(A)Appendicitis
(B) Colonic arteriovenous malformation
(C) Colonic diverticulitis
(D) Gastric stress ulcer
(E) Meckel’s diverticulitis
02. A male infant weighing 3 kg is born via spontaneous vaginal delivery at 37 weeks’gestation. His Apgar score is 6/9 at 1 and 5 minutes. The patient is in no apparent distress.Physical examination reveals no anus. What is the most appropriate initial step in this patient’s management?
(A)Colostomy
(B) Continued observation for 24 hours
(C) Intubation and mechanical ventilation
(D) Magnetic resonance imaging (MRI) of
the abdomen and pelvis
(E) Posterior sagittal anorectoplasty
03. A 12-year-old boy who is at the 90th percentile for weight complains of slight pain in the right thigh and knee for about a month. His complains are made worse by physical activity and he has a mild limp. He has no history of recent infections or trauma. Physical examination reveals a slight decrease in internal rotation of the right hip. There is mild right-sided metaphyseal osteopenia on radiograph. Of the following, which would be the MOST likely diagnosis in this boy?
A) Transient synovitis
B) Septic arthritis
C) Osteomyelitis
D) Slipped capital femoral epiphysis
E) Legg-Calve-Perthes disease
04. You are in your office late one cold winter evening,seeing a pair of siblings who have a cold and cough.
The mother and paternal grandmother are there. The grandmother notes that the best way to prevent the
spread of colds is by wearing a wool hat at all times.What should you say?
A.Agree and pull out a cartoon with the trademarked hats promoting your practice
B. Wearing a face mask and eye shields is the best method
C. Limiting exposure to other children to once weekly would help
D.Washing hands and all toys frequently would be fine
E. Isolating all children with colds is the best method
05. A 13-year-old girl appears at your office at 5:05 PM for a 3:30 PM appointment scheduled for the day before.Her mother tells you that the girl has been limping for a couple of weeks and has much knee pain. She has been afebrile, does not recall being hit in the knee or leg, and has not had any illnesses recently. She has difficulty "moving her leg inward." Given the late hour and that the workup will be done in the emergency department, you impress the pediatric emergency department staff by telling them that the most likely diagnosis is one of the following:
A. She twisted the leg trying to be on time for the appointment yesterday
B. Septic arthritis of the hip
C. Septic arthritis of the knee
D. Aseptic necrosis of the hip
E. Slipped capital femoral epiphysis
06. A newborn’s failure to pass meconium within 24 hours after birth may indicate which of the following?
a. Aganglionic Mega colon
b. Celiac disease
c. Intussusception
d. Abdominal wall defect
07. When assessing a newborn for developmental dysplasia of the hip, the nurse would expect to assess which of the following?
a. Symmetrical gluteal folds
b. Trendelemburg sign
c. Ortolani’s sign
d. Characteristic limp
08. What would cause the closure of the Foramen ovale after the baby had been delivered?
a. Decreased blood flow
b. Shifting of pressures from right side to the
left side of the heart
c. Increased PO2
d. Increased in oxygen saturation
09. A child discharged with slow cerebrospinal fluid (CSF) leak 3 days after a head injury was sustained. What will the nurse include in the discharge plans?
a) avoid use of nonsteroidal anti-inflammatory drugs
b) turn from side to side only
c) maintain complete bed rest
d) gradually increase diet to clear liquids
10. Which of the following signs and symptoms would observe in a child diagnosed
of laryngotracheobronchitis?
a) predominant stridor on inspiration
b) predominant expiratory wheeze
c) high fever
d) slow respiratory rate
11. Which of the following statements indicate that the adolescent is having an
early sign of anorexia nervosa?
a) I have my menses every month
b) I go out to eat with my friends
c) I run three times a day for a total of 5 hours per day
d) I try to maintain my weight around 115 lbs. for my height of 5 feet
12. The nurse is caring for several infants who are 2-day old. Who among these infants should be
given highest priority by the nurse?
a) a bottlefed infant who takes 1-ounce of milk every 3 to 5 hours
b) a breastfed infant who lost 0.5 ounce of his weight
c) a bottlefed infant who takes 2 to 3 ounces of milk every 2 to 4 hours
d) a breastfed infant who feeds every 2 to 4 hours
13. Which of the following can indicate leftsided heart failure in an infant?
A: fever
B: low appetite
C: increased respiratory rate
D: crying
14. Which of the following is NOT part of the triad of cystic fibrosis?
A: pancreatic enzyme deficiency
B: fever
C: high concentration of sweat electrolytes
D: COPD
15. When assessing a child with a cleft palate, the nurse is aware that the child is at risk for more frequent episodes of otitismedia due to which of the following?
a. Lowered resistance from malnutrition
b. Ineffective functioning of the Eustachian tubes
c. Plugging of the Eustachian tubes with food particles
d. Associated congenital defects of the middle ear.
16. Which of the following should the nurse expect to note as a frequent complication for a child with congenital heart disease?
a. Susceptibility to respiratory infection
b. Bleeding tendencies
c. Frequent vomiting and diarrhea
d. Seizure disorder
17. Which of the following should the nurse do first after noting that a child with Hirschsprung disease has a fever and watery explosive diarrhea?
a. Notify the physician immediately
b. Administer antidiarrheal medications
c. Monitor child ever 30 minutes
d. Nothing, this is characteristic of Hirschsprung disease
18. While assessing a child with pyloric stenosis, the nurse is likely to note which of the following?
a. Regurgitation
b. Steatorrhea
c. Projectile vomiting
d. “Currant jelly” stools
19. When positioning the neonate with an unrepaired myelomeningocele, which of the following positions would be most appropriate?
a) supine the hip at 90 degree flexion
b) right side-lying position with knees flexed
c) prone with hips in abduction
d) semi-fowler's position with chest and abdomen elevated
20. A 4 year old with hydrocephalus is scheduled to have a ventroperitoneal shunt in the right side of the head. When developing the child's postoperative plan of care, the nurse would expect to place the preschooler in which of the following positions immediately after surgery?
a) on the right side, with the foot of the bed elevated
b) on the left side, with the head of the bed elevated
c) prone with the head of the bed elevated
d) supine, with the head of the bed flat
21. After talking with the parents of a child with Down Syndrome, which of the following
would the nurse identify as an appropriate goal of care of the child?
a) encouraging self-care skills in the child
b) teaching the child something new each day
c) encouraging more lenient behavior limits for the child
d) achieving age-appropriate social skills
22. When teaching an adolescent with a seizure disorder who is receiving Valproic acid (Depakene), which of the following would the nurse instruct the client to report the health care provider?
a) three episodes of diarrhea
b) loss of appetite
c) jaundice
d) sore throat
23. A hospitalized preschooler with meningitis who is to be discharged becomes angry when
the discharge is delayed. Which of the following play activities would be most appropriate at this time?
a) reading the child a story
b) painting with water colors
c) pounding on a pegboard
d) stacking a tower of blocks
Answers and Rationals
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