CA 2- PEDIATRIC NURSING - QUIZ

1. After birth, the newborn has to adapt to the new environment alongside with the changes in his physiological
functioning. Certain cues are needed to identify that the newborn is well or problems are already present.
Samantha, a graduating student nurse assists the doctor to a G1P0 woman giving birth in the lying-in clinic.
Samantha knows that the newborn is in critical condition if:
a. Caput succedaneum is present (common, edema of the scalp so will cross the suture line since mababaw
lang) C – S = Crosses Suture
b. There are no creases in the newborn’s feet There should be, but could just be sign of defect and not a critical
condition
c. The newborn is not crying (Not common)
d. The newborn is cyanotic common in new born

2. Extra-uterine life assessment in newborns is essential to determine the over-all condition of the newborn to his new
environment. One of the most significant assessment tool used is the APGAR scoring. Which of the following is NOT
true about it?
a. APGAR scoring was formulated by Virginia Apgar FACT
b. It is done to assess the newborn’s ability to adapt to the extra-uterine life FACT
c. It can provide early detection of certain congenital diseases (Will not determine)
d. It is done on the 1st and 5th minutes of life (1-10-5 Minutes) FACT

3. Growth & Development is very crucial since, the health care provider has to identify if a child can follow the normal
pattern. One should know the characteristics of growth and development to effectively assess it. Ms. Minchin is
discussing the concepts of growth and development to a group of nursing students. She asked Cedric to summarize
it. Which of the following responses needs further teaching?
a. The sequence of each stage is unpredictable and varies from person to person (false since its predictable,
there is developmental milestones)
b. Growth is the quantitative change while development is a qualitative maturation of systems FACT
c. Growth and development occurs in a cephalocaudal and proximo-distal pattern FACT
d. Growth and development are continuous influenced by maturational, environmental and genetic factors
FACT

4. Gross motor development of an infant can also be seen to the head onto what degree the infant can lift it when
prone. When can you expect an infant to raise his head 90 when prone?
a. 1 month
b. 2 months
c. 3 months
d. 4 months

5. The reflexes present in the mouth can identify the readiness of the infant to facilitate feeding. Analyn is a mother of
a 4 month old infant asks the nurse when she can start feeding her baby solid food. Which of the following should
the nurse include in teaching Analyn about the nutritional needs of the infant?
a. Infant cereal can be introduced by spoon when the extrusion reflex fades
b. Solid foods should be given as soon as the first tooth erupts dapat wala na extrusion reflex
c. Pureed foods can be offered when the infant has tripled his birth weight walang kinalaman
d. Infant formula or breast milk provides adequate nutrients for the first year pwede pero hindi complete since
BF kulang iron

6. During the 6th month, infant’s first teeth are expected to appear. Mr. And Mrs. Lao had their first child who had
reached his 6th month. They noticed that the child becomes irritable, and frequent salivation is observed. Which of
the following could BEST explain this phenomenon?
a. The child has many sores in his mouth and gums
b. This is a normal occurrence for children 6 months and below
c. Eruption of central incisors begins
d. The mouth should be cleaned because of bacterial infection
 CA 2- PEDIATRIC NURSING - QUIZ
7. Toys should be appropriate according to the age of the infant. It should also develop the infant’s mental and physical
ability as well. During the check-up, Brian, also 7-month old cried loudly. What toy should you give to Brian to stop
him from crying?
a. Pacifier
b. Rattle
c. Cubes
d. Rubber ducky maganda pag in time of bathing

8. There is an appropriate type of play for every ages of an infant based on their ability and what they can appreciate.
During 7 months, the infant appreciates the face of his caregivers. Hubert is playing with a 7-month old boy, Santino.
What type of play will be best for Santino at his stage?
a. Hide and seek
b. Peek-a-boo (good for 5-10 month, most appreciated at 10 months)
c. Make believe
d. Building blocks

9. During 9 months, the infant learns how to communicate actively as evident by saying few words with meaning.
Louise is now 9 months old. Her parents are really happy because she can now communicate to them. In what way
do you expect how Louise communicates?
a. There is a reciprocal smiling with parents
b. She is now babbling 5-6 months
c. She squeals in excitement
d. She can say few words like “mama” and “dada”

