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Peds Exam 1 NCLEX style questions with complete solution 2025, Exams of Pediatrics

Newcastle UniversityPediatrics

Peds Exam 1 NCLEX style questions with complete solution 2025

Typology: Exams

2024/2025

Available from 07/15/2025

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Peds Exam 1 NCLEX style questions
with complete solution 2025
To establish a good interview relationship with an adolescent, which strategy
is most appropriate?
1. Asking personal questions unrelated to the situation
2. Writing down everything the teen says
3. Asking open-ended questions
4. Discussing the nurse's own thoughts and feelings about the situation -
correct answers 3. Asking open-ended questions
RATIONALE: Open-ended questions allow the adolescent to share
information and feelings. Asking personal questions not related to the situation
jeopardizes the trust that must be established because the adolescent may
feel as though he's being interrogated with unnecessary questions. Writing
everything down during the interview can be a distraction and doesn't allow
the nurse to observe how the adolescent behaves. Discussing the nurse's
thoughts and feelings may bias the assessment and is inappropriate when
interviewing any client
A chronically ill school-age child is most vulnerable to which stressor?
1. Mutilation anxiety
2. Anticipatory grief
3. Anxiety over school absences
4. Fear of hospital procedures - correct answers 3. Anxiety over school
absences
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Download Peds Exam 1 NCLEX style questions with complete solution 2025 and more Exams Pediatrics in PDF only on Docsity!

Peds Exam 1 NCLEX style questions

with complete solution 2025

To establish a good interview relationship with an adolescent, which strategy is most appropriate?

  1. Asking personal questions unrelated to the situation
  2. Writing down everything the teen says
  3. Asking open-ended questions
  4. Discussing the nurse's own thoughts and feelings about the situation - correct answers 3. Asking open-ended questions RATIONALE: Open-ended questions allow the adolescent to share information and feelings. Asking personal questions not related to the situation jeopardizes the trust that must be established because the adolescent may feel as though he's being interrogated with unnecessary questions. Writing everything down during the interview can be a distraction and doesn't allow the nurse to observe how the adolescent behaves. Discussing the nurse's thoughts and feelings may bias the assessment and is inappropriate when interviewing any client A chronically ill school-age child is most vulnerable to which stressor?
  5. Mutilation anxiety
  6. Anticipatory grief
  7. Anxiety over school absences
  8. Fear of hospital procedures - correct answers 3. Anxiety over school absences

RATIONALE: The school-age child is becoming industrious and attempts to master school-related activities. Therefore, school absences are likely to cause extreme anxiety for a school-age child who's chronically ill. Mutilation anxiety is more common in adolescents. Anticipatory grief is rare in a school- age child. Fear of hospital procedures is most pronounced in preschool-age children. When developing a care plan for an adolescent, the nurse considers the child's psychosocial needs. During adolescence, psychosocial development focuses on:

  1. becoming industrious.
  2. establishing an identity.
  3. achieving intimacy.
  4. developing initiative. - correct answers 2. establishing an identity. RATIONALE: According to Erikson, the primary psychosocial task during adolescence is to establish a personal identity while overcoming role or identity confusion. The adolescent attempts to establish a group identity by seeking acceptance and approval from peers, and strives to attain a personal identity by becoming more independent from his family. Becoming industrious is the developmental task of the school-age child; achieving intimacy is the task of the young adult; and developing initiative is the task of the preschooler. A nurse notes that an infant develops arm movement before fine-motor finger skills and interprets this as an example of which pattern of development?
  5. Cephalocaudal
  6. Proximodistal
  7. Differentiation
  8. Mass-to-specific - correct answers 2. Proximodistal
  1. Reassure the mother that each infant's sleep needs are individual.
  2. Ask the mother for more information about the infant's sleep patterns.
  3. Instruct the mother to decrease the infant's daytime sleep to increase his nighttime sleep.
  4. Inform the mother that her infant's growth and development are appropriate for his age, so sleep isn't a concern. - correct answers 2. Ask the mother for more information about the infant's sleep patterns. RATIONALE: The nurse needs more information about the infant's sleep patterns to rule out potential problems before determining whether the infant is getting enough sleep. The nurse shouldn't offer advice or reassurance without knowing more about the infant's specific sleep habits. A nurse observes a 2½-year-old child playing with another child of the same age in the playroom on the pediatric unit. What type of play should the nurse expect the children to engage in?
  5. Associative play
  6. Parallel play
  7. Cooperative play
  8. Therapeutic play - correct answers 2. Parallel play RATIONALE: Two-year-olds engage in parallel play, in which they play side by side but rarely interact. Associative play is characteristic of preschoolers, in which they are all engaged in a similar activity but there is little organization. School-age children engage in cooperative play, which is organized and goal- directed. Therapeutic play is a technique that can be used to help understand a child's feelings; it consists of energy release, dramatic play, and creative play.

