Question

A nurse is caring for a toddler.

Answer 1

Correct Answers

Blank 1 Correct Option: Prepare toddler for chest physiotherapy
Blank 2 Correct Option: Educate guardian about sweat chloride testing
Blank 3 Correct Option: Oxygen saturation level
Blank 4 Correct Option: Stools

Rationale :

✅ Actions to Take

Prepare toddler for chest physiotherapy

🫁 Chest physiotherapy helps loosen and mobilize thick respiratory secretions so the child can clear mucus from the lungs.

🫁 This reduces airway obstruction, improves ventilation, and helps prevent recurrent respiratory infections.

🫁 It is a major component of daily CF management.

Educate guardian about sweat chloride testing

🧂 The sweat chloride test is the diagnostic test used to confirm cystic fibrosis.

🧂 Children with CF have abnormally high chloride levels in their sweat due to defective chloride transport.

🧂 Teaching the guardian about this test helps with understanding diagnosis and future management.

✅ Parameters to Monitor

Oxygen saturation level

🫁 Monitoring oxygen saturation evaluates respiratory status and determines whether airway obstruction or infection is worsening.

🫁 A declining oxygen saturation may indicate increased mucus plugging or respiratory compromise.

Stools

💩 Monitoring stool characteristics helps evaluate pancreatic function and nutritional status.

💩 CF-related pancreatic insufficiency causes:

Fatty stools (steatorrhea)
Poor absorption of nutrients
Poor weight gain

💩 Changes in stool pattern can indicate whether nutritional interventions are effective.

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Answer 2

Correct Answers:

Epinephrine

Rationale :

🚨 The child is experiencing an acute allergic reaction (anaphylaxis) after receiving cefazolin, indicated by:

🌡️ Diffuse flushing
😮‍💨 Angioedema (swelling of the face, lips, tongue, or airway tissues)

🚨 After stopping the medication, the priority medication is epinephrine because it is the first-line treatment for anaphylaxis.

🚨 Epinephrine works by:

🫁 Causing bronchodilation to improve airway narrowing
❤️ Increasing blood pressure through vasoconstriction
🩸 Reducing swelling and edema of the airway
🛑 Preventing progression to respiratory failure and shock

🚨 The nurse should administer epinephrine immediately while continuing emergency interventions such as maintaining airway support and monitoring vital signs.

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Answer 3

Correct Answers:

"We should apply a skin emollient immediately after bathing our child."
"We should keep our child's fingernails trimmed short."
"We should use a mild detergent for our laundry."

Rationale :

"We should apply a skin emollient immediately after bathing our child."

🌿 This statement shows correct understanding because children with atopic dermatitis (eczema) have an impaired skin barrier that allows moisture loss and increases irritation.

🌿 Applying an emollient immediately after bathing (within a few minutes while the skin is still slightly damp) helps:

💧 Lock moisture into the skin
🛡️ Restore the protective skin barrier
🌿 Reduce dryness and itching
🩹 Prevent flare-ups

🌿 Regular moisturizing is one of the most important long-term treatments for atopic dermatitis.

"We should keep our child's fingernails trimmed short."

🌿 Children with atopic dermatitis often experience intense itching, which can lead to scratching.

🌿 Scratching can cause:

🩸 Skin breaks and bleeding
🦠 Secondary bacterial infections
Worsening of eczema lesions

🌿 Keeping fingernails short reduces skin damage when the child scratches.

"We should use a mild detergent for our laundry."

🌿 Harsh detergents, fragrances, and chemicals can irritate sensitive skin and trigger eczema flare-ups.

🌿 Families should use:

Mild, fragrance-free detergents
Avoid fabric softeners and scented products when possible

🌿 This helps reduce exposure to skin irritants.

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Answer 4

Correct Answers:

"Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy."

Rationale :

🌬️ Children with moderate persistent asthma require ongoing monitoring to evaluate how well their asthma is controlled and whether treatment needs adjustment.

🌬️ Pulmonary function tests (PFTs), such as spirometry, are used to measure:

🫁 Airflow limitation
🫁 Lung function
🫁 Response to asthma therapy

🌬️ For school-age children who can perform spirometry, these tests are typically repeated periodically (often every 1–2 years or more frequently if symptoms worsen).

🌬️ This statement indicates the parent understands that asthma management involves long-term monitoring, not only treating acute symptoms.

