Pediatric Nursing Practice Test

Question 1
To manage the chorea in rheumatic fever which of the following is administered?

Ampicillin Erythromycin Diazepam Mannitol

Question 1 Explanation:Chorea is a jerky movement seen in rheumatic fever diazepam should be given.

Question 2
A child is diagnosed with Kawasaki Disease. Which of the following manifestations is seen during the subacute phase of the disease?

Fever Conjunctivitis Strawberry tongue Desquamation of palms and soles

Question 2 Explanation:Acute Phase: fever of 5 days or more, conjunctivitis, strawberry tongue, red cracked lips, enlarged cervical lymph nodes, abdominal pain, anorexia, joint swelling, diarrhea, polymorphous rash, increase WBC and ESR. Subacute Phase (after 10 days): desquamation of palms and soles, increase platelet, vascular aneurysm

Question 3
Understanding a clubfoot disorder means knowing the normal anatomy and physiology of a skeletal foot. The weight of the body is carried by the largest tarsal bones of the foot which are: A. Cuneiform B. Talus C. Navicular D. Calcaneus E. Cuboid

A and D B and D A and E C and E

Question 3 Explanation:The weight of the body is carried by the largest tarsal bones, calcaneus (heelbone) and talus (ankle bone). Tarsus, the posterior half of the foot composed of seven tarsal bones: Medial cuneiform, Intermediate cuneiform, Lateral cuneiform, Cuboid, Navicular, Talus and Calcaneus.

Question 4
The following observations are noted in a child under the acute phase of Kawasaki disease except:

Fever Increase platelet count Conjunctivitis Increase WBC count

Question 4 Explanation:Acute Phase: fever of 5 days or more, conjunctivitis, strawberry tongue, red cracked lips, enlarged cervical lymph nodes, abdominal pain, anorexia, joint swelling, diarrhea, polymorphous rash, increase WBC and ESR. Sub acute Phase (after 10 days): desquamation of palms and soles, increase platelet, vascular aneurysm.

Question 5
A 3 year old child is admitted in the hospital. The mother asks what developmental milestone is expected for this child to accomplish. The nurse correctly responds by pinpointing which of the following?

Bowel control achieved Riding a tricycle Sitting without support Tying shoelaces
Question 5 Explanation:At three years of age you expect the child to be able to ride a tricycle. Bowel control is achieved at about 18 months (bowel before bladder). Sitting unsupported is noted when the child is 8 months old. Tying shoelaces is possible at 4 years old.

Question 6
Clamping of the cord causes the closure of what fetal accessory structure?

Ductus arteriosus Foramen ovale

Pulmonary blood vessels Ductus Venosus

Question 6 Explanation:Clamping of the cord that causes decrease blood flow causes the closure of ductus venosus (shunts blood to the fetal liver).

Question 7
The platelet receptor inhibitor specific for Kawasaki Disease is prescribed by the physician. Which of the following drugs will you expect in the doctors order?

Ibuprofen Abciximab Succimer Dimercaprol

Question 7 Explanation:Abciximab is a platelet receptor inhibitor specific for Kawasaki Disease. Ibuprofen is used to decrease the inflammation in Kawasaki Disease. Succimer and Dimercaprol are chelating agents used for the management of lead poisoning.

Question 8
A 2 year old child is diagnosed with Plumbism. Edetate Calcium Disodium (EDTA) is ordered to be administered intramuscularly. In the preparation of the medication, what should the nurse do?

Hold the syringe by the plunger Prepare calcium to be administered after EDTA is given Add 0.5 ml of procaine in the medication Add 10 ml of procaine
Question 8 Explanation:Procaine (0.5 ml) is added in the solution before administering the IM injection to the client because EDTA is very painful. The syringe should be held by the barrel not the plunger to prevent the escape of prepared medication.

Question 9
The surgical management for atrial septal defect (ASD) and ventricular septal defect (VSD) is which of the following?

Dacron or Silastic patch placement

Ductal ligation Fontan procedure Brock Procedure

Question 9 Explanation:In ASD and VSD an opening or hole is present. To treat the disorder, a patch (Dacron or Silastic) is placed in between the atria (in ASD) and ventricles (in VSD). Ductal ligation is for PDA. Fontan procedure is for tricuspid atresia and Brock procedure is indicated for patients with Tetralogy of Fallot.

