Pediatric Nursing Certification Practice Test

PED-BC exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

Exam Code: PED-BC
Exam Name: Pediatric Nursing Certification
Total number of questions: 150 (125 scored + 25 pretest/unscored)
Time allotted: 3 hours
Passing / scoring method: Scaled score system- pass/fail. The minimum passing scaled score is 350 (on a 1–500 scale)

Assessment and Diagnosis

- Knowledge
- Assessment tools and techniques (eg- pain scale- fall risk- pressure injury risk-withdrawal assessment tool- deterioration scale)
- Growth and development (eg- developmental stages and milestones- growthcharts- developmentally appropriate care)
- Pathophysiology (eg- childhood diseases- congenital/genetic abnormalities)
- Pharmacology (eg- immunization- side effects- patient education)
- Complementary and alternative therapies (eg- essential oils- cupping- herbalsupplements)
- Diagnostic tests and screenings (eg- indications- normal ranges)
- Culture- religion- socioeconomic status- and health practices of diversegroups (eg- treatment refusal- dietary restrictions- financial constraints-gender identity)

- Skill
- Physical assessments (eg- vital sign parameters- body systems)Psychosocial assessments (eg- mental health assessment/screening- high-riskbehaviors- substance use disorders- unprotected sex)
- Medication and treatment reconciliation (eg- allergies- over-the-countermedications)
- Diagnostic specimen collection (eg- venipuncture- nasal swab- urinespecimen)

Planning and Implementation

- Knowledge
- Evidence-based quality improvement measures (eg- bundles- clinicalpathways)
- Treatment interactions (eg- food-medication- herbal-medication- drug-todrug interactions)
- Legal and ethical considerations (eg- age of consent- advanced directives-professional role- HIPAA compliance)
- Identification of changes in patient status (eg- decompensation- recognizingtrends)

- Skill
- Coordination of individualized care (eg- consultations- case management)
- Formulation of realistic and measurable outcomes
- Evidence-based interventions (eg- therapeutic holding- chlorhexidine baths-oral sucrose)
- Patient safety and risk-reduction measures (eg- restraints- elopementprevention- de-escalation strategies- suicide precautions- infectionprevention)
- Medication administration (eg- oral- parenteral- enteral)
- Appropriate prioritization of patient intervention (eg- what to do first- who toassess first- time management- delegation)

Evaluation

- Knowledge
- Family structure and dynamics (eg- multiple caregivers)
- Patient response to illness and hospitalization (eg- coping- regression)
- Chronic disease management (eg- asthma- diabetes- obesity)
- Health Promotion (eg- physical activity- nutrition)
- Expected responses to interventions (eg- medication efficacy- re-assessment-re-evaluation)

- Skill
- Therapeutic communication techniques (eg- therapeutic communication-professional communication- trauma-informed care)
- Teaching methods (eg- teach-back- learning environment)
- Learning evaluation (eg- reinforcement- return demonstration)

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Question: 1106
A 3-year-old male with autism spectrum disorder presents post-seizure with heart rate
150 bpm, respiratory rate 28 breaths per minute, blood pressure 88/52 mmHg,
temperature 39�C. Labs: glucose 55 mg/dL, sodium 142 mEq/L, calcium 8.5 mg/dL,
EEG pending. Physical assessment shows nystagmus. Caregiver reports OTC melatonin
for sleep but reconciliation reveals undeclared diphenhydramine exposure from "allergy
meds." Nurse prepares urine specimen via catheterization for toxicology. What ethical
dilemma emerges regarding behavioral assessment in neurodiverse children?
A. Skip urine collection to avoid trauma, relying on history alone.
B. Notify legal authorities for potential poisoning without family input.
C. Use visual aids for assent, reconcile sedatives to explain seizure, and collect
midstream urine ethically minimizing restraint.
D. Prioritize EEG over labs, deferring reconciliation.
Answer: C
Explanation: Ethical care for neurodiverse children involves modified assent using
visuals per 2024 Autism Society guidelines, balancing beneficence with minimal harm
during catheterization for toxicology, as diphenhydramine overdose mimics seizures
(normal calcium 8.5-10.5 mg/dL). Reconciliation identifies polypharmacy risks in ASD
families. Normal toddler vitals: HR 98-140 bpm (tachycardic), RR 22-37/min, BP
88-105/52-66 mmHg, glucose 70-100 mg/dL (borderline low). Sodium normal 135-145
mEq/L. Legal reporting if intentional, but scenario suggests accidental.
Question: 1107
A nurse conducting a health screening for a 2-year-old notes that the child�s hemoglobin
is 9.5 g/dL (normal 11-13 g/dL) and the mean corpuscular volume (MCV) is 70 fL
(normal 75-87 fL). The family has limited access to fresh fruits and vegetables. What is
the most appropriate next nursing action?
A. Schedule the child for a follow-up in 3 months without interventions
B. Recommend iron supplementation and dietary counseling
C. Refer the family for genetic testing for thalassemia
D. Educate on vitamin B12 supplementation only
Answer: B
Explanation: This child has microcytic anemia, consistent with iron deficiency, especially
given limited access to iron-rich foods. Iron supplementation and dietary counseling are
first-line interventions. Thalassemia testing or vitamin B12 supplementation is not
immediately indicated based on this presentation.
Question: 1108
A 16-year-old athlete with exercise-induced bronchoconstriction is prescribed
montelukast 10 mg nightly; pre-treatment FEV1 is 80% predicted, improving to 92%
post-albuterol. After 4 weeks, the patient reports persistent symptoms during practice,
with repeat FEV1 82%. The nurse evaluates medication efficacy in this scenario. Which
action constitutes appropriate re-assessment per asthma management standards?
A. Discontinue montelukast and restart daily ICS despite no prior use
B. Perform exhaled nitric oxide test and titrate to low-dose ICS if >35 ppb
C. Order serum IgE levels and consider omalizumab if elevated
D. Switch to oral theophylline and monitor theophylline levels weekly
Answer: B
Explanation: Montelukast targets leukotriene-mediated inflammation but may
insufficiently control exercise-induced symptoms in moderate cases, necessitating step-up
therapy; Global Initiative for Asthma (GINA) guidelines advocate fractional exhaled
nitric oxide (FeNO) as a non-invasive marker of eosinophilic inflammation, with levels
>35 ppb indicating need for ICS addition to enhance efficacy without unnecessary
biologics or outdated agents. This avoids abrupt discontinuation risking exacerbations,
premature biologics without confirmation, or theophylline which has narrow therapeutic
index and side effects in adolescents. Re-evaluation post-adjustment includes symptom
diaries and FEV1 to gauge response.
Question: 1109
During the care of a neonate with suspected sepsis, the nurse notes a white blood cell
(WBC) count of 25,000/mm� with increased immature neutrophils. What does this lab
result indicate for care planning?
A. Possible bacterial infection requiring prompt treatment
B. Normal neonatal WBC count
C. Viral infection unlikely
D. No infection present
Answer: A
Explanation: Elevated WBC with increased immature neutrophils suggests bacterial
infection or acute inflammatory response, requiring prompt antibiotic therapy and careful
monitoring.
Question: 1110
A 12-year-old with juvenile idiopathic arthritis under multiple caregivers shows
inconsistent medication adherence. What is the best nursing assessment focus to identify
barriers?
A. Focus solely on the child�s willingness to adhere to treatment
B. Assess the child�s physical ability to self-administer medication only
