Capstone Nursing Care of Children

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Sample questions from Capstone Nursing Care of Children

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

1. 1.A 4-year-old with croup has stridor at rest, suprasternal retractions, and increasing agitation. Which action should the nurse take first?

   • A.Obtain a throat culture
   • B.Keep the child calm and administer humidified oxygen as prescribed
   • C.Inspect the throat with a tongue blade
   • D.Encourage the child to drink a large glass of water

   Rationale: Stridor at rest and retractions indicate significant upper-airway obstruction, so minimizing agitation and supporting oxygenation are priorities. A throat culture delays airway care, and throat inspection can worsen obstruction. Oral fluids are not the immediate priority and may be unsafe if respiratory distress progresses. The exam takeaway is to protect the airway and avoid upsetting a child with acute upper-airway obstruction.

2. 2.A nurse is assessing a 2-year-old with suspected epiglottitis who is drooling and sitting forward. Which action is most appropriate?

   • A.Use a tongue blade to visualize the epiglottis
   • B.Place the child supine for a complete examination
   • C.Keep the child upright with a caregiver and summon airway support
   • D.Obtain a nasopharyngeal swab before notifying the provider

   Rationale: Drooling and tripod positioning suggest impending airway compromise; keeping the child calm and upright while preparing for airway intervention is safest. A tongue blade or forced supine positioning can precipitate complete obstruction. A swab is not the priority and could distress the child. The exam takeaway is to avoid throat examination in suspected epiglottitis.

3. 3.A 6-month-old with bronchiolitis has nasal congestion and difficulty feeding. Which nursing action should be performed before each feeding?

   • A.Suction the nares with a bulb syringe
   • B.Administer an antitussive medication
   • C.Offer a full bottle while the infant is supine
   • D.Encourage vigorous chest percussion

   Rationale: Clearing nasal secretions before feeding can improve breathing and feeding in an infant who primarily breathes through the nose. Antitussives are generally avoided in young children and do not clear the obstruction. Supine feeding increases aspiration risk, and vigorous percussion is not routine bronchiolitis care. The exam takeaway is to support hydration and breathing with gentle nasal suctioning.

4. 4.A child with asthma is using accessory muscles and has diminished breath sounds after repeated albuterol treatments. What is the nurse's priority action?

   • A.Document that the wheezing has improved
   • B.Encourage the child to cough into a tissue
   • C.Wait 30 minutes before reassessing
   • D.Activate urgent clinical support and prepare for escalation of respiratory treatment

   Answer and rationale are in the full material.

5. 5.A 3-year-old with gastroenteritis is alert but has mild dehydration and can tolerate small amounts by mouth. Which intervention is best?

   • A.Give plain water only until diarrhea stops
   • B.Offer oral rehydration solution in frequent small amounts
   • C.Give a large volume of juice to replace losses
   • D.Withhold all fluids for 4 hours

   Answer and rationale are in the full material.