Pediatric Nurse Exam Pediatric Nurse Psychosocial and Mental Health 5 — Questions and Answers
Question 1: A nurse is caring for an adolescent with bulimia nervosa. Which laboratory finding is MOST expected?
- Hyperkalemia
- Hypokalemia (Correct answer)
- Hypernatremia
- Elevated BUN with normal creatinine
Correct answer: Hypokalemia
Repeated purging causes significant potassium loss through vomiting, leading to hypokalemia which can precipitate dangerous cardiac arrhythmias.
Question 2: When planning care for a hospitalized toddler, the nurse prioritizes rooming-in for parents primarily to:
- Reduce nursing workload during night shifts
- Prevent separation anxiety and support attachment (Correct answer)
- Ensure parents observe nursing techniques
- Comply with Joint Commission standards
Correct answer: Prevent separation anxiety and support attachment
Rooming-in minimizes separation from attachment figures, which is the primary source of distress for toddlers during hospitalization.
Question 3: A 12-year-old discloses sexual abuse by a family member. After ensuring safety, the nurse's next action is:
- Interview the alleged perpetrator to gather facts
- Notify child protective services and document the disclosure accurately (Correct answer)
- Advise the child not to discuss it further to preserve evidence
- Reassure the child that adults will handle everything without their involvement
Correct answer: Notify child protective services and document the disclosure accurately
Mandatory reporting to CPS with accurate documentation is the nurse's legal and ethical obligation following a child's abuse disclosure.
Question 4: A nurse is educating a family about childhood bipolar disorder. Which statement about pediatric bipolar disorder is ACCURATE?
- Mood episodes in children follow the same distinct pattern as in adults
- Children often present with rapid cycling, irritability, and mixed states rather than classic euphoria (Correct answer)
- Pediatric bipolar disorder is always outgrown by early adulthood
- Stimulant medication is the first-line treatment
Correct answer: Children often present with rapid cycling, irritability, and mixed states rather than classic euphoria
Children with bipolar disorder frequently present with irritability and rapid cycling rather than the classic episodic euphoria seen in adults.
Question 5: A nurse is screening a 5-year-old using the Pediatric Symptom Checklist (PSC). This tool is designed to:
- Diagnose specific psychiatric disorders in children
- Identify children at risk for psychosocial problems for further evaluation (Correct answer)
- Measure medication effectiveness in children with ADHD
- Assess developmental milestones in early childhood
Correct answer: Identify children at risk for psychosocial problems for further evaluation
The PSC is a validated psychosocial screening tool that flags children who may need further mental health evaluation, not a diagnostic instrument.
Question 6: Which nursing intervention is MOST appropriate for a child with selective mutism during a clinic visit?
- Insist the child answer questions verbally to build confidence
- Allow alternative communication methods such as writing or pointing (Correct answer)
- Speak only to the parent to avoid triggering the child's anxiety
- Refer immediately to a speech-language pathologist for articulation therapy
Correct answer: Allow alternative communication methods such as writing or pointing
Allowing non-verbal communication reduces performance pressure and anxiety without reinforcing avoidance of the clinical setting.
Question 7: A nurse is assessing a 16-year-old for depression using the PHQ-A. A score of 15 indicates:
- Minimal depressive symptoms requiring no action
- Mild depression managed with watchful waiting
- Moderately severe depression requiring active treatment and close follow-up (Correct answer)
- The screening is invalid and must be repeated
Correct answer: Moderately severe depression requiring active treatment and close follow-up
A PHQ-A score of 15–19 indicates moderately severe depression, which warrants active treatment initiation and close monitoring.
Pediatric Nurse Exam Pediatric Nurse Psychosocial and Mental Health 5
A nurse is caring for an adolescent with bulimia nervosa.
Which laboratory finding is MOST expected?