VATI Nursing Care of Children 2019
1. A nurse is teaching an adolescent how to use a peak expiratory flow meter. Which statement
by the adolescent shows correct understanding?
A. "I will record the lowest reading of the three attempts."
B. "I will record the average of the three attempts."
C. "I will record the first reading of the three attempts."
D. "I will record the highest reading of the three attempts."
Answer: D. "I will record the highest reading of the three attempts."
2. A nurse in a pediatric clinic is providing teaching to the parent of an infant who has
gastroesophageal reflux. Which statement by the parent indicates correct understanding?
A. "I will keep my baby in a flat position after feeding."
B. "I will give my baby larger feedings less frequently."
C. "I will add rice cereal to my baby’s feeding."
D. "I will give my baby cold formula to help with reflux."
Answer: C. "I will add rice cereal to my baby’s feeding."
3. A nurse is planning care for a client who has cerebral palsy and is experiencing muscle
spasms. Which of the following medications is most appropriate to administer?
A. Diazepam
B. Baclofen
C. Gabapentin
D. Acetaminophen
Answer: B. Baclofen
4. A nurse is planning care for an infant who has RSV (Respiratory Syncytial Virus) and a
respiratory rate of 46/min. Which of the following actions should the nurse take?
A. Place the infant in a negative-pressure room
B. Administer a bronchodilator
C. Initiate contact precautions
D. Restrict oral feedings
Answer: C. Initiate contact precautions
5. A nurse is creating a plan of care for a school-age child who is postoperative following a
tonsillectomy. Which of the following interventions should the nurse include?
A. Encourage the child to gargle with warm salt water
B. Provide the child with a straw to drink fluids
C. Apply an ice collar to the child’s neck
D. Position the child flat on their back
Answer: C. Apply an ice collar to the child’s neck
6. A nurse is providing discharge teaching to a group of guardians of infants about home safety.
Which of the following instructions should the nurse include?
A. Place pillows in the crib to prevent the infant from rolling
B. Keep your infant restrained when they are in a highchair
C. Use a walker to help your infant move around the house safely
D. Allow your infant to sleep with a small blanket for comfort
Answer: B. Keep your infant restrained when they are in a highchair
7. A nurse is teaching the parents of an infant how to administer antibiotic eardrops. Which of the
following instructions should the nurse include?
A. Pull the pinna upward and backward before administering the drops
B. Position the infant sitting upright during administration
C. Massage the anterior area of the ear following administration
D. Administer the drops directly into the ear canal without warming them
Answer: C. Massage the anterior area of the ear following administration
8. A nurse is preparing to obtain a blood sample for hemoglobin (Hgb) testing from a child who
has hemophilia. Which of the following actions should the nurse take?
A. Use a finger stick to obtain the blood sample
B. Apply firm pressure for 1 minute after obtaining the sample
C. Obtain the sample using venipuncture
D. Administer a dose of factor replacement therapy after the procedure
Answer: C. Obtain the sample using venipuncture
9. A nurse is providing discharge teaching to the parents of a school-age child who has epilepsy
and a new prescription for phenytoin extended-release capsules. Which of the following
instructions should the nurse include?
A. Give the medication with a glass of milk to enhance absorption
B. Encourage the child to brush their teeth after each meal
C. Discontinue the medication if the child is seizure-free for 6 months
D. Administer the medication only during a seizure event
Answer: B. Encourage the child to brush their teeth after each meal
10. A nurse is caring for a child who has terminal leukemia. Which of the following statements
should the nurse include when discussing physical changes as death approaches?
A. "Your child will experience a significant increase in appetite."
B. "Your child will lose movement in their legs."
C. "Your child's energy levels will improve briefly before death."
D. "Your child's breathing will remain regular and steady."
Answer: B. "Your child will lose movement in their legs."
11. A nurse is caring for a 6-month-old infant who has acute vomiting and diarrhea. Which of the
following findings should the nurse identify as a sign of severe dehydration?
A. Bradycardia
B. Bulging fontanel
C. Tachypnea
D. Moist mucous membranes
Answer: C. Tachypnea
12. A nurse is caring for an infant who has returned to the pediatric unit following surgical repair
of a cleft lip. Which of the following interventions should the nurse include in the plan of care?