10. According to cognitive development, preschoolers exhibit great imagination and exploration of environment. Regine
is now 3 ½ years old, according to Piaget, what characteristic of cognitive development she must now exhibit?
a. Can distinguish goals from means of attaining it hindi pa kaya ng pre school
b. Associates word with objects this is for toddler (object orientation)
c. Solves concrete problems school age (orientation)
d. Use “make believe” and “pretend to” play

11. Toddlers have a negativistic and egoistic personality. They usually exhibit temper tantrums to gain control over their
environment. Bona, a Community Health Nurse is making a newborn follow-up home visit. During the visit, Nicole a
2 year old sibling has temper tantrums. Which of the following is the most appropriate nursing action?
a. Help Nicole understand the rules
b. Leave Nicole alone in her bedroom safety concern
c. Suggest that the parents ignore the child’s behaviour
d. Explain that Nicole is jealous of the new baby

12. Imaginary friends are common among pre-school as a way for them to manipulate their environment. The parents of
Jillian a 4 year old child told the nurse that the child has an invisible friend named Jonjon. Jillian blames Jonjon for
any misbehaviour and is often heard scolding him calling him a bad boy. The nurse understands that the best
interpretation of this behaviour is which of the following?
a. A delay in moral development
b. Impaired parent-child relationship
c. A way of the child to assume control
d. Inconsistent parental discipline strategies

13. Oedipal complex arises during the pre-school based on the phallic stage of Freud’s psychosexual development. This
means that the child is towards the parent of the opposite sex. Dingdong and Marian has a son Kenneth, who is now
4 years of age. Kenneth seems to be more affectionate to his mother. What is the best indicator that Kenneth has
solved this conflict?
a. He now assume the role of his father bata naman masyado
b. He now assume the role of his mother
c. He now mimics the gestures of his father
d. He now mimics the gestures of his mother
 CA 2- PEDIATRIC NURSING - QUIZ
SITUATION: Susie, 9 y/o has been diagnosed with tracheoesophageal fistula.

14. Which of these symptoms will be noted by the nurse in Susie?

a. Bile-stained vomiting c. Excessive drooling & abdominal distention
b. Projectile vomiting d. Severe cyanosis & Stridor (coughing choking and cyanisus)

15. Which of the following actions is most important for Susie’s care?
a. Prevent infection c. Prevent aspiration
b. Prevent bleeding d. Provide oxygenation

SITUATION: Mr. & Mrs. Cua’s first child, Homer, was born with a unilateral cleft lip & cleft palate. The lip defect
extended through the floor of the nostril & communicated with the defect in the anterior palate.

16. For Homer’s parents, the most painful aspect of his deformity is probably the fact that it:
a. Interferes with feeding c. Can’t be wholly corrected
b. Affect his face d. Requires lengthy repair

17. For which reason would it be advisable for Homer’s cleft lip to be repaired as soon as possible after birth?
a. To facilitate feeding & Improve nutrition
b. To eliminate the danger of aspiration of secretions
c. To increase his parent’s acceptance of his defect
d. To prevent speech impairment & voice problem

18. Before the repair of his lip & palate defects, the physician will probably order that Homer be fed by:
a. breast feeding c. Metal cup
b. intravenous fluid d. Rubber tipped medicine dropper (a.k.a Break feeder)

19. Homer’s cleft lip predisposes him to infection primarily as a result of:
a. Accumulation of dried milk in the skin folds of his defect next best choice if there was no “d”
b. Disruption of normal circulation to the tissue
c. Faulty general nutrition from the defect
d. Mouth breathing & consequent drying of the oral mucosa

SITUATION: Gino Ang, who weighed 7 lbs. at birth, was discharged from the hospital on his 3 rd day of life. During the
nest 2 weeks at home he developed severe vomiting & weight loss, although his appetite remained good. Finally, Gino’s
mother brought him to the hospital ER for treatment. Gino’s PE revealed severe dehydration, epigastric pain &
distention, and a palpable olive-size mass in the right upper quadrant.

