Child Health NCLEX-RN Practice Exam — Set 3

The nurse is caring for a 4-month-old infant with a suspected diagnosis of necrotizing enterocolitis (NEC). Which of the following early clinical findings should the nurse report immediately?

The nurse is caring for a hospitalized 8-year-old client who is refusing to undergo a painful procedure (venipuncture). Which approach by the nurse is most developmentally appropriate?

A 4-year-old client with beta-thalassemia major is admitted for a routine blood transfusion. The client has received over 20 transfusions in the past 2 years. Which complication is the nurse most concerned about monitoring for?

The nurse is caring for a 3-year-old client with erythema infectiosum (fifth disease). The parent asks if the child can go to daycare. Which is the most appropriate response?

The nurse is assessing a 6-year-old client who received a partial-thickness burn involving 15% total body surface area (TBSA) 48 hours ago. The wound appears moist, red, and extremely painful. Which assessment finding is most concerning and requires immediate reporting?

The nurse is providing discharge teaching for a 10-year-old child who sustained a buckle fracture of the distal radius and has been placed in a short arm cast. Which instruction should the nurse include?

The nurse is teaching a parent about absence seizures diagnosed in their 8-year-old child. Which statement by the parent indicates correct understanding?

The nurse is conducting a health assessment on a 15-year-old male client who is an avid cyclist. He reports left testicular dull ache and a 'bag of worms' sensation when examining himself in the shower. Which condition does the nurse suspect?

The nurse is caring for a 6-month-old infant with croup (laryngotracheobronchitis). Which assessment finding indicates the infant's condition is worsening and requires immediate intervention?

The nurse is assessing a 3-year-old client admitted with acute kidney injury (AKI). Which of the following clinical findings would the nurse anticipate? Select all that apply.

The nurse is providing eye drop administration instruction to the parent of a 4-year-old with bacterial conjunctivitis. Which technique should the nurse demonstrate?

The nurse is caring for a 3-day-old newborn with ductal-dependent cyanotic congenital heart disease who is awaiting surgical repair. Which of the following actions by the nurse would require immediate correction?

The nurse is teaching the parent of a 12-year-old client who was recently started on levothyroxine (synthetic thyroid hormone) for hypothyroidism. Which of the following instructions should the nurse include?

The nurse is assessing a 1-month-old infant who has not passed a stool since birth and has had progressively increasing abdominal distension. A rectal examination causes sudden expulsion of large amounts of stool and gas. Which condition does the nurse suspect?

The nurse is providing teaching to parents of a 5-month-old infant about introducing solid foods. Which of the following statements by the parent indicates an understanding of the teaching?

The nurse is caring for an 8-year-old with hemophilia A who fell and has a bleeding laceration on the arm. After applying pressure, the wound continues to bleed. Which intervention should the nurse implement next?

The nurse is reviewing immunization records for a 2-month-old infant who appears healthy at a well-child visit. Which of the following vaccines should be given today? Select all that apply.

The nurse is evaluating a 12-year-old client's understanding of home care for newly prescribed tretinoin cream for acne vulgaris. Which statement by the client indicates understanding?

The nurse is assessing a 16-year-old female soccer player who reports acute left knee pain after her knee 'twisted' during a game. The nurse observes swelling, and the client says she felt a 'pop' when the injury occurred. Which injury does the nurse suspect?

The nurse is caring for a 2-year-old child who has just experienced a febrile seizure lasting 2 minutes. The child is now in the postictal state — drowsy but responsive. Which of the following is the priority nursing action?

The nurse is caring for a 16-year-old male client who is concerned about delayed puberty. His tanner stage is II for genitalia and pubic hair development. His bone age X-ray shows delayed skeletal maturation. Lab work reveals low LH, FSH, and testosterone. Which condition does the nurse anticipate this client may have?

The pediatric nurse is reviewing discharge instructions for a 9-year-old client with moderate persistent asthma. The child's current step therapy includes an inhaled corticosteroid (ICS) and a long-acting beta-2-agonist (LABA). Which statement by the parent requires follow-up?

The nurse is caring for a 7-year-old client with hemolytic uremic syndrome (HUS) following an E. coli O157:H7 infection. Which of the following nursing interventions is the highest priority?

The nurse is caring for a 4-year-old client who is scheduled for surgery to repair a congenital cataract in the right eye. The parent asks why surgery cannot be delayed until the child is older. Which is the most appropriate response by the nurse?

The nurse is reviewing the discharge medications for a 6-year-old client with a heart transplant. The nurse knows to monitor closely for which of the following side effects of cyclosporine (calcineurin inhibitor used for immunosuppression)?

The nurse is providing education to a 13-year-old newly diagnosed with type 2 diabetes mellitus. Which of the following lifestyle modifications should the nurse emphasize as the first-line intervention?

