Pediatrics Greater Lowell Technical College
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Free Pediatrics Greater Lowell Technical College Questions
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Overeating
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Aspiration risk
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Prevention of injury
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Sex education
Explanation
Correct Answer: (C) Prevention of injury
Injury prevention is the primary health teaching concern for preschoolers (ages 3–5). Children of this age are highly active, curious, and developing motor skills, yet they lack the judgment to fully recognize dangers. They are at high risk for accidents including falls, burns, drowning, and motor vehicle injuries. Teaching both parents and children about safety measures is a critical nursing priority for this age group.
Why Other Options are Incorrect:
- A. Overeating — While nutrition is important at all ages, overeating is not the primary health teaching concern specific to preschoolers.
- B. Aspiration risk — Aspiration risk is a greater concern in infants and toddlers who explore by mouthing objects; preschoolers have better chewing and swallowing abilities and understand not to put objects in their mouths.
- D. Sex education — Age-appropriate discussion of body parts is relevant for preschoolers, but comprehensive sex education is not the primary health teaching focus for this age group.
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Vastus medius muscle
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Ventrogluteal muscle
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Deltoid muscle
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Dorsogluteal muscle
Explanation
Correct Answer: (B) Ventrogluteal muscle
For children over 2 years of age, the ventrogluteal muscle is the preferred IM injection site. It is a large, well-developed muscle with no major nerves or blood vessels nearby, making it the safest and most reliable site for children in this age group. It provides adequate muscle mass and has the lowest risk of complications compared to other sites.
Why Other Options are Incorrect:
- A. Vastus medius muscle — The vastus lateralis (anterolateral thigh) is preferred for infants under 2 years; by 2½ years, the ventrogluteal site is more appropriate.
- C. Deltoid muscle — The deltoid is not sufficiently developed in a 2½ year old to safely receive IM injections and is generally used in older children and adults.
- D. Dorsogluteal muscle — This site is contraindicated in children under 3 years due to proximity to the sciatic nerve and underdeveloped gluteal muscles, posing a significant risk of nerve damage.
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She wants to distract the child from thinking about the pain
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She is encouraging quiet play after pain to stabilize vital signs
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She is attempting to reestablish rapport
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She is providing a way for the child to express his feelings
Explanation
Correct Answer: (D) She is providing a way for the child to express his feelings
Drawing is a well-recognized therapeutic tool for school-age children. It allows children to externalize and process emotions they may not yet have the verbal skills to articulate. After a painful procedure, encouraging a child to draw gives them a safe, non-threatening outlet to express fear, anxiety, anger, or discomfort, which supports emotional healing and coping.
Why Other Options are Incorrect:
- A. She wants to distract the child from thinking about the pain — Distraction is a pre-procedure technique. After the procedure, the goal shifts to emotional processing, not distraction from what has already occurred.
- B. She is encouraging quiet play after pain to stabilize vital signs — While quiet activity may have some physiological benefit, this is not the primary or best rationale for encouraging drawing specifically after a painful procedure.
- C. She is attempting to reestablish rapport — While therapeutic activities do support the nurse-patient relationship, the primary purpose of post-procedure drawing is emotional expression, not rapport-building.
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Have parent lie across the child on the table
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Pretend nurse is looking for "Mickey Mouse" in child's ear
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Lying down with parent holding hand
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Have parent hold child against chest with one hand immobilizing head
Explanation
Correct Answer: (D) Have parent hold child against chest with one hand immobilizing head
The safest and most effective position for an ear exam in a young child is to have the parent hold the child securely against their chest while using one hand to gently immobilize the child's head. This position provides comfort through parental closeness, prevents sudden head movements that could cause injury during the examination, and keeps the child calm and secure throughout the procedure.
Why Other Options are Incorrect:
- A. Have parent lie across the child on the table — This position is inappropriate and potentially dangerous as it places excessive weight and pressure on the child, causing distress and risk of injury.
- B. Pretend nurse is looking for "Mickey Mouse" in child's ear — While distraction techniques are valuable, this alone does not provide the physical immobilization necessary to safely perform the exam.
- C. Lying down with parent holding hand — Simply holding the child's hand does not provide adequate immobilization of the head needed for a safe ear examination in a young, uncooperative child.
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Radial pulse
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Femoral pulse
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Brachial pulse
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Apical pulse
Explanation
Correct Answer: (D) Apical pulse
The apical pulse is the most accurate and reliable site for assessing heart rate in infants and children under 2 years of age. It is assessed by placing a stethoscope over the apex of the heart at the 4th to 5th intercostal space, midclavicular line. Peripheral pulses in infants are difficult to palpate accurately due to their small size, rapid heart rate, and the difficulty of isolating the pulse.
Why Other Options are Incorrect:
- A. Radial pulse — The radial pulse is too small and difficult to palpate accurately in infants, making it unreliable for assessment.
- B. Femoral pulse — The femoral pulse is used to assess circulation in emergencies, not for routine pulse rate measurement in infants.
- C. Brachial pulse — While the brachial pulse is used during infant CPR, it is not the preferred site for routine pulse assessment in a 12-month-old.
