Pediatric Nursing (Infancy) NCLEX Review

1.    Nurse Nelli performs cardiopulmonary resuscitation (CPR) for 1 minute on an infant without calling for assistance. In reassessing the infant after 1 minute of CPR, the nurse finds he still isn’t breathing and has no pulse. The nurse should then:
a.    resume CPR beginning with breaths
b.    declare her efforts futile
c.    resume CPR beginning with chest compressions
d.    call for assistance
2.    An infant, 6 weeks old, is brought to the clinic for a well-baby visit. To assess the fontanels, how should nurse Oliver position the infant?
a.    Supine
b.    Prone
c.    In the left lateral position
d.    Seated upright
3.    An infant, age 8 months, has a tentative diagnosis of congenital heart disease. During physical assessment, nurse Jasmine measures a heart rate of 170 beats/minute and a respiratory rate of 70 breaths/minute. How should the nurse position the infant?
a.    Lying on the back
b.    Lying on the abdomen
c.    Sitting in an infant seat
d.    Sitting in high Fowler’s position
4.    How should nurse Amy position an infant when administering an oral medication?
a.    Seated in a high chair
b.    Restrained flat in the crib
c.    Held on the nurse’s lap
d.    Held in the bottle-feeding position
5.    A 3-month-old infant just had a cleft lip and palette repair. To prevent trauma to the operative site, nurse Aljon should do which of the following?
a.    Give the baby a pacifier to help soothe him
b.    Lie the baby in the prone position
c.    Place the infant’s arms in soft elbow restraints
d.    Avoid touching the suture line, even to clean
6.    A baby James has just had surgery to repair his cleft lip. Which nursing intervention is the most important during the immediate postoperative period?
a.    Clean the suture line carefully with a sterile solution after every feeding
b.    Lay the infant on his abdomen to help drain fluids from his mouth
c.    Allow the infant to cry to promote lung reexpansion
d.    Give the baby a pacifier to suck for comfort
7.    An infant undergoes surgery to remove a myelomeningocele. To detect increased intracranial pressure (ICP) as early as possible, nurse Amanda should stay alert for which postoperative finding?
a.    Decreased urine output
b.    Increased heart rate
c.    Bulging fontanels
d.    Sunken eyeballs
8.    When performing cardiopulmonary resuscitation on a 7-month-old, which location would nurse Sally use to evaluate the presence of a pulse?
a.    Carotid artery
b.    Femoral artery
c.    Brachial artery
d.    Radial artery
9.    Nurse Ted is administering I.V. fluids to an infant. Infants receiving I.V. therapy are particularly vulnerable to:
a.    Hypotension
b.    fluid overload
c.    cardiac arrhythmias
d.    pulmonary emboli
10.    Nurse Rose is caring for a neonate with congenital clubfoot. The child has a cast to correct the defect. Before discharge, what should the nurse tell the parents?
a.    The cast will be removed in 6 weeks
b.    A new cast is needed every 1 to 2 weeks
c.    A short leg cast is applied when the baby is ready to walk
d.    The cast will be removed when the baby begins to crawl
11.    Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment, nurse Ernie detects dry mucous membranes and lethargy. What other finding suggests a fluid volume deficit?
a.    A sunken fontanel
b.    Decreased pulse rate
c.    Increased blood pressure
d.    Low urine specific gravity
12.    When developing a postoperative plan of care for an infant scheduled for cleft lip repair, nurse Elaine should assign highest priority to which intervention?
a.    Comforting the child as quickly as possible
b.    Maintaining the child in a prone position
c.    Restraining the child’s arms at all times, using elbow restraints
d.    Avoiding disturbing any crusts that form on the suture line
13.    Nurse Dave is conducting an examination of a 6-month-old baby. During the examination, the nurse should be able to elicit which reflex?
a.    Babinski’s
b.    Startle
c.    Moro’s
d.    Dance
14.    If an infant’s I.V. access site is in an extremity, nurse Kate should:
a.    use a padded board to secure the extremity
b.    restrain all four extremities
c.    restrain the extremity to the bed’s side rail
d.    allow the extremity to be loose
15.    Nurse Wayne is aware that which finding would be least suggestive of necrotizing enterocolitis (NEC) in an infant?
a.    Hepatomegaly
b.    Distended abdomen
c.    Gastric retention
d.    Blood in the stool
16.    A 2-month-old baby hasn’t received any immunizations. Which immunizations should nurse Jess prepare to administer?
a.    Measles, mumps, rubella (MMR); diphtheria, tetanus, pertussis (DTP); and Hepatitis B (HepB)
b.    Polio (IPV), DTP, MMR
c.    Varicella, Haemophilus influenzae type b (HIB), IPV, and DTP
d.    HIB, DTP, HepB; and IPV
17.    Dr. Smith suspects tracheoesophageal fistula in a 1-day-old neonate. Which nursing intervention is most appropriate for this child?
a.    Avoiding suctioning unless cyanosis occurs
b.    Elevating the neonate’s head and giving nothing by mouth
c.    Elevating the neonate’s head for 1 hour after feedings
d.    Giving the neonate only glucose water for the first 24 hours
18.    When caring for children who are sick, who have sustained traumas, or who are suffering from nutritional inadequacies, nurse Ron should know the correct hemoglobin (Hb) values for children. Which of the following ranges would be inaccurate?
a.    Neonates: 10.6 to 16.5 g/dl
b.    3 months: 10.6 to 16.5 g/dl
c.    3 years: 9.4 to 15.5 g/dl
d.    10 years: 10.7 to 15.5 g/dl
19.    When caring for a 12-month-old infant with dehydration and metabolic acidosis, nurse May expects to see which of the following?
a.    A reduced white blood cell (WBC) count
b.    A decreased platelet count
c.    Shallow respirations
d.    Tachypnea
20.    Nurse Jake is aware that most oral pediatric medications are administered:
a.    with the nighttime formula
b.    ½ hour after meals
c.    on an empty stomach
d.    with meals
21.    A mother and grandmother bring a 3-month-old infant to the well-baby clinic for a routine checkup. Nurse Aimee weighs the infant, the grandmother asks, “Shouldn’t the baby start eating solid food? My kids started on cereal when they were 2 weeks old.” Which response by the nurse would be appropriate?
a.    “The baby is gaining weight and doing well. There is no need for solid food yet.”
b.    “Things have changed a lot since your children were born.”
c.    “We’ve found that babies can’t digest solid food properly until they’re 3 or 4 months old.”
d.    “We’ve learned that introducing solid food early leads to eating disorders later in life.”
22.    Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely?
a.    1 to 2 years
b.    1 week to 1 year, peaking at 2 to 4 months
c.    6 months to 1 year, peaking at 10 months
d.    6 to 8 weeks
23.    An infant is hospitalized for treatment of inorganic failure to thrive. Nurse Faith is aware that the nursing action is most appropriate for this child?
a.    Encouraging the infant to hold a bottle
b.    Keeping the infant on bed rest to conserve energy
c.    Rotating caregivers to provide more stimulation
d.    Maintaining a consistent, structured environment
24.    Nurse Lei is aware that one of the following is an early sign of heart failure in an infant with a congenital heart defect?
a.    Tachypnea
b.    Tachycardia
c.    Poor weight gain
d.    Pulmonary edema
25.    An 8-month-old is admitted to the pediatric unit following a fall from his high chair. The child is awake, alert, and crying. Nurse Fatima should know that a brain injury is more severe in children because of:
a.    increased myelination
b.    intracranial hypotension
c.    cerebral hyperemia
d.    a slightly thicker cranium

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