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Answer 5

Correct Answers:

Great toe

Rationale :

👶 In infants, a pulse oximeter sensor is commonly placed on a toe (especially the great toe) or another well-perfused peripheral site to accurately measure oxygen saturation.

👶 The great toe provides a reliable location because it has good blood flow and allows the sensor to detect changes in oxygen levels effectively.

👶 Proper placement is important to avoid inaccurate readings caused by movement, poor circulation, or improper positioning.

👶 The nurse should ensure the sensor is secure but not too tight, as excessive pressure can impair circulation.

👶 Therefore, the great toe is the appropriate site for pulse oximetry monitoring in an infant.

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Answer 6

Correct Answers:

Arterial blood gases
WBC count
Oxygen saturation level
Respiratory assessment

Rationale :

Arterial blood gases

🌬️ The ABG results should be reported because the child is showing signs of a worsening asthma exacerbation.

🌬️ The pH of 7.49 and PCO₂ of 32 mm Hg indicate respiratory alkalosis, which occurs when the child is hyperventilating due to airway obstruction.

🌬️ Early in an asthma attack, children compensate by breathing faster and blowing off carbon dioxide.

🌬️ A declining ability to maintain this pattern, especially a rising PCO₂, can indicate impending respiratory failure.

🌬️ Therefore, abnormal ABG findings require provider notification and continued respiratory monitoring.

WBC count

🌬️ The WBC count of 11,000/mm³ is elevated above the expected range and may indicate an infectious process contributing to the asthma exacerbation.

🌬️ Respiratory infections are common triggers for asthma flare-ups.

🌬️ Identifying a possible infection helps guide additional treatment decisions.

🌬️ Therefore, the elevated WBC count should be reported.

Oxygen saturation level

🌬️ The child’s oxygen saturation decreased from 97% to 94% despite receiving oxygen at 2 L/min via nasal cannula.

🌬️ A decreasing oxygen saturation indicates worsening airway obstruction and impaired gas exchange.

🌬️ In a child with asthma, declining oxygenation can signal progression of respiratory distress.

🌬️ The provider should be notified so treatment can be adjusted if needed.

Respiratory assessment

🌬️ The child’s respiratory status is worsening, shown by increased work of breathing, progression from mild to moderate intercostal retractions, and wheezing throughout inspiration and expiration.

🌬️ Increased respiratory rate from 22/min to 30/min and development of rhonchi indicate worsening airway inflammation and mucus production.

🌬️ These findings suggest the asthma exacerbation is not improving and requires further intervention.

🌬️ Therefore, the respiratory assessment findings should be reported immediately.

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Answer 7

Correct Answers:

1

Rationale :

Formula:

Dose (mg/day)=Weight (kg)×Ordered dose (mg/kg/day) Capsules/day=Available mg/capsuleRequired mg/day

Step 1: Convert weight

75 lb÷2.2=34.09 kg

Step 2: Calculate daily dose

Order: 1.2 mg/kg/day

34.09 kg×1.2 mg/kg/day=40.91 mg/day

Step 3: Calculate capsules

Available:

40 mg/capsule 40 mg/capsule40.91 mg=1.02 capsules

Step 4: Round to nearest whole number

1.02≈1

1 capsule

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Answer 8

Correct Answers:

Hgb

Rationale :

🩸 Hemoglobin (Hgb) is the laboratory value the nurse should review to evaluate for anemia because hemoglobin carries oxygen within red blood cells.

🩸 Chemotherapy can suppress bone marrow function, leading to decreased production of red blood cells and reduced hemoglobin levels.

🩸 A low hemoglobin level indicates reduced oxygen-carrying capacity and may cause symptoms such as fatigue, pallor, weakness, dizziness, and shortness of breath.

🩸 Monitoring hemoglobin helps determine the severity of anemia and whether interventions such as blood transfusion or medication adjustments are needed.

🩸 Therefore, the nurse should review the Hgb level when assessing for anemia.

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Answer 9

Correct Answers

Blank 1 Correct Option: splenomegaly
Blank 2 Correct Option: positive mononucleosis rapid test

Rationale :

🦠 The child is at risk for splenomegaly because the positive mononucleosis rapid test indicates infection with Epstein-Barr virus (EBV), which commonly causes infectious mononucleosis.

🦠 Infectious mononucleosis causes enlargement of lymphoid tissues, including the spleen, due to increased immune system activity.