The nurse is caring for a 5-day-old neonate who has been vomiting bile-stained (green) fluid since birth. An abdominal X-ray shows a 'double bubble' sign. Which condition does the nurse suspect?

The nurse is teaching adolescent clients in a school health clinic about the normal body changes of puberty. Which statement by a 14-year-old female requires follow-up?

The nurse is preparing a 5-year-old client with acute lymphoblastic leukemia (ALL) for a bone marrow aspiration. Which of the following actions should the nurse prioritize before the procedure?

The nurse is caring for a 6-year-old client admitted with confirmed influenza and secondary bacterial pneumonia. Which of the following medications does the nurse anticipate being prescribed?

The nurse is providing teaching to the parents of a 7-year-old client with atopic dermatitis (eczema) about bathing practices. Which of the following instructions should the nurse include?

The nurse is caring for a 12-year-old client with a new diagnosis of juvenile idiopathic arthritis (JIA) affecting the knees and ankles. The nurse is providing morning care. Which of the following is most important for the nurse to address first in the morning?

The nurse is caring for a 2-year-old client with a ventriculoperitoneal (VP) shunt for hydrocephalus. The parent reports the child has been irritable with vomiting for the past 24 hours. Which assessment is the nurse's priority?

The nurse is caring for a 15-year-old female client who has not menstruated for the past 4 months. She has been exercising 3-4 hours daily training for competitive gymnastics and reports fatigue and stress fractures in the past year. Which condition does the nurse suspect?

The nurse is caring for a 4-year-old client with suspected epiglottitis. Which of the following nursing actions takes the highest priority?

The nurse is teaching the parents of a 5-year-old client who was just diagnosed with a first urinary tract infection (UTI). Which of the following statements by the parent requires follow-up?

The nurse is providing discharge teaching to the parent of a 6-month-old infant who failed the newborn hearing screen and has been confirmed to have bilateral sensorineural hearing loss. Which of the following statements by the parent indicates correct understanding of early intervention?

The nurse is assessing a 7-year-old client who recently returned from camping and has been having daily fevers for 10 days, a rash on the wrists and ankles, headache, and myalgia. The rash has now spread to the trunk. Which condition does the nurse suspect, and what is the most important nursing action?

The nurse is caring for a 10-year-old child who was found unresponsive with a blood glucose of 32 mg/dL. The child is unable to swallow safely. Which intervention should the nurse perform first?

The nurse is conducting a health history for a 10-year-old male client who reports intermittent abdominal pain, cramping, and diarrhea for the past 6 months with 5 kg weight loss. The child also has oral aphthous ulcers. A colonoscopy reveals transmural inflammation with skip lesions. Which diagnosis does the nurse expect?

The nurse is conducting a developmental screening for a 3-year-old client. Which of the following findings would the nurse identify as a red flag requiring referral?

The nurse is caring for a 9-year-old client with hereditary spherocytosis who is experiencing a hemolytic crisis. Which laboratory finding does the nurse anticipate?

The nurse is caring for a 6-year-old client who just received a blood transfusion and now has a temperature of 103.2°F (39.6°C), severe back pain, dark colored urine, and appears anxious and agitated. Which complication does the nurse suspect, and what is the first priority action?

The nurse is assessing a 2-year-old client who has been admitted for observation after ingesting an unknown substance. The nurse notes circumoral burns and erythema around the mouth. Which type of ingestion does the nurse suspect, and what is the priority intervention?

The nurse is reviewing medication orders for a 14-year-old client with a newly diagnosed bone tumor (osteosarcoma) of the distal femur. The client is starting neoadjuvant chemotherapy. Which of the following chemotherapy side effects is most concerning for this client related to the tumor's location?

The nurse is caring for a 5-year-old client with a traumatic brain injury (TBI) following a motor vehicle accident. The nurse notes the child's blood pressure is 148/90 mmHg, heart rate is 54 beats/minute, and respirations are irregular at 8/minute. Which clinical syndrome does the nurse recognize?

The nurse is providing education to the parents of a newborn male diagnosed with hypospadias. Which of the following statements should the nurse include?

The nurse is reviewing arterial blood gas (ABG) results for an 11-year-old client admitted in status asthmaticus. The results show: pH 7.30, PaCO2 52 mmHg, HCO3 24 mEq/L, PaO2 58 mmHg. Which interpretation is correct, and what does this indicate about the client's condition?

The nurse is caring for a 10-year-old client with Wilms tumor (nephroblastoma) who is awaiting surgical removal of the right kidney. Which nursing intervention is the highest priority?

The nurse is caring for a 3-year-old client who underwent surgery for acute suppurative otitis media with tympanic membrane perforation 2 days ago. The parent notes that the child continues to have purulent drainage from the ear. Which nursing response is most appropriate?