Title WORKBOOK - PEDIA (SC) ✅

COMPREHENSIVE PHASE WORKBOOK PEDIATRIC NURSING NOV 2024 Philippine Nurse Licensure Examination Review 1. The most developed sense of the newborn is ___. A. Touch B. Taste C. Sight D. Hearing 2. The terms growth and development are often used interchangeably. To which of the following does development refer? A. A boy grows taller all through early childhood B. He learns to throw a ball overhand C. He triples his weight during the first year D. His brain increases in size until school age 3. Which of the following factors would contribute least to the ultimate height that a child reaches? A. His mother including nutritious food at meals B. The genetic material the child inherited C. Whether he enjoys active sport or not D. The occupations of his father and mother 4. The primary critical observation for Apgar scoring is the: A. Heart rate B. Respiratory rate C. Color D. Reflex irritability 5. Establishment of warmth after birth is made possible through the following means EXCEPT: A. Drying the skin immediately with towel B. Putting the baby on a pre-warmed crib with floor lamp C. Giving warm sterile water to warm up his stomach D. Letting the mother embrace the baby 6. At one minute after birth, a newborn’s body is pink with blue extremities, the heart rate is 99, there is withdrawal when the soles are flicked, the respiration are easy with no evidence of distress, and the arms and legs are flexed vigorously moving. The nurse assess the Apgar score to be: A. 6 B. 7 C. 8 D. 9 7. The following is true of neonatal screening except: A. done 24 hours after birth or before one week old B. cord blood is sent to the laboratory C. mandated to be done on all neonates D. provides information on some inborn error in metabolism that could be dangerous to the neonate 8. Several days after a baby girl’s birth she begins to vomit and lose weight. Galactosemia is diagnosed. The nurse explains to the parents that galactosemia is an inherited autosomal recessive disorder which is the result of: A. An intolerance of wheat and rye B. An inborn error of carbohydrate metabolism C. The inability to metabolize an essential amino acid D. The absence of parasympathetic ganglion cells in the colon 9. The nurse is aware that another diagnostic test is needed to further confirm phenylketonuria. The nurse is correct in choosing which of the following tests that utilizes urine specimen? A. Schillings test B. Phenistix C. Guthrie test D. Urinalysis 10. The parent of a child with congenital hypothyroidism is concerned about the condition of her child. The nurse knows that the most important consideration in caring for this child is all but which of the following? A. Safety B. Give levothyroxine C. Isolation D. Allow to play 11. During physical assessment of a newborn, which of the following comparative measurements would necessitate additional investigation? A. Head circumference 34 cm; chest circumference 31 cm B. Head circumference 31 cm; chest circumference 33 cm C. Head circumference 34.5 cm; chest circumference 32 cm D. Head circumference 32 cm; chest circumference 30 cm 12. A 6 month old infant is admitted with a diagnosis of failure to thrive. The birth weight was 7 pounds. Based on growth and development chart, the nurse should expect an infant at 6 months to weigh approximately: A. 10 pounds B. 14 pounds C. 18 pounds D. 21 pounds 13. Which of the following behaviors indicates normal biological development? A. A 6 week old begins to roll over B. A 6 months old sits without support C. A 7 month old transfer a toy from hand to hand D. A 7 month old stands unassisted 14. Appetite lags occur in toddlers for all the following reasons except: A. A form of rebellion against parents B. Physiology anorexia C. Preference from one type of food D. High activity level 15. During the oedipal stage of growth and development, the child: A. Loves and hates both parents B. Loves the parent of the same sex and the parent of the opposite sex C. Loves the parent of the opposite sex and hates the parent of the same sex D. Loves the parent of the same sex and hates the parent of the opposite sex 16. The usual position of the hand in the newborn is: A. open with fingers spread apart B. open with fingers flexed apart C. close with thumb inside the fingers D. close with thumb outside the fingers 17. Negativism and ritualistic behaviors are normal characteristics of: A. Preschoolers B. toddlers C. infants D. adolescents 18. A 5-year-old boy believes that there are “bogeymen and monsters” in his bedroom at night. What advice can the nurse give to Eric’s parent to help Eric cope with his fears? A. Let Eric sleep with his parent B. Tell Eric that bogeymen and monster do not exist C. Keep a night-light on in Eric’s room D. Tell Eric that no one else sees any monsters, so he must not see them either 19. On admission, the child’s weight is taken for the following purpose EXCEPT: A. as basis for child’s nutritional status 1 | Page