🦠 Children with mononucleosis are at risk for an enlarged spleen, which increases the risk of splenic rupture, especially with contact activities or trauma.

🦠 The nurse should educate caregivers to avoid activities that could cause abdominal injury until the spleen returns to normal size.

🦠 The nurse should monitor for signs of splenic complications, including left upper quadrant abdominal pain, shoulder pain, dizziness, or sudden weakness.

🦠 Therefore, a positive mononucleosis test places the child at risk for splenomegaly.

❌ Acute poststreptococcal glomerulonephritis (APSGN)

🦠 APSGN occurs after a group A streptococcal infection, especially after untreated strep throat or skin infections.

🦠 It is associated with findings such as hematuria, proteinuria, edema, hypertension, and decreased urine output.

🦠 This child has a positive mononucleosis test, which points toward EBV infection rather than APSGN.

❌ Dysrhythmias

🦠 Dysrhythmias are not a typical complication of infectious mononucleosis.

🦠 The child’s cardiovascular assessment is normal, with a regular heart rate, normal PMI location, and no murmurs or abnormal heart sounds.

🦠 There is no evidence suggesting a cardiac complication.

❌ Urinary output as evidence

🦠 Dark yellow urine may indicate dehydration due to decreased intake from throat discomfort.

🦠 It does not indicate the risk of splenomegaly associated with infectious mononucleosis.

🦠 The key evidence for splenic enlargement is the positive mononucleosis rapid test.

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Answer 10

Correct Answers:

Increase fat content in the child's diet to 40% of total calories.

Rationale :

🫁 Children with cystic fibrosis (CF) commonly have pancreatic insufficiency, which reduces the ability to digest and absorb fats due to decreased pancreatic enzyme secretion.

🫁 Because of malabsorption, children with CF require a high-calorie, high-protein, high-fat diet to support growth and replace lost nutrients.

🫁 Increasing fat intake to about 35%–40% of total calories helps compensate for poor fat absorption and prevents malnutrition.

🫁 The nurse should encourage calorie-dense foods and monitor growth, weight gain, and nutritional status.

🫁 Pancreatic enzyme replacement therapy should be given with meals and snacks to improve absorption of nutrients.

🫁 Therefore, increasing dietary fat content is the appropriate intervention for meeting nutritional needs in a child with CF.

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RN Pediatric Nursing Online Practice 2023 B

No.

1 :
A nurse is caring for a toddler.

Correct Answers

2 :
A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should the nurse administer first?

3 :
A nurse in a provider's office is caring for a preschooler.

Answer Options

4 :
A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?

5 :
A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure the sensor to which of the following areas on the infant?

6 :
A nurse on a pediatric unit is caring for a school-age child.

Answer Options

8 :
A nurse is reviewing the laboratory report of a 7-year-old child who is receiving chemotherapy. Which of the following laboratory tests should the nurse review to evaluate for anemia?

9 :
A nurse on a pediatric unit is admitting a preschooler.

Correct Answers

10 :
A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan?

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RN Pediatric Nursing Online Practice 2023 B

No.

1 : A nurse is caring for a toddler.

Correct Answers

2 : A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should the nurse administer first?

3 : A nurse in a provider's office is caring for a preschooler.

Answer Options

4 : A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?

5 : A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure the sensor to which of the following areas on the infant?

6 : A nurse on a pediatric unit is caring for a school-age child.

Answer Options

8 : A nurse is reviewing the laboratory report of a 7-year-old child who is receiving chemotherapy. Which of the following laboratory tests should the nurse review to evaluate for anemia?

9 : A nurse on a pediatric unit is admitting a preschooler.

Correct Answers

10 : A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan?

1 :
A nurse is caring for a toddler.

2 :
A nurse is caring for a school-age child who is receiving cefazolin via intermittent IV bolus. The child suddenly develops diffuse flushing of the skin and angioedema. After discontinuing the medication infusion, which of the following medications should the nurse administer first?

3 :
A nurse in a provider's office is caring for a preschooler.

4 :
A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include?

5 :
A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure the sensor to which of the following areas on the infant?

6 :
A nurse on a pediatric unit is caring for a school-age child.

8 :
A nurse is reviewing the laboratory report of a 7-year-old child who is receiving chemotherapy. Which of the following laboratory tests should the nurse review to evaluate for anemia?

9 :
A nurse on a pediatric unit is admitting a preschooler.

10 :
A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan?