Pediatrics Greater Lowell Technical College
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Free Pediatrics Greater Lowell Technical College Questions
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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behavior can be mistaken for recovery, but it actually represents a coping mechanism where the child has emotionally withdrawn to protect herself from the pain of repeated separations.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- D. Despair — In the despair stage, the child becomes withdrawn, quiet, and appears sad and hopeless, but still shows awareness of the parents' absence.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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They cannot read labels well and are at risk for poisoning
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They are becoming less interested in their family's opinions
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They tend to overestimate their own abilities
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They are still too young to be educated about dangerous situations
Explanation
Correct Answer: (C) They tend to overestimate their own abilities
School-age children (6–12 years) are at risk for accidental injury primarily because they overestimate their physical capabilities and underestimate dangers. As they become more independent and engage in competitive activities, sports, and daring behaviors with peers, they take risks beyond their actual abilities. Peer influence also encourages risk-taking behavior during this stage.
Why Other Options are Incorrect:
- A. They cannot read labels well — School-age children are actively developing reading skills and can generally read labels; poisoning risk is more associated with toddlers and preschoolers who explore by mouthing objects.
- B. They are becoming less interested in their family's opinions — While peer influence does increase during this stage, decreased family interest alone does not directly explain accidental injury risk.
- D. They are still too young to be educated about dangerous situations — School-age children are actually very capable of understanding safety education and benefit greatly from it; this statement is incorrect.
- 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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Tell the child the parents cannot be with them
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Discuss the procedure in detail with the parents in the presence of the child
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Demonstrate the procedure on a doll before the procedure
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Provide a video of the procedure for the child to view
Explanation
Correct Answer: (C) Demonstrate the procedure on a doll before the procedure
Preschoolers (ages 3–5) learn best through play and concrete demonstration. Using a doll to demonstrate a procedure is an age-appropriate teaching strategy that allows the child to visualize what will happen in a non-threatening way. This technique reduces fear of the unknown, promotes cooperation, and respects the preschooler's developmental need for magical thinking and concrete learning experiences.
Why Other Options are Incorrect:
- A. Tell the child the parents cannot be with them — Parental presence reduces anxiety in preschoolers and should be encouraged, not prohibited. Telling the child parents cannot be present increases fear and distress.
- B. Discuss the procedure in detail with the parents in the presence of the child — Detailed adult discussions about procedures in front of a preschooler can increase anxiety and fear, as the child may misinterpret medical terminology.
- D. Provide a video of the procedure for the child to view — While visual aids can be helpful, videos may be too graphic or overwhelming for a preschooler. Hands-on doll demonstration is more developmentally appropriate and interactive.
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They are faster to compensate for lower volumes of blood and air exchanged with each beat and respiration
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They are faster to compensate for the larger volume of blood and air exchanged with each beat and respiration
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They are slower because of the infant's slower metabolism rate
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They are slower because of the infant's smaller size
Explanation
Correct Answer: (A) They are faster to compensate for lower volumes of blood and air exchanged with each beat and respiration
Infants have smaller hearts and lungs, meaning each heartbeat pumps less blood (lower stroke volume) and each breath exchanges less air (lower tidal volume) compared to adults. To meet the body's metabolic demands for oxygen and circulation, infants compensate by having faster heart rates and respiratory rates. This is a normal physiological adaptation to their smaller cardiovascular and pulmonary capacity.
Why Other Options are Incorrect:
- B. They are faster to compensate for the larger volume — This is incorrect; infants exchange smaller, not larger, volumes with each beat and breath.
- C. They are slower because of slower metabolism — Infants actually have a higher metabolic rate than adults, requiring faster, not slower, heart and respiratory rates.
- D. They are slower because of the infant's smaller size — Infant vital rates are faster, not slower, precisely because of their smaller size and lower volume exchange per beat and breath.
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By observing the child roll a ball
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By asking the child to cut pictures from a magazine with scissors
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By asking the child to thread a needle
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By watching the child drink from a cup
Explanation
Correct Answer: (B) By asking the child to cut pictures from a magazine with scissors
Using scissors to cut pictures requires precise hand-eye coordination, finger dexterity, and controlled hand movements — all key components of fine motor development. This is a developmentally appropriate task for preschoolers and serves as an excellent evaluator of fine motor skills. By age 4, most preschoolers can use scissors with increasing control and accuracy.
