×

Quiz Session - Attempts With Random Questions

PNCB CPN Exam Questions

Page 5 of 20

81.

You are evaluating a 14-year-old boy who admits to occasional smoking and drinking at parties. To assess his risk-taking behaviors, what is the most important question to ask next?

  • "Have you ever driven yourself or others home from these parties?"

  • "Do your parents know about your smoking and drinking?"

  • "How often do you attend these parties?"

  • "Do you feel peer pressure to smoke and drink?"

Correct answer: "Have you ever driven yourself or others home from these parties?"

Asking whether the boy has driven after drinking or smoking assesses the risk of serious harm due to impaired driving. This question also opens the conversation about responsibility and legal issues associated with underage drinking, smoking, and driving.

While it's important to understand parental awareness, it does not directly address the potential for immediate harm or legal consequences associated with his actions. The frequency of attendance at parties is relevant for understanding social patterns but less critical than understanding behaviors that could result in immediate danger like driving under the influence of alcohol. Peer pressure is a broader context of why he might engage in these behaviors but does not address specific high-risk actions such as driving under the influence.

82.

A pediatric patient with chronic asthma has frequent hospitalizations. What community resource should the nurse recommend to the family?

  • Local asthma education and management programs

  • Fitness programs to improve respiratory strength

  • Support groups for children with general chronic illnesses

  • Nutritional counseling to improve general health

Correct answer: Local asthma education and management programs

Recommending local asthma education and management programs provides the family with access to specialized information and support for managing asthma, which can help reduce the frequency of hospitalizations. These programs teach effective asthma management strategies, including medication use, trigger avoidance, and symptom monitoring.

While fitness programs can improve overall health, they are not specific enough to address the complex needs of managing asthma, which can require targeted education and medical oversight. Support groups for general chronic illnesses provide emotional support but may not offer the specific management strategies needed for asthma. Nutritional counseling is beneficial for overall health but does not directly address the specific needs associated with managing asthma, such as understanding triggers and using inhalers properly.

83.

During a night shift, a pediatric nurse monitors several patients: a 4-year-old with stable chronic asthma, a 14-year-old recovering from moderate dehydration, a 6-year-old recently post-op from an appendectomy showing slight tachycardia, and a 17-year-old exhibiting early signs of septic shock. 

Which patient should the nurse prioritize?

  • The 17-year-old

  • The 4-year-old

  • The 14-year-old

  • The 6-year-old

Correct answer: The 17-year-old

The 17-year-old exhibiting early signs of septic shock should be prioritized as septic shock can rapidly become life-threatening without immediate intervention to manage blood pressure and organ function.

A 4-year-old with stable chronic asthma does not require immediate emergency intervention compared to a potential septic shock scenario. A 14-year-old recovering from dehydration does not present immediate life-threatening risks once rehydration treatment is effectively underway. A 6-year-old with post-operative mild tachycardia requires monitoring and possibly further investigation, but this is less urgent than rapidly addressing early signs of septic shock.

84.

A 7-year-old child presents to the clinic with multiple bruises of varying stages and frequent abdominal complaints. What should the nurse prioritize in assessing the child?

  • Further examination of the bruising pattern

  • Asking about the child's diet and exercise habits

  • Inquiring about the child's participation in school sports

  • Preparing to draw labs to test clotting factors

Correct answer: Further examination of the bruising pattern

Examining the pattern and stages of bruises can provide critical clues about possible abuse or medical issues, making it essential for correctly diagnosing or reporting potential abuse.

While diet and exercise are important, they do not directly relate to the assessment of bruises and abdominal complaints in a way that would prioritize them over examining potential signs of abuse or a medical condition. Inquiring about participation in sports is relevant for understanding the source of bruises but does not take precedence over examining the bruises themselves for signs of non-accidental injuries. Although testing clotting factors is important if a bleeding disorder is suspected, the priority is to assess whether the bruising pattern suggests non-accidental injury.

85.

A child with a recent diagnosis of asthma appears anxious about using an inhaler. The parents are also anxious about managing asthma attacks. What is the best approach for the nurse to assess and support the family’s response to this new diagnosis?

  • Demonstrate the use of the inhaler and assess the family’s ability to replicate the procedure

  • Prescribe anxiety medications for the patient and their parents if desired

  • Reassure the family that managing asthma is simple and encourage them not to overthink it

  • Suggest high-quality online resources about asthma management

Correct answer: Demonstrate the use of the inhaler and assess the family’s ability to replicate the procedure

Demonstrating inhaler use and assessing replication ensures that both the child and the parents are competent in managing asthma attacks, directly addressing their anxiety about using the inhaler properly.

