Pediatric Nurse Exam Pediatric Nurse Psychosocial and Mental Health 4 — Questions and Answers
Question 1: A nurse is using the CRIES scale in the NICU. This tool primarily measures:
- Developmental readiness for discharge
- Pain and distress in neonates (Correct answer)
- Nutritional status in preterm infants
- Risk for neonatal abstinence syndrome
Correct answer: Pain and distress in neonates
The CRIES scale (Crying, Requires O2, Increased vital signs, Expression, Sleeplessness) is a validated neonatal pain assessment tool.
Question 2: Which approach best supports a child with intellectual disability (ID) during a nursing assessment?
- Use complex medical terminology to respect the child's dignity
- Use simple, concrete language and allow extra time for responses (Correct answer)
- Direct all questions exclusively to the parent or caregiver
- Perform the assessment as quickly as possible to reduce distress
Correct answer: Use simple, concrete language and allow extra time for responses
Simple, concrete language and adequate processing time optimize communication and reduce anxiety in children with intellectual disability.
Question 3: A 9-year-old whose parents recently divorced begins wetting the bed after two years of being dry. The nurse should FIRST:
- Refer for urological workup
- Reassure the child and family that this is a common stress response (Correct answer)
- Restrict fluids after 5 PM immediately
- Prescribe desmopressin
Correct answer: Reassure the child and family that this is a common stress response
Secondary enuresis in a child undergoing a major life stressor is most likely functional regression; reassurance is the first appropriate response.
Question 4: A nurse is discharging a 15-year-old after a psychiatric hospitalization for self-harm. Which element is MOST critical in the safety plan?
- A list of activities the teen enjoys
- Means restriction and identified crisis contacts (Correct answer)
- Documentation of the teen's academic goals
- A schedule of outpatient therapy appointments
Correct answer: Means restriction and identified crisis contacts
Lethal means restriction combined with clear crisis contacts are the most evidence-based components of safety planning for self-harm.
Question 5: The nurse observes that a 4-year-old hospitalized child repeatedly injects a toy doll and says 'owie.' The nurse interprets this as:
- Aggressive behavior requiring behavior intervention
- Therapeutic play used to process the hospital experience (Correct answer)
- Dissociative behavior indicating trauma
- Imitative play with no psychological significance
Correct answer: Therapeutic play used to process the hospital experience
Re-enacting medical procedures through play is a healthy coping mechanism that allows young children to process and master stressful experiences.
Question 6: Which statement by a parent of a child newly diagnosed with PTSD indicates a need for further teaching?
- 'I should avoid discussing the trauma so my child isn't re-traumatized constantly.' (Correct answer)
- 'I'll follow consistent bedtime routines to help my child feel safe.'
- 'I'll monitor for increased irritability and sleep problems.'
- 'I will validate my child's feelings without dismissing their fears.'
Correct answer: 'I should avoid discussing the trauma so my child isn't re-traumatized constantly.'
Avoidance of all trauma discussion can reinforce avoidance behavior; trauma-focused therapy involves gradually processing the event in a safe way.
Question 7: A school-age child with chronic illness states, 'I'll never be normal like the other kids.' The most therapeutic nurse response is:
- 'Of course you will — many children overcome illness.'
- 'Tell me more about what feeling normal means to you.' (Correct answer)
- 'You should focus on what you can do, not what you can't.'
- 'Your friends probably don't notice as much as you think.'
Correct answer: 'Tell me more about what feeling normal means to you.'
Open-ended exploration of the child's experience validates feelings and gathers information before offering reassurance or redirection.
Pediatric Nurse Exam Pediatric Nurse Psychosocial and Mental Health 4
A nurse is using the CRIES scale in the NICU.
This tool primarily measures: