LVN Pediatric Nursing Care 3 — Questions and Answers
Question 1: A child with sickle cell disease presents with severe bone pain and fever. The nurse anticipates this is which type of crisis?
- Aplastic crisis
- Splenic sequestration crisis
- Vaso-occlusive crisis (Correct answer)
- Hyperhemolytic crisis
Correct answer: Vaso-occlusive crisis
Vaso-occlusive (painful) crisis is the most common type, caused by sickling of RBCs obstructing blood flow to bones and tissues.
Question 2: Which action is the nurse's highest priority when a 3-year-old is having a tonic-clonic seizure?
- Insert a tongue blade to prevent biting
- Restrain the child's movements
- Place the child on their side and protect from injury (Correct answer)
- Administer oral diazepam immediately
Correct answer: Place the child on their side and protect from injury
During a seizure, the priority is to prevent injury and maintain a patent airway by placing the child in the lateral position.
Question 3: A 4-year-old with leukemia is receiving chemotherapy. The nurse notes an absolute neutrophil count (ANC) of 400/mm³. What is the priority intervention?
- Administer a live attenuated vaccine
- Initiate neutropenic precautions and reverse isolation (Correct answer)
- Encourage the child to play in the common playroom
- Increase oral fluid intake only
Correct answer: Initiate neutropenic precautions and reverse isolation
An ANC below 500/mm³ indicates severe neutropenia, requiring protective (reverse) isolation to prevent life-threatening infection.
Question 4: When assessing a child using the Wong-Baker FACES Pain Scale, the nurse explains that the face showing the most distress corresponds to which numeric value?
- 6
- 8
- 10 (Correct answer)
- 12
Correct answer: 10
The Wong-Baker FACES scale ranges from 0 (no pain) to 10 (worst pain), with the crying face representing a score of 10.
Question 5: An infant with pyloric stenosis is most likely to present with which electrolyte imbalance?
- Hyperkalemia and metabolic acidosis
- Hyponatremia and hyperkalemia
- Hypokalemia and metabolic alkalosis (Correct answer)
- Hypernatremia and metabolic acidosis
Correct answer: Hypokalemia and metabolic alkalosis
Persistent projectile vomiting of gastric contents causes loss of HCl, leading to hypokalemia and metabolic alkalosis.
Question 6: A nurse is preparing to administer digoxin to a 6-month-old infant. Which assessment finding requires the nurse to withhold the dose and notify the provider?
- Apical heart rate of 110 bpm
- Respiratory rate of 38/min
- Apical heart rate of 88 bpm (Correct answer)
- Temperature of 37.2°C
Correct answer: Apical heart rate of 88 bpm
Digoxin should be withheld and the provider notified if the apical pulse is below 90–100 bpm in infants (per facility protocol).
Question 7: Which congenital heart defect causes a 'boot-shaped' heart on chest X-ray and cyanosis that worsens with crying?
- Atrial septal defect (ASD)
- Patent ductus arteriosus (PDA)
- Tetralogy of Fallot (ToF) (Correct answer)
- Coarctation of the aorta
Correct answer: Tetralogy of Fallot (ToF)
Tetralogy of Fallot produces a boot-shaped heart (coeur en sabot) on X-ray due to right ventricular hypertrophy and decreased pulmonary vascularity.
LVN Pediatric Nursing Care 3
A child with sickle cell disease presents with severe bone pain and fever.
The nurse anticipates this is which type of crisis?