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2023-2024/PEDSATI PROCTORED FINAL EXAM TEST
BANK 200 QUESTIONS AND CORRECT ANSWERS
WITH RATIONALES|AGRADE
The nurse is preparing to administer an immunization to a four-year-old child.
Which of the following actions should the nurse plan to take?
A- Place the child in a prone position for the immunization
B- request that the child's caregiver leave the room during the immunization
C- administer the immunization using a 24-gauge needle
D- inject the immunization slowly after aspirating for 3 seconds
Answer - c
The nurse should administer an immunization for a 4-year-old child using a 24-
gauge needle to minimize the amount of pain experienced by the toddler.
A- The nurse should place the child in an upright sitting position for the
immunization because this decreases the child's fear and anxiety.
B- The nurse should allow the caregiver to stay near the child during the
immunization to provide a sense of security and reduce the child's anxiety
level.D- The nurse should inject the immunization rapidly and avoid
aspiration.
These actions decrease the risk of needle displacement and lower the child's
fear and anxiety level by decreasing the amount of time it takes to
administer the immunization.
A nurse is reviewing the laboratory report of an infant who is receiving
treatment for severe dehydration. The nurse should identify which of the
following laboratory values indicates effectiveness of the current treatment?
A- Potassium 2.9 mEq/L
B- sodium 140
C- urine specific gravity 1.035
D- BUN 25 mg
Answer- b
The nurse should identify that a sodium level of 140 mEq/L is within the
expected reference range and indicates the current treatment regimen the infant
is receiving for dehydration is effective.
A- A potassium level of 2.9 mEq/L is below the expected reference range
and indicates hypokalemia.
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C- A urine specific gravity of 1.035 is above the expected reference range and
indicatesconcentrated urine.
D- A BUN level of 25 mg/dL is above the expected reference range and indicates
the kidneys arenot excreting BUN as they should be.
The nurse is providing teaching about Social Development to the parents of a
preschooler. Which of the following play activities should the nurse
recommendfor the child?
A- Play pat-a-cake
B- using a push pull toy
C- creating a scrapbook
D- playing dress-up
Answer - d
The nurse should instruct the parents that at the preschool age, play should focus
on social, mental, and physical development. Therefore, playing dress-up is a
recommended play activity for this child.
A- Playing pat-a-cake is a recommended play activity for an infant.
B- Using a push pull toy is a recommended play activity for a toddler.
C- Creating a scrapbook is a recommended play activity for a school-age child.
A nurse is teaching the parents of a newborn about ways to prevent sudden
infant death syndrome SIDS. Which of the following instructions should the
nurse include?
A- Place the infant in a prone position to sleep.
B- Allow the infant to sleep on a large pillow.
C- User soft mattress in the infant's crib.
D- Give the infant a pacifier at bedtime.
Answer- d
The nurse should inform the parent that protective factors against SIDS include
breastfeeding and the use of a pacifier when the infant is sleeping.
A- The nurse should instruct the parent to place the infant in a supine position to
sleep. Prone and side-lying positions are risk factors for SIDS.
B- Placing the infant on a large pillow to sleep can increase the risk of suffocation,
asphyxiation, and SIDS.
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A nurse is assessing an infant who has pneumonia. Which of the following
findings is the priority for the nurse to report to the provider?
A- Nasal flaring
B- WBC 11,300
C- diarrhea
D- abdominal distension
Answer- a
When using the airway, breathing, circulation approach to client care, the nurse
should place the priority on nasal flaring. Nasal flaring indicates that the
infantis experiencing acute respiratory distress.
B- The nurse should report a WBC of 11,300/mm3 because it is above the
expected reference range and indicates infection. However, another finding is the
priority for the nurse to report. C- The nurse should report diarrhea because it is a
manifestation of pneumonia in infants and indicates the current treatment is not
effective. However, another finding is the priority for thenurse to report.
D- The nurse should report abdominal distension because it is a manifestation of
pneumonia ininfants and indicates the current treatment is not effective. However,
another finding is the priority for the nurse to report.
A school nurse is assessing a school-age child blood pressure while he is seated
in a chair. The child starts to experience a tonic-clonic seizure. Which of the
following actions should the nurse take first?
