1 :

Hint : πŸ”Choose the practice that keeps the infant nearby while maintaining a separate sleep surface.

Correct Answers:

  • "Share a bedroom with your infant for the first 6 months."


Rationale :

πŸ›οΈRoom-sharing without bed-sharing reduces the risk of sleep-related infant death.

πŸ‘ΆThe infant should sleep in a separate crib or bassinet near the parent’s bed for at least the first 6 months.

πŸŒ™Close proximity allows easier observation, feeding, and comforting during the night.

πŸ›‘οΈThe sleep area should contain only a firm, flat mattress with a fitted sheet.

πŸ“ŒCore Message

Safe sleep includes room-sharing for at least 6 months, a separate crib, and a firm surface without loose objects.

2 :

Hint : πŸ”Prioritize preventing the complication caused by temporarily interrupting oxygen delivery.

Correct Answers:

  • Administer supplemental oxygen before and after the procedure.


Rationale :

🫁Suctioning temporarily removes oxygen and can cause hypoxemia in an infant.

πŸ’¨Providing supplemental oxygen before and after suctioning helps maintain adequate oxygen saturation.

❀️Infants can develop bradycardia rapidly when suctioning stimulates the vagus nerve or reduces oxygen levels.

πŸ“ŸThe nurse should monitor oxygen saturation, heart rate, and respiratory status throughout the procedure.

πŸ“ŒCore Message

Infants should receive supplemental oxygen before and after suctioning to prevent hypoxemia and bradycardia.

3 :

3 months ago

6-month-old infant seen in office for well check-up. Guardian reports infant rolls from back to abdomen and is able to hold their bottle. Infant does not vocalize or babble. On assessment, infant is able to bear weight when held in standing position. Eruption of one lower central incisor noted.

Today

9-month-old infant seen in office for well check-up. Infant has not been seen since prior visit at 6 months old. On assessment, infant able to sit with trunk support. Rolls from back to abdomen when supine. Infant does not vocalize or babble. Established crude pincer grasp. Eruption of upper lateral incisor noted.

3 months ago

Temperature 37Β° C (98.6Β° F)

Heart rate 136/min

Respiratory rate 38/min

Blood pressure 85/50 mm Hg

Oxygen saturation 99% on room air

Weight 6.6 kg (14.5 lb)

 

Today

Temperature 37.2Β°C (99Β° F)

Heart rate 128/min

Respiratory rate 40/min

Blood pressure 83/49 mm Hg

Oxygen saturation 100% on room air

Weight 8 kg (17.6 lb)


Drag words from the choices below to fill in each blank in the following sentence. The nurse identifies the assessment findings ofandshould be reported to the provider.


Hint : πŸ”Focus on the communication and gross-motor milestones normally established by 9 months.

Correct Answers

  • Blank 1 Correct Option: vocalization
  • Blank 2 Correct Option: sitting ability

Rationale :

πŸ—£οΈA 9-month-old infant should demonstrate vocalization, including repetitive babbling such as β€œmama” or β€œdada.”

πŸ‘‚Absence of babbling can indicate a hearing, speech, or developmental delay.

πŸͺ‘A 9-month-old infant should generally be able to sit independently without trunk support.

πŸ“‹Delayed vocalization and inability to sit independently require further developmental evaluation.

πŸ“ŒCore Message

Absent babbling and inability to sit independently at 9 months can indicate developmental delay and should be reported.

4 :

Hint : πŸ”Think of the antidote that replenishes the liver’s protective antioxidant supply.

Correct Answers:

  • Acetylcysteine


Rationale :

πŸ’ŠAcetylcysteine is the antidote for acetaminophen toxicity.

πŸ›‘οΈIt restores glutathione, which helps the liver neutralize the toxic acetaminophen metabolite.

πŸ«€Early administration reduces the risk of severe hepatic injury and liver failure.

⏱️The medication is most effective when administered within 8 to 10 hours, but it can still provide benefit when given later.

πŸ“ŒCore Message

Acetylcysteine treats acetaminophen toxicity by restoring glutathione and preventing potentially fatal liver damage.

5 :

0600

8-year-old child admitted for scheduled cardiac catheterization due to pulmonary valve stenosis acquired from history of rheumatic fever. Child is awake, alert, and oriented x3. Lungs clear bilaterally, heart murmur noted. Abdomen soft and nondistended, bowel sounds active. Pulses +2 in bilateral lower extremities. Caregiver at bedside.

0700

Child sent for procedure.

0900

Child returns to unit following procedure. Child was sleeping but awakened upon assessment. Dressing clean, dry, and intact. Pulses +2 in bilateral lower extremities.

