LVN Pediatric Nursing 3 — Questions and Answers
Question 1: A nurse assesses a newborn and notes the infant has not passed meconium within 48 hours of birth. Which condition should the nurse suspect?
- Pyloric stenosis
- Hirschsprung's disease (Correct answer)
- Intussusception
- Necrotizing enterocolitis
Correct answer: Hirschsprung's disease
Hirschsprung's disease (aganglionic megacolon) commonly presents as failure to pass meconium within 48 hours of birth in a newborn.
Question 2: A 4-year-old child with leukemia has an ANC of 400/mm³. Which nursing action is most appropriate?
- Encourage group play activities
- Place the child in protective (reverse) isolation (Correct answer)
- Administer live vaccines
- Allow fresh fruits and vegetables
Correct answer: Place the child in protective (reverse) isolation
An ANC below 500/mm³ indicates severe neutropenia; protective isolation prevents exposure to pathogens that could cause life-threatening infection.
Question 3: The nurse is calculating fluid maintenance for a 20 kg child using the Holliday-Segar method. What is the correct 24-hour fluid requirement?
- 1000 mL
- 1500 mL
- 1600 mL (Correct answer)
- 2000 mL
Correct answer: 1600 mL
Using Holliday-Segar: 100 mL/kg for the first 10 kg + 50 mL/kg for the next 10 kg = 1000 + 600 = 1600 mL/24 hours.
Question 4: A toddler is brought to the ED after ingesting an unknown substance. The nurse notes the child has pinpoint pupils and decreased respirations. Which substance is most likely?
- Aspirin
- Opioids (Correct answer)
- Amphetamines
- Tricyclic antidepressants
Correct answer: Opioids
Opioid toxicity classically presents with the triad of miosis (pinpoint pupils), CNS depression, and respiratory depression.
Question 5: Which positioning is safest for an infant to prevent sudden infant death syndrome (SIDS)?
- Prone (on stomach)
- Side-lying
- Supine (on back) (Correct answer)
- Semi-reclined in an infant seat
Correct answer: Supine (on back)
The 'Back to Sleep' campaign recommends placing healthy infants supine on a firm, flat surface to reduce SIDS risk.
Question 6: A nurse is caring for a child with nephrotic syndrome. Which assessment finding is most characteristic?
- Hypertension and hematuria
- Massive proteinuria and edema (Correct answer)
- Oliguria and flank pain
- Polyuria and polydipsia
Correct answer: Massive proteinuria and edema
Nephrotic syndrome is characterized by massive proteinuria (>3.5 g/day), resulting in hypoalbuminemia and dependent edema.
Question 7: A 5-year-old is scheduled for a tonsillectomy. In the immediate post-operative period, which assessment is the nurse's highest priority?
- Pain level using FACES scale
- Frequent swallowing indicating bleeding (Correct answer)
- Oral intake of clear liquids
- Temperature elevation above 38°C
Correct answer: Frequent swallowing indicating bleeding
Frequent swallowing in a post-tonsillectomy patient is a sign of hemorrhage as the child swallows blood draining from the surgical site.
LVN Pediatric Nursing 3
A nurse assesses a newborn and notes the infant has not passed meconium within 48 hours of birth.
Which condition should the nurse suspect?