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NUR 3755 NURSING CARE OF CHILDREN – HESI
PEDIATRIC FINAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
- A 2-month-old infant is brought to the clinic for a well-child visit. Which immunizations should the nurse expect to administer? DTaP, IPV, Hib, PCV, RV
These are standard vaccines given at 2 months as part of the
recommended immunization schedule.
- A nurse assesses a 4-year-old child with croup. Which assessment finding is most concerning? Stridor at rest
Stridor at rest indicates upper airway obstruction and is a medical
emergency.
- A child with nephrotic syndrome is being discharged. What instruction is most important for the parents? Monitor daily weights at home
Daily weights are essential to monitor fluid retention or loss, a key
factor in managing nephrotic syndrome.
- A toddler is admitted with severe dehydration. Which clinical finding supports this diagnosis? Sunken anterior fontanel and dry mucous membranes
These are classic signs of moderate to severe dehydration in
infants and toddlers.
- The nurse is teaching parents of a child with cystic fibrosis. What dietary advice is most appropriate? High-calorie, high-protein diet with pancreatic enzyme supplements
Children with CF require high energy intake and pancreatic
enzymes to aid digestion.
- A nurse is caring for a 7-year-old with newly diagnosed type 1 diabetes mellitus. What is the priority nursing intervention? Teach blood glucose monitoring
Self-monitoring of blood glucose is a fundamental skill in diabetes
management.
- A school-aged child is admitted with a diagnosis of rheumatic fever. Which assessment finding is most concerning? New onset murmur
A new murmur could indicate carditis, a serious complication of
rheumatic fever.
- Which intervention should the nurse implement for a child post- tonsillectomy? Observe for frequent swallowing
Minimizing trauma reduces the risk of bleeding in
thrombocytopenic patients.
14.A nurse is caring for a 6-month-old infant with bronchiolitis. What is the priority intervention? Monitor oxygen saturation levels
Respiratory status must be closely monitored to prevent hypoxia.
15.Which assessment indicates pain in a 1-year-old? Irritability and inconsolable crying
These behaviors are common indicators of pain in non-verbal
children.
16.What teaching should be included for a parent of a child with lice (pediculosis)? Wash bedding and clothing in hot water
Hot water kills lice and their eggs on fabrics.
17.Which finding is expected in a child with moderate asthma exacerbation? Wheezing and use of accessory muscles
These signs reflect increased respiratory effort and airway
narrowing.
18.What is the priority nursing action for a child with epiglottitis? Prepare for possible intubation
Epiglottitis can rapidly obstruct the airway; emergency airway
management is critical.
19.A child with Down syndrome has a new murmur. What should the nurse do first? Report the murmur to the provider
Congenital heart defects are common in Down syndrome and
require prompt evaluation.
20.A nurse is assessing an infant for developmental dysplasia of the hip. What test is used? Ortolani maneuver
The Ortolani maneuver detects a dislocated hip in infants.
21.A nurse is teaching seizure precautions to the parents of a child with epilepsy. Which statement shows understanding? "We will keep a padded side rail on the bed."
Padding helps prevent injury during a seizure.
22.What dietary change is appropriate for a child with celiac disease? Remove wheat, rye, and barley from the diet
These grains contain gluten, which damages the intestines in
celiac disease.
23.A child is being treated for Kawasaki disease. Which medication is expected? Intravenous immunoglobulin (IVIG)
IVIG reduces the risk of coronary artery aneurysms.
24.A nurse is educating a parent about otitis media. Which factor contributes to this condition?
30.A nurse is assessing a 6-month-old. Which milestone is expected? Sits with support
By 6 months, infants can typically sit with some support.
31.A nurse is teaching a group of parents about SIDS prevention. Which statement is correct? "Place infants on their backs to sleep."
Back-sleeping significantly reduces the risk of SIDS.
32.Which sign is most indicative of pain in a child post-appendectomy? Guarding the abdomen
Guarding is a physical response to pain.
33.What is a common cause of hypoglycemia in children with type 1 diabetes? Exercising without eating extra carbohydrates
Exercise lowers blood sugar; carbs help prevent hypoglycemia.
34.What assessment finding is associated with intussusception? Currant jelly stools
These stools are a classic sign of this bowel obstruction.
35.A nurse assesses a toddler with suspected lead poisoning. What lab is most important? Blood lead level
This test confirms lead exposure and guides treatment.
36.What should the nurse include in a teaching plan for juvenile idiopathic arthritis?
Encourage regular exercise and range-of-motion activities
These maintain joint mobility and prevent contractures.
37.Which is a priority concern for a child with severe eczema (atopic dermatitis)? Risk for skin infection
Broken skin from scratching increases the risk of infection.
38.A nurse is caring for a child in sickle cell crisis. What intervention is most important? Administer IV fluids and pain medication
Hydration and pain control are central to managing a crisis.
39.What symptom suggests a child has otitis media with effusion? Muffled hearing
Fluid in the middle ear can impair hearing.
40.What action should the nurse take first for a child having a generalized tonic-clonic seizure? Turn the child to a side-lying position
This prevents aspiration and promotes airway clearance.
41.A 6-year-old with chickenpox is scratching lesions. What is the best intervention? Apply mittens and trim fingernails
This reduces skin damage and prevents secondary infection.
42.A child with suspected appendicitis reports sudden relief of pain. What should the nurse do?
Allowing choice encourages independence while being age-
appropriate.
48.A child is diagnosed with scabies. What should the nurse instruct the parent to do? Apply permethrin cream from neck down and repeat in 1 week
This treatment kills the mites and is repeated to kill new
hatchlings.
49.A nurse is educating parents on injury prevention in toddlers. Which statement is appropriate? "Keep all medications locked and out of reach."