1100

Child awake upon assessment. Lungs clear bilaterally, heart rhythm regular, no murmur noted. Child asks caregiver where they are. Speech is slurred. Child requests to go to the bathroom and isare. Speech is slurred. Child requests to go to the bathroom and is assisted out of bed. Gait is uncoordinated. Child is squinting at nurse and caregiver and states, "You are all blurry." Right-sided muscle weakness noted in upper and lower extremities. Pulses +2 in all extremities.

0600

Temperature 37Β° C (98.6Β° F)

Heart rate 98/min

Respiratory rate 22/min

Blood pressure 104/60 mm Hg

Oxygen saturation 100% on room air

0900

Temperature 37Β° C (98.6Β° F)

Heart rate 82/min

Respiratory rate 20/min

Blood pressure 100/58 mm Hg

Oxygen saturation 98% on room air

1100

Temperature 37Β° C (98.6Β° F)

Heart rate 92/min

Respiratory rate 22/min

Blood pressure 98/56 mm Hg

Oxygen saturation 99% on room air


Complete the following sentence by using the lists of options. The nurse suspects that the child is experiencingas evidenced by


Hint : πŸ”Connect the sudden one-sided weakness and altered speech with an acute neurological complication.

Correct Answers

  • Blank 1 Correct Option: stroke
  • Blank 2 Correct Option: musculoskeletal findings

Rationale :

🧠The child’s sudden right-sided muscle weakness indicates a focal neurological deficit.

🚢The uncoordinated gait suggests impaired motor control following cerebral injury.

πŸ—£οΈAdditional findings of slurred speech, confusion, and blurred vision strongly support an acute stroke.

🩺Cardiac catheterization can rarely dislodge a clot, causing an embolic ischemic stroke.

πŸ“ŒCore Message

Sudden unilateral weakness, slurred speech, visual changes, and poor coordination following catheterization indicate an acute stroke.

6 :

1600

3-month-old infant is admitted due to elevated temperature, lethargy, and poor feeding x 24 Infant is irritable when aroused. Fontanel is level and soft. Skin turgor is good, capillary refill is greater than 2 seconds. Skin is very warm and dry to touch. Pupils equal round and reactive to light and accommodation, moves all extremities spontaneously. Nailbeds and mucous membranes are blue. Parent reports the infant's lips and nailbeds are about the same color as always, cyanosis is not worse. Parent reports last void was 12 hours ago, and it was a scant amount in hours. Infant was diagnosed at birth with Tetralogy of Fallot and is scheduled for cardiac surgery in one week.

Breath sounds are clear and equal upon auscultation. Mild substernal and subcostal retractions noted. A loud murmur is heard at the left mid sternal border. Abdomen is flat and soft, bowel sounds are present in all quadrants.

Parent reports concern about infant's upcoming surgery. Weight 4.5 kg (9.9 lb)

1630

While preparing infant for transport to radiology, infant began crying, inconsolable, cyanosis worsened, oxygen saturation dropping.

1600

Temperature 39Β° C (102.2Β° F)

Heart rate 180/min

Respiratory rate 66/min

Oxygen saturation 89% on room air

1630

Heart rate 184/min

Respiratory rate 76/min

Oxygen saturation 78% on room air

1630

Send blood and urine specimen for C & S.

Send blood specimen for basic metabolic panel (BMP), CBC with differential NPO.

Initiate peripheral IV and start IV fluid of D5 NSS at 16 mL/hr.

Administer acetaminophen 60 mg rectal every 4 hr for temperature greater than 38.5Β° C (101.3Β° F).

12 lead ECG

Chest x-ray

Echocardiogram

Consult cardiology service


Drag words from the choices below to fill in each blank in the following sentence. It would be a priority for the nurse toand


Hint : 🚨Use the airway-breathing-circulation framework for an infant whose oxygen saturation is rapidly falling.

Correct Answers

  • Blank 1 Correct Option: apply 100% oxygen via facemask
  • Blank 2 Correct Option: initiate a peripheral IV

Rationale :

🫁Applying 100% oxygen increases available oxygen during the infant’s acute hypercyanotic episode.

πŸ’™The worsening cyanosis, tachypnea, and oxygen saturation of 78% indicate a Tet spell requiring immediate intervention.

πŸ’‰A peripheral IV provides rapid access for prescribed fluids and emergency medications.

πŸ’§IV fluids can improve circulating volume and pulmonary blood flow, helping reduce right-to-left cardiac shunting.

πŸ“ŒCore Message

An acute Tet spell with severe hypoxemia requires immediate 100% oxygen and IV access for rapid stabilization.

7 :

Hint : πŸ”Choose a soft, developmentally appropriate food that contains little protein.

