1 :

Hint : ⚠️Consider the gastrointestinal manifestation associated with rising pressure inside the skull.

Correct Answers:

  • Vomiting


Rationale :

🧠A subdural hematoma causes blood to accumulate beneath the dura mater.

📈The accumulating blood can produce increased intracranial pressure.

🤮Vomiting is a common manifestation of increased intracranial pressure in infants.

👶Other possible findings include a bulging fontanel, irritability, seizures, and altered consciousness.

📌Core Message

A subdural hematoma can cause increased intracranial pressure, commonly producing vomiting in an infant.

2 :

Hint : 🔒Focus on preventing transmission of a highly contagious airborne infection.

Correct Answers:

  • Isolate the child until the fifth day of the rash.


Rationale :

🦠Rubeola, or measles, is a highly contagious viral infection spread through the airborne route.

😷The child requires airborne precautions during the contagious period.

📅Infectivity generally continues through the fourth day after the rash appears.

🚪Isolation until the fifth day of the rash prevents transmission to susceptible individuals.

📌Core Message

Children with rubeola require airborne isolation through four days after rash onset.

3 :

Hint : 🚑Identify the recreational activity strongly associated with orthopedic and head injuries.

Correct Answers:

  • "My child exercises by playing on the trampoline."


Rationale :

🤸Trampoline use places children at risk for fractures, head injuries, and spinal injuries.

🦴Injuries may occur from falls, collisions, or landing incorrectly.

👧School-age children may attempt dangerous movements without sufficient coordination or supervision.

⚠️The guardian’s statement identifies a significant preventable safety risk.

📌Core Message

Trampoline use is a major childhood safety risk because it can cause severe traumatic injuries.

4 :

Hint : 🔍Apply the nursing process before changing the treatment plan.

Correct Answers:

  • Ask the parent what time of the day they were giving the medication.


Rationale :

🕐The nurse should assess first before recommending a treatment change.

💡ADHD stimulants administered too late in the day can cause insomnia.

🌅Giving the medication earlier may improve sleep without changing the prescribed dose.

🗣️Determining the administration schedule provides the information needed for safe teaching.

📌Core Message

When stimulant-related insomnia occurs, first assess the time of medication administration.

5 :

Hint : 📐Convert pounds to kilograms before applying the prescribed dose.

Correct Answers:

  • 875


Rationale :

⚖️Convert the child’s weight: 77 lb ÷ 2.2 = 35 kg.

🧮Calculate the dose: 25 mg × 35 kg = 875 mg.

💉The nurse should administer 875 mg IV.

✅The result is already expressed as the nearest whole number.

📌Core Message

Use lb ÷ 2.2, then multiply the kilograms by the prescribed mg/kg dose.

6 :

Hint : 🌬️Consider the effect of pulmonary congestion on breathing.

Correct Answers:

  • Tachypnea


Rationale :

❤️Heart failure decreases effective cardiac output and promotes pulmonary congestion.

💨Pulmonary congestion makes breathing more difficult and increases the respiratory rate.

🫧Children commonly develop tachypnea, feeding difficulty, diaphoresis, and poor weight gain.

📈An increased respiratory rate can indicate worsening fluid accumulation in the lungs.

📌Core Message

Tachypnea is a common pediatric heart-failure manifestation caused by pulmonary congestion.

7 :

Day 1

Temperature 38.8° C (101.8° F)

Heart rate 110/min

Respiratory rate 18/min

Blood pressure 110/70 mm Hg

Day 2

Temperature 37.6 C (99.7° F)

Heart rate 100/min

Respiratory rate 18/min

Blood pressure 108/68 mm Hg

Day 1

6 x 6 cm indurated area on the left calf. Warmth and tenderness noted over the area. Client reports pain while walking as 6 on scale of 0 to 10. Small area of abscess, culture obtained. Wound borders marked per policy and procedure. Peripheral IV initiated, antibiotic administered as prescribed.

Day 2

Warmth and tenderness persist, 5 x 5 cm indurated area noted.

Adolescent ambulated in hall twice, tolerated well.

Day 1

Hgb 15 g/dL (10 to 15.5 g/dL)

Hct 40% (32% to 44%)

WBC count 14,000/mm3 (5,000 to 10,000/mm3)

Wound culture pending (Negative)

Day 2

WBC count 15,000/mm3 (5,000 to 10,000/mm3)


The nurse is assessing the adolescent 24 hr after the initial visit. How should the nurse interpret the findings? For each finding, click to specify whether the finding is an indication of potential improvement or an indication of potential worsening condition. There must be at least 1 selection in every row. There does not need to be a selection in every column.