Question 10
The fetal accessory that is located in between the two atria is called:

Foramen ovale Ductus venosus Ductus arteriosus Pulmonary arteries

Question 10 Explanation:In the fetal structure, the opening between the two atria is called the foramen ovale.

Question 11
A mother comes in a clinic asking about the normal development of her child. The nurse, told her that DDST (Denver Developmental Screening Test) is done for children to assess their developmental processes. When is DDST first done?

3 months 10 months 3-4 years 5 years

Question 11 Explanation:DDST is first done at 3 months, repeated at 10 months and again repeated at 3-4 years.

Question 12
As the nurse is assessing a 3-year old child, the toddler appears good. However the childs mother told the nurse that her child usually appears ill at nighttime. The cough is barking and inspiratory stridor is noted. The nurse interprets this as:

Laryngotracheobronchitis

Epiglotitis Pneumonia Bronchitis

Question 12 Explanation:Croup or Laryngotracheobronchitis is characterized by the inflammation and infection due of the larynx, trachea and bronchi. The symptoms are marked retractions, inspiratory stridor, and a barking cough.

Question 13
The child was admitted in the ER with the presenting symptoms of sitting in a leaning position, with the tongue protruding, drooling and muffled cough. The nurse should prepare what equipment at the bedside?

Tongue depressor Intubation set Sterile gauze Clamp

Question 13 Explanation:Intubation set is used prepared at the bedside for children presenting the signs and symptoms of Epiglotitis. Never used a tongue depressor, manipulation of the throat can cause pulmonary arrest in a child with epiglotitis.

Question 14
Inborn errors of metabolism are discussed in a nursing lecture. Absence of liver enzyme phenylalanine hydroxylase directly causes the absence of which of the following?

Thyroxine Melanin Epinephrine Tyrosine

Question 14 Explanation:P. Hydroxylase converts phenylalanine (an amino acid) to tyrosine. Thus, the direct effect of its absence is the lack of tyrosine. Tyrosine is the precursor of thyroxine, epinephrine and melanin.

Question 15

A preschool child has been admitted for rheumatic fever. In the diagnosis of the disease which of the following meets the Jones criteria?

Increase ESR, arthralgia, fever Leukocytosis, carditis, fever Arthralgia, fever, leukocytosis Leukocytosis, increase ESR, history of Rheumatic fever
Question 15 Explanation:Jones criteria are used in the diagnosis is rheumatic fever. There should be 1 major or 2 major symptom plus 2 minor manifestations. Major S/S: carditis, erythema marginatum, polyarthritis, subcutaneous nodules, chorea Minor S/S: fever, history of RF, prolonged PR interval, arthralgia, Increase ESR, leukocytosis

Question 16
The statements are true about communicating hydrocephalus apart from:

It is also known as non-obstructive hydrocephalus. It is due to the functional impairment of arachnoid granulations. It is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces. It can be caused by diffuse ventricular dilatation from scarring and fibrosis of subarachnoid space following infectious, inflammatory and hemorrhagic events preventing the flow of CSF.
Question 16 Explanation:Communicating hydrocephalus, also called non-obstructive hydrocephalus, is the functional impairment of arachnoid granulations. It can be caused by diffuse ventricular dilatation from scarring and fibrosis of subarachnoid space following infectious, inflammatory and hemorrhagic events preventing the flow of CSF. Noncommunicating hydrocephalus, also called obstructive hydrocephalus, is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces (e.g. atresia, tumor).

Question 17
Angelo, 1 year old has been tested for lead levels in the blood. Result shows that his blood lead level is 28 microgram pre deciliter. Which of the following management would be appropriate for Angelo?

