Pediatric Nurse Exam Pediatric Nursing NCLEX 5 — Questions and Answers
Question 1: A nurse is caring for a child post-tonsillectomy. Which finding requires IMMEDIATE intervention?
- Mild sore throat
- Frequent swallowing and restlessness (Correct answer)
- Preference for cold liquids
- Low-grade fever of 37.8°C
Correct answer: Frequent swallowing and restlessness
Frequent swallowing in a post-tonsillectomy patient is a sign of hemorrhage, as the child may be swallowing blood.
Question 2: Which positioning is CORRECT for a child with increased intracranial pressure (ICP)?
- Trendelenburg with head down 15 degrees
- Head of bed elevated 30 degrees with head in midline (Correct answer)
- Prone position to reduce aspiration risk
- Lateral decubitus on the affected side
Correct answer: Head of bed elevated 30 degrees with head in midline
Elevating the head of bed 30 degrees and keeping the head midline promotes cerebral venous drainage and reduces ICP.
Question 3: A 5-year-old with leukemia develops a temperature of 38.5°C with an ANC of 400 cells/mm³. The nurse anticipates:
- Oral antibiotics and discharge with close follow-up
- Broad-spectrum IV antibiotics after blood cultures are drawn (Correct answer)
- Isolation and watchful waiting for 24 hours
- Antifungal therapy alone
Correct 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.
Question 4: A 3-year-old swallowed a coin 20 minutes ago and is drooling and refusing to swallow. The coin is most likely located in the:
- Stomach
- Esophagus (Correct answer)
- Trachea
- Duodenum
Correct answer: Esophagus
Drooling and dysphagia indicate the coin is lodged in the esophagus; tracheal foreign bodies cause respiratory symptoms instead.
Question 5: When administering digoxin to a pediatric patient, the nurse should withhold the dose and notify the provider if the apical pulse is:
- Less than 100 bpm in an infant (Correct answer)
- Less than 60 bpm in an adolescent
- Greater than 120 bpm in a toddler
- Less than 70 bpm in a school-age child
Correct answer: Less than 100 bpm in an infant
In infants, digoxin should be held if the apical pulse is below 100 bpm due to the higher baseline heart rate and risk of bradycardia.
Question 6: A nurse is assessing a 6-month-old for developmental red flags. Which finding warrants further evaluation?
- Cannot walk independently
- Does not sit without support
- Does not respond to own name (Correct answer)
- Has a palmar grasp reflex
Correct answer: Does not respond to own name
By 6 months, infants should respond to their own name; failure to do so is a red flag for hearing loss or autism spectrum disorder.
Question 7: Which action by a nursing student caring for a child in Bryant's traction indicates a need for further education?
- Keeping the child's buttocks slightly off the bed
- Checking neurovascular status every 2 hours
- Placing the child in a prone position for comfort (Correct answer)
- Ensuring the weights hang freely
Correct answer: Placing the child in a prone position for comfort
Bryant's traction requires the child to remain supine; prone positioning disrupts traction alignment and is incorrect.
Pediatric Nurse Exam Pediatric Nursing NCLEX 5
A nurse is caring for a child post-tonsillectomy.
Which finding requires IMMEDIATE intervention?