Pediatric Nursing: Growth and Development Flashcards
24 cards from real NCLEX practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 20 Pediatric Nursing: Growth and Development flashcards as text
A nurse is assessing a 2-year-old child. Which developmental milestone would the nurse expect to find?
Answer: Using 50+ words and combining 2-word phrases
At 2 years, children typically have a vocabulary of 50+ words and combine 2-word phrases ('more milk,' 'daddy go'). Walking with alternating feet on stairs develops around age 3. Sentences develop by age 3–4.
A parent asks when their infant should receive the first dose of the hepatitis B vaccine. The nurse should respond:
Answer: Within 24 hours of birth
The CDC recommends the first dose of hepatitis B vaccine within 24 hours of birth for all newborns. This is especially important if the mother's hepatitis B status is unknown or positive.
A nurse is caring for a child with epiglottitis. Which intervention should the nurse avoid?
Answer: Examining the throat with a tongue depressor to visualize the epiglottis
Direct inspection of the throat with a tongue depressor can cause laryngospasm and complete airway obstruction in epiglottitis. This is absolutely contraindicated and can be fatal.
A nurse is caring for a child with croup (laryngotracheobronchitis). The child has a 'barky' cough and inspiratory stridor at rest. Which treatment is most appropriate?
Answer: Administer nebulized racemic epinephrine and oral/IM dexamethasone
Moderate-to-severe croup with stridor at rest is treated with nebulized racemic epinephrine (reduces edema) and dexamethasone (corticosteroid reduces inflammation). Croup is viral and does not require antibiotics.
The nurse is performing a developmental assessment on a 4-month-old infant. Which finding would be cause for concern?
Answer: No social smile in response to caregiver
Social smiling (responsive smile to a caregiver's face) normally develops by 6–8 weeks. Absence of a social smile by 4 months is a developmental red flag requiring further evaluation.
A nurse is educating parents about preventing sudden infant death syndrome (SIDS). Which recommendation is most important?
Answer: Place the infant in a supine (back) position on a firm mattress in their own sleep space
The 'Back to Sleep' (now Safe Sleep) campaign recommendation: always place infants on their backs on a firm, flat surface. This is the single most effective SIDS prevention measure, reducing SIDS by 50%.
A school-age child (8 years old) is admitted for an appendectomy. According to Erikson's theory of psychosocial development, which stage is this child in?
Answer: Industry vs. Inferiority
School-age children (6–12 years) are in Erikson's Industry vs. Inferiority stage, where the central task is developing competence and skills. Hospitalization can threaten this by disrupting school and peer activities.
A nurse is assessing a 6-month-old infant for dehydration. Which clinical sign is the most reliable indicator of dehydration in infants?
Answer: Skin turgor — tenting when pinched and slow return (>2 seconds)
Skin turgor (skin tenting) is the most reliable physical sign of dehydration in infants and young children. Normal skin returns immediately; tenting (>2 second return) indicates significant fluid deficit.
A child with sickle cell disease presents to the emergency department with severe bone pain, fever, and swelling in the hands and feet. What condition does this most likely represent?
Answer: Vaso-occlusive (pain) crisis
Vaso-occlusive (pain) crisis is the most common sickle cell complication, caused by sickling of RBCs in small vessels. Dactylitis (swelling of hands/feet) is a classic early presentation in young children.
A nurse is educating parents of a child diagnosed with type 1 diabetes about sick day management. Which instruction is most important?
Answer: Continue insulin, check blood glucose every 1–2 hours, and check urine/blood ketones
Illness triggers stress hormones that raise blood glucose and ketone production. Insulin should NEVER be withheld during illness — the child needs insulin plus additional monitoring for hypoglycemia and DKA prevention.
An adolescent patient refuses a painful dressing change. According to Piaget's cognitive development theory, which stage is the adolescent in?
Answer: Formal Operational
Adolescents (12+ years) are in the Formal Operational stage (Piaget), characterized by abstract thinking, logical reasoning, and the ability to consider hypothetical situations — relevant to understanding medical consequences.
A nurse is caring for a child with bacterial meningitis. Which assessment finding requires immediate intervention?
Answer: Petechial rash spreading rapidly with purpura
A rapidly spreading petechial/purpuric rash in bacterial meningitis indicates meningococcemia — disseminated meningococcal infection with septicemia and potential DIC. This is immediately life-threatening.
A 3-year-old child is admitted for a urinary tract infection (UTI). Which urine specimen collection method is most appropriate for this age group?
Answer: Catheter specimen (urethral catheterization) or suprapubic aspiration for accurate culture
In children who are not toilet-trained or whose bag specimen results are questionable, catheterization or suprapubic aspiration provides the most accurate, non-contaminated specimen for culture.
Which assessment finding in a newborn at 24 hours of life requires the nurse to immediately notify the provider?
Answer: Jaundice (yellow discoloration) visible at 24 hours of life
Jaundice appearing within the first 24 hours of life is pathologic (not physiologic) and requires immediate evaluation. It suggests hemolytic disease (ABO or Rh incompatibility) requiring urgent bilirubin measurement.
A nurse is assessing a toddler's pain using the FACES Pain Rating Scale. The child points to the second face with a slight frown. How should the nurse interpret this?
Answer: Mild pain — the second face represents a pain level of 2/10
In the Wong-Baker FACES Pain Scale (0–10), the second face (slight frown) represents mild discomfort (score 2/10). This indicates mild pain that may be managed with non-pharmacological methods first.
A nurse is teaching parents of a child with febrile seizures. Which statement indicates the parents need further teaching?
Answer: I should give aspirin to quickly reduce the fever and stop the seizure
Aspirin is contraindicated in children under 18 years due to the risk of Reye's syndrome. Fever reducers (acetaminophen or ibuprofen) may be used but do not reliably prevent febrile seizures.
A nurse is administering a medication to a 10-kg pediatric patient with an ordered dose of 15 mg/kg. The medication is available as 250 mg/5 mL. What volume should the nurse administer?
Answer: 3 mL
Step 1: Calculate dose = 15 mg/kg × 10 kg = 150 mg. Step 2: Calculate volume = 150 mg ÷ 250 mg/5 mL = 150 × 5/250 = 750/250 = 3 mL.
A nurse is assessing a 15-year-old for scoliosis using the Adam's forward bend test. Which finding indicates scoliosis?
Answer: Asymmetric elevation of one side of the rib cage (rib hump) on forward bending
The Adam's forward bend test reveals scoliosis as a rib hump (prominence on one side) when the patient bends forward at the waist. This is caused by vertebral rotation characteristic of idiopathic scoliosis.
A 2-year-old child is brought to the ED with suspected non-accidental trauma (child abuse). Which fracture pattern is most concerning for abuse?
Answer: Posterior rib fractures or metaphyseal 'corner' fractures in different stages of healing
Posterior rib fractures and classic metaphyseal lesions (corner/bucket-handle fractures) in various stages of healing are highly specific for non-accidental trauma as they require high-force shaking or gripping mechanisms inconsistent with typical accidents.
A nurse is educating parents about car seat safety for their 1-year-old, 20-lb child. Which recommendation is most current?
Answer: Keep the child rear-facing until they reach the maximum height/weight limit of the rear-facing seat, regardless of age
Current AAP guidelines (updated 2018) recommend keeping children rear-facing until they exceed the seat's height/weight limit — not a specific age. Rear-facing provides the best protection for young children's underdeveloped necks and spines.