C. Evaluate the family�s financial status exclusively
D. Explore communication and coordination among caregivers
Answer: D
Explanation: Communication and coordination challenges among multiple caregivers
often contribute to inconsistent adherence. Physical ability, financial status, and child
willingness are important but looking at caregiver dynamics provides a broader
understanding and more effective intervention points.
Question: 1111
A 7-year-old with JODM (C-peptide 0.2 ng/mL, low indicating beta-cell loss)
experiences DKA recurrence after parental refusal of CGM due to Amish Ordnung
prohibitions on technology, amid rural access issues. pH 7.2. What ethical intervention?
A. Offer intermittent SMBG training with cultural elder buy-in, subsidize glucometers
via community funds, and educate on acidosis risks
B. Implant CGM forcibly
C. Accept refusal
D. Urban transfer
Answer: A
Explanation: DKA (pH <7.3, bicarbonate <15 mEq/L) mortality 0.15% but higher in non-
compliance; Amish exemptions require community mediation for tools like SMBG
(accuracy 95%). Justice via rural subsidies (e.g., Lions Club) integrates tech minimally,
promoting glycemic control (A1C <7.5%) ethically.
Question: 1112
A 5-year-old with leukemia is scheduled for a bone marrow biopsy. To optimize
procedural cooperation and pain management, which nurse action reflects evidence-based
practice?
A. Withhold oral sucrose to avoid masking symptoms
B. Administer oral sucrose before the procedure and provide therapeutic holding during
C. Use chlorhexidine for pain control at biopsy site
D. Restrict parent presence during the procedure
Answer: B
Explanation: Oral sucrose reduces procedural pain in young children and therapeutic
holding provides comfort and reduces anxiety. Chlorhexidine is antiseptic and does not
provide pain control. Parental presence generally helps reduce anxiety.
Question: 1113
A 2-year-old child on a strict cardiac low-sodium diet returns for health re-assessment.
Which finding best indicates diet adherence?
A. Urine sodium consistently below 20 mEq/L
B. Increased weight gain beyond expected parameters
C. Elevated serum potassium
D. Decreased appetite
Answer: A
Explanation: Low urine sodium reflects adherence to sodium restriction. Weight changes
or appetite variations are less specific; serum potassium is unrelated to sodium intake.
Question: 1114
A 14-year-old adolescent with a chronic illness requests to withhold certain treatments
during hospitalization but has not signed any advance directive. The nursing staff is
unsure whether to honor the request. Which of the following actions is most appropriate
for the nurse?
A. Follow the adolescent�s request since they are over 12 years old
B. Consult with the healthcare provider about the adolescent�s capacity to consent
C. Proceed with all treatments as ordered by the healthcare provider
D. Contact the parents immediately to make treatment decisions
Answer: B
Explanation: The nurse should consult with the healthcare provider to determine the
adolescent�s capacity to consent or assent to or refuse treatment, especially when no
formal advance directive exists. While adolescents over age 12 often participate in
decisions, legal consent usually depends on state laws and medical judgment. Parental
involvement is important but should be balanced with respecting mature minors'
autonomy.
Question: 1115
A nurse is teaching about medication administration to a school-aged child with
leukemia. Which learning evaluation strategy best confirms comprehension and skill?
A. Watching an educational video only
B. Nurse explains again without child participation
C. Child nods during teaching
D. Return demonstration of oral medication preparation by the child
Answer: D
Explanation: Return demonstration by the child confirms both understanding and ability
to execute medication administration safely.
Question: 1116
A 5-year-old child is admitted for evaluation of failure to thrive. The nurse notes that the
child is a latest immigrant with limited English proficiency and the mother practices
strict vegetarianism. What consideration is most important in the nutritional plan?
A. Encourage high-protein animal products only
B. Restrict all high-calorie snacks to prevent obesity
C. Assess and supplement non-meat sources of essential nutrients like vitamin B12 and
iron
D. Recommend a standard American diet without modification
Answer: C
Explanation: Vegetarian diets can be deficient in vitamin B12 and iron, which are critical
for growth. The nurse should assess intake and provide appropriate supplementation or
alternatives. For immigrant families, cultural sensitivity and language-appropriate
education are essential. Standard diets may not meet needs or respect beliefs.
Question: 1117