B. to determine child’s approximate age C. as basis for the dose of drug doctor will give D. to determine if child’s growth is within the normal. 20. Zendy was assessing melber, a 30 month-old child. She is correct if she states that the expected type of play Melbert should be exhibiting at his age would be: A. Parallel play B. Solitary play C. Competitive play D. Associative play 21. When assessing the social and emotional needs of a school-age child, you should focus on: A. psychosexual development and establishment of relationship B. development of self-esteem and feeling of social responsibility C. body image and feelings about future adult responsibility D. resolving role model conflict with parent of the same sex 22. The following are typical characteristics in the social behavior of a schooler. The most important is: A. opposite sex friends are preferred for variety B. not so significant as long as feeling of achievement is met C. same gender company gives more satisfaction D. teachers become most preferred company 23. Nutritional problems during adolescence are caused by all of the following except: A. Increased concern about their developing body image B. Greater variability in caloric needs about due to variability in activity patterns and growth requirements C. Peer group influence D. A lower basal metabolism 24. Which of the following statements best describes the nutritional profile of the adolescent? A. slow but steady growth, poor eating habits B. stunted growth, voracious appetite C. rapid growth, likes to eat alone D. rapid growth, desires companionship at meals 25. An 11-year-old adolescent asks you what the term puberty means. You tell her: A. it is the age at which one becomes capable of sexual reproduction B. it denotes completion of the development of secondary sex characteristics C. it is the time span between 12 and 18 years D. it is when boys and girls go out on dates 26. A nurse is performing an admission assessment on a 6-month-old infant with a diagnosis of hydrocephalus. The nurse assesses for the major sign associated with hydrocephalus when the nurse A. Palpates anterior fontanel. B. Takes the blood pressure. C. Takes the apical pulse. D. Test the urine for protein. 27. The following are normal characteristics of NB except: A. Jaundice after delivery B. pink body, blue extremities C. With full flexion of extremities D. Vigorous cry 28. A maternity nurse employed in a newborn nursery receives a telephone call from the delivery room and is told the newborn with spina bifida (meningomyelocele type) will be transported to the nursery. The maternity nurse prepares for the arrival of the newborn and places which of the following priority items at the newborn’s bedside? A. A bottle of sterile normal saline. B. A specific gravity urinometer. C. A rectal thermometer. D. A blood pressure cuff. 29. The nurse assesses a 5 year old child after a shunt procedure to correct increased ICP. The observation that is most concern would be: A. Marked irritability B. Complaints of pain C. A temperature of 99.4 degree F D. A pulse of 100 beats per minute 30. A newborn is diagnosed with coarctation of the aorta. The baby is discharged with a prescription for digoxin (Lanoxin) 0.01 mg po q12h. The bottle of digoxin is labeled 0.01 mg in 1⁄2 teaspoon. The nurse should teach the mother to administer the medication by using: A. A nipple B. A plastic baby spoon C. The calibrated dropper in the bottle D. The small size baby bottle with 1 0z of water 31. Which nursing diagnosis would best apply to an infant with Tetralogy of Fallot? A. Impaired gas exchange related to a left-to-right shunt B. Impaired skin integrity related to constant cyanosis C. Ineffective airway clearance related to constricted aorta D. Altered tissue perfusion related to pulmonary artery stenosis 32. Tetralogy of Fallot is the most frequently occurring type of cyanotic heart disease. The four anomalies associated with this defect are: A. Atrial septal defect, pulmonary stenosis, left ventricular hypertrophy, overriding of aorta B. Ventricular septal defect, aortic stenosis, mitral stenosis, right-sided aorta C. Mitral stenosis, right ventricular hypertrophy, pulmonary stenosis, atrial-septal defect D. Ventricular septal defect and right ventricular hypertrophy, pulmonary stenosis, overriding