Pediatric NCLEX Questions
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Question 1 of 5.
A primigravida is in second stage of labour for the past two hours. Fetal head is at +1 station. Inspite of effective uterine contractions,mother is unable to push as she is exhausted. What will be the next step in her management:
A. Wait for another one hour.
B. Give sedation to the mother.
C. Shift her for emergency section.
D. Instrumental delivery.
E. Call the anaesthetist for regional anaesthesia.
Explanation: Instrumental delivery (e.g. forceps or vacuum) is indicated for prolonged second stage due to maternal exhaustion provided the fetal head is engaged (+1 station). Cesarean section is considered if instrumental delivery is not feasible.
Question 2 of 5.
If the parents report all the following history findings to the nurse, which one is most closely correlated with an increased risk of rheumatic fever?
A. The child was exposed to measles within the past 4 weeks.
B. The child had a severe sore throat within the past 2 weeks.
C. The child is lethargic and no longer interested in schoolwork.
D. The child received a bump on the head while playing.
Explanation: Rheumatic fever is strongly associated with a recent streptococcal infection, such as a sore throat caused by group A Streptococcus. A severe sore throat within the past 2 weeks is a key risk factor, as it may indicate an untreated or inadequately treated streptococcal infection.
Question 3 of 5.
Which response by the nurse best explains why aspirin is preferred to acetaminophen (Tylenol) in the treatment of rheumatic fever?
A. Aspirin controls fever better.
B. Aspirin prevents infections.
C. Aspirin relieves joint inflammation.
D. Aspirin prevents cardiac enlargement.
Explanation: Aspirin is preferred in rheumatic fever due to its anti-inflammatory properties, which relieve joint inflammation and pain associated with polyarthritis. Acetaminophen lacks significant anti-inflammatory effects, making aspirin more effective.
Question 4 of 5.
Which of the following is a priority for the nurse to assess when testing the child's urine?
A. Blood in the urine
B. Bilirubin in the urine
C. Ketones in the urine
D. White blood cells in the urine
Explanation: In DKA, assessing for ketones in the urine is a priority, as ketonuria confirms the presence of ketones, a hallmark of DKA resulting from fat metabolism due to insulin deficiency.
Question 5 of 5.
Which response by the nurse best explains why insulin must be given subcutaneously?
A. The oral form of insulin can lead to the worsening of diabetes.
B. The oral form of insulin is not yet available for use.
C. Insulin is a protein that is destroyed by digestive enzymes.
D. Insulin given by the oral route causes severe vomiting.
Explanation: Insulin is a protein hormone that would be broken down by digestive enzymes in the gastrointestinal tract if taken orally, rendering it ineffective. Subcutaneous administration ensures it reaches the bloodstream intact.
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