NCLEX-RN
NCLEX RN Pediatric Questions Questions
Question 1 of 5
A toddler diagnosed with nephrotic syndrome has a nursing diagnosis of Excess fluid volume related to fluid accumulation in the tissues. Which measure should the nurse anticipate including in the child's plan of care?
Correct Answer: D
Rationale: Daily weights monitor fluid balance.
Question 2 of 5
A nurse is assessing an infant with failure to thrive. Which finding requires immediate intervention?
Correct Answer: B
Rationale: A heart rate of 180 bpm suggests distress (e.g., dehydration, sepsis), requiring urgent evaluation. Low weight, poor feeding, and dry membranes are concerning but less acute.
Question 3 of 5
The nurse explains to the parents of a 1-year-old child admitted to the hospital in sickle cell crisis that the local tissue damage the child has on admission is caused by which of the following?
Correct Answer: D
Rationale: In sickle cell crisis, sickle-shaped red blood cells obstruct blood flow, leading to inadequate tissue perfusion and infarction, causing local tissue damage.
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:
Correct Answer: D
Rationale: The anterior fontanelle typically closes between 12-18 months, so this is normal.
Question 5 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.
Correct Answer: C,D,E
Rationale: 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.