of aorta 33. A child with sickle cell anemia is admitted to the hospital with a vaso occlusive pain episode. The nurse is aware that this is a result of: A. Diminished red blood cell production by the bone marrow B. Pooling of blood in the spleen with resultant splenomegaly C. Blockage of small blood vessels with clumped red blood cells D. Severe depression in circulating thrombocytes 34. When giving nursing care to a child with leukemia, the nurse notes blood on the pillow case and several bloody tissues. The nurse should check the child’s laboratory report for the: A. Platelet count B. Uric acid level C. Prothrombin time D. Red blood cell count 35. The mother of a 13 year old has sickle cell anemia tells the nurse that the family is going camping this summer. She asks what activities would be appropriate for the child. The nurse should suggest: A. Softball games with the family B. Collecting logs for the campfire C. Motorboat rides around the lake D. Walking along the mountain trails 36. When obtaining history from the mother of an infant with celiac disease, the nurse would expect the mother to say that he baby: A. Is irritable at all times B. Has bulky, foul, frothy stools C. Drinks large amount of fluids D. Voids strong, concentrated urine 37. A 10-month-old infant was admitted to the hospital for severe abdominal pain. The doctor found out that the distal ileal segment of the child’s bowel has invaginated into the cecum. The nurse will suspect what disease condition? A. Intussusception B. Pyloric stenosis C. Hirschprung’s disease D. Vaginismus 38. Why does a toddler typically experience temper tantrums? A. It is the only way the toddler can gain attention from his or her mother B. More than likely, toddler is spoiled and needs a spanking C. The toddler cannot express his or her frustration verbally D. The toddler is expressing his or her need for identity 2 | Page
Situation: A full-term baby boy is delivered an hour ago via NSD. 39. For which of the following findings should the nurse notify the physician? A. Absent Pupillary reflex B. Expiratory grunt C. Respiratory rate of 40 breath/minutes D. Full breast areola 40. Which of the following assessment findings would alert the nurse that a newborn needs special attention? A. birth weight of 3,500 grams B. APGAR score of 3 C. positive babinski reflex D. RBC = 6 million/cu mm 41. The following are true in Apgar Scoring except: A. done by the birth attendant at 1 minute then 5 minutes after baby’s birth B. must have a perfect score of 10 at one minute to guarantee baby’s survival C. determines prioritization of the baby’s care after birth D. shows capability of the baby to adapt to extra-uterine life Situation: The nurse is caring for a neonate delivered by cesarean section at 43 weeks’ gestation. The neonate weighed 7 lbs, 8 oz. and had Apgar score of 7 at 1 minute and 9 at 5 minutes. 42. While assessing the neonate, the nurse explains to the mother that post-term neonates typically have A. soft, oily skin B. a long, thin body C. very few sole creases D. abundant lanugo 43. Soon after delivery, the neonate receives an injection of Vitamin K. The nurse explains to the mother that Vitamin K is given to the neonate because A. neonates have no gastrointestinal bacteria B. neonates are susceptible to clotting disorders C. hemolysis of the fetal red blood cells destroys vitamin K D. the neonate’s liver does not produce vitamin K 44. In caring for a newborn the nurse should consider the following normal EXCEPT: A. meconium which colored greenish black is passed 20 hours after birth B. yellow discoloration of skin and sclera 6 hours after birth C. secretions coming from slightly engorged breast D. urine is colorless, odorless Situation: A nurse is assigned at the NICU. During endorsement rounds the nurse performs her assessment of the newborn. 45. A newborn’s bilirubin level is 12mg/dl. The Doctor ordered Phototherapy. Which of the following interventions is NOT appropriate? A. Covering eyes and scrotum with an opaque mask B. Exposing the infant’s skin to light, turning q2h C. Assess capillary Blood glucose q6h D. Measure Intake and output 46. Which of the following interventions is done in order to hasten the excretion of Direct Bilirubin in a Newborn? A. Gentle exercise to stop muscle breakdown B. Keep Infant in a warm & dark environment C. Administration of oxygen supplement D. Early feeding Situation: Nurse Pauline works in a children’s clinic and helps with care for well and ill children of various age. 47. A nurse performs physical assessment to a two-month-old infant. Which of the following findings would require further