A- Clear the immediate area around the child of hazardous objects
B- loosen the child restrictive clothing
C- assist the child to a side-lying position on the floor
D- apply an oxygen mask to the child
Answer- c
The greatest risk to this child is aspiration, occlusion of the airway, and bodily
injury from falling out of the chair. The nurse should ease the child down to
floor in a side-lying position immediately. This position enables the child's
secretions to drain from the mouth, preventing aspiration, and maintaining a
patentairway.
A- The nurse should clear the area around the child of hazardous objects.
However, this is not the first action the nurse should take.
B- The nurse should loosen the child's restrictive clothing. However, this is not
the first action the nurse should take.
D- The nurse should apply an oxygen mask to the child to prevent hypoxia.
However, this is not the first action the nurse should take.
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ibuprofen liquid 100mg/ 5 ml. how many milliliters should the nurse
administer to the infant per dose? Round the answer to the nearest whole
number. Use a leading zero if it applies.
Answer: 2 mL
A nurse is receiving change-of-shift Report on for children. Which of the
following children should the nurse assesses first?
A- A toddler who has a concussion and an episode of forceful vomiting
B- an adolescent who has infective endocarditis and reports having a headache
C- an adolescent who was placed into Halo traction 1 hour ago and rates his pain
at a 6 on a 0-10 scale
D- school-age child who has acute glomerulonephritis and brown colored urine
Answer- a
When using the urgent vs. no urgent approach to client care, the nurse should assess
this child first. An episode of forceful vomiting is an indication of increased
intracranial pressure in a toddler who has a concussion.
B- A report of a headache is no urgent because it is an expected finding for a child
who has infective endocarditis; therefore, the nurse should assess another child
first.C- A report of moderate pain is no urgent because it is an expected finding for
a child who has a new halo traction device; therefore, the nurse should assess
another child first.
D- Brown-colored urine is no urgent because it is an expected finding for a
school-age child who has acute glomerulonephritis; therefore, the nurse
shouldassess another child first.
A nurse in the emergency department is caring for an adolescent who has
severe abdominal pain due to appendicitis. Which of the following
locationsshould the nurse identify as mcburney's point?
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B is incorrect. The nurse should not identify the left lower quadrant as the
location ofMcBurney's point.
C is incorrect. The nurse should not identify the right upper quadrant as the location
ofMcBurney's point.
A nurse is providing teaching to the family of a school-age child who has
juvenile idiopathic arthritis. Which of the following instructions should
thenurse include in the teaching?
A- Limit the movement of the child large joints.
B- Encourage the child to perform independent self-care.
C- Provide the child with a soft mattress for sleeping.
D- Schedule a 2-hour daily nap for the child in the afternoon.
Answer- b
The nurse should teach the family the importance of encouraging the child to
perform independent self-care. This will minimize the child's pain while maximizing
mobility.
Encouraging and praising the child's efforts for independence will also increase his
self-esteem.
A- Large joints should be exercised regularly to maintain mobility and strengthen
muscles.
C- Children who have juvenile idiopathic arthritis should sleep on a firm mattress to
enhance comfort and rest. A soft mattress can increase pressure to the affected joints
and increase the child’s pain.
D- Daytime naps are discouraged because stiffness can occur quickly and easily
with inactivity, and naps can interfere with nighttime sleeping.
A nurse is assessing a client who has a new diagnosis of celiac disease. Which
of the following clinical manifestations should the nurse expect?
A- Steatorrhea
B- projectile vomiting
C- sunken abdomen
D- weight gain
Answer- a
The nurse should realize that clients who have celiac disease are unable to digest
gluten. This will cause damage to the cells in the bowel, leading to
malabsorption,steatorrhea, and diarrhea.
B- Clients who have pyloric stenosis will exhibit projectile vomiting rather than
celiac disease.
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C- A distended abdomen, rather than a sunken abdomen, is a manifestation of celiac
disease.
D- Weight loss, rather than weight gain, is a manifestation of celiac disease.
A nurse is providing teaching to an adolescent about how to manage tinea
pedis. Which of the following statements by the Adolescent indicates an
understanding of the teaching?