20. Vomiting due to this type of obstruction is typically characterized as:

1. Bile stained no 3. Decreasing inseverity in time no
2. initiated with great force 4. Unaccompanied by nausea (because its not neurologic)

a. 1,2 b. 1,3 c. 2,3 d. 2,4

21. Careful history taking may reveal that Gino had developed which gastrointestinal symptom besides vomiting?
a. Excessive salivation c. Noisy eructation’s
b. Decreased frequency of stools d. Fresh blood in the stool
 CA 2- PEDIATRIC NURSING - QUIZ
SITUATION : Sonya Santos weighed 7 lbs at the time of her birth. 2 months later, her mother noted that the stools were
frequently foul-smelling and frothy. During the next few months, Sonya failed to gain weight so her mother
took her to the pediatric clinic at the age of 9 months. The examining physician found Sonya to be poorly developed,
underweight and suffering from bronchitis with frequent non-productive cough. Chest x-ray, blood
tests, stool analysis and sweat were done. Sonya’s family history revealed that she has a first cousin who had
mucoviscidosis (cystic fibrosis).

22. The pathophysiologic problem underlying the symptoms of this disease is :

a. Sluggish lymph circulation due to increased tortuosity of vessels no
b. Hypertrophy of smooth muscle fiber surrounding tubular structure no
c. Production of abnormally tenacious secretions by the exocrine glands
d. Obstructions of granular ducts by uric acid crystals

23. Sonya’s small stature was probably due to

a. Poor appetite and ingestion of less than normal quantities of food
b. Failure to absorb nutrients because of the lack of pancreatic enzymes (because there is lack of pancreatic
enzyme due to obstruction)
c. Secretion of less than amount of pituitary growth hormone
d. Development of muscular and bony atrophy from lack of motor activity

24. Mucoviscidosis would also predispose Sonya to later development of which of the
following lung disorder?
a. Pleural Effusion c. Obstructive emphysema (loose its lung recoil)
b. Pneumothorax d. Tuberculosis

SITUATION : Kurt Sy was a full term baby delivered without complication who was found to have a heart murmur during a
early well baby check up. The doctor told Mrs Sy that the murmur indicate a possible cardiac defect, and Kurt was
referred to the pediatric clinic for follow up and complete cardiac work up. Between his 2 nd and 4th year of age, Kurt
experienced 2 episodes of cyanosis, easy fatigability, dyspnea on exertion and clubbing of fingers.

25. Which of the following maternal factors has been implicated as a possible cause of CHD’s?
a. Rubella during the first trimester of pregnancy (organogenesis the virus can cross the placenta during 1 st
trimester)
b. Excessive and rapid weight gain during pregnancy
c. Hypertension associated with pre-eclampsia
d. Metabolic acidosis due to diabetes mellitus

26. Kurt’s easy fatigability was probably due to

a. Deficient intake of high caloric and high vitamin containing foods
b. Inadequate development and decreased tone of skeletal muscle
c. Low BP associated with decreased numbers of RBC
d. Inadequate oxygen to support tissue glucose oxidation for energy

27. Kurt developed polycythemia. This can be understood as an adjustment evoked by his :
a. cardiac enlargement c. low BP
b. poor valve stenosis d. Tissue oxygen need

28. The x-ray findings of right ventricular hypertrophy combined with decreased pulmonary blood flow are
suggestive of :
a. Tricuspid atresia c. Patent ductus arteriosus
b. Pulmonic valve stenosis d. Aortic valve stenosis

29. Defects associated with Tetralogy of Fallot include :

a. severe coarctation of aortic valve, pulmonic valce stenosis, mitral valve stenosis
b. ventricular septal defect, overriding the aorta, pulmonic stenosis, right ventricular hypertrophy
c. tricuspid valve atresia, atrial septal defect, hypoplastic right ventricle, PDA
d. none of these
 CA 2- PEDIATRIC NURSING - QUIZ
30. PDA is a CHD that allows abnormal blood flow between the aorta and the pulmonary artery. Thorough
evaluation of Rachelle revealed a large patent ductus arteriosus. A correct understanding of PDA (cyanotic, left
to right shunt) will make the nurse anticipate Rachelle to exhibit which of the following symptoms:

a. Having breathing difficulty and becoming cyanotic with slight activity

b. Being acyanotic but having difficulty breathing after physical activity
c. Becoming cyanotic during feeding and exertion
d. Often assuming a squatting position (postion for cyanotic)