You match developmental age, safety, and family teaching instead of treating the child as a small adult. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five pediatrics questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Which assessment finding of a newborn requires prompt action by the nurse?
A. Respiratory rate of 50 breaths per minute
B. Cyanosis of the extremities
C. Pause in breathing lasting 20 seconds
D. Pause in breathing for 15 seconds followed by rapid respirations
Show answer and rationale
Correct answer: C — Pause in breathing lasting 20 seconds
The correct answer is C: Pause in breathing lasting 20 seconds. This finding indicates a potential apnea episode in the newborn, which requires immediate attention to prevent further complications like hypoxia. The pause in breathing lasting 20 seconds exceeds the normal range for apnea in newborns, typically defined as a pause lasting more than 15 seconds. Prompt action is necessary to assess and address the underlying cause of the apnea episode.
Choice A (Respiratory rate of 50 breaths per minute) is within the normal range for newborns (30-60 breaths per minute) and does not require immediate action. Choice B (Cyanosis of the extremities) may indicate poor circulation but is not as urgent as a prolonged pause in breathing. Choice D (Pause in breathing for 15 seconds followed by rapid respirations) is incorrect as it does not meet the criteria for apnea in newborns and does not require immediate action.
Question 2
Edward, a newborn delivered at 41 weeks' gestation, weighs 10 lb 4 oz. Vaginal delivery for this G1P1 mother was assisted with forceps. The nurse is completing her assessment and notes a sharply demarcated swelling over the parietal bones. The occipital and frontal skull bones are not affected. The neck does not appear edematous and is soft to the touch with full mobility. The infant is awake and active and has been breast-feeding well. What is the most probable cause of the swelling?
A. cephalohematoma
B. subgaleal hemorrhage
C. caput succedaneum
D. skull fracture
Show answer and rationale
Correct answer: A — cephalohematoma
The correct answer is A: cephalohematoma. Cephalohematoma is a subperiosteal collection of blood that occurs due to trauma during delivery, such as with forceps assistance. The swelling is sharply demarcated because it is bound by suture lines of the skull bones. In this case, the parietal bones are affected, while the other skull bones are not involved. The absence of edema in the neck and the infant's good activity and feeding suggest no significant underlying issues.
Summary:
B: Subgaleal hemorrhage involves bleeding into the potential space between the periosteum and the skull, resulting in diffuse swelling extending beyond suture lines.
C: Caput succedaneum is soft tissue swelling that crosses suture lines and involves the scalp, not just the parietal bones.
D: Skull fracture would present with additional signs such as crepitus, misshapen skull, or neurological deficits, which are not mentioned
Question 3
A healthcare provider is assessing a newborn who has a coarctation of the aorta. Which of the following should the provider recognize as a clinical manifestation of coarctation of the aorta?
A. Increased blood pressure in the arms with decreased blood pressure in the legs
B. Decreased blood pressure in the arms with increased blood pressure in the legs
C. Increased blood pressure in both the arms and the legs
D. Decreased blood pressure in both the arms and the legs
Show answer and rationale
Correct answer: A — Increased blood pressure in the arms with decreased blood pressure in the legs
The correct answer is A: Increased blood pressure in the arms with decreased blood pressure in the legs. Coarctation of the aorta causes narrowing of the aorta, leading to increased blood pressure in the arms due to the pressure build-up before the narrowing and decreased blood pressure in the legs due to reduced blood flow beyond the narrowing. This pressure difference is a classic clinical manifestation of coarctation of the aorta.
Choices B, C, and D are incorrect because they do not align with the pathophysiology of coarctation of the aorta. B is incorrect as decreased blood pressure in the arms is not typical. C is incorrect as increased blood pressure in both the arms and legs does not reflect the characteristic pressure difference caused by the aortic narrowing. D is incorrect as decreased blood pressure in both the arms and legs is not consistent with the presentation of coarctation of the aorta.
Question 4
A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make?
A. It's a minor inconvenience, which you should ignore.
B. In most cases it only lasts until the 12th week, but it will continue if you have poor bladder tone.
C. There is no way to predict how long it will last in each individual client.
D. It occurs during the first trimester and near the end of the pregnancy.
Show answer and rationale
Correct answer: D — It occurs during the first trimester and near the end of the pregnancy.
The correct answer is D because urinary frequency is common in early pregnancy due to hormonal changes and pressure on the bladder from the growing uterus. This symptom typically improves by the end of the first trimester, as the uterus rises and reduces pressure on the bladder. Therefore, telling the client that it occurs during the first trimester and near the end of pregnancy is accurate.
