Pediatrics Greater Lowell Technical College

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Ace Your Test with Pediatrics Greater Lowell Technical College Actual Questions and Solutions - Full Set

Free Pediatrics Greater Lowell Technical College Questions

1.

A child has a continuous intravenous infusion. How frequently should the nurse assess a child's intravenous infusion site?

  • Every three hours

  • Every hour

  • Every four hours

  • Every two hours

Explanation

Explanation:
Correct Answer: (B) Every hour
In pediatric nursing, IV infusion sites in children must be assessed every hour. Children are at higher risk for IV complications such as infiltration, phlebitis, and extravasation due to their smaller, more fragile veins and their inability to communicate discomfort effectively. Hourly assessment allows for early detection and prompt intervention to prevent tissue damage.
Why Other Options are Incorrect:
  • A. Every three hours — This interval is too long for pediatric patients and increases the risk of undetected complications such as infiltration or swelling.
  • C. Every four hours — This is the standard assessment interval for adults, not children, who require more frequent monitoring due to their vulnerability.
  • D. Every two hours — While more frequent than adult standards, two hours is still not frequent enough for pediatric IV site monitoring per nursing guidelines.
2.

At which age would the nurse expect a child to have the most difficulty coping with separation from parents because of hospitalization?

  • 7 years old

  • 3 months old

  • 4 years old

  • 16 months old

Explanation

Explanation:
Correct Answer: (D) 16 months old
Toddlers between 6 months and 2-3 years of age experience the greatest distress from separation anxiety. At 16 months, a child has developed a strong attachment to caregivers but lacks the cognitive ability to understand that separation is temporary. This stage, known as the phase of protest-despair-detachment, makes hospitalization especially distressing for toddlers.
Why Other Options are Incorrect:
A. 7 years old — School-age children have developed cognitive skills to understand temporary separation and can cope more effectively.
B. 3 months old — Infants at this age have not yet developed strong object permanence or specific caregiver attachment, making separation less distressing.
C. 4 years old — Preschoolers do experience separation anxiety, but it is less intense than in toddlers as they begin to develop some understanding of time and temporary absence.
3.

You are teaching a student nurse how to apply a medicated cream to an infant's buttocks. You explain that a plastic diaper can:

  • Cause maceration

  • Diminish absorption

  • Have no effect on absorption

  • Increase absorption

Explanation

Explanation:
Correct Answer: (D) Increase absorption
A plastic diaper acts as an occlusive dressing over the skin, trapping heat and moisture against the area where the medicated cream has been applied. This occlusive effect increases the absorption of topical medications through the skin (percutaneous absorption). In infants, this effect is even more significant because their skin is thinner and more permeable than adult skin, making them more susceptible to systemic absorption of topical medications. Nurses must be aware of this when applying medicated creams to diaper areas, as increased absorption can lead to systemic effects or toxicity.
Why Other Options are Incorrect:
  • A. Cause maceration — While plastic diapers can contribute to skin maceration from trapped moisture, this is not the primary concern when teaching about medicated cream application. The more clinically significant effect is increased drug absorption.
  • B. Diminish absorption — This is incorrect; the occlusive nature of a plastic diaper enhances, not diminishes, the absorption of topical medications.
  • C. Have no effect on absorption — This is incorrect; the plastic diaper has a significant effect by acting as an occlusive barrier that increases percutaneous drug absorption.
4.

When the nurse measures an infant's temperature, it is 102.4°F. The nurse understands that a serious complication of a rapid rise in temperature in infants and young children is:

  • Lethargy

  • Febrile seizures

  • Tachycardia

  • Hypertension

Explanation

Explanation
Correct Answer: (B) Febrile seizures
Febrile seizures are the most serious and well-recognized complication of a rapid rise in temperature in infants and young children. They occur most commonly in children between 6 months and 5 years of age when body temperature rises rapidly. Although febrile seizures are generally brief and self-limiting, they are frightening and require immediate nursing intervention to ensure the child's safety.
Why Other Options are Incorrect:
  • A. Lethargy — While lethargy can accompany fever, it is a common symptom rather than a serious complication of a rapid temperature rise.
  • C. Tachycardia — An elevated heart rate is an expected physiological response to fever, not a serious complication unique to rapid temperature rise in infants.
  • D. Hypertension — Hypertension is not a recognized serious complication of rapid fever elevation in infants and young children.
5.