A. Position the infant prone to prevent aspiration
B. Administer feedings with a spoon to protect the surgical site
C. Monitor temporal artery temperature
D. Apply petroleum jelly to the incision site immediately after surgery
Answer: C. Monitor temporal artery temperature
13. A nurse is assessing an infant who has Tetralogy of Fallot. Which of the following findings
are expected? (Select all that apply)
A. Heart murmurs
B. Cyanotic spells
C. Wide pulse pressure
D. Tachypnea
Answer: A. Heart murmurs
B. Cyanotic spells
14. A nurse is assessing a child who has full-thickness burns of the legs. Which of the following
findings should the nurse expect?
A. Injured skin is pink to red in color
B. Injured skin is cream to black in color
C. Injured skin is blanchable with pressure
D. Injured skin is moist with blisters
Answer: B. Injured skin is cream to black in color
15. A nurse is planning care for a newly admitted child who has autism spectrum disorder (ASD).
Which of the following interventions should the nurse include in the plan of care?
A. Encourage the child to engage in group activities immediately
B. Establish a reward system for the child
C. Limit communication to nonverbal interactions only
D. Provide an unstructured, flexible routine
Answer: B. Establish a reward system for the child
16. A nurse is teaching a female adolescent who reports frequent urinary tract infections (UTIs).
Which of the following instructions should the nurse include in the teaching?
A. Drink only cranberry juice to prevent infections
B. Void at least every 3-4 hours
C. Use feminine hygiene sprays regularly
D. Avoid showering and only take baths
Answer: B. Void at least every 3-4 hours
17. A nurse is providing discharge teaching to the parent of a school-age child who has juvenile
idiopathic arthritis (JIA). Which of the following statements by the parent indicates
understanding of the teaching?
A. "I will have my child wear splints during the night."
B. "I will encourage my child to rest for the entire day."
C. "I will avoid any physical activity to prevent joint stress."
D. "I will limit my child's fluid intake to reduce swelling."
Answer: A. "I will have my child wear splints during the night."
18. A nurse is assessing a 4-month-old infant at a well-child visit. Which of the following
findings is abnormal for this age?
A. The infant has an absent grasp reflex.
B. The infant turns head toward a sound.
C. The infant can lift the head while on the stomach.
D. The infant demonstrates social smiling.
Answer: A. The infant has an absent grasp reflex.
19. A nurse is reviewing the admission laboratory report of a school-age child who has
glomerulonephritis. Which of the following laboratory findings is consistent with this condition?
A. BUN 32
B. Hemoglobin 14 g/dL
C. Platelet count 200,000/mm³
D. Serum albumin 4.5 g/dL
Answer: A. BUN 32
20. A nurse is admitting a child who has pertussis. Which of the following precautions should the
nurse implement?
A. Contact
B. Airborne
C. Droplet
D. Standard
Answer: C. Droplet
21. A nurse is assessing a 9-month-old infant who has gastroenteritis. Which of the following
findings would indicate dehydration?
A. Absence of tears when they cry
B. Fontanel is bulging
C. Increase in urinary output
D. Moist mucous membranes
Answer: A. Absence of tears when they cry
22. A nurse is teaching a group of new parents about expected language development. At what
age should parents expect a child to begin saying a few words, such as "mama" or "dada"?
A. 6 months
B. 12 months
C. 18 months
D. 24 months
Answer: B. 12 months
23. A nurse is caring for an infant who has pyloric stenosis and a new prescription for 0.9%
sodium chloride. What is the priority action the nurse should take?
A. Check the infant’s serum creatinine
B. Assess the infant’s blood pressure
C. Monitor the infant’s intake and output
D. Obtain a urine culture
Answer: A. Check the infant’s serum creatinine
24. A nurse in the emergency department is caring for a preschool-age child who has hemophilia
A and was involved in a motor vehicle accident (MVA). Select all that apply:
A. Administer factor VIII
B. Assess for changes in LOC (Level of Consciousness)
C. Encourage the child to walk to assess mobility
D. Apply pressure to all bleeding sites to control hemorrhage
Answer: A. Administer factor VIII
B. Assess for changes in LOC (Level of Consciousness)
D. Apply pressure to all bleeding sites to control hemorrhage
25. A nurse is teaching the parent of a school-age child who has cystic fibrosis about home care.
Select all that apply:
A. I will give my child stool softeners for constipation.
B. I will encourage my child to take a multivitamin with iron daily.
C. I will ensure my child receives pancreatic enzyme replacements with meals.
D. I will monitor my child’s weight and report any weight loss to the healthcare provider.
Answer: A. I will give my child stool softeners for constipation.