A- I should buy some plastic shoes to wear at the swimming pool
B- I should wear sandals as much as possible
C- I should place the permethrin cream between my toes twice-daily
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D- I should I seal my non washable shoes in plastic bags for a couple of weeks
Answer- a
The use of plastic shoes increases the occurrence of tinea pedis. The nurse should
instruct the adolescent to avoid wearing plastic shoes.
B- Sandals allow air to circulate around the feet, decreasing perspiration and
eliminating the medium for bacteria and fungus to grow. The nurse should inform
the adolescent that wearing sandals, open-toed, or well-ventilated shoes will
promote healing of his fungal infection.
C- Permethrin 5% cream is a scabicide used to place on the lesions created by
scabies. This treatment is not recommended for tinea pedis.
D- Sealing non-washable items in plastic bags for 14 days is a recommended
practice for clients who have pediculosis. This practice is not recommended for
tineapedis.
Teaching the parents of a school-aged child who has a new diagnosis of
osteomyelitis of the tibia. The nurse should identify that which of the
followingstatements by the parents indicates an understanding of the
teaching?
my child will have a cast until healing is complete.
My child will receive antibiotics for several weeks.
My child can return to playing sports once he is
discharged. My child needs to be in contact
isolation.
Answer: b
The nurse should instruct the parent that the child will receive antibiotic therapy for
at least 4weeks. Surgery might be indicated if the antibiotics are not successful.
A - incorrect
Weight bearing must be avoided with osteomyelitis. Therefore, the child is placed in
comfortable position with the limb supported. There is no indication for a cast.
C- incorrect
Weight bearing should be avoided to prevent complications and minimize pain.
Therefore, it will be several weeks to months before the child can play contact
sports.
D- incorrect
Contact isolation is NOT necessary, because osteomyelitis is not a communicable
illness.
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A nurse is auscultating the lungs of an adolescent who has asthma. The nurse
should identify the sound as which of the following? Click the audio button
tolisten.
A- Biots respiration
B- Chaney Stokes respiration
C- tackypnea
D - Bradypnea
Answer- c
The nurse should identify the sound heard during auscultation as tachypnea, which
is a rapid, regular breathing pattern. This breathing pattern often occurs with
anxiety, fever, metabolic acidosis, or severe anemia.
A- Biot's respirations are periods of apnea alternating with two or three shallow
breaths.
B- Cheyne-Stokes respirations are periods of apnea alternating with periods of
hyperventilation.
D- Bradypnea is a slow, regular breathing pattern.
A nurse in an emergency department is caring for a school-age child who is
experiencing an anaphylactic reaction. Which of the following is the
priorityaction by the nurse?
A- Elevate the head of the child's bed
B- insert a large-bore IV catheter for the child
C- determine the allergen that caused the child's reaction
D- administer IM epinephrine to the
child Answer- d
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When using the urgent vs no urgent approach to client care, the nurse determinesthat
the priority action is administering IM epinephrine to the child. During an
anaphylactic reaction, histamine release causes bronchoconstriction and
vasodilation. This is an emergency becauseultimately it causes decreased blood
return to the heart.
A- Elevating the head of the child's bed is important to facilitate breathing and
circulation. However, it is not the priority action the nurse should take.
B- Inserting a large bore IV catheter is important to facilitate administration of IV
fluids and medications. However, it is not the priority action the nurse should
take.C- Determining the allergen that caused the child's reaction is important to
preventany additional episodes of anaphylaxis. However, it is not the priority
action the nurse should take.
A nurse at an urgent care clinic is assessing an adolescent client who has an
upper respiratory tract infection. Which of the following findings should the
nurse recognize as a manifestation of pertussis?
A- Inflamed throat with exudate
B- purulent eye drainage
C- dry, hacking cough
D- koplik spots on buccal mucosa
Answer- c
The nurse should recognize that a dry, hacking cough is a manifestation of
pertussis. This disease usually begins with indications of an upper respiratory
tract infection, which includes a dry, hacking cough that is sometimes more
severeat night.
A- An inflamed throat with exudate is a manifestation of acute streptococcal
pharyngitis.
B- Purulent eye drainage is a manifestation of bacterial conjunctivitis.
D- Koplik spots on buccal mucosa are a manifestation of rubeola (measles).
