Caring for Children

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Sample questions from Caring for Children

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a pediatric unit, a 6-year-old with pneumonia has a temperature of 39.1 C, HR 146/min, RR 36/min, BP 88/50 mm Hg, and SpO2 90% on room air. Which action should the nurse take first?

   • A.Notify the family about the delayed discharge
   • B.Obtain a sputum specimen
   • C.Administer the prescribed antipyretic
   • D.Apply oxygen and assess respiratory effort

   Rationale: Hypoxemia and tachypnea indicate impaired oxygenation, so support breathing and reassess immediately. A specimen and antipyretic may be appropriate after stabilization. Discharge communication is not the priority.

2. 2.In the pediatric emergency department, a 3-year-old being treated for dehydration has received an isotonic fluid bolus. Refer to the client's chart. Which finding best indicates that the intervention is effective?

   • A.Heart rate remains 158/min
   • B.Urine output is 1.2 mL/kg/hr
   • C.The child is increasingly lethargic
   • D.Capillary refill is 4 seconds

   Rationale: Urine output above 1 mL/kg/hr in a young child supports improved renal perfusion after rehydration. Persistent tachycardia and delayed refill suggest ongoing volume deficit, while worsening lethargy is concerning for deterioration. Reassess the full perfusion picture rather than relying on one measure.

3. 3.During a pediatric clinic visit, a 9-year-old with newly diagnosed type 1 diabetes is preparing to self-administer insulin. Which action by the nurse is appropriate?

   • A.Ask the child to demonstrate the injection using a practice device
   • B.Teach the child to omit insulin when appetite is poor
   • C.Tell the child to inject into the same site each time
   • D.Have the parent administer all injections indefinitely

   Rationale: A demonstration allows the nurse to assess skill and correct technique in a developmentally appropriate way. A parent can supervise, but children can gradually participate rather than being excluded from care. Sites should be rotated, and basal insulin should not be stopped without a prescribed plan.

4. 4.On a pediatric medical unit, a 7-year-old is admitted with an acute asthma exacerbation. Which tasks may the RN delegate to experienced unlicensed assistive personnel (UAP)? Select all that apply.

   • A.Teach the parent how to use a spacer
   • B.Obtain routine vital signs after the child is stable
   • C.Assist the child with bathing
   • D.Report an SpO2 reading below the unit's prescribed threshold
   • E.Assess breath sounds after a nebulizer treatment

   Answer and rationale are in the full material.

5. 5.A provider prescribes an oral antibiotic for a 5-year-old with otitis media. The child weighs 18 kg, and the caregiver says the child spits out liquid medicine. Which nursing action is best?

   • A.Crush any available tablet and estimate the dose
   • B.Tell the caregiver to double the next dose if some is spit out
   • C.Ask the pharmacist about an appropriate formulation and administration strategy
   • D.Mix the full dose into a large bottle of juice

   Answer and rationale are in the full material.