NCLEX questions from

Sophie Asifiwe

7/8/2022

NCLEX questions from Saunders Comprehensive Review for the NCLEX-RN Examination Pediatric #50

Chapter 29 : Integumentary Problems

Practice Questions

• The nurse is monitoring a child with burns during treatment. Which assessment provides the

most accurate guide to determine the adequacy of fluid resuscitation?A.Skin turgor B.Level of edema at burn site C.Adequacy of capillary filling D.Amount of fluid tolerated in 24 hours

• The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been

scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child’s skin?A.Fine grayish red lines B.Purple-colored lesions C.Thick, honey-colored crusts D.Clusters of fluid-filled vesicles

• Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which

instruction to the parents regarding the use of this treatment?A.Apply the lotion to areas of the rash only.B.Apply the lotion and leave it on for 6 hours.C.Avoid putting clothes on the child over the lotion.D.Apply the lotion to cool, dry skin at least 30 minutes after bathing.

• The school nurse has provided an instructional session about impetigo to parents of the

children attending the school. Which statement, if made by a parent, indicates a need for further instruction?A.“It is extremely contagious.” B.“It is most common in humid weather.” C.“Lesions most often are located on the arms and chest.” D.“It might show up in an area of broken skin, such as an insect bite.”

• The clinic nurse is reviewing the health care provider’s prescription for a child who has been

diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child’s record?A.The child is 18 months old.B.The child is being bottle-fed.C.A sibling is using lindane for the treatment of scabies.D.The child has a history of frequent respiratory infections.

Sophie Asifiwe

7/8/2022

• A topical corticosteroid is prescribed by the health care provider for a child with contact

dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream?A.Apply the cream over the entire body.B.Apply a thick layer of cream to affected areas only.C.Avoid cleansing the area before application of the cream.D.Apply a thin layer of cream and rub it into the area thoroughly.

• The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment

finding indicates that a child has a “positive” head check for lice?A.Maculopapular lesions behind the ears B.Lesions in the scalp that extend to the hairline or neck C.White flaky particles throughout the entire scalp region D.White sacs attached to the hair shafts in the occipital area

• The nurse caring for a child who sustained a burn injury plans care based on which pediatric

considerations associated with this injury? Select all that apply.A.Scarring is less severe in a child than in an adult.B.A delay in growth may occur after a burn injury.C.An immature immune system presents an increased risk of infection for infants and young children.D.Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area.E.The lower proportion of body fluid to body mass in a child increases the risk of cardiovascular problems.F.Infants and young children are at increased risk for protein and calorie deficiency, because they have smaller muscle mass and less body fat than adults.

Chapter 30: Hematological Problems

Practice Questions 9.The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child?a.Platelet count b.Hematocrit level c.Hemoglobin level d.Partial thromboplastin time

• The nurse is providing home care instructions to the parents of a 10-year-old child with

hemophilia. Which sport activity should the nurse suggest for this child?a.Soccer b.Basketball c.Swimming d.Field hockey

Sophie Asifiwe

7/8/2022

• The nursing student is presenting a clinical conference and discusses the cause of β-

thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these?a.A child of Mexican descent b.A child of Mediterranean descent c.A child whose intake of iron is extremely poor d.A breast-fed child of a mother with chronic anemia 12.A child with β-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate being prescribed?a.Fragmin b.Meropenem c.Metoprolol d.Deferoxamine 13.The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction?a.Stress b.Trauma c.Infection d.Fluid overload 14.A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription?a.Injection of factor X b.Intravenous infusion of iron c.Intravenous infusion of factor VIII d.Intramuscular injection of iron using the Z-track method

• The nurse is instructing the parents of a child with iron deficiency anemia regarding the

administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents?a.Administer the iron at mealtimes.b.Administer the iron through a straw.c.Mix the iron with cereal to administer.d.Add the iron to formula for easy administration.

16.Laboratory studies are performed for a child suspected to have iron deficiency anemia.The nurse reviews the laboratory results, knowing that which result indicates this type of anemia?a.Elevated hemoglobin level b.Decreased reticulocyte count c.Elevated red blood cell count d.Red blood cells that are microcytic and hypochromic 17.The nurse is reviewing a health care provider’s prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis.

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7/8/2022

Which prescriptions documented in the child’s record should the nurse question? Select all that apply.a.Restrict fluid intake.b.Position for comfort.c.Avoid strain on painful joints.d.Apply nasal oxygen at 2 L/minute.e.Provide a high-calorie, high-protein diet.f.Give meperidine, 25 mg intravenously, every 4 hours for pain.

18.The nurse is conducting staff in-service training on von Willebrand’s disease. Which should the nurse include as characteristics of von Willebrand’s disease? Select all that apply.a.Easy bruising occurs.b.Gum bleeding occurs.c.It is a hereditary bleeding disorder.d.Treatment and care are similar to that for hemophilia.e.It is characterized by extremely high creatinine levels.f.The disorder causes platelets to adhere to damaged endothelium.

Chapter 31: Oncological Problems

Practice Questions

• The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor.

The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which action should the nurse perform immediately?a.Notify the surgeon.b.Reinforce the dressing.c.Document the findings and continue to monitor.d.Circle the area of drainage and continue to monitor.

20.A child undergoes surgical removal of a brain tumor. During the postoperative period, the nurse notes that the child is restless, the pulse rate is elevated, and the blood pressure has decreased significantly from the baseline value. The nurse suspects that the child is in shock. Which is the most appropriate nursing action?a.Place the child in a supine position.b.Place the child in Trendelenburg’s position.c.Increase the flow rate of the intravenous fluids.d.Notify the primary health care provider (PHCP).

21.The mother of a 4-year-old child tells the pediatric nurse that the child’s abdomen seems to be swollen. During further assessment, the mother tells the nurse that the child is eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilms’ tumor, should avoid which during the physical assessment?a.Palpating the abdomen for a mass b.Assessing the urine for the presence of hematuria c.Monitoring the temperature for the presence of fever