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RN Pediatrics Progressive Case Chains

Question 1 of 54

A 5-year-old child is brought to the ER with fever, lethargy, and a stiff neck. What is the nurse’s priority action?

Select one answer.

Review all questions in this quiz

RN Pediatrics Progressive Case Chains Practice Questions

Review these RN Pediatrics Progressive Case Chains nursing practice questions with answer choices and explanations.

Question 1

A 5-year-old child is brought to the ER with fever, lethargy, and a stiff neck. What is the nurse’s priority action?

  1. Administer antipyretics
  2. Initiate droplet precautions
  3. Encourage oral fluids
  4. Perform full neuro exam
View answer and explanation

Correct answer:

  1. Initiate droplet precautions

Explanation: Suspected meningitis requires immediate droplet precautions.

Question 2

The same child is diagnosed with bacterial meningitis. Which medication should the nurse expect to administer first?

  1. IV antibiotics
  2. Oral analgesics
  3. Diuretics
  4. Antivirals
View answer and explanation

Correct answer:

  1. IV antibiotics

Explanation: Immediate IV antibiotics are critical.

Question 3

After 24 hours of antibiotics, what indicates improvement?

  1. Reduced fever
  2. Negative CSF culture
  3. Improved appetite
  4. Less irritability
View answer and explanation

Correct answer:

  1. Negative CSF culture

Explanation: Negative CSF culture confirms treatment effectiveness.

Question 4

A 7-year-old with asthma presents with wheezing and difficulty breathing. What is the first intervention?

  1. Administer albuterol
  2. Give IV fluids
  3. Administer steroids
  4. Obtain ABG
View answer and explanation

Correct answer:

  1. Administer albuterol

Explanation: Short-acting bronchodilator is first-line.

Question 5

After albuterol, the child still has retractions. What is next?

  1. Repeat albuterol
  2. Administer corticosteroids
  3. Discharge home
  4. Encourage rest
View answer and explanation

Correct answer:

  1. Administer corticosteroids

Explanation: Steroids reduce airway inflammation.

Question 6

Which finding indicates worsening condition?

  1. Decreased wheezing
  2. SpO2 92%
  3. Accessory muscle use
  4. Mild cough
View answer and explanation

Correct answer:

  1. Accessory muscle use

Explanation: Accessory muscle use signals severe distress.

Question 7

A 2-year-old presents with vomiting and dehydration. What is priority?

  1. Oral rehydration
  2. IV fluids
  3. Monitor intake
  4. Educate parents
View answer and explanation

Correct answer:

  1. IV fluids

Explanation: Moderate dehydration requires IV fluids.

Question 8

After fluids, which indicates improvement?

  1. Increased urine output
  2. Dry lips
  3. Tachycardia
  4. Sunken eyes
View answer and explanation

Correct answer:

  1. Increased urine output

Explanation: Urine output shows improved perfusion.

Question 9

Which lab value would the nurse monitor closely?

  1. Potassium
  2. Hemoglobin
  3. Platelets
  4. Calcium
View answer and explanation

Correct answer:

  1. Potassium

Explanation: Fluid shifts affect potassium levels.

Question 10

A child with type 1 diabetes presents with DKA. What is first priority?

  1. Insulin
  2. IV fluids
  3. Electrolytes
  4. Bicarbonate
View answer and explanation

Correct answer:

  1. IV fluids

Explanation: Fluid resuscitation is first.

Question 11

After fluids, what is next?

  1. Administer insulin
  2. Give potassium
  3. Start oral feeding
  4. Discharge
View answer and explanation

Correct answer:

  1. Administer insulin

Explanation: Insulin corrects hyperglycemia.

Question 12

Which finding indicates improvement?

  1. pH 7.35
  2. Glucose 250
  3. Ketones present
  4. K+ 5.0
View answer and explanation

Correct answer:

  1. pH 7.35

Explanation: Normal pH shows resolved acidosis.

Question 13

A 3-year-old has a barking cough and stridor. What is priority?

