RN Pediatric NCLEX Questions
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Question 1 of 5.
A 12-year-old child has had a traumatic head injury from playing in a football game. He is admitted to the emergency department and transferred to the pediatric intensive care unit. He has an I.V. of dextrose 5% in water at a 'keep-open' rate and nasal oxygen at 2 L/minute. The nurse is assessing the child at the beginning of the shift (11:00 p.m.) and reviews the Glasgow Coma Scale flow sheet. The nurse notes that the child responds to pain, is making incomprehensible sounds, and has abnormal flexion of the limbs. What should the nurse do first?
A. Notify the physician.
B. Administer pain medication.
C. Increase oxygen flow.
D. Document the findings.
Explanation: A Glasgow Coma Scale score indicating pain response, incomprehensible sounds, and abnormal flexion (approximately 6-8) suggests severe neurological impairment, warranting immediate physician notification.
Question 2 of 5.
The nurse is teaching the parents of an 8-month-old about what the child should be eating. The nurse should include which of the following points in the teaching plan?
A. Items from all four food groups should be introduced to the infant by the time the child is 10 months old.
B. Solid foods should not be introduced until the infant is 10 months old.
C. Iron deficiency rarely develops before 12 months of age, so iron-fortified cereals should not be introduced until the infant is 12 months old.
D. The infant's diet can be changed from formula to whole milk when the infant is 12 months old.
Explanation: Whole milk can be introduced at 12 months, as infants need the fat content for brain development.
Question 3 of 5.
To assess the development of a 1-month-old, the nurse asks the parent if the infant is able to:
A. Smile and laugh out loud.
B. Roll from back to side.
C. Hold a rattle briefly.
D. Turn the head from side to side.
Explanation: A 1-month-old can turn their head side to side, a basic motor milestone.
Question 4 of 5.
A 2-year-old always puts his teddy bear at the head of his bed before he goes to sleep. The parents ask if this behavior is normal. The nurse should explain to the parents that toddlers use ritualistic patterns to:
A. Establish a sense of identity.
B. Establish control over adults in their environment.
C. Establish sequenced patterns of learning behavior.
D. Establish a sense of security.
Explanation: Ritualistic behaviors in toddlers provide comfort and security.
Question 5 of 5.
When observing the parent instilling prescribed ear drops ordered twice a day for a toddler, the nurse decides that the teaching about positioning of the pinna for instillation of the drops is effective when the parent pulls the toddler's pinna in which of the following directions?
A. Up and forward.
B. Up and backward.
C. Down and forward.
D. Down and backward.
Explanation: In children under 3, the pinna is pulled down and back to straighten the ear canal.
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