NR-328 Pediatric Nursing - Set 1 - Part 1

Correct Answer: Sits with support and no longer thrusts the tongue

Readiness rests on head and trunk control, sitting with support, loss of the tongue-thrust reflex, and opening the mouth toward the spoon. These signs show the infant can safely move food backward and swallow. Option b is incorrect because sleeping through the night tracks neurologic maturity, not feeding skill. Length also doubles far later than the first year, so neither observation tells the parents anything about swallowing readiness. Option c is incorrect because drooling and reaching appear months before the infant can handle a spoon. Both are ordinary infant behaviors tied to teething and grasping, and neither shows that the extrusion reflex has faded. Option d is incorrect because frequent night waking and a large intake point to a growth spurt or a feeding routine problem. Starting cereal early does not settle an infant and adds a choking risk.

Correct Answer: Keep a hand on him whenever he is up there

An infant who has learned to roll can go over the edge in the second a caregiver looks away. Never leave him unattended on a raised surface, and keep one hand on him throughout. Option a is incorrect because a pillow stops nothing once a four-month-old starts to roll. Soft barriers give way under a moving infant, and the same pillow is a suffocation risk if it ends up nearby at sleep. Option b is incorrect because supervision of an infant is an adult responsibility, never a sibling's. A young child cannot recognize danger or move fast enough, and leaving one in charge shifts blame onto a child. Option d is incorrect because timing the change around feedings does nothing about the height. Falls happen whether the infant is full or hungry, so the surface and the caregiver's hand are what matter.

Correct Answer: Use a behavioral scale with the caregiver's description

A behavioral scale scores what the nurse can see, and the caregiver knows this child's baseline signals. Combining the two builds an individualized picture no standard number could supply alone. Option b is incorrect because a faces tool still needs the child to understand and select an image. This child cannot speak or reliably indicate a choice, so the resulting rating would be guesswork. Option c is incorrect because charting numbers postpones treatment while the child keeps hurting. Physiologic values also settle back toward baseline during sustained pain, so a normal record would falsely reassure the team. Option d is incorrect because a child who cannot talk will never ask. Waiting for a request in a nonverbal child guarantees under-treatment, which is the commonest pain error in pediatrics.

Correct Answer: Serve one tablespoon of each food per year of age

A serving of about one tablespoon per year of age looks manageable to a three-year-old instead of overwhelming. Small portions, repeated calm offers, and no bargaining are what turn mealtimes back into ordinary events. Option a is incorrect because an adult-sized plate is precisely what starts the standoff. A preschooler eats roughly half an adult portion, and a mountain of food invites refusal before the first bite. Option b is incorrect because trading sweets for a cleared plate teaches her to eat past fullness for a prize. Food used as reward or punishment is linked with disordered eating in later childhood. Option d is incorrect because dropping a food after a few refusals ends the exposure too soon. Ten to fifteen offerings may be needed, presented without pressure beside something familiar, before acceptance shows up.

Correct Answer: Hold the dose and contact the prescriber

A dose outside the safe range is not given, high or low. The nurse holds it and clarifies with the prescriber, because adjusting a dose independently sits outside nursing scope. Option b is incorrect because choosing a different amount rewrites the prescription. Selecting the closest safe dose without an order is a scope violation, even when the substituted number would be harmless. Option c is incorrect because watching for harm after causing it is not a safety plan. Acetaminophen overdose is the leading cause of drug-induced liver failure in children, and the antidote is acetylcysteine. Option d is incorrect because handing an unsafe order to a colleague transfers the risk without resolving it. Every nurse who administers carries responsibility for verifying the dose against the child's weight first.

Correct Answer: Score face, legs, activity, cry and consolability

A behavioral observational scale is the right tool when a child cannot self-report. Scoring face, legs, activity, cry and consolability gives a number that guides dosing and shows whether treatment worked. Option a is incorrect because the caregiver's impression supplements but never replaces a validated scale in an infant this age. Ask the caregiver about baseline behaviors, then score the observable items yourself. Option b is incorrect because physiologic numbers blunt within minutes of acute pain and stay normal in ongoing pain. A settled heart rate in a sedated infant proves nothing about comfort. Option c is incorrect because waiting for speech in a six-month-old means waiting years. Untreated postoperative pain in infants is real, alters later pain responses, and under-treatment remains the far more common error.

Correct Answer: "I switched her to whole cow milk last month."

