Pediatric Nurse Exam Pediatric Nurse Chronic Conditions and Care 2 — Questions and Answers
Question 1: A 10-year-old with type 1 diabetes presents with blood glucose of 350 mg/dL, fruity breath, and Kussmaul respirations. Which intervention is the priority?
- Administer oral glucose gel
- Establish IV access and begin fluid resuscitation (Correct answer)
- Give subcutaneous regular insulin immediately
- Provide a high-carbohydrate snack
Correct answer: Establish IV access and begin fluid resuscitation
Diabetic ketoacidosis requires IV fluid resuscitation as the first priority to correct dehydration and electrolyte imbalances before insulin administration.
Question 2: A child with juvenile idiopathic arthritis (JIA) is scheduled for morning physical therapy. Which nursing action best supports treatment adherence?
- Schedule therapy in the afternoon when stiffness improves
- Apply warm compresses to joints before therapy (Correct answer)
- Administer NSAIDs only after therapy sessions
- Restrict physical activity to prevent joint damage
Correct answer: Apply warm compresses to joints before therapy
Warm compresses applied before physical therapy reduce morning stiffness and improve joint mobility, supporting therapy participation in JIA.
Question 3: A 7-year-old with moderate persistent asthma uses a metered-dose inhaler (MDI) with a spacer. The nurse notes the child inhales rapidly. What teaching is needed?
- Rapid inhalation increases drug deposition in the lungs
- A slow, steady breath optimizes medication delivery (Correct answer)
- The spacer eliminates the need for proper technique
- Holding breath is unnecessary with a spacer device
Correct answer: A slow, steady breath optimizes medication delivery
Slow, steady inhalation over 3–5 seconds with an MDI and spacer ensures optimal medication deposition in the lower airways.
Question 4: A nurse is teaching a family about sickle cell crisis triggers. Which environmental factor should be emphasized as a primary prevention measure?
- High altitude and extreme cold or heat exposure (Correct answer)
- Moderate exercise and balanced nutrition
- Sunlight exposure and vitamin D supplementation
- Stress management only
Correct answer: High altitude and extreme cold or heat exposure
High altitude, extreme temperatures, and dehydration are key environmental triggers for vaso-occlusive sickle cell crises.
Question 5: A 5-year-old with cystic fibrosis is prescribed pancreatic enzyme replacement therapy (PERT). When should enzymes be administered?
- Once daily in the morning before breakfast
- With every meal and snack containing fat (Correct answer)
- Only with high-fat meals such as dinner
- Two hours after each main meal
Correct answer: With every meal and snack containing fat
Pancreatic enzymes must be taken with every meal and fat-containing snack to facilitate proper digestion and nutrient absorption in CF.
Question 6: During a well-child visit, a 9-year-old with epilepsy reports breakthrough seizures. The nurse notes the child recently started a growth spurt. What is the most likely explanation?
- Medication non-adherence by the child
- Weight-based dosing may need adjustment due to growth (Correct answer)
- The child has developed drug resistance
- Environmental stress is lowering seizure threshold
Correct answer: Weight-based dosing may need adjustment due to growth
Antiepileptic drug doses are weight-based, so rapid growth can result in subtherapeutic levels and breakthrough seizures requiring dosage recalculation.
Question 7: A 12-year-old with inflammatory bowel disease (IBD) expresses embarrassment about needing to use the bathroom frequently at school. Which nursing response is most therapeutic?
- Advise the child to limit fluids during school hours
- Help develop a 504 plan for unrestricted bathroom access (Correct answer)
- Recommend the child inform classmates about the condition
- Suggest the parent request home schooling temporarily
Correct answer: Help develop a 504 plan for unrestricted bathroom access
A 504 accommodation plan legally ensures the child has unrestricted bathroom access at school, protecting dignity and managing the chronic condition effectively.
Pediatric Nurse Exam Pediatric Nurse Chronic Conditions and Care 2
A 10-year-old with type 1 diabetes presents with blood glucose of 350 mg/dL, fruity breath, and Kussmaul respirations.
Which intervention is the priority?