Rescreen the child to confirm level every year for 6 years

Administer oral Succimer Hospitalization and administer Edetate Calcium Disodium (EDTA) intramuscularly Assess kidney function
Question 17 Explanation:Blood lead level: 10-14 microgram/dl rescreen to confirm level every year for 6 years 15-19 microgram/dl retest every 3-4 months for children age 6-35 years old. Remove the child from the environment with lead; cover walls with paneling or MASONITE. 20-44 microgram/dl retest every 3-4 months; chelating agent SUCCIMER (Chemet) orally for 19 days 45-69 microgram/dl admit the child; chelation therapy with Dimercaprol (BAL) or Edetate Calcium Disodium (EDTA); EDTA is administered intramuscularly and add 0.5 ml procaine because administration of this drug is painful. >70 microgram/dl immediate treatment with chelating agent, Dimercaprol (BAL); after BAL, oral Penicillamine (Cuprimine) is given for 3-6 months

Question 18
An infant with phenylketonuria (PKU) has a mousy odor of urine. Which of the following causes this indifferent odor?

Phenylpyruvic acid Lactic Acid Galactic acid Insulin

Question 18 Explanation:Phenylpyruvic acid is the breakdown product when phenylalanine is metabolized. This ketoacid goes to the urine giving its musty/mousy odor.

Question 19
Presence of what hormone causes the ductus arteriosus to open?

Estrogen Progesterone Human Chorionic Gonadrotopin Prostaglandin

Question 19 Explanation:High levels of prostaglandin in the uterus cause the opening in the pulmonary artery and aorta which is the

ductus arteriosus.

Question 20
Phalanges form the toes and are composed of 14 bones. The big toe is made up of how many phalanges?

2 3 1 5
Question 20 Explanation:Each toe has 3 phalanges with the exception of the great toe having only 2. Therefore, B,C and D are incorrect.

Question 21
Health teaching is important in successful management of a certain disease. In Kawasaki disease, what is the main reason why steroids are not administered to clients with Kawasaki disease?

It can cause aneurysms. It can cause increase body temperature. It decreases WBC count and increases ESR. It causes more rashes in children.
Question 21 Explanation:Steroids are not given to children with K.Disease as this causes aneurysm that poses danger to the child.

Question 22
The fetal accessory ductus venosus closes due to which of the following?

Increase pressure of the right side of the heart Clamping of the cord Increase pressure of left side of the heart Increase prostaglandin levels
Question 22 Explanation:Clamping of the cord causes the closure of the ductus venosus of a newborn. Increase pressure of the left side of a neonates heart as well as increase PO2 level help the foramen ovale to close. Decrease prostaglandin level and increase PO2 contribute to the closure of the ductus arteriosus.

Question 23
A diagnosis of hydrocephalus is confirmed. The mother of a 2 year old patient is asking about the types of hydrocephalus. Which of the following correctly defines non-communicating hydrocephalus?

It is also known as non-obstructive hydrocephalus. It is characterized by enlarged cerebral ventricles, with only intermittently elevated cerebrospinal fluid pressure. It is due to the functional impairment of arachnoid granulations. It is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces.
Question 23 Explanation:Non-communicating hydrocephalus, also called obstructive hydrocephalus, is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces (e.g. atresia, tumor). Communicating hydrocephalus, also called non-obstructive hydrocephalus, is the functional impairment of arachnoid granulations. Normal Pressure Hydrocephalus (a form of communicating hydrocephalus) is caused by enlarged cerebral ventricles, with only intermittently elevated cerebrospinal fluid pressure.

Question 24
A child diagnosed with PKU should be managed by giving which soy-based milk formula?

Nutraminogen Similac Lofenalac Sustagen

Question 24 Explanation:Lofenalac is the soy-based formula given to children with PKU. Nutraminogen is given for infants with galactosemia. Similac is given for those who have failure to thrive.

Question 25
Which of the following accurately describes the treatment of a Pseudo talipes?

Pseudo-talipes does not need a surgical procedure, however ilizarov frames can be used at nighttime Pseudo-talipes only requires tendon replacement No procedures are done with pseudo-talipes, however passive foot

exercises would be fine A cast above the knee is required for alignment; if the procedure poses no effect surgical procedures can be done
uestion 25 Explanation:Some newborns have developed a twisted foot appearance due to intrauterine position. However, with manipulation the foot can be brought into a straight position. This temporary abnormality is called a pseudo-talipes disorder. A true clubfoot cannot be aligned properly without further intervention. (Letter a) P.Talipes does not need a surgery and traction with ilizarov frame. (Letter b) Tendon replacement is the last corrective treatment for a true talipes. (Letter d) the management is for T.Talipes.