  1. Humidified oxygen
  2. Antibiotics
  3. Throat culture
  4. Supine position
View answer and explanation

Correct answer:

  1. Humidified oxygen

Explanation: Croup requires airway support.

Question 14

If stridor occurs at rest, what does this indicate?

  1. Mild illness
  2. Moderate
  3. Severe
  4. Recovery
View answer and explanation

Correct answer:

  1. Severe

Explanation: Stridor at rest is severe.

Question 15

What medication may be given?

  1. Epinephrine
  2. Insulin
  3. Digoxin
  4. Ibuprofen
View answer and explanation

Correct answer:

  1. Epinephrine

Explanation: Nebulized epinephrine reduces airway swelling.

Question 16

A 5-year-old child is brought to the ER with fever, lethargy, and a stiff neck. What is the nurse’s priority action?

  1. Administer antipyretics
  2. Initiate droplet precautions
  3. Encourage oral fluids
  4. Perform full neuro exam
View answer and explanation

Correct answer:

  1. Initiate droplet precautions

Explanation: Suspected meningitis requires immediate droplet precautions.

Question 17

The same child is diagnosed with bacterial meningitis. Which medication should the nurse expect to administer first?

  1. IV antibiotics
  2. Oral analgesics
  3. Diuretics
  4. Antivirals
View answer and explanation

Correct answer:

  1. IV antibiotics

Explanation: Immediate IV antibiotics are critical.

Question 18

After 24 hours of antibiotics, what indicates improvement?

  1. Reduced fever
  2. Negative CSF culture
  3. Improved appetite
  4. Less irritability
View answer and explanation

Correct answer:

  1. Negative CSF culture

Explanation: Negative CSF culture confirms treatment effectiveness.

Question 19

A 7-year-old with asthma presents with wheezing and difficulty breathing. What is the first intervention?

  1. Administer albuterol
  2. Give IV fluids
  3. Administer steroids
  4. Obtain ABG
View answer and explanation

Correct answer:

  1. Administer albuterol

Explanation: Short-acting bronchodilator is first-line.

Question 20

After albuterol, the child still has retractions. What is next?

  1. Repeat albuterol
  2. Administer corticosteroids
  3. Discharge home
  4. Encourage rest
View answer and explanation

Correct answer:

  1. Administer corticosteroids

Explanation: Steroids reduce airway inflammation.

Question 21

Which finding indicates worsening condition?

  1. Decreased wheezing
  2. SpO2 92%
  3. Accessory muscle use
  4. Mild cough
View answer and explanation

Correct answer:

  1. Accessory muscle use

Explanation: Accessory muscle use signals severe distress.

Question 22

A 2-year-old presents with vomiting and dehydration. What is priority?

  1. Oral rehydration
  2. IV fluids
  3. Monitor intake
  4. Educate parents
View answer and explanation

Correct answer:

  1. IV fluids

Explanation: Moderate dehydration requires IV fluids.

Question 23

After fluids, which indicates improvement?

  1. Increased urine output
  2. Dry lips
  3. Tachycardia
  4. Sunken eyes
View answer and explanation

Correct answer:

  1. Increased urine output

Explanation: Urine output shows improved perfusion.

Question 24

Which lab value would the nurse monitor closely?

  1. Potassium
  2. Hemoglobin
  3. Platelets
  4. Calcium
View answer and explanation

Correct answer:

  1. Potassium

Explanation: Fluid shifts affect potassium levels.

Question 25

A child with type 1 diabetes presents with DKA. What is first priority?

  1. Insulin
  2. IV fluids
  3. Electrolytes
  4. Bicarbonate
View answer and explanation

Correct answer:

  1. IV fluids

Explanation: Fluid resuscitation is first.

Question 26

After fluids, what is next?

  1. Administer insulin
  2. Give potassium
  3. Start oral feeding
  4. Discharge
View answer and explanation

Correct answer:

  1. Administer insulin

Explanation: Insulin corrects hyperglycemia.

Question 27

Which finding indicates improvement?

