Pediatric CCRN Practice Questions

Pediatric CCRN Practice Questions Related

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A 45-year old female diabetic is displaying signs of irritability and irrational behavior during an office visit. The nurse observes visible tremors in the client's hands. based on the client's history and the nurse's understanding of diabetes mellitus, the nurse interprets these findings to be signs of:

  • A. hyperglycemia
  • B. hyperglycemic hyperosmolar
  • C. diabetic ketoacidosis (DKA) nonketosis (HHNK)
  • D. hypoglycemia
Correct Answer: D

Rationale: The signs of irritability, irrational behavior, and visible tremors in the hands observed in the 45-year old female diabetic suggest hypoglycemia. Hypoglycemia occurs when blood sugar levels drop below normal levels, causing the body and brain to receive inadequate fuel. This leads to symptoms like irritability, irrational behavior, and tremors, which are signs of the brain not receiving enough glucose for proper functioning. In diabetic patients, particularly those on medications like insulin or certain oral hypoglycemic agents, hypoglycemia can occur if they take too much medication, skip meals, or engage in excessive physical activity without adjusting their treatment regimen. Immediate treatment for hypoglycemia usually involves consuming a rapid source of sugar, such as glucose tablets, juice, or candy, to quickly raise blood sugar levels back to normal range.

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A newborn has small, whitish, pinpoint spots over the nose, which the nurse knows are caused by retained sebaceous secretions. When charting this observation, the nurse identifies it as:

  • A. Milia
  • B. Lanugo
  • C. Whiteheads
  • D. Mongolian spots
Correct Answer: A

Rationale: Milia are small, whitish, pinpoint spots that commonly occur in newborns due to retained sebaceous secretions in the skin. They are commonly seen on the nose and can also appear on the cheeks and chin. Milia are not indicative of any illness and tend to disappear on their own without any treatment. They are a benign and temporary skin condition in newborns.

Nurse Kai is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?

  • A. Increased urine output
  • B. Increased appetite
  • C. Increased energy level
  • D. Decreased diarrhea
Correct Answer: A

Rationale: In a female child with acute post-streptococcal glomerulonephritis, the earliest sign of improvement is often seen as an increase in urine output. This occurs as the kidneys start to recover and normal functioning is restored. Increased urine output indicates improved glomerular filtration and clearance of waste products from the body. It is an essential indicator of renal function and overall improvement in the condition of the child. Other signs such as increased appetite and energy levels may follow but increased urine output is typically the first noticeable sign of improvement in cases of glomerulonephritis.

A patient complains of tingling in his fingers. He has positive Trousseau's and Chvostek's signs. He says that he feels depressed. Choose the most likely serum calcium (Ca ) value for this patient:

  • A. 11mg/dl
  • B. 7mg/dl
  • C. 9mg/dl
  • D. 5mg/dl
Correct Answer: A

Rationale: The patient's symptoms of tingling in the fingers, positive Trousseau's and Chvostek's signs, and feeling depressed are suggestive of hypocalcemia, which is commonly associated with low serum calcium levels. In this case, the most likely serum calcium value would be below the normal range, which is around 8.5-10.5 mg/dl. Among the given choices, an extremely low calcium value of 5mg/dl (Choice D) would be more consistent with severe hypocalcemia presenting with tetany and other neuromuscular symptoms rather than depression and mild symptoms. On the other hand, a high calcium level of 11mg/dl (Choice A) would indicate hypercalcemia, which can lead to neuropsychiatric symptoms like depression, as seen in this patient's presentation. Therefore, Choice A (11mg/dl) is the most likely serum calcium value for

Which of the ff is a nursing intervention to ensure that the client is free from injury caused by falls?

  • A. Nurse monitors for chest pain and elevated low-density lipoprotein levels
  • B. Nurse monitors for swelling and heaviness of legs
  • C. Nurse monitors postural changes in BP
  • D. Nurse monitors temperature for mild fever
Correct Answer: B

Rationale: Monitoring for swelling and heaviness of legs is a nursing intervention that can help prevent falls. Swelling and heaviness of legs could indicate conditions such as edema or circulation problems, which may increase the risk of falls due to impaired mobility and stability. By identifying these signs early on, the nurse can intervene promptly to address the underlying issues and prevent potential falls. This proactive approach aligns with the goal of ensuring the client is free from injury caused by falls. Monitoring for chest pain and elevated low-density lipoprotein levels, postural changes in BP, or mild fever may be important for overall client care but are not directly related to fall prevention.

Although melanoma is relatively rare in children, some risk factors may increase its incidence. All the following are risk factors for development of melanoma EXCEPT

  • A. positive family history of melanoma
  • B. dark-skinned child
  • C. hairy nevus
  • D. dysplastic nevus
Correct Answer: B

Rationale: Dark-skinned individuals have a lower risk of melanoma.

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