FNP Pediatric Practice Questions

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A client with idiopathic thrombocytopenic purpura (ITP), an autoimmune disorder, is admitted to an acute care facility. Concerned about hemorrhage, the nurse monitors the client's platelet count and observes closely for signs and symptoms of bleeding. The client is at greatest risk for cerebral hemorrhage when the platelet count falls below:

  • A. 135,000/ul
  • B. 20,000/ul
  • C. 75,000/ul
  • D. 500/ul
Correct Answer: B

Rationale: In a client with idiopathic thrombocytopenic purpura (ITP), a platelet count falling below 20,000/ul puts them at the greatest risk for cerebral hemorrhage. This is because the risk of spontaneous bleeding, especially in critical areas like the brain, significantly increases as platelet counts drop below this level. The brain is a sensitive organ, and even minor bleeds can have serious consequences. Therefore, it is crucial for healthcare providers to closely monitor platelet counts and promptly intervene to prevent life-threatening hemorrhage in clients with ITP.

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The nurse is providing dietary instructions to a client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

  • A. increasing saturated fat intake and fasting in the afternoon.
  • B. increasing intake of vitamins B and D and taking iron supplements.
  • C. eating a candy bar if light-headedness occurs.
  • D. consuming a low-carbohydrate, high-protein diet and avoiding fasting.
Correct Answer: D

Rationale: Consuming a low-carbohydrate, high-protein diet and avoiding fasting is the best recommendation to control hypoglycemic episodes in clients. When someone has hypoglycemia, their blood sugar levels drop too low. A diet that is low in carbohydrates and high in protein can help regulate blood sugar levels and prevent sudden drops that lead to hypoglycemic episodes. Additionally, avoiding fasting helps maintain a consistent intake of nutrients throughout the day, which is important for managing blood sugar levels. It is essential to eat regular, balanced meals and snacks to keep blood sugar levels stable and prevent hypoglycemia.

the vital sign that the nurse should most certainly check before administering digoxin is:

  • A. pulse rate
  • B. temperature
  • C. blood pressure
  • D. respiratory rate 99- coarctation of the aorta reflects which of the statements?
Correct Answer: A

Rationale: Before administering digoxin, it is crucial for the nurse to check the patient's pulse rate. Digoxin is a medication commonly used to treat heart conditions such as atrial fibrillation and heart failure by increasing the strength and efficiency of the heart's contractions. However, digoxin can also cause adverse effects such as bradycardia (slow heart rate) or heart block. Therefore, it is important to assess the patient's pulse rate to ensure that it is within the safe range before administering digoxin.

When teaching a client about insulin administration, the nurse should include which instruction?

  • A. "Administer insulin after the first meal of the day."
  • B. "Inject insulin at a 45-degree angle into the deltoid muscle."
  • C. "Shake the insulin vial vigorously before withdrawing the medication."
  • D. "Draw up clear insulin first when mixing two types of insulin in one syringe."
Correct Answer: D

Rationale: When mixing two types of insulin in one syringe, it is essential to draw up the clear insulin first before drawing up the cloudy insulin. This sequence prevents the clear insulin from becoming contaminated with the cloudy insulin and ensures accurate dosing. Drawing up the clear insulin first helps to minimize the risk of inaccurate dosing and maintains the effectiveness of the insulin being administered.

A 3-day-old neonate has a large, soft, painless mass involving the head and neck region that mostly transilluminate; CT scan reveals a cystic mass involving the neck and intrathoracic mediastinum. The BEST modality for treatment of this neonate is

  • A. surgical resection
  • B. injection sclerosing agent
  • C. laser therapy
  • D. systemic interferon therapy
Correct Answer: A

Rationale: Surgical resection is the definitive treatment for cystic hygroma.

Biopsy is not usually performed for a child with suspicion of Wilms tumor EXCEPT

  • A. age of 2-3 year
  • B. signs of inflammation or infection
  • C. significant lymph node enlargement radiologically
  • D. intratumoral calcification radiologically
Correct Answer: D

Rationale: Presence of intratumoral calcifications may warrant biopsy to rule out other diagnoses.

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