Choice A is incorrect because urinary frequency should not be ignored as it could be a sign of a urinary tract infection or other underlying issue.
Choice B is incorrect because it inaccurately suggests that urinary frequency only lasts until the 12th week and implies that poor bladder tone is the sole factor influencing this symptom.
Choice C is incorrect because while it is true that individual experiences can vary, there are general patterns and timelines for common pregnancy symptoms like urinary frequency.
Question 5
A mother conveys concern over the fact that she is not certain if her newborn is receiving enough nutrients from breastfeeding. This is the baby's first clinic visit after birth. What information can you provide that will help alleviate her fears regarding nutrient status for her newborn?
A. Monitor the infant's output; as long as at least six or more diapers are changed in a 24-hour period, the baby is receiving sufficient intake.
B. Tell the mother that if a baby is satisfied with feeding, she or he will be content and not fussy.
C. Tell the mother that breast milk contains everything required for the infant and not to worry about nutrition.
D. Provide nutrition information in the form of pamphlets for the mother to take home with her so that she uses them as a point of reference.
Show answer and rationale
Correct answer: A — Monitor the infant's output; as long as at least six or more diapers are changed in a 24-hour period, the baby is receiving sufficient intake.
Step 1: Monitoring the infant's output through diaper changes is a reliable indicator of sufficient nutrient intake.
Step 2: Six or more diapers changed in a 24-hour period signifies that the baby is getting enough nutrients from breastfeeding.
Step 3: This method is practical and easy for the mother to observe and track regularly.
Step 4: It reassures the mother that her newborn is receiving adequate nutrition, addressing her concerns effectively.
Summary:
- Choice A is correct as it provides a tangible and practical method for assessing the baby's nutrient intake.
- Choice B is incorrect as satisfaction with feeding does not directly correlate with nutrient intake.
- Choice C is incorrect as it oversimplifies the situation and does not offer a practical solution.
- Choice D is incorrect as providing pamphlets may not address the mother's immediate concerns about the baby's nutrient status.
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Question 6
The nurse is providing support for the parents of a neonate born with anencephaly. The parents repeatedly state, “I don’t believe this is happening to us. We were so careful during pregnancy.†The nurse associates the parents’ comments with which stage of grief?
A. Disbelief
B. Depression
C. Denial of reality
D. Anger with each other
Correct answer:
The correct answer is A: Disbelief. In the context of the scenario, the parents' statements indicate a sense of shock and difficulty accepting the reality of their situation, which aligns with the stage of disbelief in the grief process. During this stage, individuals may struggle to comprehend the situation and may question how it could have happened despite their efforts. This initial stage typically involves denial and confusion.
Choice B: Depression, is incorrect because the parents' statements do not reflect feelings of sadness or hopelessness, which are typical of the depression stage of grief.
Choice C: Denial of reality, is incorrect as the parents' statements are more about disbelief and questioning rather than outright denial of the situation.
Choice D: Anger with each other, is incorrect as there is no mention of the parents expressing anger towards each other in the scenario.
A 5 year old child with seizure disorder presents with vomiting and abdominal tenderness. Lipase values are 6x upper limits of normal. Medications include valproic acid and melatonin. There is no history of trauma nor fever. Family history is unremarkable. The child is stable. Laboratory tests reveal normal CBC, liver enzymes, triglycerides, calcium values. Abdominal ultrasound reveals a mildly prominent pancreas without any signs of chronicity; the liver, gallbladder and biliary tree are all within normal limits. What would be your next step?
A. Discontinue the valproic acid
B. ERCP
C. Cholecystectomy
D. Sweat chloride
Correct answer:
With a presentation of acute pancreatitis, one must review the presentation and particulars of a patient and compare them against common etiologies (including trauma, anatomic, biliary/stones, medications/toxic, infectious, metabolic, genetic, 'idiopathic'). In the scenario provided, there is no indication of anatomic abnormalities nor biliary causes (ultrasound; liver enzymes), first-line metabolic workup is unremarkable (calcium 2+, triglycerides), there is no history of trauma nor any suggestion of infection (including lack of fever), and family history is unremarkable. The most likely culprit is the valproic acid, a medication that has been strongly associated/linked with acute pancreatitis (which can occur at any time, likely as an idiosyncratic complication not related to duration of therapy nor dose of medication). In this case, the recommendation would be to discontinue the valproic acid.
The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?
A. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.
B. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control.
C. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives.
D. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.
Correct answer:
The correct rationale for discontinuing the oral contraceptives in a patient with excessive menstrual bleeding and bleeding between periods is that this condition is often associated with hyperplasia of the endometrial tissue, which can be exacerbated with the use of oral contraceptives. Endometrial hyperplasia is a condition characterized by the abnormal thickening of the lining of the uterus, which can lead to heavy or prolonged menstrual bleeding. Estrogen contained in oral contraceptives can contribute to this thickening of the endometrial tissue, potentially worsening the patient's symptoms. By discontinuing the oral contraceptives, the provider aims to reduce the estrogen levels in the body, which may help alleviate the symptoms associated with endometrial hyperplasia. An endometrial biopsy is also important in this case to further investigate the underlying cause of the abnormal bleeding.
The nurse is assessing a 33-year-old female patient who comes to the family practice clinic with complaints of excessive menstrual bleeding with bleeding between periods for the past 6 months. The health care provider has performed an endometrial biopsy and has discontinued the patient's oral contraceptives. What is the rationale for this treatment?
A. This condition is often associated with use of oral contraceptives and may subside upon discontinuation.
B. This condition is often associated with type 2 diabetes and must be controlled with a different type of birth control.
C. This condition is often associated with hyperplasia of the endometrial tissue, which is exacerbated with oral contraceptives.
D. This condition is often associated with ovarian cysts, which are exacerbated with the use of oral contraceptives.
Correct answer:
The correct rationale for discontinuing the oral contraceptives in a patient with excessive menstrual bleeding and bleeding between periods is that this condition is often associated with hyperplasia of the endometrial tissue, which can be exacerbated with the use of oral contraceptives. Endometrial hyperplasia is a condition characterized by the abnormal thickening of the lining of the uterus, which can lead to heavy or prolonged menstrual bleeding. Estrogen contained in oral contraceptives can contribute to this thickening of the endometrial tissue, potentially worsening the patient's symptoms. By discontinuing the oral contraceptives, the provider aims to reduce the estrogen levels in the body, which may help alleviate the symptoms associated with endometrial hyperplasia. An endometrial biopsy is also important in this case to further investigate the underlying cause of the abnormal bleeding.
After birth, the nurse immediately dries a neonate's face and hair with a clean, prewarmed towel. After drying, the nurse covers the neonate's hair with a cap. What type of heat loss is the nurse preventing?
A. convection
B. conduction
C. evaporation
D. radiation
Correct answer:
The correct answer is C: evaporation. After birth, drying the neonate's face and hair with a towel and covering the hair with a cap prevents heat loss through evaporation. Evaporation occurs when moisture on the skin evaporates into the air, leading to cooling of the body. By drying the neonate's hair and covering it with a cap, the nurse reduces the potential for heat loss through evaporation, helping to maintain the neonate's body temperature.
Incorrect choices:
A: Convection - Heat transfer through the movement of air or liquid. Drying and covering the hair do not directly impact convection heat loss.
B: Conduction - Heat transfer through direct contact with a cooler surface. Drying and covering the hair with a cap do not address conduction heat loss.
D: Radiation - Heat transfer through electromagnetic waves. Drying and covering the hair do not specifically target radiation heat loss.
A 13-year-old girl tells the nurse at the pediatric clinic that she took a pregnancy test and it was positive. She adds that her grandfather, with whom she, her younger sisters, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks the girl if she has told this to anyone, she replies, 'Yes, but my mother doesn't believe me.' Legally, who should the nurse notify?
A. Police regarding a possible sex crime
B. Healthcare provider to confirm the pregnancy
C. Child Protective Services for immediate intervention
D. Girl's mother about the positive pregnancy test result
Correct answer:
In this scenario, the nurse should notify Child Protective Services for immediate intervention. The girl disclosed ongoing sexual abuse by her grandfather, which is a serious concern requiring immediate protection and intervention by the appropriate authorities. Child Protective Services are trained to handle cases of child abuse and neglect, ensuring the safety and well-being of the child. While notifying the police about a possible sex crime is crucial, Child Protective Services should be the first point of contact in cases of suspected child abuse due to their specialized role. Confirming the pregnancy through a healthcare provider is not the priority at this moment, as ensuring the safety of the child is paramount. Informing the girl's mother about the positive test result is not appropriate given the lack of belief in the abuse disclosure and the potential risk to the child's safety.
