2023 PN Pediatrics

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Sample questions from 2023 PN Pediatrics

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

1. 1.A 2-month-old infant is seen in the emergency department during respiratory syncytial virus season. The infant has a respiratory rate of 68/min, nasal flaring, subcostal retractions, and an oxygen saturation of 89% on room air. Which action should the practical nurse take first?

   • A.A. Offer a bottle of formula to assess feeding tolerance
   • B.B. Position the infant to support the airway and apply prescribed oxygen
   • C.C. Obtain a nasopharyngeal specimen for viral testing
   • D.D. Teach the parent how to use a bulb syringe at home

   Rationale: The infant has hypoxemia and increased work of breathing, so supporting oxygenation and airway positioning are the priority. Feeding may increase aspiration risk during respiratory distress, and specimen collection does not address the immediate threat. Home-care teaching is appropriate only after the infant is stable.

2. 2.A 4-year-old with asthma is in the clinic with audible wheezing, a respiratory rate of 36/min, and an oxygen saturation of 93%. The child is alert and speaking in short phrases. Which prescribed medication should the practical nurse expect to administer first?

   • A.A. Inhaled albuterol
   • B.B. Oral montelukast
   • C.C. Inhaled fluticasone
   • D.D. Oral prednisolone

   Rationale: Albuterol is a rapid-acting bronchodilator used to relieve acute bronchospasm. Montelukast and fluticasone are controller therapies and do not provide immediate relief. Prednisolone can reduce airway inflammation but does not work as quickly as a rescue bronchodilator.

3. 3.A 6-year-old with cystic fibrosis is admitted for pulmonary exacerbation. The child has thick sputum, a temperature of 38.2 C, and oxygen saturation of 95% on room air. Which scheduled intervention should the practical nurse perform before the child's meal?

   • A.A. Administer pancreatic enzymes with the meal
   • B.B. Perform prescribed airway-clearance therapy
   • C.C. Restrict oral fluids to reduce sputum production
   • D.D. Give the prescribed fat-soluble vitamins

   Rationale: Airway-clearance therapy before eating helps mobilize secretions while reducing the chance of vomiting during or after a meal. Pancreatic enzymes are given with food, not before airway clearance as the priority intervention. Fluids are generally encouraged to help thin secretions, and vitamins are not timed to replace airway treatment.

4. 4.A 3-year-old arrives at the emergency department with a barking cough, hoarse voice, and inspiratory stridor at rest. The temperature is 38.0 C and oxygen saturation is 94%. Which action is the priority?

   • A.A. Inspect the throat with a tongue blade
   • B.B. Keep the child calm and prepare for prescribed nebulized epinephrine
   • C.C. Encourage the child to cough forcefully
   • D.D. Obtain a throat culture before treatment

   Answer and rationale are in the full material.

5. 5.A 5-year-old with suspected epiglottitis is sitting upright, drooling, and leaning forward. The child has a temperature of 39.5 C and an oxygen saturation of 91%. Which action should the practical nurse take?

   • A.A. Place a tongue blade to visualize the epiglottis
   • B.B. Keep the child upright and summon the emergency airway team
   • C.C. Lay the child flat for a complete assessment
   • D.D. Offer a cup of water to assess swallowing

   Answer and rationale are in the full material.