investigation? A. Closed anterior fontanelle B. Symmetrical magnet reflex C. Multiple mongolian spots D. Positive moro reflex 48. An infant’s parent says “The soft spot near the front of my baby’s head is still big. When will it close?” The nurse’s best response would be at A. 2 to 4 months B. 5 to 8 months C. 9 to 11 months D. 12 to 18 months 49. When providing instructions regarding play to a mother of a 4-month old infant, the nurse should include which of the following? A. A rattle is an appropriate toy for baby this age B. A teething ring is an appropriate toy for baby his age. C. The baby should be provided with a playpen where he can roll over D. The mother can play peek-a-boo with the baby to stimulate cognitive development 50. When developing plan of care for a child, the nurse identifies which Eriksonian stage as corresponding to Freud’s oral stage of psychosexual development? A. Initiative vs. Guilt B. Autonomy vs. Shame & Doubt C. Industry vs. Inferiority D. Trust vs. Mistrust 51. A mother of a 5-month-old baby asks the nurse which tooth typically erupts first? A. lower central incisor B. upper central incisor C. lower lateral incisor D. upper lateral incisor 52. When teaching the mother on accident prevention on a 6-month-old infant, the nurse should emphasize that at this age the infant can usually A. sit up B. roll over C. crawl lengthy distances D. stand while holding on a furniture 53. An infant’s developmental task in the psychosocial theory is “trust vs mistrust”. Which of the following interventions will help the infant develop trust? A. Attend to the infant’s needs B. Motivate to explore and produce C. Allow child to make simple choices D. Encourage creativity and imagination 54. When obtaining vital signs on a sleeping 3-month old infant, which of the following assessments would the nurse obtains first A. Respiratory rate B. Apical pulse C. axillary temperature D. blood pressure 55. A 2 1⁄2-year-old child is brought with her 2-month-old sibling to the clinic by his father, who explains that the older child says “no” whenever asked to do something. The nurse would explain that the negativism demonstrated by toddlers is frequently an expression of A. a need to expend excess energy B. a pursuit of autonomy C. separation anxiety D. sibling rivalry 56. A father brings his 18 month old son to the clinic. He asks the nurse why his son is so difficult to please, has temper tantrums, and annoys him by throwing food from the table. The nurse should explain that A. Toddlers need to be disciplined at this stage to prevent the development of antisocial behaviors B. The child is learning to assert independence, and his behavior is considered normal for his age C. This is the usual way that the toddler expresses his needs during the initiative stage of development D. It is best to leave the child alone in his crib after calmly telling him why his behavior is unacceptable 57. Ear drops, instilled twice a day, are prescribed for a 2 year old child. When observing the parent instilling the drops, the nurse decides the teaching concerning how to position the ear lobe when instilling drops is effective when the parent pulls the toddler’s ear lobe A. up and forward B. up and backward C. down and forward D. down and backwards 58. Mrs. Wallace expresses concern because Robby has begun thumb sucking which he had previously outgrown. The nurse would note this behavior as: 3 | Page
A. Conservation B. Regression C. Castration D. Bruxism 59. Which of the following type of play would a preschooler typically be involved in? A. Solitary B. Parallel C. Associative D. Competitive 60. The Oedipus or Electra Complex is likely to occur In which period of development according to Freud? A. Oral B. Anal C. Phallic D. Genital 61. While playing Joshua accidentally obtained an inch of scraped skin on the left knee. He cries intensely after seeig the injury, you described it as a manifestation to fear of: A. Dark B. Mutilation C. Separation D. Abandonment 62. A mother shares to the nurse about her preschooler child who is bedwetting. Which of the following would be appropriate to advise? A. “Give less fluid at night.” B. “Allow Robby to wear diapers every night.” C. “Bribe your child as a way of reinforcement.” D. “Threaten him as a way of disciplining.” 