C. I will ensure my child receives pancreatic enzyme replacements with meals.
D. I will monitor my child’s weight and report any weight loss to the healthcare provider.
26. A nurse is teaching about injury prevention to the parent of a toddler. Which of the following
is an appropriate recommendation?
A. Place a throw rug under the crib.
B. Allow the toddler to play with small objects to enhance motor skills.
C. Install safety gates at the top of stairs.
D. Use a toddler bed without guardrails to encourage independence.
Answer: C. Install safety gates at the top of stairs.
27. A nurse is providing dietary teaching for an 11-year-old child who has type 1 diabetes
mellitus. Which of the following recommendations are appropriate? (Select all that apply)
A. Eat extra food to prevent hypoglycemia.
B. Increase intake of sugar-free foods and beverages.
C. Eat a snack 30 minutes before physical activity.
D. Skip meals if blood sugar is high to reduce intake.
E. Choose foods high in carbohydrates for stable blood sugar levels.
Answer: A. Eat extra food to prevent hypoglycemia.
B. Increase intake of sugar-free foods and beverages.
C. Eat a snack 30 minutes before physical activity.
28. A nurse is planning to obtain a rectal temperature from a toddler. Which of the following
actions should the nurse take?
A. Place the child in a prone position.
B. Have the child sit on the examination table.
C. Hold the child in a standing position.
D. Place the child in a supine position with legs extended.
Answer: A. Place the child in a prone position.
29. A nurse is providing pre-procedure teaching to the parents of a preschooler who has nephrotic
syndrome and is scheduled for a percutaneous renal biopsy. Which of the following statements
should the nurse include in the teaching?
A. Your child will have a pressure dressing on the biopsy site following the test.
B. Your child will need to remain in a standing position for several hours after the procedure.
C. Your child will be given a sedative to ensure they remain awake during the procedure.
D. Your child will be allowed to eat a regular meal immediately after the biopsy.
Answer: A. Your child will have a pressure dressing on the biopsy site following the test.
30. A nurse in an emergency department is providing pre-procedure teaching to the parents of a
child who is to undergo a bronchoscopy due to aspiration of a foreign body. Which of the
following statements should the nurse include in the teaching?
A. The provider will remove the object during this procedure.
B. Your child will be awake during the procedure to help locate the object.
C. A chest X-ray will be performed immediately after the bronchoscopy to confirm removal.
D. Your child will be given a general anesthetic and will remain awake throughout the procedure.
Answer: A. The provider will remove the object during this procedure.
31. A nurse is assessing a 4-year-old child who is 2 days postoperative following insertion of a
ventriculoperitoneal (VP) shunt. Which of the following findings should the nurse identify as a
potential complication?
A. Lethargy
B. Increased appetite
C. Improved mobility
D. Decreased pain at the surgical site
Answer: A. Lethargy
32. A nurse is caring for a toddler who is experiencing hyperglycemia. Which of the following
findings should the nurse expect?
A. Lethargic mood
B. Increased energy and activity
C. Increased appetite and thirst
D. Rapid breathing and dry skin
Answer: A. Lethargic mood
33. A nurse is planning care for an adolescent client who has sickle cell anemia and is
experiencing a vaso-occlusive crisis. Which of the following actions should the nurse prioritize?
A. Promote bed rest.
B. Encourage participation in physical activities.
C. Restrict fluid intake to prevent swelling.
D. Provide cold compresses to the affected area.
Answer: A. Promote bed rest.
34. A nurse is caring for an adolescent client experiencing a vaso-occlusive crisis due to sickle
cell anemia. Which of the following actions should the nurse prioritize?
A. Give fluids.
B. Apply cold packs to the affected area.
C. Restrict oral intake to prevent swelling.
D. Encourage activity to promote circulation.
Answer: A. Give fluids.
35. A nurse is providing discharge teaching to the parent of a 5-year-old who has leukemia and is
receiving chemotherapy. Which of the following statements by the parent indicates
understanding of the teaching?
A. "I will make sure to inspect my son’s mouth every day for sores."
B. "I will give my son his regular vaccinations as scheduled."
C. "I should avoid giving my son any fruits or vegetables during chemotherapy."
D. "I will make sure my son spends time with other children to build his immunity."
Answer: A. "I will make sure to inspect my son’s mouth every day for sores."