  1. pH 7.35
  2. Glucose 250
  3. Ketones present
  4. K+ 5.0
View answer and explanation

Correct answer:

  1. pH 7.35

Explanation: Normal pH shows resolved acidosis.

Question 28

A 3-year-old has a barking cough and stridor. What is priority?

  1. Humidified oxygen
  2. Antibiotics
  3. Throat culture
  4. Supine position
View answer and explanation

Correct answer:

  1. Humidified oxygen

Explanation: Croup requires airway support.

Question 29

If stridor occurs at rest, what does this indicate?

  1. Mild illness
  2. Moderate
  3. Severe
  4. Recovery
View answer and explanation

Correct answer:

  1. Severe

Explanation: Stridor at rest is severe.

Question 30

What medication may be given?

  1. Epinephrine
  2. Insulin
  3. Digoxin
  4. Ibuprofen
View answer and explanation

Correct answer:

  1. Epinephrine

Explanation: Nebulized epinephrine reduces airway swelling.

Question 31

A 5-year-old child is brought to the ER with fever, lethargy, and a stiff neck. What is the nurse’s priority action?

  1. Administer antipyretics
  2. Initiate droplet precautions
  3. Encourage oral fluids
  4. Perform full neuro exam
View answer and explanation

Correct answer:

  1. Initiate droplet precautions

Explanation: Suspected meningitis requires immediate droplet precautions.

Question 32

The same child is diagnosed with bacterial meningitis. Which medication should the nurse expect to administer first?

  1. IV antibiotics
  2. Oral analgesics
  3. Diuretics
  4. Antivirals
View answer and explanation

Correct answer:

  1. IV antibiotics

Explanation: Immediate IV antibiotics are critical.

Question 33

After 24 hours of antibiotics, what indicates improvement?

  1. Reduced fever
  2. Negative CSF culture
  3. Improved appetite
  4. Less irritability
View answer and explanation

Correct answer:

  1. Negative CSF culture

Explanation: Negative CSF culture confirms treatment effectiveness.

Question 34

A 7-year-old with asthma presents with wheezing and difficulty breathing. What is the first intervention?

  1. Administer albuterol
  2. Give IV fluids
  3. Administer steroids
  4. Obtain ABG
View answer and explanation

Correct answer:

  1. Administer albuterol

Explanation: Short-acting bronchodilator is first-line.

Question 35

After albuterol, the child still has retractions. What is next?

  1. Repeat albuterol
  2. Administer corticosteroids
  3. Discharge home
  4. Encourage rest
View answer and explanation

Correct answer:

  1. Administer corticosteroids

Explanation: Steroids reduce airway inflammation.

Question 36

Which finding indicates worsening condition?

  1. Decreased wheezing
  2. SpO2 92%
  3. Accessory muscle use
  4. Mild cough
View answer and explanation

Correct answer:

  1. Accessory muscle use

Explanation: Accessory muscle use signals severe distress.

Question 37

A 2-year-old presents with vomiting and dehydration. What is priority?

  1. Oral rehydration
  2. IV fluids
  3. Monitor intake
  4. Educate parents
View answer and explanation

Correct answer:

  1. IV fluids

Explanation: Moderate dehydration requires IV fluids.

Question 38

After fluids, which indicates improvement?

  1. Increased urine output
  2. Dry lips
  3. Tachycardia
  4. Sunken eyes
View answer and explanation

Correct answer:

  1. Increased urine output

Explanation: Urine output shows improved perfusion.

Question 39

Which lab value would the nurse monitor closely?

  1. Potassium
  2. Hemoglobin
  3. Platelets
  4. Calcium
View answer and explanation

Correct answer:

  1. Potassium

Explanation: Fluid shifts affect potassium levels.

Question 40

A child with type 1 diabetes presents with DKA. What is first priority?

  1. Insulin
  2. IV fluids
  3. Electrolytes
  4. Bicarbonate
View answer and explanation

Correct answer:

  1. IV fluids

Explanation: Fluid resuscitation is first.

