Free ANCC Pediatric Nursing Questions and Answers 1 — Questions and Answers
Question 1: Which of the following circumstances is likely to be the greatest barrier to a child's access to medical care?
- Living in a rural area
- Being homeless (Correct answer)
- Lacking an extended family
- Having a single parent
Correct answer: Being homeless
Explanation: <br> The circumstance that is likely to be the greatest barrier to a child's access to medical care is being homeless. People who are homeless often move from shelter to shelter or other temporary living situations, and their medical care is often provided through emergency departments or free clinics, so there is little consistency in care or follow-up. Children who are homeless are often exposed to others who are ill and may not have facilities for adequate hygiene.
Question 2: Anticipatory guidance most appropriate for a male child during early adolescence (11-14) includes:
- age-appropriate sports activities.
- abstinence, safe sex, and contraception.
- risk-taking behaviors (drugs, drinking, smoking, speeding).
- bodily changes and secondary sex characteristics. (Correct answer)
Correct answer: bodily changes and secondary sex characteristics.
Explanation: <br> Anticipatory guidance most appropriate for a male child during early adolescence (11-14) includes bodily changes and the development of secondary sexual characteristics. The child will change thought patterns and awareness so the child's feelings about academic responsibilities should be explored. The child may begin to experience peer pressure to conform to the norms of a group, so the pediatric nurse should begin discussions about issues such as gangs, tobacco, drugs, alcohol, and abusive relationships (which should be explored more during adolescence).
Question 3: When participating in the development of the Individualized Education Plan (IEP) for a child with mild intellectual disability and IQ of 65, the pediatric nurse should explain that the child should be educated about the:
- 8th grade level
- 6th grade level (Correct answer)
- 4th grade level
- 2nd grade level
Correct answer: 6th grade level
Explanation: <br> When participating in the development of the Individualized Education Plan (IEP) for a child with mild cognitive impairment and an IQ of 65, the pediatric nurse should explain that the child should be educated about the 6th-grade level. The child should be able to master many skills and may, as an adult, be able to work and live independently or with minimal supervision, so this should be an ultimate goal.
Question 4: An example of lateral violence is:
- a team member disagrees with the team leader about a plan of care.
- a nurse complains to the supervisor about forced overtime.
- a nurse insults and denigrates a colleague. (Correct answer)
- a nurse reports another nurse for committing a medical error.
Correct answer: a nurse insults and denigrates a colleague.
Explanation: <br> An example of lateral violence is when a nurse insults and denigrates a colleague. Lateral violence (AKA horizontal violence) can include physical as well as verbal abuse and may be overt or covert. For example, a staff member may attempt to undermine another's accomplishments or backstab the person to engage fellow staff members in similar abusive behavior. Lateral violence can take a large emotional toll on a victim.
Question 5: When serving as a mentor for a newly licensed nurse, the primary role of the pediatric nurse is to:
- assess the nurse's skills.
- provide support and guidance. (Correct answer)
- assign duties.
- supervise patient care.
Correct answer: provide support and guidance.
Explanation: <br> When serving as a mentor for a newly licensed nurse, the primary role of the pediatric nurse is to provide support and guidance. The nurse should feel free to bring questions and concerns to the mentor. Skills that enhance mentoring include nurturing, providing clinical expertise, motivating, modeling, and providing feedback. Mentoring is usually a one-on-one relationship although a pediatric nurse may also serve as a mentor to a group.
Question 6: The Braden @ Scale is most appropriate for children who are:
- 3 weeks to 8 years. (Correct answer)
- 5 to 8 years.
- 8 to 14 years.
- 15 to 18 years.
Correct answer: 3 weeks to 8 years.
Explanation: <br> The Braden Q Scale is most appropriate for children who are 3 weeks to 8 years while the Braden Scale is used for older children. The Braden Q scale assesses the risk of pressure ulcers for children related to immobility. Seven categories are scored from 1 (severe) to 4 (normal): mobility, activity, sensory perception, moisture, friction-shear, nutrition, tissue perfusion, and oxygenation. Possible scores range from 7 to 28 with a score of 16 or higher indicating increased risk.
