LVN Pediatric Nursing Care 5 — Questions and Answers
Question 1: A 7-year-old with nephrotic syndrome has periorbital edema and proteinuria. Which dietary modification should the nurse teach the parents?
- High sodium, low protein diet
- Low sodium, adequate protein diet (Correct answer)
- High protein, unrestricted sodium diet
- Low potassium, high carbohydrate diet
Correct answer: Low sodium, adequate protein diet
In nephrotic syndrome, sodium restriction reduces edema, and adequate protein intake compensates for urinary protein losses.
Question 2: During auscultation, the nurse notes a harsh systolic murmur at the left sternal border in a 3-month-old. This finding is most consistent with which defect?
- Patent ductus arteriosus (PDA)
- Pulmonary stenosis
- Ventricular septal defect (VSD) (Correct answer)
- Aortic regurgitation
Correct answer: Ventricular septal defect (VSD)
A harsh holosystolic murmur best heard at the left lower sternal border is characteristic of a ventricular septal defect.
Question 3: An 8-year-old is admitted with Reye's syndrome. Which recent history finding is most significant?
- Receiving amoxicillin for strep throat
- Taking aspirin during a recent viral illness (Correct answer)
- Eating raw shellfish 48 hours ago
- Immunization with MMR vaccine last week
Correct answer: Taking aspirin during a recent viral illness
Reye's syndrome is associated with aspirin use during viral illness (especially influenza or varicella), causing hepatic encephalopathy.
Question 4: The nurse is caring for a child with croup. Which intervention is the priority for managing mild croup at home?
- Administer IV corticosteroids
- Expose the child to cool mist or night air (Correct answer)
- Perform chest physiotherapy every 2 hours
- Begin broad-spectrum antibiotics
Correct answer: Expose the child to cool mist or night air
Cool mist or cool night air reduces laryngeal edema and relieves mild croup symptoms; humidified air is the first-line home management.
Question 5: A nurse suspects shaken baby syndrome in a 4-month-old. Which clinical triad supports this suspicion?
- Fever, vomiting, and bulging fontanelle
- Retinal hemorrhage, subdural hematoma, and encephalopathy (Correct answer)
- Petechiae, thrombocytopenia, and splenomegaly
- Hypotonia, absent Moro reflex, and jaundice
Correct answer: Retinal hemorrhage, subdural hematoma, and encephalopathy
The classic triad of abusive head trauma includes retinal hemorrhages, subdural hematoma, and encephalopathy without an adequate explanation.
Question 6: A 2-year-old with intussusception is most likely to present with which classic symptom pattern?
- Watery diarrhea and low-grade fever for 5 days
- Sudden intermittent abdominal pain, vomiting, and currant jelly stools (Correct answer)
- Continuous cramping, bloody diarrhea, and tenesmus
- Projectile vomiting without abdominal pain
Correct answer: Sudden intermittent abdominal pain, vomiting, and currant jelly stools
Intussusception classically presents with sudden episodic colicky pain, vomiting, and currant jelly stools (blood mixed with mucus).
Question 7: Which age group is at highest risk for accidental poisoning, making anticipatory guidance essential for parents?
- Infants (0–12 months)
- Toddlers (1–3 years) (Correct answer)
- School-age children (6–12 years)
- Adolescents (13–18 years)
Correct answer: Toddlers (1–3 years)
Toddlers are at greatest risk for accidental poisoning due to oral exploration, mobility, and lack of understanding of danger.
LVN Pediatric Nursing Care 5
A 7-year-old with nephrotic syndrome has periorbital edema and proteinuria.
Which dietary modification should the nurse teach the parents?