Prescribing anxiety medications does not address the root concern about inhaler use and should not be a first-line response to anxiety about asthma management. Reassuring the family without providing practical demonstrations and support can lead to a misunderstanding of asthma management complexities. While online resources are helpful, they do not replace direct, hands-on instruction and reassurance through personal interaction and demonstration.

86.

An 8-year-old child with repeated visits for injuries states they fell down the stairs. During the examination, the nurse notices bald patches and hesitation when answering questions. Which indicator is most concerning for potential maltreatment?

  •  The bald patches on the child's head

  • The child's explanation for the falls

  • The repeated visits

  • The child's hesitation to answer questions

Correct answer: The bald patches on the child's head

Bald patches can indicate physical abuse or severe psychological stress, such as from pulling one’s hair out, making it a particularly concerning sign of potential maltreatment.

While the child's explanation for injuries could be concerning, it does not immediately suggest abuse as clearly as physical signs like bald patches, which are unusual and alarming. Repeated visits for injuries are a red flag for potential abuse but do not provide as specific a data point as bald patches, which are more directly indicative of maltreatment. Hesitation may suggest fear or anxiety but is less specific than physical evidence of potential abuse, such as bald patches, in indicating maltreatment.

87.

During a health assessment of a 5-year-old child, what should the nurse prioritize to accommodate the child's developmental stage?

  • Allowing the child to handle some medical instruments

  • Asking the child to describe any pain using a numeric scale

  • Ensuring the child's privacy by asking the parent to leave the room

  • Completing the physical examination while the child is watching a cartoon

Correct answer: Allowing the child to handle some medical instruments

Allowing a 5-year-old to handle some medical instruments can help alleviate anxiety by making the medical environment more familiar and engaging. This approach is suitable for a child’s curiosity and desire for hands-on learning at this developmental stage.

Asking a child of this age to describe pain using a numeric scale is generally not reliable, as children at this age may not have the numerical understanding or verbal skills to quantify their pain. Ensuring privacy by asking the parent to leave the room may not be suitable for this age, as young children often need the reassurance of a parent's presence during medical procedures. Completing the examination while the child is distracted by a cartoon might be less effective in engaging the child directly and can limit the nurse's ability to interact and assess the child's responses during the examination.

88.

A nurse is working with a family who lost a child in a recent accident. Which statement by the nurse is most supportive when communicating with the grieving parents?

  • "It’s important to remember the good times you had together."

  • "You need to focus on your other children now."

  • "You should take some time to yourself to grieve and move on for the sake of your family."

  • "I’m sure they’re in a better place now."

Correct answer: "It’s important to remember the good times you had together."

This statement encourages parents to reflect on positive memories, which can be a comforting part of the grieving process. It supports emotional healing by acknowledging the value of the relationship and the positive aspects of the past.

Suggesting that parents focus on their other children could be perceived as dismissive of their grief for the lost child, potentially adding guilt to their emotional burden. Telling parents to take time for themselves and then move on can be seen as insensitive, as it simplifies the complex and individual nature of grief. Stating that the deceased is in a better place may not align with the family’s beliefs or feelings and can come off as a cliché that minimizes their pain.

89.

During a public health crisis, a pediatric nurse lobbyist is advocating for priority access to resources for children. Which strategy should the nurse prioritize to influence this policy?

  • Presenting data on pediatric needs and outcomes at a policy-making session

  • Organizing a petition among healthcare professionals

  • Writing an article for a nursing journal on the crisis

  • Conducting an internal survey of hospital staff opinions and sharing the results with policymakers

Correct answer: Presenting data on pediatric needs and outcomes at a policy-making session

Presenting data on pediatric needs and outcomes at a policy-making session directly informs policymakers of the specific requirements and potential benefits of prioritizing children in a public health crisis. This approach is evidence-based and likely to be impactful.

Organizing a petition among healthcare professionals, while potentially raising awareness, may not be as effective in influencing policy directly compared to presenting concrete data to decision-makers. Writing an article for a nursing journal raises awareness among peers but does not directly influence policy decisions. Conducting an internal survey of hospital staff opinions provides insight but lacks the direct impact of presenting data to policymakers and is less likely to influence immediate policy decisions.

90.

A pediatric nurse is assessing a 2-month-old baby. Which assessment technique is most appropriate for evaluating physical development at this age?

