Welcome to Pediatric NCLEX Questions. Enjoy answering and I hope that NCLEX Prep Course Online can somehow help you in your future examination.
1. A mother arrives at the emergency department with her child, stating that she just found the child sitting on the floor next to an empty bottle of aspirin. On assessment, the nurse notes that the child is drowsy but conscious. The nurse anticipates that the physician will prescribe which of the following?
a) ipecac syrup
b) activated charcoal
c) magnesium citrate
d) magnesium sulfate
2. A preschooler with a history of cleft palate repair comes to the clinic for a routine well-child check up. To determine whether this child is experiencing a long-term effect of cleft palate, the nurse asks the parent which question?
a) does the child play with an imaginary friend?
b) was the child recently treated for pneumonia?
c) is the child unresponsive when given directions?
d) has the child had any difficulty swallowing food?
3. A child is admitted to the orthopedic nursing unit after spinal rod insertion for the treatment of scoliosis. Which assessment is most important in the immediate postoperative period?
a) pain level
b) ability to flex and extend the feet
c) ability to turn using the logroll technique
d) capillary refill, sensation, and motion in all extremities
4. A child has just returned from surgery and has a hip spica cast. A priority nursing action this time is to:
a) elevate the head of the bed
b) assess the child's circulatory status
c) abduct the hips, using pillows
d) turn the child on the right side
5. An emergency department nurse prepares to treat a child with acetaminophen (tylenol) overdose. The nurse reviews the physician's orders, expecting that which of the following will be prescribed?
a) protamine sulfate
b) succimer (chemet)
c) acetylcysteine (mucomyst)
d) vitamin K (aquaMEPHYTON)
Pediatric NCLEX Questions
Answers and Rationale
- Whereas ipecac is administered to induce vomiting in certain poisoning situations, it is not recommended as the initial treatment in the hospital setting for ingestion of salicylates. This is because ipecac does not totally remove the poison from the child's system. In this situation, the child is conscious and the ingested substance (aspirin) would not damage the esophagus or lungs from vomiting. However, activated charcoal would be prescribed as an antidote in this poisoning situation, because its action is to absorb ingested toxic substances and thus decrease absorption. Options C and D are unrelated to treatment for this occurrence.
- Unresponsiveness may be an indication that the child is experiencing hearing loss. A child who has a history of cleft palate should be routinely checked for hearing loss. Options B and D are unrelated to cleft palate after repair. Option A is normal behavior for a preschool child. Many preschoolers with vivid imaginations have imaginary friends.
- When the spinal column is manipulated during surgery, altered neurovascular status is a possible complication; therefore, neurovascular checks including circulation, sensation, and motion should be done at least every 2 hours. Level of pain is an important postoperative assessment, but circulatory status is more important. Assessment of flexion and extension of the lower extremities is a component of option D, which includes checking motion. Logrolling is performed by nurses.
- During the first few hours after a cast is applied, the chief concern is swelling that may cause the cast to act as a tourniquet and obstruct circulation, resulting in compartment syndrome. Therefore, circulatory assessment is the priority. Elevating the head of the bed of a child in a hip spica cast would cause discomfort. Using pillows to abduct the hips is not necessary because a hip spica cast immobilizes the hip and knee. Turning the child side to side at least every 2 hours is important because it allows the body cast to dry evenly and prevents complications related to immobility; however, it is not a higher priority than checking circulation.
- Acetylcysteine (Mucomyst) is the antidote for acetaminophen overdose. It is administered orally or via nasogastric tube in a diluted form with water, juice, or soda. It can also be administered intravenously. Vitamin K is the antidote for warfarin (Coumadin). Protamine sulfate is the antidote for heparin. Succimer (Chemet) is used in the treatment of lead poisoning.
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Pediatric NCLEX Questions (6-10)