Asthmatic 6-year-old (eNO 50 ppb) exposed to parental vaping, denies symptoms.
Ethical reporting?
A. Report immediately
B. Wait for exacerbation
C. Education on vaping risks, cessation resources per CDC-GINA
D. Ignore denial
Answer: C
Explanation: Education ethics (CDC 2024) empowers denial acknowledgment, resources
mitigate exposure (eNO >35 ppb inflammation), avoiding premature reports.
Question: 1118
A 11-year-old with anxiety: HR 100 bpm, RR 20/min, BP 105/65 mmHg. Labs: TSH 6
mIU/L. High-risk: vaping, OTC CBD. Nasal swab for nicotine? No, psych screen. Legal:
report vaping?
A. Yes, mandatory.
B. Parents inform.
C. Labs only.
D. Reconcile CBD interactions, screen confidentially.
Answer: D
Explanation: CBD may affect thyroid meds; confidentiality for substance. Normal TSH
0.5-4.5. Vitals normal.
Question: 1119
After reconciling medications, a nurse discovers the child�s chart lists an allergy to
penicillin, but the parent denies this. What is the best nursing action?
A. Ask specific questions about the nature and timing of the allergy
B. Remove the allergy from the chart immediately
C. Ignore the allergy since the parent denies it
D. Document the denial but keep the allergy listed until confirmed
Answer: A
Explanation: Specific questioning clarifies potential allergy history before deciding to
remove it. Immediate removal or ignoring without verification risks patient safety.
Documentation with clarification is appropriate but without deeper inquiry is insufficient.
Question: 1120
Planning implementation for a 8-year-old with celiac disease and poor adherence (IgA
tTG 89 U/mL, down from 120 but elevated), the pediatric nurse addresses gluten
exposure from school lunches. BMI stable at 25th percentile. Which multidisciplinary
strategy best promotes nutritional healing?
A. Refer to gastroenterology for repeat endoscopy in 6 months
B. Prescribe enzyme supplements for accidental exposure and monitor weight monthly
C. Educate on gluten-free alternatives and reassess serology annually
D. Develop a 504 plan for safe meal accommodations and dietitian consult
Answer: D
Explanation: Celiac adherence relies on environmental controls, with school plans
ensuring gluten-free options per IDEA/ADA, facilitating villous recovery (tTG
normalization <20 U/mL) and growth. This integrates dietitian expertise for balanced
nutrition, outperforming enzymes which supplement not prevent, annual checks delaying
correction, or endoscopy which is invasive without behavioral fix. Evaluation via serial
tTG and height velocity.
Question: 1121
A 15-year-old patient diagnosed with cancer requests confidentiality about their condition
from their parents. The nurse should:
A. Respect confidentiality unless parents are legally responsible
B. Disclose information to parents as they are minors� guardians
C. Refuse to provide care until confidentiality is resolved
D. Encourage adolescent to share information with parents
Answer: D
Explanation: While respecting adolescent confidentiality is important, encouraging open
communication with parents is ethically supported for comprehensive care. Complete
nondisclosure is complex and depends on maturity and legal context, but refusal to care is
inappropriate.
Question: 1122
A 12-year-old patient with asthma has been prescribed inhaled corticosteroids and
leukotriene receptor antagonists. During follow-up, the child reports fewer asthma attacks
but persistent mild cough. How should the nurse interpret this?
A. Allergy to leukotriene receptor antagonist
B. Poor drug adherence; reinforce medication compliance
C. Development of steroid-resistant asthma
D. Treatment partially effective; consider further pulmonary evaluation
Answer: D
Explanation: Reduction in asthma exacerbations indicates partial medication efficacy.
Persistent symptoms such as a cough warrant further evaluation to rule out airway
hyperreactivity or other triggers. Poor adherence is less likely with reported symptom
improvement. Steroid resistance or drug allergy typically present with worsening
symptoms or side effects.
Question: 1123
A 2-year-old child with possible Kawasaki disease presents with fever lasting 6 days,
conjunctivitis, cracked lips, and swollen lymph nodes. Which laboratory test supports this
diagnosis?
A. Positive antinuclear antibody (ANA) test
B. Leukopenia with elevated lymphocytes
C. Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
D. Hypokalemia and hyponatremia
Answer: C
Explanation: Elevated inflammatory markers like ESR and CRP reflect systemic
inflammation seen in Kawasaki disease. Leukopenia and ANA are not typical, and
electrolyte abnormalities are nonspecific.
Question: 1124
A 10-year-old child diagnosed with ADHD is started on methylphenidate. Which side
