NCLEX : Identifying Pediatric Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #71 : Conditions And Treatments

Which of the following terms describes the congenital abnormality of the forebrain in which an infant is born with a diminished brain size?

Possible Answers:

Microcephaly

Agyri

Anencephaly

Polymicrogyri

Correct answer:

Microcephaly

Explanation:

Microcephaly denotes a congenital abnormality of the forebrain in which an infant is born with a diminished brain size. Potential causes include fetal alcohol syndrome, congenital rubella, and trisomy 18. 

The other answers are all examples of congenital forebrain birth defects:

  • Anencephaly is the complete absence of major portions of the brain, skull, and scalp.
  • Agyri is the absence of gyri.
  • Polymicrogyri is a condition in which gyri are too many, too small, and very shallow.

Example Question #76 : Conditions And Treatments

Anencephaly and other neural tube defects have been linked to maternal deficiency of what nutrient?

Possible Answers:

Beta carotene

Biotin

Folate

Calcium

Correct answer:

Folate

Explanation:

Anencephaly and other neural tube defects have been linked to maternal deficiency of folate. This is most likely due to folate's role in methylation and nucleic acid synthesis. The other nutrients listed are all important to maternal health but have no known correlation with neural tube defects such as anencephaly.

Example Question #77 : Conditions And Treatments

Periventricular leukomalacia (PVL) is the most common finding on autopsy of newborns with what condition?

Possible Answers:

Cerebral palsy

Anencephaly

Fetal alcohol syndrome

Hypoxia

Correct answer:

Cerebral palsy

Explanation:

Periventricular leukomalacia is the most common finding on autopsy of newborns with cerebral palsy. PVL involves the softening of the brain tissue and subsequent death of the white matter. This is caused by lack of blood flow to the periventricular area of the brain, which results in necrosis and gliosis of brain tissue. Neonates born with PVL are likely to have mental impairment, motor disorders, and compromised vision and hearing. PVL is usually diagnosed with ultrasound of the head. None of the other conditions listed typically present with this finding.

Example Question #78 : Conditions And Treatments

A mother one hour post birth expresses concern because her baby's head looks slightly cone shaped. The nurse tells the mother that __________.

Possible Answers:

this is abnormal but does not require immediate medical intervention

this is abnormal and she should contact her pediatrician

this is abnormal and she should consult a neurologist

this is normal and usually temporary

this is normal but is not temporary

Correct answer:

this is normal and usually temporary

Explanation:

It is normal for a child's head to be slightly misshapen immediately following birth. The infant's skull is composed of bony plates connected by membranes (fontanelles), allowing for accommodation of the baby's growing brain. Caput succedaneum (swelling of the scalp) can also be found following a long delivery. A misshapen head usually resolves on its own and is normal but does not require any medical intervention.

Example Question #1 : Identifying Pediatric Conditions

A baby is born with a heart rate of 99 beats per minute, irregular breathing, good flexion, frowns when you suction the nose, and with pink color throughout the body and limbs. What is the baby's APGAR score at one minute? 

Possible Answers:

Correct answer:

Explanation:

An APGAR (Appearance Pulse Grimace Activity Respiration) score is a quick assessment designed to indicate the condition of the baby after birth. Referring to the APGAR scoring method, point allocations are as follows:

Heart rate of less than 100: 1

Good flexion: 2

Frown (reflex): 1

Irregular respirations: 1

Pink skin color: 2

We add these to get the final APGAR score of 7.

Example Question #2 : Identifying Pediatric Conditions

A baby is born with a heart rate of 60 beats per minute. The baby is not breathing, has limp limbs, is flaccid and pale. What is the baby's APGAR score at 1 minute? 

Possible Answers:

Correct answer:

Explanation:

An APGAR (Appearance Pulse Grimace Activity Respiration) score is a quick assessment designed to indicate the condition of the baby after birth. Referring to the APGAR scoring method, point allocations are as follows

Heart rate less than 100: 1

Poor flexion: 0

Absent reflex: 0

Apnea: 0

Pallor: 0

We add these individual scores to get the APGAR score of 1.

Example Question #3 : Identifying Pediatric Conditions

A pair of new parents are concerned because their baby has lost 4% of it's birth weight at 3 days of life. The nurse instructs the parents to __________.

Possible Answers:

feed only breast milk until the infant's weight increases

consider switching brands of formula

feed every 5 hours

continue feedings as usual

notify a pediatrician

Correct answer:

continue feedings as usual

Explanation:

It is common for infants to lose up to 10% of their weight in the first week of life. Greater than a 10% loss indicates a problem. For an infant within these parameters, there is no need to make a change in feedings. Infants in the first week of life should be fed every 2-3 hours if breast feeding and every 3-4 hours if formula feeding. 

Example Question #4 : Identifying Pediatric Conditions

Julie is a new registered nurse who is assessing a child in his third month of life. The assessment is part of a routine appointment at a public health clinic. She knows that the anterior fontanelle of most infants closes between __________.

Possible Answers:

18 to 20 months of age

6 to 9 months of age

3 to 6 months of age

12 to 18 months of age

1 to 3 months of age

Correct answer:

12 to 18 months of age

Explanation:

The anterior fontanelle is commonly referred to as the "soft spot" located atop a child's head. It allows considerable brain growth until it closes, generally between 12-18 months. However, the fontanelle may close on some children as early as 9 months.

Example Question #5 : Identifying Pediatric Conditions

Which of the following is considered a late sign of hunger in the newborn? 

Possible Answers:

Chewing on the fists

Bringing hands to chin

Rooting

Sucking motions

Crying

Correct answer:

Crying

Explanation:

Crying is considered a late sign of hunger. By the time the infant cries, they may be more difficult to console or to feed, especially if breastfeeding. Feed on cue when the infant is rooting, making sucking motions, or when they are frequently bringing their hands to their face or mouth.

Example Question #6 : Identifying Pediatric Conditions

A pediatric nurse is assessing a 4-day-old infant. He notes irregular breathing of 45 breaths per minute. The nurse should __________.

Possible Answers:

deliver oxygen through a simple mask

check oxygenation through a portable pulse oximeter

note the finding on the patient's chart

reposition the infant by placing a roll under the neck to open the airway

check for oral obstruction of the infant's airway

Correct answer:

note the finding on the patient's chart

Explanation:

It is normal for infants to breathe irregularly. Often, brief periods of apnea are present. Infants should breathe between 30 and 60 times per minute. For this purpose, noting the finding as a vital sign in the patient's chart is the correct action. No further intervention is necessary in response to a normal assessment.

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