- Is dose safe?
- What is SDR?
- Dose given?
Explanation
Correct Answer:
Answer 2 — Safe Dose Range (SDR): Minimum: 28 kg × 50 mg = 1,400 mg/day ÷ unclear — SDR per dose: Literature states 50–100 mg per dose Q5 hours SDR per dose = 50 mg to 100 mg per dose
Maximum daily limit: 28 kg × 12 mg/kg/day = 336 mg/day
Answer 3 — Dose given: 110 mg ordered Q8 hours = 3 doses per day 110 mg × 3 = 330 mg/day
Answer 1 — Is dose safe? The ordered single dose of 110 mg exceeds the safe single dose range of 50–100 mg, therefore the dose is NOT safe. Additionally 330 mg/day is within the maximum daily limit of 336 mg/day, however the single dose still exceeds the safe range and should not be administered. The nurse should hold the medication and contact the prescriber.
Volume to administer if dose were corrected: Using the available concentration of 80mg/15ml: 110 mg ÷ 80 mg × 15 ml = 20.6 ml
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Attachment
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Protest
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Detachment
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Despair
Explanation
Correct Answer: (C) Detachment
The toddler is in the detachment stage of separation anxiety. In this stage, the child appears to have adjusted to the separation and shows interest in the surrounding environment, plays with toys, and may seem indifferent to or uninterested in the parents when they visit. This behavior can be mistaken for recovery, but it actually represents a coping mechanism where the child has emotionally withdrawn to protect herself from the pain of repeated separations.
Why Other Options are Incorrect:
- A. Attachment — Attachment is not a recognized stage of separation anxiety; it refers to the bond formed between child and caregiver.
- B. Protest — In the protest stage, the child cries loudly, is inconsolable, and actively searches for the parents. This toddler is not exhibiting these behaviors.
- D. Despair — In the despair stage, the child becomes withdrawn, quiet, and appears sad and hopeless, but still shows awareness of the parents' absence. This is different from the apparent indifference seen in detachment.
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Tell the child the procedure won't hurt
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Have the child's parent leave the room for painful procedures
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Perform all painful procedures in a separate treatment room
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Tell the child about the procedure the day before
Explanation
Correct Answer: (C) Perform all painful procedures in a separate treatment room
Performing painful procedures in a separate treatment room — rather than in the child's hospital room — is a key strategy in pediatric nursing. This preserves the child's hospital room as a safe, comfortable space free from painful associations. When the child associates their room with safety and comfort, they feel less fearful and anxious overall during their hospitalization.
Why Other Options are Incorrect:
- A. Tell the child the procedure won't hurt — This is dishonest and destroys trust. If the procedure is painful, the child will feel deceived, making future interactions and procedures more difficult and frightening.
- B. Have the child's parent leave the room for painful procedures — Parental presence during procedures actually provides comfort and reduces anxiety in toddlers. Parents should be encouraged to stay unless they choose not to.
- D. Tell the child about the procedure the day before — Telling a toddler about a painful procedure the day before gives them too much time to worry and increases anticipatory anxiety. Toddlers should be informed shortly before the procedure in simple, age-appropriate terms.
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Offer the child fruit juice after the medication is swallowed
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Tell the child that the medication is candy
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Give the medication quickly if the child is crying
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Mix the medication with chocolate milk
Explanation
Correct Answer: (A) Offer the child fruit juice after the medication is swallowed
Offering fruit juice or a pleasant-tasting drink after medication is swallowed is an appropriate and safe strategy to improve medication compliance in young children. It helps wash away any unpleasant taste left by the medication and serves as a positive reinforcement that encourages cooperation with future medication administration.
Why Other Options are Incorrect:
- B. Tell the child that the medication is candy — This is dangerous and unethical. Telling a child medication is candy can lead to accidental overdose if the child seeks out and self-administers medication unsupervised, thinking it is a treat.
- C. Give the medication quickly if the child is crying — Administering medication to a crying child increases the risk of aspiration. The nurse should calm the child first before attempting medication administration.
- D. Mix the medication with chocolate milk — Mixing medication with a large volume of milk or food is not recommended because if the child does not finish the entire amount, the full dose is not received, leading to underdosing.
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Qualitative pain scale
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NIPS
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Wong Baker Faces scale
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Numeric pain scale
Explanation
Correct Answer: (B) NIPS
The Neonatal Infant Pain Scale (NIPS) is specifically designed for assessing pain in neonates and infants under 1 year of age. It evaluates behavioral and physiological indicators such as facial expression, cry, breathing patterns, arm and leg position, and state of arousal. Since a 3-week-old infant cannot self-report pain, an observational tool like NIPS is the most appropriate choice.
Why Other Options are Incorrect:
- A. Qualitative pain scale — This type of scale requires verbal communication and self-reporting, which a 3-week-old infant is incapable of.
- C. Wong Baker Faces scale — This scale is appropriate for children aged 3 years and older who can identify facial expressions that match their pain level; it is not suitable for neonates.
- D. Numeric pain scale — This scale requires the patient to assign a number to their pain and is used in older children and adults who can understand numerical concepts.
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