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Example NCLEX RN Child Health Questions 2019, 2020, 2021, 2022, 2023 23th Edition
1. Antibiotics are prescribed for a child following a myringotomy with insertion of tympanostomy tubes, and the nurse provides instructions to the parents regarding the administration of the antibiotics. Which statement, if made by a parent, would indicate that the instructions were understood?
A. “We will administer the antibiotics if the child has a fever.”
B. “We will administer the antibiotics until the child feels better.”
C. “We will administer the antibiotics until they are gone.”
D. “We will begin to taper the antibiotics after 3 days of a full course.”
Answer: C. “We will administer the antibiotics until they are gone.”
Rationale: Antibiotics need to be taken as prescribed, and the full course needs to be completed. It is important that parents are instructed regarding the administration of antibiotics. Options 1, 2, and 4 are incorrect. Antibiotics are not tapered but administered until they are completed.
Test-Taking Strategy: Use the process of elimination. Recalling that antibiotics must be taken for the full course regardless of whether the child is feeling better will direct you to option C. Review concepts related to the administration of antibiotics if you had difficulty with this question.
Level of Cognitive Ability: Comprehension Client Needs: Physiological Integrity Integrated Process: Nursing Process/Evaluation Content Area: Child Health Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 1199.
2. A nurse is collecting data on a 2-year-old child diagnosed with croup. Which of the following findings are not associated with this illness?
A. Symptoms usually worsen at night and are better during the day
B. Symptoms usually worsen during the day and are relieved during sleep
C. The cough is harsh and metallic
D. Inspiratory stridor may be present
Answer: B. Symptoms usually worsen during the day and are relieved during sleep
Rationale: Croup often begins at night and may be preceded by several days of upper respiratory tract infection symptoms. It is characterized by a sudden onset of a harsh, metallic cough, sore throat, and inspiratory stridor. Symptoms usually worsen at night and are better in the day.
Test-Taking Strategy: Use the process of elimination and note the key words not associated. This word indicates a false response question and that you need to select the incorrect clinical manifestation. Remember that with croup symptoms usually worsen at night and are better in the day. This will direct you to option B. Review the manifestations associated with croup if you had difficulty with this question.
Level of Cognitive Ability: Comprehension Client Needs: Physiological Integrity Integrated Process: Nursing Process/Data Collection Content Area: Child Health
Reference: Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 188.
3. A child with croup is being discharged from the hospital. The nurse provides home care instructions to the mother and advises the mother to bring the child to the emergency room if the child:
A. Appears tired
B. Takes fluids poorly
C. Is irritable
D. Develops stridor
Answer: D. Develops stridor
Rationale: The mother should be instructed to bring the child to the emergency room if the child develops stridor at rest, cyanosis, severe agitation or fatigue, or moderate to severe retractions, or is unable to take oral fluids.
Test-Taking Strategy: Use the ABCs—airway, breathing, and circulation. This should direct you to option D. Review home care instructions related to croup if you had difficulty with this question.
Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Teaching/Learning Content Area: Child Health References:
Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 190.
McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 1209.
4. A hospitalized 2-year-old child with croup is receiving corticosteroid therapy. The mother asks the nurse why the physician did not prescribe antibiotics. Which of the following is the correct response that the nurse should make to the mother?
A. “The child is too young to receive antibiotics.”
B. “The child still has the maternal antibodies from birth and does not need antibiotics.”
C. “Antibiotics are not indicated unless a bacterial infection is present.”
D. “The child may be allergic to antibiotics.”
Answer: C. “Antibiotics are not indicated unless a bacterial infection is present.”
Rationale: Antibiotics are not indicated in the treatment of croup unless a bacterial infection is present. Options 1, 2, and 4 are incorrect. Additionally, there are no supporting data in the question to indicate that the child may be allergic to antibiotics.
Test-Taking Strategy: Use the process of elimination. Eliminate option 4 because there are no supporting data in the question regarding the potential for allergies. Noting the age of the child will assist in eliminating options 1 and B. Review the indications for the use of antibiotics if you had difficulty with this question.
Level of Cognitive Ability: Application Client Needs: Physiological Integrity Integrated Process: Nursing Process/Implementation Content Area: Child Health References:
McKenry, L., & Salerno, E. (2003). Mosby’s pharmacology in nursing (21st ed.). St. Louis: Mosby, p. 981.
McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 1214.
Wong, D., & Hockenberry, M. (2003). Nursing care of infants and children (7th ed.). St. Louis: Mosby, p. 1363.
5. A child with croup is placed in a cool-mist tent. The mother becomes concerned because the child is frightened, is consistently crying, and tries to climb out of the tent. The appropriate nursing action would be to:
A. Call the registered nurse to obtain an order for a mild sedative
B. Tell the mother that the child must stay in the tent
C. Place a toy in the tent to make the child feel more comfortable
D. Let the mother hold the child and direct a cool mist over the child’s face
Answer: D. Let the mother hold the child and direct a cool mist over the child’s face
Rationale: Crying will aggravate laryngospasm and increase hypoxia, which may cause airway obstruction. If the use of a tent or hood is causing distress, treatment may be more effective if the child is held by the parent and a cool mist is directed toward the child’s face. A mild sedative should not be administered to the child. Options 2 and 3 will not alleviate the child’s fear.
Test-Taking Strategy: Use the process of elimination. Options 1, 2, and 3 will not alleviate the child’s fear. Additionally, they are all similar in that they do not address the fear. Option 4 is the option that addresses the issue of the question. Review care to the child in a mist tent if you had difficulty with this question.
Level of Cognitive Ability: Application Client Needs: Psychosocial Integrity Integrated Process: Nursing Process/Implementation Content Area: Child Health Reference: Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 188.
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