63. According to Erikson's theory of development, chronic illness can interfere with which stage of development in an 11-year-old? A. Intimacy versus isolation B. Trust versus mistrust C. Industry versus inferiority D. Identity versus role confusion 64. A mother of a 7-year-old boy ported that he son resist to attend his classes. As a school nurse which of the following is the appropriate action? A. Determine the cause of resistance to school B. Allow the client to take a vacation C. Discipline and punish the child D. Isolate the child 65. On average, the adolescent growth spurt begins: A. Earlier for boys than for girls B. Earlier for girls than for boys C. At approximately the same time for both sexes D. Between the seventh and eighth years 66. According to developmental authorities, the tasks of adolescents include the following except: A. Development of strong family ties B. Acquiring a set of values and ethics C. Acceptance of a new body image D. Achieving a masculine or feminine social role 67. A 14-year-old child must have the capacity for self-awareness to: A. Develop role identity B. Eliminate fear of the dark C. Maintain self-control D. Focus on more than one dimension of an object 68. A post-mature baby will be anticipated for the following problems EXCEPT: A. infection due to meconium aspiration B. metabolic acidosis due to cold stress C. hyperbilirubinemia due to polycythemia D. hyperglycemia due to overstaying inside the uterus 69. Immediate nursing care for a neonate born with a cleft lip is directed primarily toward: A. Modifying feeding methods B. Keeping the baby from crying C. Minimizing handling by parents D. Preventing the occurrence of infection 70. A priority nursing measure for an infant during the immediate post-operative period following a surgical repair of a cleft lip is to: A. Minimize the infant’s crying B. Restraint the infant at all times C. Oxygenate the infant frequently D. Handle the infant as little as possible 71. The characteristic cough of laryngotracheobronchitis will be: A. dry and hacking B. barking and “seal-like” C. moist and productive D. spasmodic with wheezing 72. An infant with tetralogy of Fallot became cyanotic and dyspneic after a crying episode. To relieve the cyanosis and dyspnea, the nurse should place the infant in the: A. Knee-chest position B. Orthopneic position C. Side lying position D. Semi Fowler’s position 73. The mother of a 5-month-old infant with heart failure questions the necessity of weighing the infant every morning. The nurse’s response should be based on the fact that this daily information is important in determining: A. Renal failure B. Fluid retention C. Nutritional status D. Medication dosage 74. The clubbing seen on the fingers of patients with tetralogy of fallot indicates: A. clot formation on the distal extremities B. the body responding to peripheral hypoxia C. the child is dehydrated D. the child is calcium deficient 75. A 1-year-old with postductal coarctation of the aorta is admitted to the acute care unit for treatment. When performing an assessment, you find that the lower extremities are cool. Which finding should you anticipate as the assessment continues? A. Bounding femoral pulse B. Low blood pressure in the arms C. Low blood pressure in the legs D. Bilateral pedal edema 76. When a child with hemophilia complains of joint pains, what should be the immediate management upon noting that the part is swelling? A. apply warm compress to relieve the pain B. give aspirin then apply ice to the area C. immobilize the part then bring to the hospital D. consider this as normal for hemophilic patient 77. Teaching for parents whose baby is undergoing frequent casting to correct a foot deformity should include information on cast care, such as: A. Covering damp cast with adhesive petals B. Applying lotion to the skin at cast edges to keep it soft C. Checking the skin at the edges of the cast daily for redness D. Immersing the cast briefly during the tab bath and wiping it lightly 78. When assessing a newborn for developmental dysplasia of the hip, the nurse would expect to asses which of the following? A. Symmetrical gluteal folds B. Trendelenburg sign C. Ortolani sign D. Characteristic limp 79. A 6-week-old infant is brought to the clinic by her parents. They state that their baby has been vomiting with increasing frequency and force after feeding. Pyloric stenosis is diagnosed. The nurse is aware that the manifestations of pyloric stenosis are: A. Avid hunger and effortless vomitus B. Non-bile stained vomitus and visible peristaltic wavesc C. Vomiting several hours after a feeding and tarry stools D. Bile-stained vomitus and generalized abdominal distention 80. An 8-month-old infant was admitted to the ER from the OPD. The manifestations presented points to a possible Hirschsprungs disease. These would include the following EXCEPT: A. olive-shaped mass B. stool with blood and mucus C. severe abdominal distention D. history of constipation 4 | Page