Why Other Options are Incorrect:
- A. By observing the child roll a ball — Rolling a ball is a gross motor skill involving large muscle groups and coordination of the whole body, not fine motor ability.
- C. By asking the child to thread a needle — Threading a needle requires extremely precise fine motor control that exceeds the developmental capabilities of a preschooler; this task is more appropriate for school-age children or adults.
- D. By watching the child drink from a cup — Drinking from a cup is a basic self-care skill typically mastered in toddlerhood and does not specifically evaluate fine motor development in preschoolers.
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Encourage the child to personalize his or her space
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Make meal choices for the child
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Discourage social interaction with other patients on the unit
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Do not explain procedures in detail so as not to frighten the child
Explanation
Correct Answer: (A) Encourage the child to personalize his or her space
Allowing preschool children to personalize their hospital space with familiar items from home — such as photos, toys, or drawings — helps them feel a sense of control and security in an unfamiliar environment. This promotes emotional comfort and eases the adjustment to hospitalization by making the environment feel less threatening and more like their own.
Why Other Options are Incorrect:
- B. Make meal choices for the child — Preschoolers benefit from being given simple choices, such as what to eat, as this fosters a sense of autonomy and control. Making choices for them undermines this need.
- C. Discourage social interaction with other patients — Social interaction with peers is beneficial for preschoolers' emotional well-being and adjustment during hospitalization and should be encouraged, not discouraged.
- D. Do not explain procedures in detail — Age-appropriate explanations of procedures actually reduce fear and anxiety in preschoolers. Withholding information increases distrust and fear of the unknown.
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Increased secretion of hydrochloric acid
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Faster metabolism in the liver
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Immature kidney function
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Slower intestinal transit
Explanation
Correct Answer: (C) Immature kidney function
Infants have immature renal function, which significantly affects their ability to excrete medications. The kidneys are responsible for filtering and eliminating many drugs and their metabolites from the body. Because glomerular filtration rate and tubular secretion are reduced in infants, drugs remain in the body longer, increasing the risk of toxicity. This is a critical consideration when dosing medications in infants.
Why Other Options are Incorrect:
- A. Increased secretion of hydrochloric acid — Infants actually have decreased gastric acid secretion compared to adults, which affects oral drug absorption rather than overall physiological response.
- B. Faster metabolism in the liver — Infants have immature hepatic enzyme systems, resulting in slower, not faster, liver metabolism of medications.
- D. Slower intestinal transit — Infants actually have increased (faster) gastrointestinal motility, not slower transit, which affects oral drug absorption.
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210
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198
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85
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126
Explanation
Correct Answer: (D) 126
The normal heart rate for a 6-month-old infant ranges from 80–160 beats per minute, with an average of approximately 120–130 bpm. A pulse rate of 126 falls well within this normal range. Accurate knowledge of age-appropriate vital sign ranges is essential for nurses to distinguish normal from abnormal findings in pediatric patients.
Why Other Options are Incorrect:
- A. 210 — A pulse rate of 210 is significantly above the normal range for a 6-month-old and would indicate tachycardia requiring immediate assessment and intervention.
- B. 198 — This rate is also far above the normal range and would be considered tachycardia in a 6-month-old infant.
- C. 85 — While 85 is technically within the lower end of the broad infant range, it is below the typical expected range for a 6-month-old and could suggest bradycardia requiring further assessment.
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47 grams
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47 milliliters
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1.5 ounces
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50 milliliters
Explanation
Correct Answer: (B) 47 milliliters
In pediatric nursing, urine output in infants is measured by weighing diapers. The standard conversion is 1 gram = 1 milliliter of urine. Therefore, a diaper weighing 47 grams indicates 47 mL of urine output. This method is the most accurate way to measure urine in infants who cannot use a collection device.
Why Other Options are Incorrect:
A. 47 grams — Urine output is documented in milliliters (mL), not grams, even though the measurement comes from weighing the diaper.
C. 1.5 ounces — Urine output in clinical settings is always recorded in metric units (mL), not ounces.
D. 50 milliliters — The diaper weighed exactly 47 grams, so the output is 47 mL, not 50 mL. Rounding up would be inaccurate documentation.
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