An infant who weighs 7.5 kg is to receive ampicillin (Omnipen) 25 mg/kg I.V. every 6 hours. How many milligrams should the nurse administer per dose? Record your answer using one decimal place. Answer: milligrams - correct answers 187.5 milligrams RATIONALE: The nurse should calculate the correct dose using the following equation: 25 mg/kg × 7.5 kg = 187.5 mg When making ethical decisions about caring for preschoolers, a nurse should remember to:

  1. provide beneficial care and avoid harming the child.
  2. make decisions that will prevent legal trouble.
  3. do what she would do for her own child or loved ones.
  4. be sure to do what the physician says. - correct answers 1. provide beneficial care and avoid harming the child. RATIONALE: Nurses must provide beneficial care and avoid harming all clients. A nurse shouldn't base any decision solely on the desire to prevent legal trouble, on her own feelings for her loved ones, or what the physician says. An emergency department nurse suspects neglect in a 3-year-old boy admitted for failure to thrive. Signs of neglect in the child would include:
  1. point out that tongue thrusting is the infant's way of rejecting food.
  2. instruct the mother to place the food at the back and toward the side of the infant's mouth.
  3. advise the mother to puree foods if the child resists them in solid form.
  4. suggest that the mother force-feed the child if necessary. - correct answers
  5. instruct the mother to place the food at the back and toward the side of the infant's mouth. RATIONALE: The nurse should instruct the mother to place the food at the back and toward the side of the infant's mouth because it encourages swallowing. Tongue thrusting is a physiologic response to food placed incorrectly in the mouth. Offering pureed foods wouldn't encourage swallowing, which is a learned behavior. Force-feeding is inappropriate because it may be frustrating for both the mother and child and may cause the child to gag and choke when attempting to reject the undesired food; also, it may lead to a higher-than-normal caloric intake, resulting in obesity. A nurse is caring for an adolescent who underwent surgery for a perforated appendix. When caring for this adolescent, the nurse should keep in mind that the main life-stage task for an adolescent is to:
  6. resolve conflict with parents.
  7. develop an identity and independence.
  8. develop trust.
  9. plan for the future - correct answers 2. develop an identity and independence. RATIONALE: An adolescent strives for a sense of independence and identity. During this time, conflicts are heightened, not resolved. Trust begins to develop during infancy and matures during the course of development.

Adolescents rarely finalize plans for the future; this normally happens later in adulthood What is a normal systolic blood pressure for a 3-year-old child?

  1. 60 mm Hg
  2. 93 mm Hg
  3. 120 mm Hg
  4. 150 mm Hg - correct answers 2. 93 mm Hg RATIONALE: The normal range for systolic blood pressure in preschoolers is 82 to 110 mm Hg. The normal range for diastolic blood pressure is 50 to 78 mm Hg. A child, age 3, is admitted to the pediatric unit with dehydration after 2 days of nausea and vomiting. The mother tells the nurse that her child's illness "is all my fault." How should the nurse respond?
  5. "Maybe next time you'll bring the child in sooner."
  6. "Tell me why you think this is your fault."
  7. "Try not to cry in front of the child. It'll only upset her."
  8. "Don't be so upset. Your child will be fine." - correct answers 2. "Tell me why you think this is your fault." RATIONALE: Having the mother explain why she feels the illness is her fault is appropriate because many parents feel responsible for their child's illness and may need instruction about the actual cause of the illness. Pointing out that the mother could have brought the child in sooner could increase the mother's feelings of guilt. Telling the mother not to cry or be upset ignores her feelings

A toddler develops acute otitis media and is ordered cefpodoxime proxetil (Vantin) 5 mg/kg P.O. every 12 hours. If the child weighs 22 lb (10 kg), how many milligrams will the nurse administer with each dose?