36. A nurse is assessing a toddler for signs of potential child maltreatment. Which of the
following findings is most concerning?
A. Circular burns on the soles of the toddler’s feet.
B. A small bruise on the toddler's forearm.
C. Redness and swelling on the toddler's knees from crawling.
D. A scratch on the toddler’s cheek from playing outside.
Answer: A. Circular burns on the soles of the toddler’s feet.
37. A nurse in an emergency department is caring for a child who has ingested kerosene. Which
of the following actions should the nurse prioritize?
A. Prepare for intubation with a cuffed endotracheal tube.
B. Administer activated charcoal to absorb the kerosene.
C. Induce vomiting to remove the kerosene from the stomach.
D. Give the child milk to neutralize the kerosene.
Answer: A. Prepare for intubation with a cuffed endotracheal tube.
38. A nurse on a pediatric unit is admitting a 5-year-old child who has a submersion injury and is
awake and alert. Which of the following statements is most appropriate for the nurse to include
in the teaching for the child’s parents?
A. "We need to observe your child for cerebral swelling."
B. "Your child is at no risk of complications since they are awake and alert."
C. "Your child can be discharged if they remain awake for the next 24 hours."
D. "We will monitor for signs of dehydration and provide fluids as needed."
Answer: A. "We need to observe your child for cerebral swelling."
39. A nurse is providing nutritional teaching to the parents of a 2-year-old child. Which of the
following statements by the parent indicates an understanding of the dietary recommendations?
A. "I should feed my child 1 cup of vegetables per day."
B. "My child should have 2 cups of fruit per day."
C. "My child needs 3 cups of milk per day."
D. "My child should avoid grains and focus on protein."
Answer: A. "I should feed my child 1 cup of vegetables per day."
40. A nurse is providing teaching about home safety to the parents of an infant. Which of the
following statements by the parent indicates an understanding of the safety recommendations?
A. "I should place my child on a soft mattress for sleeping to ensure comfort."
B. "I will place my child on a firm mattress for sleeping."
C. "I will let my child sleep with a blanket and pillow to keep warm."
D. "I should place my child on their stomach to sleep for safety."
Answer: B. "I will place my child on a firm mattress for sleeping."
41. A nurse is planning a community education series for teachers of children with ADHD.
Which of the following strategies should the nurse recommend to improve learning and behavior
management?
A. Accompany verbal instructions with visual references.
B. Provide long, detailed instructions to ensure understanding.
C. Use loud and direct commands to gain the child’s attention.
D. Allow the child to choose their own schedule for assignments.
Answer: A. Accompany verbal instructions with visual references.
42. A home health nurse is developing a plan of care for the parents of a toddler who has
hemophilia A. Which of the following actions should the nurse recommend to reduce the risk of
injury?
A. Place knee pads on the child.
B. Allow the child to play with other children without supervision.
C. Encourage the child to engage in high-contact sports.
D. Restrict the child from any physical activity to avoid injury.
Answer: A. Place knee pads on the child.
43. A nurse is providing home care instructions to the parents of a child who is in the edema
phase of nephrotic syndrome. Which of the following recommendations should the nurse make
to help manage the child’s condition?
A. Provide quiet activities for the child.
B. Encourage the child to engage in vigorous physical activity.
C. Allow the child to eat foods high in sodium to improve fluid balance.
D. Limit fluid intake to prevent further edema.
Answer: A. Provide quiet activities for the child.
44. A nurse is assessing a 2-year-old child following a surgical procedure. Which of the
following pain assessment tools is most appropriate for this child?
A. FLACC scale.
B. Visual analog scale (VAS).
C. Wong-Baker Faces scale.
D. Numeric rating scale.
Answer: A. FLACC scale.
45. A nurse is providing discharge teaching to the parents of a school-age child who is
immobilized following spinal surgery. Which of the following instructions should the nurse
include?
A. Encourage small, frequent meals high in protein.
B. Restrict fluid intake to prevent overhydration.
C. Avoid the use of pressure-relieving mattresses.
D. Limit passive range-of-motion exercises.
Answer: A. Encourage small, frequent meals high in protein.
46. A nurse is caring for a 3-year-old child who has viral meningitis. Which of the following
findings should the nurse expect?
A. Nuchal rigidity
B. Hypotension
C. Hyperactive reflexes
D. Cyanosis
Answer: A. Nuchal rigidity
47. A nurse is creating a plan of care for a school-age child who has moderate partial-thickness
burns on both lower extremities. Which of the following interventions should the nurse include?
