LVN Pediatric Nursing Care 4 — Questions and Answers
Question 1: A toddler swallowed a button battery 30 minutes ago. Which nursing action is most urgent?
- Administer ipecac syrup to induce vomiting
- Give the child milk to coat the battery
- Prepare for emergency endoscopic removal (Correct answer)
- Observe the child for 24 hours at home
Correct answer: Prepare for emergency endoscopic removal
Button batteries lodged in the esophagus can cause tissue necrosis within 2 hours; emergency endoscopic removal is required.
Question 2: The nurse is assessing a child with suspected meningitis. A positive Kernig's sign is identified by which finding?
- Involuntary flexion of hips and knees when the neck is flexed
- Inability to extend the knee when the hip is flexed to 90° (Correct answer)
- Bulging fontanelle in a supine infant
- Absence of the Moro reflex
Correct answer: Inability to extend the knee when the hip is flexed to 90°
Kernig's sign is positive when the patient cannot fully extend the knee while the hip is flexed at 90° due to meningeal irritation.
Question 3: A 10-year-old with type 1 diabetes mellitus becomes diaphoretic, tremulous, and confused during recess. What should the nurse do first?
- Administer insulin per sliding scale
- Give 15 g of fast-acting carbohydrate such as juice (Correct answer)
- Call 911 immediately
- Check HbA1c level
Correct answer: Give 15 g of fast-acting carbohydrate such as juice
Signs of hypoglycemia in a conscious child are treated with 15 g of fast-acting carbohydrate followed by reassessment in 15 minutes.
Question 4: Which immunization is contraindicated in a child who is immunocompromised due to chemotherapy?
- Inactivated influenza vaccine (IIV)
- Pneumococcal conjugate vaccine (PCV13)
- Varicella (VAR) vaccine (Correct answer)
- Hepatitis B vaccine
Correct answer: Varicella (VAR) vaccine
Varicella is a live attenuated vaccine and is contraindicated in immunocompromised children who cannot mount a safe immune response.
Question 5: A premature infant in the NICU is receiving phototherapy for hyperbilirubinemia. Which nursing intervention is essential?
- Cover the infant with a warm blanket
- Shield the infant's eyes and genitals and monitor temperature (Correct answer)
- Restrict feedings to prevent vomiting under the lights
- Apply sunscreen to prevent skin burns
Correct answer: Shield the infant's eyes and genitals and monitor temperature
Eye protection prevents retinal damage and temperature monitoring prevents hyperthermia or hypothermia during phototherapy.
Question 6: A nurse is caring for a child post-appendectomy. Which assessment finding suggests a ruptured appendix with peritonitis?
- Sudden relief of pain followed by board-like abdominal rigidity (Correct answer)
- Mild periumbilical cramping with normal bowel sounds
- Low-grade fever and right lower quadrant tenderness only
- Nausea without vomiting
Correct answer: Sudden relief of pain followed by board-like abdominal rigidity
Sudden relief of pain followed by generalized rigidity and rebound tenderness indicates rupture and peritoneal contamination.
Question 7: Which growth measurement is most reflective of long-term nutritional status in children?
- Head circumference
- Weight for age
- Length/height for age (Correct answer)
- Body mass index (BMI)
Correct answer: Length/height for age
Height/length for age reflects chronic nutritional status because stunting (short stature) results from prolonged nutritional deficiency.
LVN Pediatric Nursing Care 4
A toddler swallowed a button battery 30 minutes ago.
Which nursing action is most urgent?