Question 41

After fluids, what is next?

  1. Administer insulin
  2. Give potassium
  3. Start oral feeding
  4. Discharge
View answer and explanation

Correct answer:

  1. Administer insulin

Explanation: Insulin corrects hyperglycemia.

Question 42

Which finding indicates improvement?

  1. pH 7.35
  2. Glucose 250
  3. Ketones present
  4. K+ 5.0
View answer and explanation

Correct answer:

  1. pH 7.35

Explanation: Normal pH shows resolved acidosis.

Question 43

A 3-year-old has a barking cough and stridor. What is priority?

  1. Humidified oxygen
  2. Antibiotics
  3. Throat culture
  4. Supine position
View answer and explanation

Correct answer:

  1. Humidified oxygen

Explanation: Croup requires airway support.

Question 44

If stridor occurs at rest, what does this indicate?

  1. Mild illness
  2. Moderate
  3. Severe
  4. Recovery
View answer and explanation

Correct answer:

  1. Severe

Explanation: Stridor at rest is severe.

Question 45

What medication may be given?

  1. Epinephrine
  2. Insulin
  3. Digoxin
  4. Ibuprofen
View answer and explanation

Correct answer:

  1. Epinephrine

Explanation: Nebulized epinephrine reduces airway swelling.

Question 46

A 5-year-old child is brought to the ER with fever, lethargy, and a stiff neck. What is the nurse’s priority action?

  1. Administer antipyretics
  2. Initiate droplet precautions
  3. Encourage oral fluids
  4. Perform full neuro exam
View answer and explanation

Correct answer:

  1. Initiate droplet precautions

Explanation: Suspected meningitis requires immediate droplet precautions.

Question 47

The same child is diagnosed with bacterial meningitis. Which medication should the nurse expect to administer first?

  1. IV antibiotics
  2. Oral analgesics
  3. Diuretics
  4. Antivirals
View answer and explanation

Correct answer:

  1. IV antibiotics

Explanation: Immediate IV antibiotics are critical.

Question 48

After 24 hours of antibiotics, what indicates improvement?

  1. Reduced fever
  2. Negative CSF culture
  3. Improved appetite
  4. Less irritability
View answer and explanation

Correct answer:

  1. Negative CSF culture

Explanation: Negative CSF culture confirms treatment effectiveness.

Question 49

A 7-year-old with asthma presents with wheezing and difficulty breathing. What is the first intervention?

  1. Administer albuterol
  2. Give IV fluids
  3. Administer steroids
  4. Obtain ABG
View answer and explanation

Correct answer:

  1. Administer albuterol

Explanation: Short-acting bronchodilator is first-line.

Question 50

After albuterol, the child still has retractions. What is next?

  1. Repeat albuterol
  2. Administer corticosteroids
  3. Discharge home
  4. Encourage rest
View answer and explanation

Correct answer:

  1. Administer corticosteroids

Explanation: Steroids reduce airway inflammation.

Question 51

Which finding indicates worsening condition?

  1. Decreased wheezing
  2. SpO2 92%
  3. Accessory muscle use
  4. Mild cough
View answer and explanation

Correct answer:

  1. Accessory muscle use

Explanation: Accessory muscle use signals severe distress.

Question 52

A 2-year-old presents with vomiting and dehydration. What is priority?

  1. Oral rehydration
  2. IV fluids
  3. Monitor intake
  4. Educate parents
View answer and explanation

Correct answer:

  1. IV fluids

Explanation: Moderate dehydration requires IV fluids.

Question 53

After fluids, which indicates improvement?

  1. Increased urine output
  2. Dry lips
  3. Tachycardia
  4. Sunken eyes
View answer and explanation

Correct answer:

  1. Increased urine output

Explanation: Urine output shows improved perfusion.

Question 54

Which lab value would the nurse monitor closely?

  1. Potassium
  2. Hemoglobin
  3. Platelets
  4. Calcium
View answer and explanation

Correct answer:

  1. Potassium

Explanation: Fluid shifts affect potassium levels.