A. Maintain aseptic technique
B. Limit fluid intake to reduce edema
C. Apply cold compresses to burned areas
D. Encourage vigorous physical activity
Answer: A. Maintain aseptic technique
48. A nurse is preparing to administer a medication. The provider has prescribed 250 mg of the
medication. The medication available is in a concentration of 20 mg/mL. How many mL should
the nurse administer?
A. 10 mL
B. 12.5 mL
C. 15 mL
D. 20 mL
Answer: B. 12.5 mL
49. A charge nurse on a pediatric unit is reviewing informed consent guidelines with a newly
licensed nurse. Which of the following clients can provide their own informed consent?
A. A 12-year-old who requires sutures for a laceration
b) A 15-year-old who is seeking treatment for a sexually transmitted infection
c) A 14-year-old who needs surgery for a fractured arm
d) A 10-year-old who needs a dental extraction
Answer: B. A 15-year-old who is seeking treatment for a sexually transmitted infection
50. A nurse in an emergency department is assessing a 5-year-old child who has a concussion.
Which of the following findings should the nurse expect?
A. Nausea
B. Fever
C. Increased energy levels
D. Loss of appetite lasting several days
Answer: A. Nausea
51. A nurse is providing teaching about food choices to the parent of a school-age child who has
celiac disease. Which of the following statements by the parent indicates an understanding of the
teaching?
A. "I can offer popcorn as a snack food."
B. "I will include whole wheat crackers in their meals."
C. "I can prepare sandwiches using rye bread."
D. "I will use oats as a substitute for wheat flour in recipes."
Answer: A. "I can offer popcorn as a snack food."
52. A nurse is providing nutritional teaching to the parent of a child who has acute
glomerulonephritis with pitting edema. Which of the following foods should the nurse
recommend avoiding?
A. Apples
B. Hot dogs
C. Rice
D. Carrots
Answer: B. Hot dogs
53. A nurse is providing teaching to the parent of a child about an MRI without contrast. Which
of the following statements by the nurse is appropriate?
A. "Your child will need to drink a special liquid to prepare for the procedure."
B. "You can remain in the room with your child during the MRI."
C. "Your child must avoid eating or drinking for 12 hours before the MRI."
D. "The MRI procedure involves exposure to radiation."
Answer: B. "You can remain in the room with your child during the MRI."
54. A nurse is providing a presentation for parents of a toddler about preventing childhood burns.
Which of the following statements by the parent indicates an understanding of the teaching?
A. "I will place hot beverages on the edge of the counter so I can easily reach them."
B. "I will plug protective guards into my electrical outlets."
C. "I will allow my toddler to play with the stove while I supervise."
D. "I will keep matches and lighters out of my toddler's reach but still visible."
Answer: B. "I will plug protective guards into my electrical outlets."
55. A nurse is caring for a child diagnosed with bacterial meningitis. Which of the following
precautions should the nurse initiate?
A. Initiate airborne precautions
B. Initiate contact precautions
C. Initiate droplet precautions
D. Initiate neutropenic precautions
Answer: C. Initiate droplet precautions
56. A nurse is performing an initial physical examination on a child. Which of the following
findings should the nurse be concerned about? Select all that apply.
A. Vomiting
B. Clumsiness
C. Irritability
D. Normal appetite
E. Stable weight
Answer: A. Vomiting, B. Clumsiness, C. Irritability
57. A nurse is planning care for a child who is postoperative following a below-the-knee
amputation. Which of the following interventions should the nurse include in the care plan?
A. Perform active and isotonic range of motion exercises
B. Keep the stump elevated on a pillow for extended periods
C. Encourage the child to lie on the unaffected side only
D. Apply a compression bandage immediately after surgery
Answer: A. Perform active and isotonic range of motion exercises
58. A nurse is assessing a child who has heart failure. Which of the following findings should the
nurse expect?
A. Distended neck veins
B. Decreased respiratory rate
C. Warm, dry skin
D. Increased urinary output
Answer: A. Distended neck veins
59. A nurse in the emergency department is caring for a child who is experiencing an acute
asthma attack. Which of the following findings should the nurse expect?
A. Profuse sweating
B. Calm and relaxed posture
C. Slow and deep respirations
D. Pink, warm skin
Answer: A. Profuse sweating