effect should the nurse monitor during therapy?
A. Weight gain and excessive sleepiness
B. Increased salivation and dry mouth
C. Growth suppression and insomnia
D. Constipation and bradycardia
Answer: C
Explanation: Methylphenidate commonly causes appetite suppression leading to growth
delay and insomnia. Weight gain and sleepiness are less common. Increased salivation
and constipation are not typical side effects. Bradycardia is uncommon.
Question: 1125
A 9-year-old with type 1 diabetes is admitted for diabetic ketoacidosis (DKA)
management, with initial labs showing pH 7.15 (normal 7.35-7.45), bicarbonate 8 mEq/L
(normal 22-28 mEq/L), and glucose 450 mg/dL. The nurse prepares insulin infusion at
0.1 units/kg/hr per 2024 ISPAD guidelines but notes the on-site pharmacy stocks only
U-500 insulin, risking a 5-fold overdose if miscalculated. The child's parent expresses
anxiety about long-term adherence, citing school barriers. Prioritizing medication safety
per Joint Commission 2026 high-alert standards and ethical non-maleficence, which
intervention should the nurse implement first?
A. Double-check infusion pump programming with a colleague and educate parent on
carb counting
B. Administer IV fluids bolus 10 mL/kg normal saline and delegate blood glucose
monitoring q1h to LPN
C. Initiate continuous glucose monitoring and refer to diabetes educator for school plan
D. Request U-100 insulin STAT from off-site provider and document pharmacy variance
Answer: D
Explanation: DKA resolution hinges on precise insulin dosing, and U-500 availability
poses a critical error risk in pediatrics, where calculations are weight-based and errors
amplify harm; the 2026 ISMP update mandates immediate substitution for standard
concentrations to prevent adverse events. Requesting U-100 ensures safe administration
while documenting the variance supports quality improvement and legal accountability.
Double-checking is routine but ineffective without correct concentration. Fluid bolus is
priority physiologic support but secondary to insulin safety. Delegation of monitoring is
appropriate post-stabilization, and education/referrals promote health but follow acute
risk mitigation. This upholds ethical principles by averting iatrogenic hypoglycemia,
which could exacerbate acidosis.
Question: 1126
During a 2026 hospital-wide audit of the central line-associated bloodstream infection
(CLABSI) prevention bundle, a 3-year-old oncology patient on total parenteral nutrition
(TPN) via central line develops fever (38.5�C) and CRP 45 mg/L. The family admits to
using garlic supplements for immunity. The pathway requires bundle compliance for line
maintenance. What nursing action addresses the herbal-drug interaction while upholding
ethical standards?
A. Screen for garlic's antiplatelet effects on TPN compatibility and isolate administration
B. Remove the line immediately and start peripheral IV antibiotics
C. Continue TPN and monitor for infection without herbal discussion
D. Discontinue garlic and re-audit bundle adherence post-resolution
Answer: A
Explanation: Garlic inhibits platelet aggregation, increasing bleeding risk with TPN-
related line manipulations in immunocompromised children, per 2024 NCCIH updates on
herb-drug interactions. The CLABSI bundle, per CDC 2026 pediatric guidelines, includes
daily oral care and interaction checks to achieve <1 infection/1000 line-days. The nurse's
action involves pharmacist verification for separate administration routes, family
education on risks (e.g., hemorrhage incidence 5-10%), and consent for withholding,
ensuring beneficence, autonomy, and quality metrics through root-cause analysis in
audits.
Question: 1127
A 7-year-old child is admitted with dehydration and scheduled for venipuncture. The
nurse notices the child expresses fear and anxiety. Which action is best to reduce distress
during specimen collection?
A. Restrain child tightly to complete procedure faster
B. Use topical anesthetic and encourage parental presence
C. Postpone venipuncture until child calms down fully
D. Administer oral sedative before procedure without consent
Answer: B
Explanation: Using topical anesthesia and facilitating parental presence reduces anxiety
and pain. Restraining or sedatives without consent are inappropriate; delaying may
compromise care.
Question: 1128
A pediatric nurse is teaching a patient with cystic fibrosis and caregiver about airway
clearance. The patient becomes frustrated and resistant. What trauma-informed care
strategy should the nurse use?
A. Insist on completing teaching without breaks
B. Ignore frustration to continue uninterrupted teaching
C. Acknowledge the frustration, validate feelings, and offer breaks during teaching
D. Use fear-based messages to enforce compliance