Toddler curiosity puts them at risk for poisoning.
50.What dietary instruction should be provided to a child with lactose intolerance? Avoid milk products and use lactase enzyme supplements
This prevents GI symptoms from lactose malabsorption.
51.A nurse is reviewing safety precautions with the parents of a toddler. Which instruction is appropriate? Use rear-facing car seat until at least 2 years old
This position provides the best protection for the child’s head and
neck in a collision.
52.Which finding is consistent with measles (rubeola)? Koplik spots inside the cheeks
These small white lesions are a distinctive early sign of measles
infection.
53.A nurse is caring for a child receiving chemotherapy. Which lab result requires immediate action? Absolute neutrophil count (ANC) of 400
An ANC below 500 places the child at high risk for infection.
54.A nurse assesses a child with suspected pertussis. What symptom is expected? Paroxysmal coughing with inspiratory "whoop"
Pertussis is characterized by severe coughing fits followed by a
high-pitched gasp.
55.A nurse is preparing to give ear drops to a 2-year-old. What technique is correct? Pull the pinna down and back
For children under 3, this straightens the ear canal for medication
administration.
56.A 10-year-old is post-op from a spinal fusion for scoliosis. What is the priority assessment? Neurovascular checks of the lower extremities
These checks detect complications such as nerve damage or
impaired circulation.
Skin integrity must be preserved to prevent breakdown or pressure
injuries.
63.A parent reports their child has a barky cough at night. What condition does this suggest? Croup
This condition typically presents with a barking cough, especially
at night.
64.What is the best method to promote comfort for a child with a viral illness and fever? Give acetaminophen and encourage fluids
Acetaminophen lowers fever and fluids prevent dehydration.
65.A child with mononucleosis is returning to school. What activity should be restricted? Contact sports
Splenomegaly from mono increases the risk of splenic rupture with
trauma.
66.A nurse is teaching a group of parents about signs of child abuse. Which is a possible indicator? Inconsistent stories about the injury
Discrepancies in the explanation of injuries raise red flags for
abuse.
67.A 7-year-old with diabetes is confused and sweaty. What is the nurse’s first action?
Check blood glucose level
Symptoms indicate possible hypoglycemia; glucose level must be
verified immediately.
68.What assessment finding in an infant with hydrocephalus requires immediate action? Bulging fontanel while calm
This suggests increased intracranial pressure and requires prompt
intervention.
69.A 4-year-old with cerebral palsy has difficulty swallowing. What is a priority concern? Risk for aspiration
Children with swallowing difficulties are at increased risk for
aspiration pneumonia.
70.What immunization is contraindicated in a child with leukemia undergoing chemotherapy? MMR vaccine
Live vaccines are contraindicated in immunocompromised
children.
71.What should the nurse include when teaching about administering digoxin to an infant? Withhold if heart rate is below 90 bpm
Digoxin can cause bradycardia; withholding the drug prevents
complications.
The sac is prone to rupture and infection, especially pre-
operatively.
78.A child with sickle cell anemia is febrile. What is the nurse’s first action? Notify the provider
Fever may indicate infection, which can quickly escalate in these
children.
79.A nurse is caring for a child with idiopathic thrombocytopenic purpura (ITP). What should be avoided? Aspirin-containing products
Aspirin increases bleeding risk by inhibiting platelet function.
80.Which activity is best for a school-aged child on bedrest? Playing board games with peers
This provides cognitive stimulation and social interaction.
81.A nurse is evaluating a child for developmental delay. Which is a red flag at 18 months? Not walking independently
Most children walk by 15 months; delay suggests motor
development concern.
82.A 3-year-old is scheduled for surgery. What strategy helps reduce anxiety? Use play therapy to explain the procedure
Play therapy helps children express emotions and understand
procedures.
83.A child with asthma is prescribed montelukast. What is the purpose of this medication? Prevent nighttime symptoms
Montelukast is a leukotriene receptor antagonist used for asthma
control.
84.A parent asks about toilet training readiness. Which sign indicates readiness? Child stays dry for 2 hours during the day
This indicates developing bladder control.
85.A 6-year-old with autism is admitted. What environment is most therapeutic? Structured routine with minimal stimulation
Predictability and low stimulation reduce distress and support
coping.
86.Which behavior is developmentally appropriate for a 2-year-old? Parallel play near other children
Toddlers engage in parallel play rather than cooperative play.
87.A nurse is teaching a child with nephrotic syndrome. Which sign indicates worsening condition? Periorbital edema
This is a hallmark sign of fluid retention in nephrotic syndrome.
88.Which lab finding is expected in a child with acute lymphoblastic leukemia (ALL)?
Albuterol stimulates beta receptors, often causing increased heart
rate.
95.A child is receiving IV vancomycin. What should the nurse monitor closely? Hearing and kidney function
Vancomycin is nephrotoxic and ototoxic.
96.A nurse is teaching about safe sleep for infants. Which recommendation is correct? Place infant in a crib without blankets or pillows
Soft items increase the risk of suffocation and SIDS.
97.A child with bacterial meningitis is on droplet precautions. What PPE is required? Mask within 3 feet of the patient
Droplet precautions protect against respiratory secretions.
98.Which pain scale is best for a 3-year-old child? Faces Pain Scale
This visual scale is appropriate for young children who cannot rate
pain numerically.
99.A nurse notes an irregular pulse in a child with Kawasaki disease. What is the best action? Report to the healthcare provider
Cardiac arrhythmias are serious and require immediate attention.
- What teaching should be provided to parents of a child newly diagnosed with epilepsy?
Do not place anything in the child’s mouth during a seizure
Placing objects in the mouth can cause injury and is not
recommended.
