DOH Nursing Pediatric Nursing 1 — Questions and Answers
Question 1: A 3-year-old child is brought to the clinic. According to normal developmental milestones, which skill should the child have already mastered?
- Riding a tricycle and speaking in 3-word sentences (Correct answer)
- Reading simple words
- Tying shoelaces independently
- Drawing a person with 6 body parts
Correct answer: Riding a tricycle and speaking in 3-word sentences
By age 3, children typically ride a tricycle (gross motor) and speak in 3-word or longer sentences (language). Reading and tying shoes develop later. Drawing a person with 6 parts is a milestone for age 4–5 years.
Question 2: What is the appropriate method for calculating medication dosage in pediatric patients?
- Weight-based dosing (mg/kg), verified against maximum adult dose (Correct answer)
- Age-based dosing using standard adult dose tables
- Body surface area only for all medications
- Fixed dose same as adult regardless of weight
Correct answer: Weight-based dosing (mg/kg), verified against maximum adult dose
Pediatric medications are dosed by weight (mg/kg) because children's body composition, renal and hepatic function differ significantly from adults. The calculated dose must not exceed the maximum adult dose. BSA is used for some chemotherapy drugs.
Question 3: A child is brought in with a barking cough, inspiratory stridor, and low-grade fever. What condition is most likely?
- Croup (laryngotracheobronchitis) (Correct answer)
- Epiglottitis
- Asthma exacerbation
- Foreign body aspiration
Correct answer: Croup (laryngotracheobronchitis)
Croup (viral laryngotracheobronchitis) classically presents with the 'seal bark' cough, inspiratory stridor, and low-grade fever in children aged 6 months–3 years, typically caused by parainfluenza virus. Epiglottitis presents with high fever, drooling, and tripod posture.
Question 4: What is the normal resting heart rate for a 2-year-old child?
- 80–130 beats per minute (Correct answer)
- 60–100 beats per minute
- 140–160 beats per minute
- 50–70 beats per minute
Correct answer: 80–130 beats per minute
Normal heart rate ranges vary by age. Toddlers (1–3 years) have a resting HR of 80–130 bpm. This is higher than adult normal (60–100 bpm) due to higher metabolic demands and smaller stroke volume. Knowing age-specific normals prevents false alarms.
Question 5: A child with a febrile seizure has stopped convulsing. What is the priority nursing action?
- Position on side, maintain airway, administer oxygen, and assess neurological status (Correct answer)
- Administer antipyretics immediately to prevent recurrence
- Restrain the child to prevent injury during possible recurrence
- Insert an oral airway and prepare for intubation
Correct answer: Position on side, maintain airway, administer oxygen, and assess neurological status
After the seizure ends, the priority is maintaining a patent airway by positioning the child on their side (recovery position) to prevent aspiration, assessing breathing, and applying oxygen. The child will typically be post-ictal and sleepy.
Question 6: Which sign is used to assess dehydration severity in infants?
- Anterior fontanelle depression (sunken fontanelle) (Correct answer)
- Capillary refill time of 1 second
- Increased urine output
- Bulging fontanelle
Correct answer: Anterior fontanelle depression (sunken fontanelle)
A sunken anterior fontanelle indicates moderate-to-severe dehydration in infants. The fontanelle is normally flat and slightly pulsatile; it bulges with increased ICP and sinks with fluid deficit. It is only accessible in infants before fontanelle closure (~18 months).
DOH Nursing Pediatric Nursing 1
A 3-year-old child is brought to the clinic.
According to normal developmental milestones, which skill should the child have already mastered?