Correct Answers:

  • "I will steam carrots and cut them into small pieces for her."


Rationale :

πŸ₯•Carrots are naturally low in phenylalanine, making them appropriate for an infant with phenylketonuria.

♨️Steaming the carrots creates a soft texture that a 10-month-old infant can manage safely.

πŸ”ͺCutting them into small pieces reduces the risk of choking while encouraging self-feeding.

🧠A low-phenylalanine diet prevents accumulation that can cause irreversible neurological damage.

πŸ“ŒCore Message

A child with phenylketonuria requires low-phenylalanine foods, and appropriately prepared carrots are a safe choice.

8 :

2200

6-year-old accompanied by caregiver. Immunizations are up to date. Child was seen by primary care provider 3 weeks ago. Diagnosed with a viral upper respiratory infection and caregiver educated on supportive care. Child presents today with edema and erythema on hands and feet. Caregiver reports fever for several days. Child reports pain when moving joints in hands and feet has erythema and cracking of lips. Rash on trunk and extremities.

Weight 25 kg (55.1 lb)

2200

Temperature 38.5Β° C (101.3Β° F)

Heart rate 112/min

Respiratory rate 24/min

Blood pressure 100/58 mm Hg

Oxygen saturation 98% on room air

2300

Temperature 38.8Β° C (101.8Β° F)

Heart rate 115/min

Respiratory rate 26/min

Blood pressure 105/62 mm Hg

Oxygen saturation 98% on room air

2330

Antistreptolysin O (ASO) titer 440 Todd

units/mL (170 to 330 Todd units/mL)

2210

Ibuprofen 250 mg by mouth every 6 hr as needed for pain or fever


For each of the child's findings, click to specify if the finding is consistent with rheumatic fever or Kawasaki disease. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.


Findings Rheumatic Fever Kawasaki Disease
Mucous membranes
Pain characteristics
Temperature
Skin findings
Laboratory results
Findings on hands and feet

Hint : βœ…Separate the signs of recent streptococcal infection from the mucosal and extremity changes of systemic vasculitis.

Correct Answers

  • Mucous membranes [ Kawasaki Disease ]
  • Pain characteristics [ Rheumatic Fever ]
  • Temperature [ Rheumatic Fever ; Kawasaki Disease ]
  • Skin findings [ Rheumatic Fever ; Kawasaki Disease ]
  • Laboratory results [ Rheumatic Fever ]
  • Findings on hands and feet [ Kawasaki Disease ]

Rationale :

πŸ‘…Red, cracked lips and oral mucosal changes are characteristic findings of Kawasaki disease.

🦡Painful joint movement or migratory polyarthritis is a major manifestation of rheumatic fever.

πŸ”₯Fever can occur with both rheumatic fever and Kawasaki disease because both involve systemic inflammation.

🎨A rash can occur as erythema marginatum in rheumatic fever or as a polymorphous rash in Kawasaki disease.

πŸ”¬An elevated antistreptolysin O titer indicates a recent group A streptococcal infection, supporting rheumatic fever.

🧀Redness and swelling of the hands and feet are characteristic extremity changes of Kawasaki disease.

πŸ“ŒCore Message

Elevated ASO titer and joint pain support rheumatic fever, while cracked lips and swollen red extremities support Kawasaki disease; fever and rash can occur with both.

9 :

Hint : πŸšͺThink about the precaution used for an infection transmitted through touching skin lesions.

Correct Answers:

  • Initiate contact isolation precautions.


Rationale :

🦠Impetigo is highly contagious and spreads through direct contact with infected lesions or contaminated objects.

🧀Contact precautions reduce transmission to other hospitalized children and healthcare workers.

πŸ›οΈThe nurse should use appropriate gloves, gowns, hand hygiene, and dedicated equipment.

🧼Lesions should remain covered when possible to limit the spread of infectious drainage.

πŸ“ŒCore Message

Hospital-acquired impetigo requires contact precautions because it spreads easily through direct and indirect contact.

10 :

Hint : πŸ”Begin by discovering how the guardians currently understand the child’s prognosis.

Correct Answers:

  • "Tell me what you know about your child's illness."


Rationale :

πŸ—£οΈThis open-ended statement encourages the guardians to express their understanding and beliefs.

🧠Their response helps the nurse assess possible denial, misconceptions, and readiness to receive information.

🀝The statement supports therapeutic communication without confronting or judging the guardians.

🫢Assessment allows the nurse to provide individualized emotional support and education.

πŸ“ŒCore Message

An open-ended assessment helps the nurse understand the guardians’ perceptions before offering support.

Total Questions: 10

Choose Different Exam !