Answer: C
Explanation: Trauma-informed care involves recognizing emotional states and adjusting
teaching accordingly, which helps build trust and reduces distress. Ignoring frustration or
using fear tactics can retraumatize or increase resistance.
Question: 1129
A 6-month-old infant with failure to thrive is admitted. The infant�s serum albumin is 2.3
g/dL (normal 3.5 - 5.0 g/dL). Which nursing intervention is the priority?
A. Monitor for signs of dehydration and electrolyte imbalance
B. Initiate fluid restriction to prevent edema
C. Encourage oral feeding with frequent small meals
D. Prepare for immediate parenteral nutrition
Answer: A
Explanation: Hypoalbuminemia can lead to fluid shifts causing edema and potential
dehydration. Monitoring hydration status and electrolytes is essential. Oral feeding is
important but monitoring takes priority. Fluid restriction is not usually indicated unless
edema is severe. Parenteral nutrition may be needed but after assessment.
Question: 1130
A 15-year-old transgender male adolescent seeks confidential care for depression, vital
signs heart rate 95 bpm, respiratory rate 16 breaths per minute, blood pressure 118/76
mmHg, temperature 36.8�C. Labs from routine screen: hemoglobin 13 g/dL, TSH 3 mIU/
L, positive for chlamydia on urine NAAT. Psychosocial assessment discloses high-risk
behaviors: condomless receptive anal sex, binge drinking, and self-harm ideation. No
parental involvement per state minor consent laws. The nurse reconciles testosterone
therapy with OTC St. John's wort. What legal action follows positive STI diagnosis in
this context?
A. Mandatory parental notification regardless of consent laws for STI treatment.
B. Treat chlamydia empirically with azithromycin, reconcile herbals for drug interactions,
and refer to behavioral health without breaching confidentiality.
C. Report to public health only after guardian consent.
D. Defer treatment pending full venipuncture for HIV co-screening.
Answer: B
Explanation: Minor consent laws (2025 updates in 45 states) allow confidential STI
treatment for adolescents, ethically supporting autonomy and reducing barriers to care per
AAP guidelines. Urine NAAT is sensitive for chlamydia, treated with single-dose
azithromycin to prevent PID. Reconciliation flags St. John's wort inducing CYP3A4,
reducing testosterone efficacy. Normal labs: hemoglobin 13-16 g/dL, TSH 0.5-4.5 mIU/
L. Vitals normal for adolescent. Public health reporting is anonymous/de-identified for
STIs, not requiring guardian. Self-harm screening via PHQ-9 mandates suicide risk
assessment, but treatment priority.
Question: 1131
In NICU, a 28-week preterm infant with NEC (bell stage II) has abdominal distension,
bloody stools, and labs: CRP 45 mg/L (normal <10 mg/L), platelets 80,000/mm�.
Parenteral TPN is infusing, but line sepsis suspected (temp 100.9�F). Parents request
enteral feeds resumption for bonding. Prioritizing implementation?
A. Resume trophic feeds enterally despite risks for ethical bonding.
B. Assess for perforation first, continue NPO, delegate line cultures to lab tech.
C. Administer broad-spectrum antibiotics orally and document parental request.
D. Transfuse platelets prophylactically without assessment.
Answer: A
Explanation: NEC requires serial abdominal assessments for perforation signs (e.g., free
air on X-ray), with NPO status to rest bowel per AAP guidelines. Cultures confirm
sepsis; delegation is routine but RN verifies. Bonding ethically supports kangaroo care,
not feeds. Oral antibiotics ineffective; prophylactic transfusion not indicated without
bleeding.
Question: 1132
During a clinic visit, a 9-month-old infant's developmental screen flags autism risk (M-
CHAT score 6/23, cutoff =3). Parents, devout Jehovah's Witnesses, decline genetic
microarray (normal variants <5% pathogenic) fearing blood products in processing,
preferring Reiki energy healing. Labs: ASO titer 250 IU/mL (normal <200 IU/mL),
suggesting strep link. As the pediatric nurse, you promote early intervention. Which
ethical strategy respects refusal while ensuring health promotion?
A. Override refusal for microarray under best interest standard.
B. Offer saliva-based WES alternative per 2026 ACMG updates and refer to IDEA EI for
behavioral therapy, noting 50% language gains by age 3.
C. Recommend herbal echinacea for neuroprotection.
D. Monitor without testing, as scores self-resolve.
Answer: B
Explanation: M-CHAT positives warrant ADOS confirmation; 2026 ACMG endorses
non-invasive WES for ASD (yield 10-20% de novo variants). Jehovah's Witness doctrine
prohibits blood but allows saliva/cell-free methods. Early EI under IDEA improves
outcomes 40%; strep-ASD link via autoimmunity treated with penicillin if ASO elevated.