Garamycin ear drops are prescribed for a 2-year-old child. To administer the ear drops the nurse would:

  • Pull the auricle up and back

  • Pull the auricle down and back

  • Pull the auricle down and out

  • Pull the auricle up and out

Explanation

Explanation
Correct Answer: (B) Pull the auricle down and back
In children under 3 years of age, the ear canal is shorter and more horizontal than in adults. To straighten the ear canal and allow proper instillation of ear drops, the nurse must pull the auricle (pinna) downward and backward. This technique ensures the drops reach the ear canal effectively and provides optimal medication delivery.
Why Other Options are Incorrect:
  • A. Pull the auricle up and back — This is the correct technique for adults and children over 3 years of age, not for a 2-year-old child.
  • C. Pull the auricle down and out — While the downward direction is correct for young children, pulling outward rather than backward does not adequately straighten the ear canal for proper drop instillation.
  • D. Pull the auricle up and out — This technique is incorrect for any age group and does not straighten the ear canal appropriately.
6.

What can a nurse do to assist a pre-school child adjust to hospitalization?

  • Encourage the child to personalize his or her space

  • Make meal choices for the child

  • Discourage social interaction with other patients on the unit

  • Do not explain procedures in detail so as not to frighten the child

Explanation

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.
7.

The nurse preparing an intramuscular injection for an 18-month-old child is aware that the maximum volume of medication that can be injected into one site is:

  • 3ml

  • 1ml

  • .5ml

  • 2ml

Explanation

Explanation
Correct Answer: (B) 1ml
For infants and small children under 2 years of age, the maximum volume that can be safely administered in a single IM injection site is 1 mL. This limit exists because young children have smaller, less developed muscle mass that cannot safely absorb larger volumes. Exceeding this volume can cause pain, tissue damage, and poor medication absorption.
Why Other Options are Incorrect:
  • A. 3ml — This volume is appropriate for large adults with well-developed muscle mass, not for infants.
  • C. 0.5ml — While this is a safe volume, it is the maximum for neonates, not 18-month-old infants.
  • D. 2ml — This volume is appropriate for older children over 2 years of age and adults, not for an 18-month-old infant.
8.

In order to allow the hospitalized toddler to feel less afraid, which of the following strategies is used for painful procedures?

  • Tell the child the procedure won't hurt

  • Have the child's parent leave the room for painful procedures

  • Perform all painful procedures in a separate treatment room

  • Tell the child about the procedure the day before

Explanation

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.
9.

Which type of restraint is most appropriate for the insertion of an intravenous line in a scalp vein in an infant?

  • Mummy

  • Clove hitch

  • Elbow

  • Jacket

Explanation

Explanation
Correct Answer: (A) Mummy
The mummy restraint is the most appropriate restraint for procedures involving the head and neck of an infant, such as scalp vein IV insertion. It involves wrapping the infant snugly in a blanket to immobilize the arms and legs, keeping the infant still while allowing access to the head. This restraint is safe, effective, and prevents sudden movements that could cause injury during the procedure.
Why Other Options are Incorrect:
  • B. Clove hitch — This restraint is used to secure a single extremity (arm or leg), not appropriate for immobilizing the whole body during a scalp procedure.
  • C. Elbow — The elbow restraint prevents the child from bending the elbow to reach the face or an IV site, and is not suitable for scalp vein procedures.
  • D. Jacket — A jacket restraint is used to keep a child in bed or a chair and does not provide the full-body immobilization needed for scalp IV insertion.
10.

A nurse encourages a school-age child to draw a picture after a painful procedure. What is the best rationale for this intervention?

  • She wants to distract the child from thinking about the pain

  • She is encouraging quiet play after pain to stabilize vital signs

  • She is attempting to reestablish rapport

  • She is providing a way for the child to express his feelings

Explanation

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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