NCLEX-PN Test #11 2 — Questions and Answers
Question 1: A 6-month-old infant is diagnosed with iron-deficiency anemia. Which finding is most consistent with this diagnosis?
- Ruddy skin color and plethora
- Pallor, irritability, and tachycardia (Correct answer)
- Petechiae and easy bruising
- Jaundice and dark urine
Correct answer: Pallor, irritability, and tachycardia
Iron-deficiency anemia in infants presents with pallor (due to reduced hemoglobin), irritability, fatigue, and compensatory tachycardia. It is the most common nutritional deficiency in children. Risk factors include exclusive breastfeeding beyond 6 months without iron supplementation and cow's milk introduction before 12 months.
Question 2: The nurse is teaching parents of a toddler about poison prevention. Which instruction is most important?
- Keep medications in purses or bags at child's eye level for easy access
- Store all medications and cleaning products in locked cabinets out of reach (Correct answer)
- Teach the child never to touch cleaning products
- Keep the Poison Control number stored in the phone only
Correct answer: Store all medications and cleaning products in locked cabinets out of reach
The most effective poison prevention strategy is storing all potential toxins (medications, vitamins, cleaning products, pesticides) in locked cabinets that are out of reach of children. Child-resistant caps are not childproof. The Poison Control number (1-800-222-1222) should be posted visibly, not only in a phone.
Question 3: A 3-year-old child is admitted with burns from a splash of hot liquid. The burns cover the child's anterior trunk. Using the Rule of Nines for a child, what percentage of BSA is involved?
- 9%
- 18% (Correct answer)
- 27%
- 36%
Correct answer: 18%
In children, the Lund and Browder chart is more accurate than the Rule of Nines due to proportionally larger head size. However, the anterior trunk in children (as in adults) represents 18% BSA. The anterior and posterior trunk together = 36% BSA.
Question 4: A child is diagnosed with Kawasaki disease. Which clinical finding is characteristic of this disease?
- Purpuric rash on the buttocks and legs
- Strawberry tongue, bilateral conjunctival injection, and prolonged fever (Correct answer)
- Vesicular rash that began on the trunk and spread outward
- Sandpaper-texture rash with circumoral pallor
Correct answer: Strawberry tongue, bilateral conjunctival injection, and prolonged fever
Kawasaki disease is a systemic vasculitis of unknown etiology affecting children under 5. Diagnostic criteria include fever > 5 days plus ≥4 of: bilateral conjunctival injection (without exudate), strawberry tongue/lip changes, polymorphous rash, extremity changes (edema/peeling), and cervical lymphadenopathy. Untreated, it can cause coronary artery aneurysms.
Question 5: A child with suspected appendicitis complains of sudden relief of abdominal pain followed by worsening diffuse abdominal pain, rigidity, and fever. What complication does the nurse suspect?
- Mesenteric adenitis
- Ruptured appendix (perforation) with peritonitis (Correct answer)
- Intussusception
- Meckel's diverticulum
Correct answer: Ruptured appendix (perforation) with peritonitis
Sudden relief of pain followed by return of more severe, diffuse pain with board-like rigidity and high fever is the classic sequence of appendiceal rupture and peritonitis. The initial pain relief occurs when the appendix ruptures (pressure release), then peritoneal contamination causes diffuse inflammation. This is a surgical emergency.
Question 6: The PN is administering an oral liquid medication to a 2-year-old. Which method is safest for medication administration?
- Mix the medication into a full bottle of formula or breast milk
- Use a calibrated oral syringe and administer toward the inner cheek slowly (Correct answer)
- Draw the medication up in a household teaspoon
- Crush and dissolve a tablet equivalent in juice
Correct answer: Use a calibrated oral syringe and administer toward the inner cheek slowly
A calibrated oral syringe is the safest and most accurate method for administering liquid medications to small children. Direct the syringe toward the inner cheek (not the back of the throat) to prevent choking. Mixing into a full bottle risks incomplete dosing if the infant does not finish it. Household spoons are inaccurate for medication measurement.
NCLEX-PN Test #11 2
A 6-month-old infant is diagnosed with iron-deficiency anemia.
Which finding is most consistent with this diagnosis?