A nurse is providing teaching about car seat use to the mother of a six-month-
old infant. Which of the following statements by the mother indicates an
understanding of the teaching?A- I should secure the car seat using lower
anchors and tethers instead of the seat belt
B- I should position the car seat harness one inch above my baby's shoulders
C- I will make sure that the car seat is placed at a 90-degree angle
D- I will pad my baby's car seat with a blanket for traveling long distances
Answer- a
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Lower anchors and tethers, or the LATCH child safety seat system, should be
used to secure an infant's car seat in the vehicle. This system provides anchors
between the front cushion and the back-rest for the car seat. Therefore, if this
system is available, the seatbelt does not have to be used.
B- The car seat harness in rear-facing car seats should be positioned at or just below
the infant’s shoulders.
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C- The car seat should be positioned at a 45-degree angle to prevent slumping and
injury to the infant.
D- Padding placed underneath the infant or anywhere in the car seat can
compress and/or create space between the infant and the harness. This could
increase the risk for injury to theinfant and should be avoided.
A nurse is assessing the pain level of a three-year-old toddler. Which of the
following pain assessment scales should the nurse use?
A- FACES Pain rating scale
B- numeric pain rating scale
C- CRIES pain assessment scale
D- non communicating children's pain checklist
Answer- a
The nurse should use the FACES pain rating scale for pediatric clients who are 3
years old and older. This scale allows the toddler to point to the face that depicts the
current level of pain. The nurse can then determine the need for pain management.
B- The nurse should use the numeric pain rating scale when assessing the need
for pain management in pediatric clients who are 5 years old and older. The nurse
should identify that the 3-year-old toddler does not yet possess a concept of
numbers and numerical value to effectively use this pain rating scale.
C- The nurse should use the CRIES pain assessment scale when assessing the need
for pain management in infants.
D- The nurse should use the noncommunicating children's pain checklist when
assessing the need for pain management in pediatric clients who have a cognitive
impairment.
A nurse is caring for a preschooler who is scheduled for hydrotherapy
treatment for wound debridement following a burn injury. Which of
thefollowing actions should the nurse take prior to the procedure?
A- Apply topical antimicrobial ointment to the child wound
B- place a mesh gauze dressing over the child wound
C- administer an analgesic to the child
D- initiate prophylactic antibiotic therapy for the child
Answer- c
Hydrotherapy for debridement of a wound is an extremely painful procedure
which requires analgesia and/or sedation. When pain is controlled, it leads to
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B- A nurse should apply mesh gauze to the child's wound following hydrotherapy to
prevent infection.
D- Prophylactic antibiotic therapy is not recommended for children who have burns.
A nurse is caring for a 10-year-old child following a head injury. Which
of the following findings should the nurse identify as an indication that
the child is developing diabetes insipidus?
A- Urine specific gravity of 1.045
B- sodium 155
C- blood glucose 45
D- urine output 35 ml per hour
Answer- b
A child who has a head injury can develop diabetes insipidus as a result of
pituitary hypo function leading to a deficiency of antidiuretic hormone.
Under excretion of antidiuretic hormone leads to polyuria and polydipsia and
possibly dehydration. With the excessive loss of free water, sodium levels rise
above the expected reference range.
A- Urine specific gravity of 1.045 is above the expected reference range. A child
who has diabetes insipidus is more likely to have diluted urine and urine specific
gravity below the expected reference range.
C- Blood glucose of 45 mg/dL is below the expected reference range. A child who
has diabetes insipidus should have a blood glucose level within the expected
reference range.
D- Urine output of 35 mL/hr is within the expected reference range. A child who has
diabetes insipidus is more likely to have polyuria.
A nurse is creating a plan of care for a toddler who has minimal change
nephrotic syndrome mcns and 3 + pitting edema. Which of the following
interventions should the nurse include in the plan?
A- Encourage an increased fluid intake for the toddler
B- place the child in an Airborne infection isolation room
C- increase the toddler's dietary sodium intake
D- administer corticosteroids to the toddler
Answer- d
The nurse should recognize that corticosteroids are the treatment of choice for
providers caring for children who have MCNS. Therefore, the nurse should
includeadministration of prescribed corticosteroids in the plan of care for this
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2023-2024 ATI Peds Proctored Final Exam with Answers (60 Solved Questions)

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