Pediatric Nurse Exam Pediatric Nursing NCLEX 4 — Questions and Answers
Question 1: A 4-week-old presents with projectile vomiting after every feeding and a palpable olive-shaped mass in the epigastric region. The nurse suspects:
- Intussusception
- Pyloric stenosis (Correct answer)
- Hirschsprung disease
- Duodenal atresia
Correct 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.
Question 2: A child with hemophilia A requires emergency dental surgery. Which factor replacement should the nurse anticipate administering?
- Factor IX concentrate
- Factor VIII concentrate (Correct answer)
- Fresh frozen plasma only
- Vitamin K
Correct answer: Factor VIII concentrate
Hemophilia A is a deficiency of factor VIII, so factor VIII concentrate is required before and after surgical procedures.
Question 3: A 2-year-old ingests a button battery. Which action is the nurse's PRIORITY?
- Induce vomiting immediately
- Give milk to neutralize the acid
- Prepare the child for emergent endoscopic removal (Correct answer)
- Observe for 24 hours and repeat X-ray
Correct answer: Prepare the child for emergent endoscopic removal
Button batteries in the esophagus generate an electrical current that causes rapid tissue necrosis; emergent endoscopic removal is required within 2 hours.
Question 4: When teaching a parent about acetaminophen dosing for a 3-year-old, the nurse emphasizes:
- Doses are based on the child's age
- The maximum dose is 15 mg/kg every 4 hours not exceeding 5 doses in 24 hours (Correct answer)
- Alternate with aspirin for better fever control
- Adult strength tablets are fine if halved
Correct answer: The maximum dose is 15 mg/kg every 4 hours not exceeding 5 doses in 24 hours
Pediatric acetaminophen dosing is weight-based at 10–15 mg/kg every 4–6 hours with a maximum of 5 doses per 24 hours.
Question 5: A nurse notes that a 9-month-old has not begun to babble and does not turn toward sounds. Which referral is MOST appropriate?
- Ophthalmology
- Audiology (Correct answer)
- Speech therapy only, no further workup needed
- Neurology for MRI
Correct answer: Audiology
Absence of babbling and response to sound by 9 months warrants immediate audiology evaluation to rule out hearing impairment.
Question 6: A 16-year-old athlete collapses during practice with a suspected heat stroke (core temp 41°C). The nurse's FIRST action is:
- Administer antipyretic medication
- Begin rapid external cooling with ice packs to groin and axilla (Correct answer)
- Obtain IV access and start fluids
- Perform a 12-lead ECG
Correct 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.
Question 7: A premature infant at 32 weeks gestation is at highest risk for which respiratory complication?
- Bronchopulmonary dysplasia from oxygen toxicity only
- Respiratory distress syndrome due to surfactant deficiency (Correct answer)
- Pneumothorax from coughing
- Reactive airway disease
Correct answer: Respiratory distress syndrome due to surfactant deficiency
Premature infants lack sufficient surfactant, which reduces alveolar surface tension, leading to respiratory distress syndrome (RDS).
Pediatric Nurse Exam Pediatric Nursing NCLEX 4
A 4-week-old presents with projectile vomiting after every feeding and a palpable olive-shaped mass in the epigastric region.
The nurse suspects: