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Q1: A nurse is assessing a 10-month-old infant. Which of the following findings should the nurse report to the provider?
Answer Choices:
A. The infant does not sit steadily without support.
B. The infant cannot build a tower of three or four cubes.
C. The infant cannot turn pages in a book.
D. The infant is unable to imitate animal sounds-
Correct Answer: The infant does not sit steadily without support.
Rationale:
- By 10 months of age, infants are expected to sit steadily without support. This gross motor milestone typically develops by around 6–8 months.
- An inability to sit unsupported by 10 months may signal a delay in neuromuscular development and warrants further evaluation.
- Building a cube tower, turning pages, imitating animal sounds are milestones expected later—closer to toddlerhood—they are not concerning at this age.
- Early identification of developmental delays is key to prompt intervention and optimal outcomes.
Q2: A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take?
Answer Choices:
A. Place the child in an upright position_
B. Transport the child to radiology for a throat x-ray.
C. Visualize the epiglottis with a tongue depressor.
D. Obtain a throat culture.
Correct Answer: Place the child in an upright position_
Rationale:
- Epiglottitis is a life-threatening condition characterized by inflammation of the epiglottis, leading to airway obstruction. The priority is to maintain airway patency.
- Sitting the child upright allows gravity to aid breathing and reduces airway obstruction.
- Throat cultures and visualizing the throat with a tongue depressor are contraindicated as they can provoke laryngospasm, leading to complete airway obstruction.
- Transport to radiology should not occur until the airway is secured and the child is stable.
- The nurse must prioritize non-invasive airway support and prepare for potential emergency intubation.
Q3: An 8-year-old child on the pediatric unit recovering from severe persistent asthma is on the cardiac monitor. The nurse hears an alarm, and noted the leads on the child are on. The nurse checked for responsiveness, and the child is not responding to tactile response. What are the nurse's next actions?
Answer Choices:
A. Maintain the child's airway
B. Call for help, then check for a pulse
C. Start chest compression
D. Inform the physician that the child has no pulse
Correct Answer: Call for help, then check for a pulse
Rationale:
- In a pediatric emergency, the first step when a child is unresponsive is to call for help, then check for a pulse.
- If the child has no pulse, the nurse should then begin chest compressions.
- Ensuring the airway is important but not the first step before confirming pulselessness.
- Telling the physician comes after initiating emergency measures.
- The correct action sequence aligns with pediatric basic life support (BLS): Check responsiveness → call for help → check pulse → start CPR if no pulse.
Q4: A nurse is assessing a 15-month-old toddler. Which of the following findings should the nurse report to the provider?
Answer Choices:
A. The toddler cannot jump with both feet.
B. The toddler cannot stand upright without support.
C. The toddler cannot turn a doorknob.
D. The toddler cannot build a tower of six to seven cubes.
Correct Answer: The toddler cannot stand upright without support.
Rationale:
- By 12–15 months, toddlers are expected to stand and walk independently.
- If a 15-month-old cannot stand without support, this is a gross motor delay that requires further evaluation.
- In contrast, jumping with both feet, turning doorknobs, and stacking multiple cubes are fine motor or coordination milestones expected later, typically around 2–3 years.
- Gross motor delays are typically prioritized for earlier intervention due to their impact on mobility and development.
Q5: A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.)
Answer Choices:
A. Symptoms are continuous throughout the day
B. Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value.
C. Nighttime symptoms occur approximately twice a month.
D. Daytime symptoms occur more than twice a week.
E. Minor limitations with normal activity
Correct Answer: Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value.
Rationale:
- Mild persistent asthma is characterized by daytime symptoms more than twice a week but not daily, nighttime symptoms 3–4 times a month, and PEF ≥80% of the predicted value.
- These children may have minor limitations in normal activities. Symptoms are not continuous throughout the day—that would describe severe persistent asthma.
- Understanding these classifications helps guide treatment plans such as inhaled corticosteroids and rescue inhaler use.
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