Pediatrics

1. Liam, a 5-week-old infant, is brought to the clinic for persistent vomiting after feeds. His mother reports the vomiting is forceful and occurs in a “projectile” manner. Liam appears hungry right after vomiting and cries until fed again. On assessment, you note visible peristaltic waves across the upper abdomen. Which finding supports the nurse’s suspicion of pyloric stenosis? *
2. A 3-year-old child presents with chronic diarrhea, abdominal distention, irritability, and poor weight gain. The mother reports stools are large, pale, and difficult to flush. The child consumes pasta and bread daily. Which finding is most characteristic of celiac disease? *
3. You assess a newborn with hypotonia, a single palmar crease, and upward slanting eyes. The infant has difficulty maintaining a strong suck and shows a protruding tongue. Which finding is most associated with Down syndrome? *
4. A 4-year-old child is being assessed for developmental concerns. The parents report he avoids eye contact, does not respond to his name, lines up toys repeatedly, and becomes extremely distressed with routine changes. Which behavior most strongly indicates Autism Spectrum Disorder? *
5. A 6-year-old child with cystic fibrosis is seen for worsening cough. The mother reports frequent greasy stools and difficulty gaining weight despite good appetite. Lung auscultation reveals coarse crackles. Which finding is most consistent with cystic fibrosis? *
6. A 2-year-old presents with vomiting and diarrhea for 2 days. You observe dry mucous membranes, no tears when crying, sunken eyes, and capillary refill of 4 seconds. Which assessment indicates moderate dehydration? *
7. A 4-year-old arrives drooling, sitting leaning forward, with a muffled voice and high fever. The mother reports sudden onset. What is the priority nursing action? *
8. A 14-month-old pulls on her right ear and cries when lying down. She has a fever of 38.9°C and decreased appetite. The tympanic membrane appears red and bulging. Which finding is typical of acute otitis media? *
9. A 2-month-old infant presents with frequent spit-ups, irritability after feeds, arching of the back, and slow weight gain. The mother reports the infant only sleeps when held upright. Which manifestation is most consistent with GERD? *
10. A 7-year-old with a history of asthma presents with wheezing, respiratory rate 32/min, nasal flaring, and difficulty speaking in full sentences. His oxygen saturation is 91%. Which finding indicates worsening respiratory distress? *
11. A one-year-old child has just been admitted to the pediatric unit. The child has skin lesions filled with a yellowish liquid on the face and hands. The mother explains to the LPN that her child often cries, in inclined to rub his right ear, and is running a fever. He has had a temperature of 38.5 for the past 24 hours. The mother also adds that her son refuses to eat and drink. Upon physical examination, the physician observes an outbreak of red patches and prescribes an antibiotic for impetigo. Which of the following clinical manifestations relates to the young patient’s condition? *
12. A fourteen-year-old patient is admitted to the medical unit after losing consciousness on a soccer field. The LPN observes that he has difficulty forming coherent sentences. She completes the admission questionnaire with the patient’s parents. They tell the LPN that their son has always been very athletic. For some time, they have noticed that he has become increasingly demotivated and tired, but that he still has a good appetite. The physician requests a blood test STAT and confirms a diagnosis of type 1 diabetes. Which of the following clinical manifestations relates to the patient’s condition? *