NCLEX RN Pediatric Questions
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Question 1 of 5.
Parents bring a 10-month-old boy born with myelomeningocele and hydrocephalus with a ventriculoperitoneal shunt to the emergency department. His symptoms include vomiting, poor feeding, lethargy, and irritability. What interventions by the nurse are appropriate? Select all that apply.
A. Weigh the child.
B. Listen to bowel sounds.
C. Palpate the anterior fontanel.
D. Obtain vital signs.
E. Assess pitch and quality of the child's cry.
Explanation: These symptoms suggest possible shunt malfunction or increased intracranial pressure. Palpating the anterior fontanel assesses for bulging, indicating increased pressure. Obtaining vital signs monitors for abnormalities like bradycardia or hypertension. Assessing the cry's pitch and quality can indicate neurological distress. Weighing and listening to bowel sounds are less critical in this acute context.
Question 2 of 5.
After reading the vaccine information sheets, the parent of a 2-month-old infant is hesitant to consent to the recommended vaccinations. The nurse should first ask the parent:
A. Did you know that vaccinations are required by law for school entry?
B. What personal beliefs or safety concerns do you have about vaccinations?
C. Would you prefer that fewer vaccines are given at a time?
D. Can you please sign this vaccine waiver form?
Explanation: Addressing the parent's specific concerns fosters trust and encourages informed decision-making.
Question 3 of 5.
A parent brings a 4-month-old to the clinic for a regular well visit and expresses concern that the infant is not developing appropriately. Which findings in the infant would indicate the need for further developmental screening?
A. Has no interest in peek-a-boo games.
B. Does not turn front to back.
C. Does not babble.
D. Continues to have head lag.
Explanation: Head lag at 4 months suggests delayed motor development, requiring further evaluation.
Question 4 of 5.
The parent of a 9-month-old infant is concerned that the infant's front soft spot is still open. The nurse should tell the parent:
A. I will measure your baby's head to see if it is a normal size.
B. Your infant will need to be referred for more testing.
C. You should contact your physician immediately.
D. It is normal because this soft spot usually closes between 12 and 18 months.
Explanation: The anterior fontanelle typically closes between 12-18 months, so this is normal.
Question 5 of 5.
A mother brings her 18-month-old to the clinic because the child 'eats ashes, crayons, and paper.' Which of the following information about the toddler should the nurse assess first?
A. Evidence of eruption of large teeth.
B. Amount of attention from the mother.
C. Any changes in the home environment.
D. Intake of a soft, low-roughage diet.
Explanation: Changes in the home environment may contribute to pica, which requires immediate assessment.
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