Cow milk as a drink waits until the first birthday. It is low in iron, poorly digested, and can cause occult intestinal blood loss, a combination that sets up iron deficiency anemia. Option a is incorrect because supine positioning in a bare crib is exactly what safe sleep guidance calls for. Back sleeping continues through the first birthday, and nothing soft belongs in the sleep space. Option b is incorrect because rear-facing seating remains correct at this age and well beyond it. The child stays turned toward the back until she reaches the height or weight ceiling printed on her seat. Option d is incorrect because holding and rocking an unhappy infant is appropriate comfort, not spoiling. Responsive soothing settles the infant, and a mother who describes it is doing something the nurse should reinforce.

Correct Answer: Macules, vesicles and crusts present together

Chickenpox erupts in successive crops, so macules, vesicles and crusts sit next to one another at the same moment. That mixture of stages is the feature that separates it from other rashes. Option b is incorrect because a rash marching downward from the hairline is the cephalocaudal spread of measles. Those lesions are flat and blotchy rather than fluid-filled, and they never crust over. Option c is incorrect because a band of blisters staying on one side describes shingles, the reactivation of the same virus. It follows a single dermatome and stops at the midline. Option d is incorrect because papules kept inside the diaper area suggest irritant dermatitis or a yeast infection. Chickenpox never respects clothing borders, appearing on the scalp and face as well.

Correct Answer: Use the treatment room with a comfort hold

Painful procedures belong in a treatment room so the bed and playroom stay safe. A comfort hold with the caregiver present gives secure positioning, distraction and the least distressing experience possible. Option a is incorrect because the playroom must stay a place where nothing hurts. A child who is jabbed there loses the one safe space on the unit and may refuse to return. Option b is incorrect because removing the caregiver strips away the toddler's main source of security. Atraumatic care works to minimize separation, and a willing parent is an asset during the procedure. Option c is incorrect because a false promise about pain destroys trust the moment the needle goes in. Honesty about what the child will feel is a core rule at every age.

Correct Answer: "Will you share how you came to this decision?"

An open-ended, non-judgmental question surfaces the actual worry instead of arguing with a guess. From there the nurse listens, acknowledges the concern, gives plain information and makes a clear recommendation. Option a is incorrect because pointing to what other families choose applies social pressure rather than information. A parent who already feels judged usually digs in, and the real concern stays hidden. Option b is incorrect because the wording carries an accusation inside a question. Challenging a parent this way hardens the refusal and closes the door on any discussion at the next visit. Option d is incorrect because jumping straight to documentation ends the conversation before it starts. Refusal is recorded, certainly, but only after the nurse has explored the worry and offered a recommendation.

Correct Answer: "Your child may attend school now and is no longer contagious."

Fifth disease spreads before the rash arrives. Once the slapped cheeks and lacy pattern appear the child is no longer infectious, so no school exclusion applies and the rash may keep coming and going. Option a is incorrect because this rash waxes and wanes for one to three weeks, flaring with sun, heat and exercise. Waiting for it to clear would cost the child many school days. Option b is incorrect because the four day rule belongs to measles, where the child stays out four days after the rash begins. Parvovirus follows the opposite timing entirely. Option c is incorrect because fever is not part of this illness once the cheeks turn red. Applying the general fever rule here keeps a well, non-infectious child out of the classroom needlessly.

Correct Answer: Speaks in simple two-word phrases

Two-word phrases and a vocabulary near fifty words define language at two years, and speech is about half intelligible to a stranger. Absence of two-word phrases at this age is a referral red flag. Option a is incorrect because pedaling a tricycle arrives at three years, along with climbing stairs one foot per step. A two-year-old still walks stairs placing both feet on each step. Option b is incorrect because copying a circle is the three-year drawing skill; at two the child manages only a scribble and later a vertical stroke. Squares follow at four and triangles at five. Option d is incorrect because shoelace tying waits until about five years, when fine motor control has matured considerably. Expecting it from a toddler who is only starting to remove clothing sets the bar impossibly high.

Correct Answer: Limit teen passengers and ban phone use while driving

Motor vehicle crashes are the leading cause of death in adolescence, and teen passengers plus phone use are the two biggest multipliers. Graduated licensing restrictions target exactly those, which is why they save the most lives. Option b is incorrect because extra coursework has not been shown to lower crash rates for new drivers. Skill was never the shortfall here, since distraction and a carful of friends are what cause these crashes. Option c is incorrect because night driving limits belong in graduated licensing, yet weekend daylight rules alone leave the two habits described untouched. She would still drive a full car with the phone beside her. Option d is incorrect because texting at a red light still pulls attention from the road and the habit carries over into moving traffic. The guidance is no phone use at all behind the wheel.

Correct Answer: "He rides in a booster until the adult belt fits him."

