1 :

Hint : 🩸Active bleeding requires immediate direct pressure.

Correct Answers:

  • Apply pressure to the site if bleeding occurs


Rationale :

🩸 A child on bleeding precautions is at increased risk for prolonged bleeding following even a minor injury such as a cut.

🩸 The immediate priority is to apply firm, direct pressure to the injured site to promote clot formation and control blood loss.

🩸 Pressure should be maintained continuously until bleeding stops rather than repeatedly removing the dressing to inspect the wound.

🩸 The nurse should then assess the amount of bleeding, wound severity, vital signs, and other manifestations of abnormal hemorrhage.

🩸 Controlling active bleeding takes priority because continued blood loss can progress to hemodynamic instability if not managed promptly.


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2 :

Hint : 🦴Persistent unexplained bone pain needs evaluation.

Correct Answers:

  • Nonspecific bone pain.


Rationale :

🦴 Bone pain is one of the most common early manifestations of primary bone malignancies such as osteosarcoma and Ewing sarcoma.

🦴 The pain may initially be intermittent, vague, or mistaken for a sports injury or normal growing pains.

🦴 As the tumor progresses, discomfort commonly becomes persistent, localized, and worse with activity or at night.

🦴 Swelling, tenderness, decreased range of motion, limping, or a palpable mass can develop near the affected bone.

🦴 Persistent nonspecific bone pain without a clear injury should therefore prompt further assessment and diagnostic imaging.


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3 :

Hint : 🚶Proximal muscle weakness alters walking pattern.

Correct Answers:

  • Waddling gait


Rationale :

🚶 Duchenne muscular dystrophy causes progressive degeneration and weakness of skeletal muscles, especially the proximal muscles of the hips and thighs.

🚶 Pelvic-girdle weakness causes the child to shift the trunk from side to side when walking, producing a characteristic waddling gait.

🚶 The child may also demonstrate Gowers sign by using the hands to push upward along the thighs when rising from the floor.

🚶 Additional findings include frequent falls, difficulty climbing stairs, toe walking, and calf pseudohypertrophy.

🚶 The waddling gait becomes increasingly noticeable as proximal muscle weakness progresses during childhood.


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4 :

Hint : 🧬Low platelets cause bleeding and petechiae.

Correct Answers:

  • Frequent nosebleeds and petechiae


Rationale :

🧬 Myelosuppression occurs when chemotherapy suppresses bone-marrow production of red blood cells, white blood cells, and platelets.

🧬 Decreased platelet production causes thrombocytopenia, which increases the child’s risk for spontaneous or prolonged bleeding.

🧬 Petechiae are small pinpoint areas of bleeding under the skin and are a classic manifestation of a low platelet count.

🧬 Frequent epistaxis, easy bruising, bleeding gums, and prolonged bleeding after minor trauma can also occur.

🧬 The nurse should monitor platelet counts and implement bleeding precautions when thrombocytopenia develops.


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5 :

Hint : 📌Desired dose ÷ available dose × volume.

Correct Answers:

  • 2.5


Rationale :

✔️Available: 500 mg in 5 mL

✔️Prescribed: 250 mg

✔️Formula

📌Desired dose ÷ available dose × volume.

📌250 mg​/500 mg×5 mL

📌0.5×5

📌2.5 mL​


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6 :

Hint : 💊Reduce hip inflammation while protecting the joint.

Correct Answers:

  • Administer nonsteroidal anti-inflammatory drugs (NSAIDs)


Rationale :

💊 Legg-Calvé-Perthes disease involves temporary disruption of blood supply to the femoral head, causing avascular necrosis and later bone remodeling.

💊 NSAIDs can decrease hip pain and inflammation, improving comfort and allowing the child to participate in prescribed therapy.

💊 Treatment also focuses on maintaining hip range of motion and keeping the femoral head properly positioned within the acetabulum.

💊 Activity may be restricted depending on disease severity, and physical therapy or bracing may be prescribed.

💊 The overall goal is to preserve the shape and function of the femoral head while healing and revascularization occur.


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7 :

Hint : 🚻Neurogenic bladder needs scheduled emptying.

Correct Answers:

  • "We will learn how to perform intermittent urinary catheterization."


Rationale :

🚻 Children with spina bifida commonly have a neurogenic bladder because spinal nerve impairment interferes with normal bladder emptying.

🚻 Clean intermittent catheterization allows regular bladder drainage and decreases urinary retention.

🚻 Effective bladder management helps reduce urinary tract infections, vesicoureteral reflux, hydronephrosis, and renal damage.

🚻 Parents and eventually the child can be taught clean catheterization technique at developmentally appropriate stages.

🚻 Long-term urinary management is essential because surgical closure of the spinal defect does not restore damaged neurological function.


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8 :

Hint : 🔷Physically remove attached nits after treatment.

Correct Answers:

  • Remove nits with a fine-tooth comb or tweezers.


Rationale :

🪮 Pediculosis capitis, or head lice, is treated with an appropriate pediculicide along with careful removal of lice and nits when indicated.

🪮 A fine-tooth nit comb can remove remaining lice and eggs that are firmly attached to the hair shaft.

🪮 Parents should comb through small sections of damp hair carefully and repeat inspections according to the treatment instructions.

🪮 Nits can remain attached after treatment, so mechanical removal can help decrease persistent infestation and improve detection of newly hatched lice.

🪮 The CDC recommends checking the hair after treatment and using a nit comb to remove lice and nits when appropriate.


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9 :

Hint : 🧤Spina bifida carries high latex-allergy risk.

Correct Answers:

  • Provide a latex-free environment.


Rationale :

🧤 Children with spina bifida and myelomeningocele have a markedly increased risk of developing latex sensitivity because of repeated medical and surgical exposure.

🧤 A latex-free environment helps prevent allergic reactions ranging from contact dermatitis to severe anaphylaxis.

🧤 The nurse should ensure that gloves, catheters, tubing, adhesive products, and other equipment are latex-free whenever possible.

🧤 The infant should also be positioned to protect the exposed sac from pressure, contamination, and rupture before surgery.

🧤 Latex precautions remain important throughout the child's life because sensitization can become more severe with repeated exposure.


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10 :

Hint : 💎Convert minutes to hours before calculating.

Correct Answers:

  • 100


Rationale :

💎Available: 50 mL

💎Infusion time: 30 minutes = 0.5 hr

💎Formula

💎mL/hr=Total volume (mL)​​/Infusion time (hr)

💎50 mL/0.5 hr​

💎100 mL/hr


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Total Questions: 10

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