Mixed Deck — All Pediatric Nurse Exam Topics Flashcards

A 5-year-old with leukemia develops a temperature of 38.5°C with an ANC of 400 cells/mm³. The nurse anticipates:

Answer: Broad-spectrum IV antibiotics after blood cultures are drawn

Febrile neutropenia (ANC <500) is an oncologic emergency requiring immediate blood cultures and broad-spectrum IV antibiotics.

A 10-year-old with sickle cell disease presents with sudden severe headache and left-sided weakness. The nurse suspects:

Answer: Stroke

Sudden neurological deficits such as severe headache and focal weakness indicate stroke, a known complication of sickle cell disease.

When administering IM injections to a toddler (1-3 years), which muscle site is preferred?

Answer: Vastus lateralis

The vastus lateralis is the preferred IM site for toddlers because it is well-developed and free of major nerves and vessels.

Which organism is responsible for hand, foot, and mouth disease (HFMD) in children?

Answer: Coxsackievirus A16 (enterovirus)

HFMD is most commonly caused by Coxsackievirus A16, an enterovirus, producing vesicular lesions on the hands, feet, and oral mucosa.

A newborn has not passed meconium within 48 hours of birth. Which condition should the nurse suspect?

Answer: Hirschsprung disease

Failure to pass meconium within 24–48 hours is a classic sign of Hirschsprung disease, caused by absence of ganglion cells in the colon.

A nurse witnesses a physician perform a procedure on a child without first obtaining informed consent. What should the nurse do first?

Answer: Immediately report the incident to the supervisor or risk management

Performing procedures without informed consent is a legal violation that must be reported to the appropriate authority to protect the patient and institution.

A nurse is providing anticipatory guidance to the parents of a 4-month-old infant. Which of the following topics is most crucial to include for preventing the leading cause of injury-related death in this age group?

Answer: Safe sleep practices to prevent SUID/SIDS.

Sudden Unexpected Infant Death (SUID), which includes Sudden Infant Death Syndrome (SIDS), is the leading cause of injury-related death in infancy. Therefore, educating parents on safe sleep practices—such as placing the infant on their back to sleep, using a firm sleep surface, and keeping the crib free of soft bedding—is the highest priority for injury prevention at this age.

Which of the following is the recommended daily intake of vitamin D for infants who are exclusively breastfed?

Answer: 400 IU

The AAP recommends 400 IU of vitamin D daily beginning shortly after birth for all breastfed infants.

A 4-week-old presents with projectile vomiting after every feeding and a palpable olive-shaped mass in the epigastric region. The nurse suspects:

Answer: Pyloric stenosis

Pyloric stenosis causes progressive projectile non-bilious vomiting and a palpable pyloric 'olive' in young infants around 2–6 weeks of age.

A 16-year-old athlete collapses during practice with a suspected heat stroke (core temp 41°C). The nurse's FIRST action is:

Answer: Begin rapid external cooling with ice packs to groin and axilla

Heat stroke is a life-threatening emergency; immediate external cooling to reduce core temperature is the first priority intervention.

A child with varicella (chickenpox) should be excluded from school until which point?

Answer: All lesions have crusted over

Varicella is contagious until all lesions have crusted, indicating the end of viral shedding and the infectious period.

The parents of a child with a complex cardiac condition are discussing treatment options. One option involves a high-risk surgery, while another is a less invasive palliative procedure. Which nursing action best exemplifies the 'information sharing' component of family-centered care?

Answer: Ensuring the parents receive complete, unbiased information about the risks and benefits of all available options in understandable terms.

A core principle of family-centered care is sharing complete, unbiased information in a way families can understand, empowering them to participate effectively in decision-making. While other options can be supportive, the nurse's primary role is to ensure the family receives and comprehends all necessary information from the healthcare team to make an informed choice.

When a call bell rings, the nurse answers it to discover a terrified mother holding her child, who is experiencing a seizure. Which of these should the nurse choose to do?

Answer: The nurse should clear the area and position the child safely

During a seizure, the immediate priority is to ensure the child's safety and prevent injury. This involves clearing the area of any potentially harmful objects and carefully positioning the child on their side to maintain an open airway and prevent aspiration. Restraining the child or inserting objects into their mouth can cause further harm and is contraindicated.

A nurse overhears a colleague making derogatory comments about a pediatric patient's family. The most appropriate action is to:

Answer: Report the behavior to management per the professional conduct policy

Derogatory remarks about patients violate professional standards and patient dignity; reporting to management is the appropriate response.

A mother is Rh-negative and delivers an Rh-positive newborn. Which postpartum medication should the nurse prepare?

Answer: Rho(D) immune globulin (RhoGAM)

RhoGAM prevents Rh sensitization in the mother, protecting future pregnancies from hemolytic disease of the newborn.

A nurse is administering vancomycin IV to a child and notices flushing, erythema, and hypotension developing during the infusion. What is the most likely cause?

Answer: Red man syndrome from too-rapid infusion

Red man syndrome is a histamine-related reaction caused by rapid vancomycin infusion, characterized by flushing and hypotension.

Which situation requires the nurse to file an incident report?

Answer: A patient falls from a hospital bed during the nurse's shift

Adverse events and near-misses such as patient falls require an incident report to support quality improvement and risk management processes.

A nursing student working in a pediatric unit makes a medication error. Who bears legal responsibility?

Answer: Both the supervising nurse and the institution share responsibility with the student

Legal responsibility for nursing student errors typically extends to the supervising nurse, the clinical facility, and potentially the educational institution, in addition to the student.

Which finding requires the nurse to withhold digoxin in a pediatric patient before administration?

Answer: Apical pulse below 90 bpm in an infant

Digoxin should be withheld and the provider notified if the apical pulse is below 90-110 bpm in infants (or below 70 bpm in older children).

A metabolic flaw that is inherited that causes RBC to be destroyed too soon?

Answer: G6PD

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited metabolic disorder where the body lacks or has insufficient G6PD, an enzyme vital for red blood cell protection against oxidative stress. Without adequate G6PD, red blood cells become vulnerable to premature destruction (hemolysis) when exposed to certain triggers like specific medications, foods, or infections.