Question 7: The cultural group in which grandmothers often have an active role in childcare or are primary caregivers is:
- Middle Eastern.
- Asian.
- Mexican.
- African American. (Correct answer)
Correct answer: African American.
Explanation: <br> The cultural group in which grandmothers often have an active role in child care or are primary caregivers is African American. Extended family is very important among African Americans and children are expected to be obedient and respectful. Children often avoid eye contact as a sign of respect, and this can be misinterpreted as being evasive. High rates of obesity are common among children and increase the risk of hypertension and diabetes.
Question 8: A 15-year-old girl weighing 54 kg (120 lb.) took ten 500-mg acetaminophen tablets in a suicide attempt 6 hours before discovery. The initial treatment should be:
- GI decontamination with activated charcoal.
- gastric lavage.
- supportive therapy and psychiatric referral.
- to initiate the 72-hour N-acetylcysteine protocol. (Correct answer)
Correct answer: to initiate the 72-hour N-acetylcysteine protocol.
Explanation: <br> The 72-hour N-acetylcysteine protocol is recommended between 4- and 24 hours post-ingestion of intentional acetaminophen overdose. This can be initiated while awaiting results of blood work for acetaminophen levels. Only if the patient is exhibiting symptoms after the 24-hour mark may this protocol still be indicated at that time. Gl decontamination must be done within four hours of ingestion and gastric lavage within one hour of ingestion. Supportive therapy and psychiatric referral are also indicated for this patient, after initiating N-acetylcysteine administration.
Question 9: According to Piaget's Theory of Cognitive Development, at which of the following ages does a child begin to act with intention and may first attempt to climb over obstacles, such as crib side rails?
- 4 to 8 months.
- 9 to 12 months. (Correct answer)
- 13 to 18 months.
- 18 to 24 months.
Correct answer: 9 to 12 months.
Explanation: <br> According to Piaget's Theory of Cognitive Development, at age 9 to 12 months, a child begins to act with intention and may first attempt to climb over obstacles, such as crib side rails. This is a transitional stage for the children during which intellectual development progresses and the child begins to understand that hidden objects are not permanently gone. They also begin to associate words and symbols (such as "bye-bye") with events, such as the parent leaving.
Question 10: Considering Erikson's developmental stages, before carrying out assessment and treatment on a preschooler (ages 3 to 6), the pediatric nurse should:
- pretend the assessment/treatment is a game.
- sedate the child to lessen anxiety.
- allow the child to play with medical equipment. (Correct answer)
- give detailed explanations of the purpose of interventions.
Correct answer: allow the child to play with medical equipment.
Explanation: <br> Considering Erikson's developmental stages, before carrying out assessment and treatment on a preschooler (ages 3 to 6), the pediatric nurse should allow the child to play with the medical equipment to lessen the child's anxiety because strange equipment may frighten the child. The parent/caregiver should assist with the assessment/treatment when possible, such as by holding the child, and the pediatric nurse should explain to the child in simple, age-appropriate terms what the assessment/treatment will entail.
Question 11: The genetic disorder that puts the child at risk for developing aortic aneurysm later in life is:
- Marfan syndrome. (Correct answer)
- sickle cell disease.
- Gaucher disease.
- fragile X syndrome.
Correct answer: Marfan syndrome.
Explanation: <br> The genetic disorder that puts the child at risk for developing aortic aneurysm later in life is Marfan syndrome. Marfan syndrome is an autosomal dominant disorder of the connective tissue characterized by elongated head, long arms and legs, scoliosis, crowded teeth, unusual stretch marks, and cardiac abnormalities, including aortic enlargement, which can result in rupture and sudden death. Some children have evidence of aortic enlargement at birth, but many are not diagnosed until later in life when signs and symptoms become more evident.
Free ANCC Pediatric Nursing Questions and Answers 1
Which of the following circumstances is likely to be the greatest barrier to a child's access to medical care?