Override unethical absent life-threat; herbals unproven (no RCT data); monitoring misses
window (ASD diagnosis by 2 years optimal).
Question: 1133
A nurse is planning care for a pediatric patient with cerebral palsy who experiences
frequent aspiration. What measurable outcome should be included in the care plan?
A. Patient remains NPO indefinitely
B. Patient will demonstrate safe swallowing with no aspiration episodes during
hospitalization
C. Patient will never cough during oral feeding
D. Caregiver avoids oral intake permanently
Answer: B
Explanation: A realistic, measurable goal focuses on safe swallowing and prevention of
aspiration during hospitalization. Permanent NPO status or avoidance may not be
necessary long-term. Coughing can be a protective reflex and is not an adverse outcome.
Question: 1134
An 11-year-old child with obesity and early type 2 diabetes is hospitalized with
hyperglycemia. The nurse notes the family structure involves alternating caregivers on
weekdays and weekends. What is the best nursing goal?
A. Focus educational efforts on the weekday caregiver only
B. Coordinate education sessions to include all caregivers for unified management
C. Recommend the child manage care independently
D. Reduce caregiver involvement to immediate family only
Answer: B
Explanation: Coordinated education involving all caregivers ensures a unified approach
to diabetes management despite complex family structures. Isolating education or
recommending independent care is less effective in this age group.
Question: 1135
During a well-child visit for a 4-year-old with a history of sexual abuse, the child's
mother reports night terrors and a latest urinary tract infection confirmed by urinalysis
showing >100,000 CFU/mL E. coli (normal <10,000 CFU/mL). The child clings to the
mother and refuses to engage with the nurse. The nurse must teach hygiene to prevent
recurrent infections while evaluating the mother's understanding of trauma triggers.
Which teaching method, combined with learning evaluation, best aligns with professional
standards for trauma-informed care and ethical beneficence?
A. Use a puppet show to demonstrate wiping front-to-back, followed by teach-back with
the child observing
B. Provide a pamphlet on hygiene and ask the mother to read it aloud immediately
C. Lecture the mother on infection risks while the child plays nearby, then quiz her on
key points
D. Demonstrate on the mother and require her to return-demonstrate in the next visit
Answer: A
Explanation: Puppet shows engage young children non-threateningly, reducing trauma
triggers like direct touch or authority figures, while teach-back evaluates the mother's
retention of hygiene instructions, crucial for preventing UTIs in abuse survivors where
somatic symptoms like infections may link to unaddressed trauma. This method upholds
ethical beneficence by promoting family-centered health promotion and the nurse's role
in creating safe learning environments, ensuring comprehension without overwhelming
the child, whose clinging indicates attachment needs influenced by prior abuse.
Question: 1136
In palliative care, a 5-year-old with end-stage neuroblastoma (stage 4, NSE 150 ng/mL,
normal <15 ng/mL) experiences dyspnea. Parents from a faith healing community refuse
morphine PCA (0.02 mg/kg/hr) for "soul pain," opting for prayer oils, amid hospice cost
concerns. As the pediatric nurse, you uphold nonmaleficence. Which legal-ethical
response prioritizes comfort?
A. Withhold opioids, honoring refusal.
B. Ethics consult for assent proxy and secure 2026 Medicare Hospice Benefit covering
PCA, educating on 70% symptom relief.
C. Apply cupping for respiratory "blockages."
D. Transition to experimental trials.
Answer: B
Explanation: 2026 NHPCO guidelines mandate pain control in pediatric hospice;
morphine titrates to RR >12/min, preventing 80% distress. Refusal triggers consult if
suffering evident; Medicare covers 100% for <21 years. Faith oils provide placebo but
not analgesia (opioid receptor absent). Withholding violates beneficence; cupping risks
pneumothorax (1%); trials unethical in terminal phase.
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Killexams has introduced Online Test Engine (OTE) that supports iPhone, iPad, Android, Windows and Mac. PED-BC Online Testing system will helps you to study and practice using any device. Our OTE provide all features to help you memorize and VCE exam Dumps while you are travelling or visiting somewhere. It is best to Practice PED-BC MCQs so that you can answer all the questions asked in test center. Our Test Engine uses Questions and Answers from real Pediatric Nursing Certification exam.

              

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