary concern in the first 24 hours?
- Respiratory distress syndrome due to surfactant deficiency (Correct answer)
- Hyperbilirubinemia from Rh incompatibility
- Neonatal abstinence syndrome
- Hypoglycemia from gestational diabetes
Correct answer: Respiratory distress syndrome due to surfactant deficiency
Premature infants at 34 weeks have immature lungs with insufficient surfactant production, making respiratory distress syndrome (RDS) the primary immediate risk. Surfactant therapy and respiratory support are the primary interventions.
Question 4: Which pain assessment tool is appropriate for a 3-year-old child?
- FLACC scale (Faces, Legs, Activity, Cry, Consolability) (Correct answer)
- Visual Analog Scale (0–10 line)
- Numeric rating scale (0–10)
- McGill Pain Questionnaire
Correct answer: FLACC scale (Faces, Legs, Activity, Cry, Consolability)
The FLACC scale is used for pre-verbal children and those who cannot self-report (typically 2 months–7 years). It assesses behavioral indicators. The numeric and VAS scales require cognitive ability typically present by age 7+. Wong-Baker Faces is valid from age 3+.
Question 5: A child with nephrotic syndrome has massive edema and low serum albumin. What dietary modification is indicated?
- Moderate protein intake and sodium restriction (Correct answer)
- High-protein, high-sodium diet to replace losses
- Protein restriction and high-potassium diet
- Unrestricted diet with high fluid intake
Correct answer: Moderate protein intake and sodium restriction
In nephrotic syndrome, protein is lost in urine, causing hypoalbuminemia. Sodium restriction reduces edema by limiting water retention. Moderate protein intake replaces losses without overburdening the kidneys. High sodium worsens edema.
Question 6: What is the normal newborn blood glucose level?
- ≥45 mg/dL (2.5 mmol/L) (Correct answer)
- <30 mg/dL
- 70–100 mg/dL
- 110–140 mg/dL
Correct answer: ≥45 mg/dL (2.5 mmol/L)
Neonatal hypoglycemia is defined as blood glucose <45 mg/dL in the first 24 hours. Normal glucose in a neonate is ≥45 mg/dL. Levels of 70–100 mg/dL are normal adult values; neonates normally run slightly lower due to ongoing adaptation.
DOH Nursing Pediatric Nursing 4
A 4-year-old is admitted with Kawasaki disease.
Which clinical sign is NOT part of the diagnostic criteria?