A booster stays in use until the adult belt fits properly, which usually happens near four feet nine inches and somewhere between eight and twelve years. Fit, not age, ends this stage. Option a is incorrect because a belt on an eight-year-old typically crosses the neck and rides up over the belly. Those two positions cause the spinal and abdominal injuries that boosters exist to prevent. Option c is incorrect because the front seat waits until age thirteen, whatever restraint the child uses. Airbags deploy with force meant for adults, and a child sitting there absorbs it at head height. Option d is incorrect because a birthday does not decide when the booster comes out. Some children reach the needed height at eight and others not until twelve, so the belt fit is checked instead.

Correct Answer: If he falls asleep I will know the pain is gone.

Sleep does not rule out pain. Children fall asleep from exhaustion and distract themselves through play, so a quiet child may still be hurting and needs assessment with a proper tool. Option a is incorrect because asking a child to point to the sore place is exactly right for this age. Preschoolers locate pain well even though they describe its quality poorly. Option b is incorrect because premedicating before a painful procedure is sound practice, not an error. Treating pain ahead of the dressing change prevents the anticipatory dread that makes each later change worse. Option c is incorrect because a faces tool suits a preschooler and lets the child do the rating. The caregiver has described the method correctly, so this statement shows the teaching landed.

Correct Answer: Fifth disease caused by parvovirus

The slapped-cheek appearance with circumoral pallor followed by a lacy trunk and limb rash is erythema infectiosum. Flaring after heat, sunlight or exercise for weeks is expected and does not signal relapse. Option a is incorrect because rubella shows a pink maculopapular rash moving down from the face and clearing within about three days. Tender nodes behind the ears, not red cheeks, mark that illness. Option c is incorrect because roseola strikes infants with three to five days of high fever, then a rose-pink trunk rash as the fever breaks. Cheeks are not involved at all. Option d is incorrect because scarlet fever feels like sandpaper under the fingers and starts on the neck, axillae and groin. Sore throat, fever and a strawberry tongue come with it.

Correct Answer: It will pinch for a moment, then stop.

Honesty preserves trust, and a preschooler needs concrete words about what the body will feel. Saying it pinches briefly and then stops describes the sensation without promising something the nurse cannot deliver. Option b is incorrect because promising no pain sets up a betrayal the child will remember. Once the needle hurts, every later explanation from staff is doubted and cooperation for future procedures collapses. Option c is incorrect because praising bravery in advance shames a frightened child into hiding distress. The question asked about sensation, and this reply answers a different one while adding pressure. Option d is incorrect because preschoolers hear figurative language literally. A child who has never been stung imagines an insect in the room, and the comparison creates a fear larger than the procedure.

Correct Answer: The numeric rating scale from zero to ten

By ten years a child grasps number order and magnitude, so a zero to ten rating captures intensity directly. Self-report is the most reliable indicator whenever the child can give it. Option a is incorrect because that observational scale exists for children who cannot speak for themselves. Using it on an articulate ten-year-old substitutes the nurse's judgment for the child's own report. Option b is incorrect because neonatal scoring was built for newborns, reaching only to about the first birthday. Applying it to a school-age child produces a number that means nothing clinically. Option d is incorrect because behavioral observation belongs with children too young to describe pain. A ten-year-old can name the site, the quality and the intensity, so watching from a distance loses information.

Correct Answer: Place the client on droplet precautions

A non-blanching purpuric rash with meningeal signs suggests meningococcal disease, which travels in large droplets. Droplet precautions with a mask on entry stay in place until twenty-four hours of effective antibiotics. Option a is incorrect because negative pressure suits organisms suspended in droplet nuclei, and this bacterium is not one of them. Moving an unstable adolescent costs time better spent starting intravenous antibiotics without delay. Option b is incorrect because gown and glove barriers address organisms picked up from skin and surfaces. This organism spreads through respiratory secretions during close contact, so a mask protects staff far better. Option c is incorrect because watching perfusion matters yet does nothing to contain a reportable organism already loose on the unit. Every close contact would then need chemoprophylaxis that isolation could have prevented.

Correct Answer: Calcium and iron, both needed heavily during puberty

Adolescence carries the highest nutritional demand of childhood. Calcium at thirteen hundred milligrams daily builds peak bone mass that cannot be recovered later, and menstruating girls who skip meat and breakfast run the greatest risk of iron deficiency. Option b is incorrect because vitamin K deficiency shows up in newborns and in fat malabsorption, not in teenagers who avoid dairy. Magnesium shortfall from ordinary teenage eating is uncommon and is not the concern here. Option c is incorrect because sodium and chloride are plentiful in soda, fast food, and nearly every processed snack. A teenager eating this way takes in more salt than she needs, never less. Option d is incorrect because zinc and vitamin A do rise with the growth spurt, yet neither is the pair this diet strips out. Skipping dairy and meat targets calcium stores and iron stores directly.