# NCLEX-PN : Conditions and Treatments

## Example Questions

### Example Question #1 : 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 #81 : Conditions And Treatments

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 #81 : Conditions And Treatments

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:

notify a pediatrician

feed only breast milk until the infant's weight increases

consider switching brands of formula

continue feedings as usual

feed every 5 hours

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 #82 : Conditions And Treatments

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:

3 to 6 months of age

12 to 18 months of age

6 to 9 months of age

18 to 20 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 #1 : 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

Sucking motions

Rooting

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 #1 : 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:

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

deliver oxygen through a simple mask

check oxygenation through a portable pulse oximeter

check for oral obstruction of the infant's airway

note the finding on the patient's chart

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.

### Example Question #83 : Conditions And Treatments

Kerry is a first-time mother caring for her new baby boy. She notices that as she touches his cheek, he turns towards that side and opens his mouth. The nurse tells Kerry that this is a reflex called __________.

Possible Answers:

the Moro reflex

the rooting reflex

palmar grasp

the Babinski reflex

plantar grasp

Correct answer:

the rooting reflex

Explanation:

The question describes the rooting reflex. The Moro reflex is shown when an infant is startled and/or feels loss of support as if he/she is falling. He/she will extend the arms above the body in a curved shape. The Babinski reflex occurs in response to stimulation of the sole of the foot. Typically, the large toe will extend or remain extended as the others move. Infants may also exhibit plantar grasp with application of pressure to the foot. In plantar grasp, the toes will flex inward. Infants displaying palmar grasp will close their fingers around an object placed in their hand.

### Example Question #83 : Conditions And Treatments

Which of the following findings are abnormal upon assessment of an infant on the third day of life?

Possible Answers:

Fine hair covering large body surfaces

Small, white spots present on the bridge of the nose

Mottled skin

Blue tint to the hands and feet

Firm stools

Correct answer:

Firm stools

Explanation:

Hard or firm stools are abnormal for an infant on their third day of life. Typically, infants will have meconium (dark, sticky) stools for the first several days as a result of amniotic fluid ingestion. Over the next couple days they will transition to a seedy yellow (breastfed infants) or peanut butter consistency (formula-fed infants). Acrocyanosis, blue color on the extremities, is normal in infants. Mottling is also common. Infants have a developing cardiovascular system and many capillaries that exist close to the surface of the skin. Milia are normal white spots that frequent the faces of newborns. It is important not to pick or scratch these white spots to prevent scarring. Infants are also frequently born with fine hair called lanugo covering the body's surfaces. Some babies may be born with more lanugo than others.

### Example Question #84 : Conditions And Treatments

While assessing a 4-month-old infant, the nurse notices hyperpigmented nevi on the lower back. Which of the following is false regarding hyperpigmented nevi?

Possible Answers:

Hyperpigmented nevi fade over time

Hyperpigmented nevi are most commonly found on dark skinned children

Hyperpigmented nevi may be associated with Sturge-Weber syndrome

Hyperpigmented nevi are frequently mistaken as bruises

Hyperpigmented nevi may be scattered

Correct answer:

Hyperpigmented nevi may be associated with Sturge-Weber syndrome

Explanation:

Hyperpigmented nevi have been previously called "Mongolian spots". They occur most commonly in dark skinned children and fade as the child ages. They are often mistaken for bruises. Sturge-Weber syndrome is a neurological disorder which is present at birth and associated with port-wine stain birthmarks.

### Example Question #85 : Conditions And Treatments

While using an otoscope, how does the practitioner correctly examine the tympanic membrane of a toddler?

Possible Answers:

Pull forward on the upper pinna

Pull down on the earlobe

Pull back on the upper pinna

Pull upwards on the earlobe

Pull up on the upper pinna

Correct answer:

Pull down on the earlobe

Explanation:

Examine the eardrum of infants and toddlers by pulling down on the ear lobe. Examine the eardrum of an older child by pulling up on the outer pinna. Additional help from colleagues or caregivers may be necessary when examining small or upset children.