Pediatric Nursing Fundamentals Flashcards

A 3-year-old child is admitted with suspected epiglottitis. Which nursing action is the priority?

Answer: Keep the child calm, do not agitate, and notify the charge nurse immediately

Epiglottitis can cause complete airway obstruction. Examination of the throat with a tongue depressor can trigger laryngospasm. The priority is maintaining a calm environment and preparing for emergency airway management.

The LPN is caring for a 2-year-old child in a mist tent. Which nursing action is most important?

Answer: Change the child's clothing and bed linens frequently to prevent hypothermia

Mist tents create a cool, moist environment that can cause hypothermia in young children. Frequent changes of wet clothing and linens are essential to maintain temperature.

A 7-month-old infant is brought to the emergency department. The parent reports the infant 'won't stop crying and is pulling at the right ear.' The infant has a temperature of 38.8°C (101.8°F). The LPN should expect the provider to order:

Answer: Assessment for otitis media and likely antibiotic therapy

Ear pulling combined with fever, irritability, and age less than 2 years are classic signs of acute otitis media (middle ear infection), treated with antibiotics in infants under 2 years.

A child is admitted with suspected Reye's syndrome. Which historical finding in the chart most supports this diagnosis?

Answer: Aspirin use during a recent viral illness (chickenpox or influenza)

Reye's syndrome is strongly associated with aspirin (salicylate) use in children during viral illnesses, particularly varicella or influenza, causing acute hepatic encephalopathy.

An LPN is assessing a 4-year-old with suspected intussusception. Which clinical finding is most characteristic of this condition?

Answer: Episodic severe abdominal cramping with periods of normal behavior and currant jelly stools

Intussusception classically presents with colicky abdominal pain (episodic with normal intervals), vomiting, and currant jelly stools (blood and mucus from intestinal ischemia).

The LPN is caring for a 6-year-old child with nephrotic syndrome. Which finding is the primary characteristic of this condition?

Answer: Massive proteinuria, hypoalbuminemia, and generalized edema (anasarca)

Nephrotic syndrome is defined by the triad of massive proteinuria (>3.5 g/day), hypoalbuminemia (<3 g/dL), and generalized edema from reduced oncotic pressure.

A school-age child receives a tympanostomy tube (ear tube) and is being discharged. Which instruction should the LPN include?

Answer: Keep water out of the ear with earplugs during bathing and swimming until the provider clears it

Water in the ear canal can travel through the tympanostomy tube into the middle ear, causing otitis media. Earplugs or cotton with petroleum jelly protect the ear during water exposure.

A 9-month-old infant is brought in for a well-child visit. Which developmental milestone would the LPN expect this infant to demonstrate?

Answer: Sitting without support and pulling to stand

By 9 months, infants should be able to sit without support (achieved by 6–7 months) and begin pulling to a standing position using furniture.

A 4-year-old child is scheduled for a tonsillectomy. Which postoperative finding requires immediate nursing action?

Answer: Swallowing frequently and blood-tinged saliva

Frequent swallowing after tonsillectomy is a sign of hemorrhage — the child is swallowing blood. This is a postoperative emergency requiring immediate intervention.

A child with sickle cell disease presents with fever of 38.9°C (102°F), severe bone pain, and pallor. The LPN recognizes this as a vaso-occlusive crisis. Which intervention is the priority?

Answer: Administer supplemental oxygen, IV fluids, and analgesics as ordered

Vaso-occlusive crisis treatment focuses on hydration (to reduce blood viscosity), opioid analgesia (to manage severe pain), oxygen (if hypoxic), and warmth.

A 2-year-old child is brought to the clinic after ingesting an unknown amount of acetaminophen approximately 1 hour ago. The child is currently asymptomatic. The LPN should:

Answer: Immediately notify the charge nurse and contact Poison Control

Even asymptomatic acetaminophen overdose can cause delayed liver failure. Any ingestion in a child requires immediate notification and contact with Poison Control for guidance on N-acetylcysteine administration.

A 5-year-old child is hospitalized and undergoing a painful procedure. Which distraction technique is most developmentally appropriate?

Answer: Providing a pinwheel or bubbles to blow during the procedure

Blowing bubbles or a pinwheel provides developmentally appropriate distraction for a preschooler during painful procedures, promoting controlled breathing and reducing anxiety.

A 15-year-old adolescent with type 1 diabetes is being discharged. Which statement by the adolescent indicates a need for further teaching?

Answer: I can skip my insulin on days when I'm not eating much to avoid low blood sugar

Insulin must NEVER be skipped in type 1 diabetes because the pancreas produces no insulin. Skipping insulin causes diabetic ketoacidosis (DKA), not just low blood sugar.

A newborn is born with a cleft lip and palate. Which nursing action is the priority in the neonatal period?

Answer: Ensure adequate nutrition by using specialized cleft feeder and positioning

Before surgical repair (done at 2–3 months for cleft lip), the priority is ensuring adequate nutrition using a specialized cleft palate feeder and upright positioning to reduce regurgitation and aspiration.

An 8-year-old child is admitted with diabetic ketoacidosis (DKA). Which laboratory finding is most consistent with this diagnosis?

Answer: Blood glucose 320 mg/dL, pH 7.20, positive serum ketones, bicarbonate 10 mEq/L

DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.30, bicarbonate <18 mEq/L), and positive serum or urine ketones.

The LPN is caring for a child who has been physically abused. After stabilizing the child medically, which action is the priority?

Answer: Document objective findings and report to the charge nurse for mandatory reporting

All healthcare workers are mandated reporters. The LPN must objectively document physical findings and report suspected abuse through proper channels without confronting or investigating independently.

A 4-year-old is admitted with croup (laryngotracheobronchitis). The parents are anxious because the child has a harsh, seal-like barking cough. The LPN should explain that initial home management includes:

Answer: Taking the child outside into cool, humid night air or sitting in front of an open freezer

Cool, moist air (night air or from a cool mist humidifier) reduces subglottic edema and quickly relieves the barking cough and stridor of croup.

A 14-year-old with anorexia nervosa is admitted for medical stabilization. The LPN recognizes the most immediate physiological danger as:

Answer: Cardiac arrhythmias from electrolyte disturbances (hypokalemia, hypomagnesemia)

In anorexia nervosa, electrolyte disturbances — especially hypokalemia from purging or severe restriction — are the most immediate life-threatening risk, causing potentially fatal cardiac arrhythmias.

A 3-year-old child is in Bryant's traction for a fractured femur. The LPN should assess for which complication specific to this traction type?

Answer: Impaired circulation to the buttocks and perineum

Bryant's traction suspends both legs vertically at 90 degrees, which can impair blood flow to the buttocks, perineum, and lower extremities, risking ischemia.

A toddler is admitted with iron deficiency anemia. The LPN is teaching the parents about dietary iron sources. Which foods should be recommended?

Answer: Lean meats, fortified cereals, legumes, and dark leafy vegetables

Heme iron (lean meats) and non-heme iron (fortified cereals, legumes, dark leafy vegetables) are the best dietary sources of iron for toddlers with iron deficiency anemia.