The parents of an infant have just been told that their infant has physiological anemia of infancy. Which serves as an important rationale to support why this occurred?
A. Gestational diabetes in the mother leading to LGA in the infant
B. Hypervolemia as a result of maternal bleeding, which accumulates in the fetal circulation
C. Red blood cell death, which occurs every 15 days in the infant
D. Decline in fetal erythrocytes around 2 months of age
Correct answer:
The correct answer is D: Decline in fetal erythrocytes around 2 months of age. Physiological anemia of infancy occurs around 2-3 months of age due to a natural decline in fetal erythrocytes. This decline is a normal process as the infant's body adjusts to extrauterine life.
A: Gestational diabetes leading to LGA in the infant is unrelated to physiological anemia.
B: Hypervolemia from maternal bleeding is not a known cause of physiological anemia in infants.
C: Red blood cell death every 15 days is not a recognized physiological process leading to anemia in infants.
In summary, the correct answer is D because it directly addresses the natural decline in fetal erythrocytes that occurs around 2 months of age, leading to physiological anemia of infancy. The other choices are incorrect as they do not provide a relevant explanation for the occurrence of physiological anemia in infants.
The newborn is having occasional gasping respirations with a heart rate of 90 beats per minute. Skin color is cyanotic with poor muscle tone. Interpreting relevant clinical data in this scenario, what problems are possible? Select all that apply.
A. The newborn is hypothermic.
B. The newborn is full term.
C. The newborn is experiencing respiratory distress.
D. The newborn is anemic.
Correct answer:
The correct answer is C: The newborn is experiencing respiratory distress. Gasping respirations, low heart rate, cyanotic skin, and poor muscle tone are indicative of respiratory distress in a newborn. Gasping is an abnormal breathing pattern seen in severe respiratory distress. A low heart rate is a compensatory response to decreased oxygen levels. Cyanotic skin color indicates poor oxygenation. Poor muscle tone can be a sign of inadequate oxygen delivery to tissues.
Explanation for other choices:
A: The newborn may be hypothermic due to poor temperature regulation, but the primary concern in this scenario is respiratory distress.
B: Being full term does not directly explain the newborn's clinical presentation, so it is not a likely cause.
D: Anemia could contribute to poor oxygen delivery, but the clinical presentation suggests a more acute issue related to respiratory distress.
A client who is at 22 weeks of gestation reports concern about the blotchy hyperpigmentation on her forehead. Which of the following actions should the nurse take?
A. Tell the client to follow up with a dermatologist.
B. Explain to the client this is an expected occurrence.
C. Instruct the client to increase her intake of vitamin D.
D. Inform the client she might have an allergy to her skin care products.
Correct answer:
The correct answer is B. The blotchy hyperpigmentation on the client's forehead is likely melasma, a common occurrence during pregnancy. This is due to hormonal changes causing increased melanin production. The nurse should educate the client that this is an expected occurrence during pregnancy and reassure her that it is usually temporary and will fade postpartum.
Choice A (Tell the client to follow up with a dermatologist) is incorrect because dermatological consultation is not typically necessary for melasma during pregnancy.
Choice C (Instruct the client to increase her intake of vitamin D) is incorrect because vitamin D deficiency is not typically associated with blotchy hyperpigmentation on the forehead during pregnancy.
Choice D (Inform the client she might have an allergy to her skin care products) is incorrect because melasma is not caused by allergies to skincare products.
The United States ranks poorly in terms of worldwide infant mortality rates. Which factor has the greatest impact on decreasing the mortality rate of infants?
A. Providing more women’sN sheRlterIs G B.C M U S N T O
B. Ensuring early and adequate prenatal care
C. Resolving all language and cultural differences
D. Enrolling pregnant women in the Medicaid program by their eighth month of pregnancy
Correct answer:
The correct answer is B: Ensuring early and adequate prenatal care. Prenatal care plays a crucial role in monitoring the health of the mother and the developing fetus, detecting and managing any potential health issues early on, and providing essential education on nutrition and healthy practices. This ultimately leads to healthier pregnancies, reduced risks of complications, and improved outcomes for both the mother and the infant. Providing more women's shelters (A) may help address social issues but does not directly impact infant mortality rates. Resolving language and cultural differences (C) is important for effective healthcare delivery but is not the primary factor in reducing infant mortality. Enrolling pregnant women in Medicaid (D) is beneficial for access to healthcare but does not address the importance of early and adequate prenatal care in reducing infant mortality rates.
LPN exams pediatrics practice questions, set 4 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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