NCLEX-RN
NCLEX RN Pediatric Questions Questions
Extract:
Question 1 of 5
Two months after an adolescent's thoracic spinal cord injury, he complains of a pounding headache. The nurse notes that the client's arms and face are flushed and he is diaphoretic. What should the nurse do next?
Correct Answer: A
Rationale: These symptoms suggest autonomic dysreflexia, often triggered by bladder distension; checking the catheter is the first step.
Question 2 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 3 of 5
During the initial assessment of a child admitted to the pediatric unit with osteomyelitis of the left tibia, when assessing the area over the tibia, which is a new needed finding?
Correct Answer: C
Rationale: Increased warmth is a key sign of osteomyelitis, indicating inflammation and possible infection in the affected bone.
Question 4 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.
Question 5 of 5
The nurse is inspecting the child's throat (see figure). The nurse should:
Correct Answer: D
Rationale: Having the child participate by holding the tongue blade while the nurse guides it to facilitate visualization of the throat is appropriate technique. It is not useful to remove the tongue blade or have the child hold it because the nurse will need to use the tongue blade to depress the tongue. It is preferable to engage the child's cooperation before asking the parent to restrain the child.