Peditric Nursing/maternal Newborn

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Sample questions from Peditric Nursing/maternal Newborn

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

1. 1.A 2-year-old is admitted with severe dehydration from gastroenteritis. The child is lethargic, has a heart rate of 168/min, capillary refill of 4 seconds, and urine output of 0.3 mL/kg/hr. Which prescription should the nurse implement first?

   • A.Offer oral rehydration solution in small sips
   • B.Administer the prescribed antidiarrheal medication
   • C.Begin an isotonic IV fluid bolus as prescribed
   • D.Weigh the child after the next diaper change

   Rationale: An isotonic fluid bolus treats hypovolemia and poor perfusion, the immediate threat. Oral fluids are inappropriate as the initial intervention for a lethargic child with impaired perfusion, antidiarrheals are generally avoided in children, and weighing a diaper does not stabilize circulation. Reassess perfusion and urine output after fluid resuscitation.

2. 2.A laboring client at 39 weeks has recurrent late decelerations on the fetal monitor, a blood pressure of 118/72 mm Hg, and contractions every 2 minutes. Which action should the nurse take first?

   • A.Increase the oxytocin infusion
   • B.Reposition the client to a lateral position
   • C.Encourage the client to begin pushing
   • D.Document the pattern and reassess in 30 minutes

   Rationale: Lateral repositioning can improve uteroplacental blood flow and is an immediate response to recurrent late decelerations. Increasing oxytocin may worsen uterine activity, pushing is not appropriate without a fully dilated cervix, and delaying reassessment risks fetal hypoxia. The nurse should also discontinue oxytocin and notify the provider if the pattern persists.

3. 3.A 4-year-old with asthma is admitted to the pediatric unit with wheezing, retractions, and an oxygen saturation of 91% on room air. Which actions should the nurse anticipate as part of initial management? Select all that apply.

   • A.Provide supplemental oxygen as prescribed to maintain the target saturation
   • B.Assess breath sounds, work of breathing, and oxygen saturation frequently
   • C.Administer the prescribed inhaled short-acting bronchodilator
   • D.Keep the child supine and discourage position changes
   • E.Delay treatment until a chest radiograph confirms bronchospasm

   Rationale: Frequent respiratory assessment identifies response or deterioration, and an inhaled short-acting bronchodilator treats acute bronchospasm. Supplemental oxygen is appropriate when prescribed for hypoxemia; keeping the child supine can worsen breathing, and treatment should not be delayed for imaging when the clinical presentation supports asthma exacerbation. Reassess after each intervention.

4. 4.A charge nurse is assigning care on a pediatric unit. Which task is appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Assess a 6-month-old with new-onset stridor
   • B.Evaluate whether a toddler's pain medication was effective
   • C.Teach a parent how to administer an inhaler to a 7-year-old
   • D.Obtain and record the vital signs of a stable 10-year-old awaiting discharge

   Answer and rationale are in the full material.

5. 5.A newborn is 1 hour old after a vacuum-assisted vaginal birth. The infant has a boggy swelling that crosses the suture lines, a heart rate of 176/min, and pallor. What should the nurse do first?

   • A.Notify the neonatal provider and urgently assess for blood loss
   • B.Apply pressure to the swelling for 10 minutes
   • C.Place the newborn prone and recheck the swelling in 2 hours
   • D.Document the finding as expected caput succedaneum

   Answer and rationale are in the full material.