Findings Potential improvement Potential worsening
WBC count
Weight-bearing ability on the affected leg
Temperature
Wound assessment

Hint : 🔍Compare each Day 2 finding with its Day 1 baseline.

Correct Answers

  • WBC count [ Potential worsening ]
  • Weight-bearing ability on the affected leg [ Potential improvement ]
  • Temperature [ Potential improvement ]
  • Wound assessment [ Potential improvement ]

Rationale :

🧫The WBC count increased from 14,000/mm³ to 15,000/mm³, suggesting persistent or worsening infection.

🚶The adolescent’s ability to ambulate twice and tolerate activity indicates improved weight-bearing ability.

🌡️The temperature decreased from 38.8°C to 37.6°C, showing that the fever is resolving.

📏The indurated area decreased from 6 × 6 cm to 5 × 5 cm, indicating reduced local inflammation.

📌Core Message

A rising WBC count suggests worsening, while improved ambulation, reduced fever, and a smaller wound indicate clinical improvement.

8 :

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 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 37° C (98.6° F)

Heart rate 98/min

Respiratory rate 22/min

Blood pressure 104/60 mm Hg

Oxygen saturation 100% on room air

0900

Temperature 37° C (98.6° F)

Heart rate 82/min

Respiratory rate 20/min

Blood pressure 100/58 mm Hg

Oxygen saturation 98% on room air

1100

Temperature 37° C (98.6° 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 : 🔦Look for sudden one-sided neurologic deficits after an invasive vascular procedure.

Correct Answers

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

Rationale :

🧠Sudden unilateral weakness following cardiac catheterization suggests an acute stroke.

🖐️Right-sided upper- and lower-extremity weakness represents a focal neurologic deficit.

🚶‍♂️An uncoordinated gait further supports impaired motor function.

🗨️Slurred speech, confusion, and blurred vision provide additional evidence of cerebral injury.

📌Core Message

Sudden unilateral weakness and impaired coordination after catheterization indicate a stroke.

9 :

0900

Child admitted to unit in vaso-occlusive crisis. Child reports pain in the right knee as 7 on a scale of 0 to 10. Right knee is swollen and warm to the touch. Pulses are +2 and capillary refill 2 seconds in all extremities.

1000

Notified provider regarding laboratory results. Child reports pain in the right knee is now 10 on a scale of 0 to 10.

0900

Temperature 37° C (98.6° F)

Heart rate 90/min

Respiratory rate 22/min

Blood pressure 110/70 mm Hg

Oxygen saturation 96% on room air

1000

Temperature 37.3° C (99.1° F)

Heart rate 98/min

Respiratory rate 25/min

Blood pressure 120/74 mm Hg

Oxygen saturation 96% on room air

1000

WBC count 9,500/mm3 (5,0000 to 10,000/mm3)

Hgb 9 g/dL (10 to 15.5 g/dL)

Hct 18% (32% to 44%)

Platelets 450,000/mm3 (150,000 to 400,000/mm3)


Complete the following sentence by using the lists of options. The nurse should anticipate a provider prescription fordue to the child's


Hint : 🔥Prioritize the rapidly worsening manifestation of vaso-occlusion.

Correct Answers

  • Blank 1 Correct Option: IV hydromorphone
  • Blank 2 Correct Option: pain

Rationale :

💥A vaso-occlusive crisis causes severe pain from microvascular obstruction and tissue ischemia.

💧The child’s pain increased from 7 to 10 out of 10, requiring rapid analgesia.

💉IV hydromorphone is appropriate for severe acute sickle cell pain.

⏱️Intravenous administration provides a rapid and reliable therapeutic effect.

📌Core Message

A severe vaso-occlusive pain crisis requires prompt administration of a potent IV opioid.

10 :

Hint : 🧪Diagnostic reliability improves when an abnormal measurement is confirmed.

Correct Answers:

  • "Two separate samples will be collected to ensure accuracy of the test results."


Rationale :

🧂The sweat chloride test measures the amount of chloride in sweat.

🧴Pilocarpine stimulates sweat production so samples can be collected for analysis.

🔁Separate adequate samples help confirm consistently elevated chloride results.

🧬Elevated sweat chloride levels support a diagnosis of cystic fibrosis.

📌Core Message

The sweat chloride test is a painless procedure that uses separate samples to confirm elevated chloride levels.

Total Questions: 10

Choose Different Exam !