NCLEX-RN
NCLEX RN Pediatric Questions Questions
Extract:
Question 1 of 5
Assessment of a school-age child with Guillain-Barré syndrome reveals absent gag and cough reflexes. Which of the following nursing diagnoses should receive the highest priority during the acute phase?
Correct Answer: B
Rationale: Absent gag and cough reflexes increase the risk of respiratory compromise, making ineffective breathing pattern the highest priority.
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:
Correct Answer: B
Rationale: Addressing the parent's specific concerns fosters trust and encourages informed decision-making.
Question 3 of 5
A nurse compares a child's height and weight with standard growth charts and finds the child to be in the 50th percentile for height and in the 45th percentile for weight. The nurse interprets these findings as indicating that the child is:
Correct Answer: A
Rationale: 50th percentile height and 45th percentile weight indicate average growth, as they are close.
Question 4 of 5
When developing a teaching plan for the mother of an asthmatic child concerning measures to reduce allergic triggers, which of the following suggestions should the nurse include:
Correct Answer: C
Rationale: Using a scented room deodorizer can irritate airways and trigger asthma symptoms. The nurse should advise against this to reduce allergic triggers, while recommending measures like dust mite control and avoiding strong odors.
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.