  1. 50 mg
  2. 100 mg
  3. 110 mg
  4. 220 mg - correct answers 1. 50 mg RATIONALE: The dose is 5 mg/kg and the child weighs 10 kg. To determine the dose, the nurse would calculate: 5 mg/1 kg × 10 kg = 50 mg per dose. According to Erikson's psychosocial theory of development, an 8-year-old child would be in which stage?
  5. Trust versus mistrust
  6. Initiative versus guilt
  7. Industry versus inferiority
  8. Identity versus role confusion - correct answers 3. Industry versus inferiority RATIONALE: In middle childhood, the 6- to 12-year-old child is mastering the task of industry versus inferiority. The trust versus mistrust task is in infancy (birth to 1 year). In early childhood, the 1- to 3-year-old child is in the stage of initiative versus guilt. Identity versus role confusion occurs during adolescence. A nurse is preparing a child, age 4, for cardiac catheterization. Which explanation of the procedure is appropriate?
  1. "Don't worry. It won't hurt."
  2. "The test usually takes an hour."
  3. "You must sleep the whole time that the test is being done."
  4. "The special medicine will feel warm when it's put in the tubing." - correct answers 4. "The special medicine will feel warm when it's put in the tubing." RATIONALE: To prepare a 4-year-old child without increasing anxiety, the nurse should provide concrete information in small amounts about nonthreatening aspects of the procedure. Therefore, saying the special medicine will feel warm is most appropriate. Saying that it won't hurt may prevent the child from trusting the nurse in the future. Explaining the time needed for the procedure wouldn't provide sufficient information. Stating that the child will need to sleep isn't true and could provoke anxiety. A child has just been admitted to the facility and is displaying fear related to separation from his parents, the room being too dark, being hurt while in the hospital, and having many different staff members come into the room. Based on the nurse's knowledge of growth and development, the child is likely:
  5. 7 to 12 months old (an infant).
  6. 1 to 3 years old (a toddler).
  7. 6 to 12 years old (a school-age child).
  8. 12 to 18 years old (an adolescent - correct answers 2. 1 to 3 years old (a toddler). RATIONALE: Toddlers show fear of separation from their parents, the dark, loud or sudden noises, injury, strangers, certain persons, certain situations, animals, large objects or machines, and change in environment. Infants show fear of strangers, the sudden appearance of unexpected and looming objects (including people), animals, and heights. School-age children show fear of
  1. to talk with her daughter about bad people and remind her to tell Mommy if someone she doesn't know talks to her.
  2. contact social services, which is better equipped to respond to her questions - correct answers 1. to talk with her daughter about what she should do if a stranger talks to her. RATIONALE: Preschoolers can begin to take a role in their own safety. They must be taught what a stranger is and what to do if a stranger approaches them. Living in a safe town doesn't eliminate the need to warn a child about talking to strangers. Although it's appropriate for the mother to talk with her daughter about strangers and have the daughter tell her if a stranger approaches her, the child needs to be aware of what to do at the time that the situation occurs, not only afterward. Contacting social services isn't appropriate because the nurse is capable of answering the mother's questions. An 8-month-old infant is admitted with a febrile seizure. The infant weighs 17 lb (7.7 kg). The physician orders ceftriaxone (Rocephin), 270 mg I.M. every 12 hours. (The safe dosage range is 50 to 75 mg/kg daily.) The pharmacy sends a vial containing 500 mg, to which the nurse adds 2 ml of preservative-free normal saline solution. The nurse should administer how many milliliters?
  3. None because this isn't a safe dosage
  4. 0.08 ml
  5. 1.08 ml
  6. 1.8 ml - correct answers 3. 1.08 ml RATIONALE: Because the infant weighs 17 lb (7.7 kg), the safe dosage range is 385 to 578 mg daily. The ordered dosage, 540 mg daily, is safe. To calculate the amount to administer, the nurse may use the following fraction method: 500 mg/2 ml = 270 mg/X ml

500X = 270 × 2

500X = 540

X = 540/

X = 1.08 ml A nurse is teaching the parents of a 6-month-old infant about usual growth and development. Which statements about infant development are true? Select all that apply.

  1. A 6-month-old infant has difficulty holding objects.
  2. A 6-month-old infant can usually roll from prone to supine and supine to prone positions.
  3. A teething ring is appropriate for a 6-month-old infant.
  4. Stranger anxiety usually peaks at 12 to 18 months.
  5. Head lag is commonly noted in infants at age 6 months.
  6. Lack of visual coordination usually resolves by age 6 months - correct answers 2. A 6-month-old infant can usually roll from prone to supine and supine to prone positions.
  7. A teething ring is appropriate for a 6-month-old infant.
  8. Lack of visual coordination usually resolves by age 6 months. RATIONALE: Gross motor skills of the 6-month-old infant include rolling from front to back and back to front. Teething usually begins around age 6 months; therefore, a teething ring is appropriate. Visual coordination is usually resolved by age 6 months. At age 6 months, fine motor skills include purposeful grasps. Stranger anxiety normally peaks at 8 months of age. The 6-month-old infant also should have good head control and no longer display head lag when pulled up to a sitting position.

during a procedure is a form of helpful distraction. In addition, holding the breath isn't beneficial and could have adverse effects (such as feeling dizzy or faint). The nurse should prepare a child for a procedure by using nonpain descriptors and not suggesting pain. For example, the nurse might say, "Sometimes this feels like pushing or sticking, and sometimes it doesn't bother children at all." A school-age child presents to the office for a routine examination. Given the child's developmental level, a nurse should give highest priority to:

  1. allowing the child to change into a gown while she isn't in the room.
  2. allowing the child to play with medical equipment before the examination begins.
  3. asking the parents to leave the room during the child's examination.
  4. encouraging the child to hold a stuffed animal during the examination. - correct answers 1. allowing the child to change into a gown while she isn't in the room. RATIONALE: School-age children tend to be very modest. The nurse should allow them to change into gowns while she isn't in the examination room. Children shouldn't have to take off their underwear for routine medical examinations. Playing with medical equipment is characteristic of younger children. The nurse shouldn't ask parents to leave the room unless the child requests that they not be present. A school-age child may feel too old to hold a stuffed animal during the examination. Ten days after cardiac surgery, an 18-month-old child is recovering well. The child is alert and fairly active and is playing well with the parents. Discharge is planned soon. The nurse notes that the parents are still very reluctant to allow the child to do anything without help. What is the best initial action for the nurse to take?
  5. Reemphasize the need for autonomy in toddlers
  1. Provide opportunities for autonomy when the parents are not present
  2. Reassess the parent's needs and concerns
  3. Discuss the success of the surgery and how well the child is doing - correct answers 3. Before the nurse can teach the parents, it will be necessary to reassess their needs and concerns. The question asks for the best initial action. Initially, the nurse should assess. Later, the nurse may emphasize the toddler's need for autonomy. The nurse may provide the child with opportunities to develop autonomy, although it would be better to teach the parents. The nurse may also discuss the success of the surgery and how well the child is doing, but this is not the initial action. A 3-year-old child has all of the following abilities. Which did he acquire most recently?
  4. Walking
  5. Throwing a large ball
  6. Riding a tricycle
  7. Stating his name - correct answers 3. Riding a tricycle is 3-year-old behavior. Remember, "three years, three wheels." Children start to walk at about 1 year of age. Throwing a large ball and stating his name are 2-year-old behaviors. Remember to use developmental trends when determining the most recently acquired behavior—head to tail and simple to complex. Look for a complex lower body behavior. The parents of a 3-year-old child are leaving for the evening. Which behavior would the nurse expect the child to exhibit?
  8. Wave goodbye to the parents
  9. Cry when the parents leave
  10. Hide his/her head under the covers

Which activity would best occupy a 12-month- old child while the nurse is interviewing the parents?

  1. String of large snap beads and a large plastic bowl
  2. Riding toy
  3. Several small puzzles
  4. Paste, paper, and scissors - correct answers 1. Stringing large beads is appropriate for 12 months. Note that the beads are large and therefore not subject to being swallowed. A riding toy and small puzzles would be more appropriate for a toddler. Paste, paper, and scissors are appropriate for a preschooler when used with supervision. A 10-year-old girl is being treated for rheumatic fever. Which would be an appropriate activity while she is on bed rest?
  5. Stringing large wooden beads
  6. Engaging in a pillow fight
  7. Making craft items from felt
  8. Watching television - correct answers 3. Craft work allows her to accomplish something while meeting her needs for rest. Industry is the developmental task for school-age children. The joint pains with rheumatic fever tend to be in the large joints, not the small ones, so craft work using finger activity would probably not be painful. Stringing large wooden beads is appropriate for younger children. Pillow fighting requires too much energy for a child on bed rest and is not appropriate for a hospital environment. Watching television is a solitary activity with no sense of accomplishment A hospitalized 2.5-year-old child has a temper tantrum while her mother is bathing her. Her mother asks the nurse how she should handle this behavior. Which information should be included in the nurse's reply?
  9. Temper tantrums in a hospitalized child indicate regression.
  10. Tantrums suggest a poorly developed sense of trust.
  11. Discipline is necessary when a child has a temper tantrum.
  1. This behavior is a normal response to limit setting in a child of this age. - correct answers 4. Temper tantrums are a normal response to limit setting in a 2-year-old child. Answer 1 might be correct if the child were older. However, temper tantrums in a 2-year-old child do not indicate regression; rather, they are normal for this age. Tantrums are not suggestive of a poorly developed sense of trust; they are normal. Ignoring the tantrum is preferable to discipline when a 2-year- old has a tantrum. A 2-year-old child is hospitalized for a fractured femur. During his first two days in the hospital, he lies quietly, sucks his thumb, and does not cry. Which is the best interpretation of his behavior?
  2. He has made a good adjustment to being in the hospital.
  3. He is comfortable with the nurses caring for him.
  4. He is experiencing anxiety.
  5. He does not have a good relationship with his parents. - correct answers 3. The child's behavior is typical of the despair phase of toddler responses to anxiety. The child should cry. Lying quietly, sucking his thumb, and saying nothing are suggestive of severe anxiety, a bad adjustment to the hospital, and no comfort with the nurses. This anxiety response does not suggest a poor relationship with his parents. In fact, his severe separation anxiety may be because he is so close to his parents.