  • Testing the baby's ability to hold their head while on their tummy

  • Asking the parents if the baby can roll from stomach to back

  • Checking for the absence of the rooting reflex

  • Evaluating the baby's response to their name

Correct answer: Testing the baby's ability to hold their head while on their tummy

Testing a 2-month-old baby's ability to hold their head while on their tummy is an appropriate assessment of physical development at this age, reflecting the strengthening of neck muscles and overall motor development.

Expecting a 2-month-old to roll from stomach to back is premature, as most infants develop this ability closer to 4 months. Checking for the absence of the rooting reflex is not suitable for physical development assessment at this age as this reflex typically disappears around 4 months of age and should still be present. Evaluating the baby's response to their name is not appropriate at 2 months, as infants this young do not yet have the cognitive or auditory development to respond to their names.

91.

During a well-child visit, a nurse needs to counsel a family on preventing iron deficiency in a preschool-aged child. Which food should the nurse recommend?

  • Red meat, fish, or lentils

  • Rice cakes

  • Greek yogurt

  • Low-fat milk

Correct answer: Red meat, fish, or lentils

Red meat and fish are rich sources of heme iron, which is highly bioavailable and effective in preventing iron deficiency. Plant sources also offer non-heme iron and may be easier for children to chew and digest.

Rice cakes are low in iron and other nutrients, offering little benefit in preventing iron deficiency. Dairy foods are poor sources of iron, and excessive intake can hamper iron absorption, contributing to iron deficiency.

92.

A 14-year-old with type 1 diabetes consistently shows high blood sugar levels. The nurse needs to assess for potential barriers to insulin therapy adherence. What is the first step?

  • Ask the patient about their daily routine and how they integrate insulin therapy 

  • Ask the patient’s parents how the patient is doing with insulin therapy adherence

  • Ask the patient if they avoid sugary foods and monitor their diet strictly

  • Refer the patient to a diabetes educator for an assessment

Correct answer: Ask the patient about their daily routine and how they integrate insulin therapy

Asking about the patient’s daily routine and how insulin therapy is integrated allows the nurse to understand the patient's adherence challenges and lifestyle factors. This understanding is critical for tailoring education and interventions to the patient’s specific situation and improving adherence.

Asking the parents may not provide accurate information about the patient’s own experiences and challenges with their insulin therapy. While diet is important, it does not directly address the issue of insulin therapy adherence. Referring to a diabetes educator does not immediately address how the patient manages insulin in their daily life, which is crucial for understanding adherence issues.

93.

A 6-year-old child has been hospitalized following an asthma attack. What is the most important factor to consider when evaluating the child and family's readiness for discharge?

  • The child's ability to use an inhaler correctly with supervision

  • The parent’s ability to teach back information about the pathophysiology of asthma

  • The distance of the family's home from the hospital

  • The age of the child

Correct answer: The child's ability to use an inhaler correctly with supervision

Ensuring the child can properly use an inhaler is crucial for effective management of asthma symptoms post-discharge. Proper inhaler use is vital to prevent future asthma attacks and ensure safety if the child experiences breathing difficulties.

While it's important for parents to understand asthma, their ability to teach back pathophysiology does not directly affect the immediate management of the child's condition post-discharge. The distance from the hospital might affect emergency care but does not impact the daily management of asthma or readiness for discharge. While age can influence a child’s ability to manage their asthma, the direct assessment of inhaler use is a more immediate and practical indicator of readiness for discharge.

94.

A 5-year-old child with developmental delays is scheduled for elective surgery. During the pre-operative assessment, you notice the parents appear overwhelmed with the information given by various health professionals. What is the most appropriate action to facilitate their understanding?

  • Arrange a multidisciplinary meeting with health professionals to simplify and unify communication

  • Advise the parents to search for additional information online when they return home

  • Arrange to have the surgeon be the family’s sole point of contact and information

  • Suggest that they should speak to other families who have undergone similar procedures

Correct answer: Arrange a multidisciplinary meeting with health professionals to simplify and unify communication

Arranging a multidisciplinary meeting with health professionals to simplify and unify communications ensures that the parents receive coherent and consistent information. This approach reduces confusion and allows for questions to be addressed directly by various experts in a coordinated manner.

Advising the parents to search for additional information online may lead to misinformation or overwhelm them with conflicting advice. It does not ensure that they receive accurate or tailored information relevant to their child's specific condition. While having a single point of contact can streamline communication, relying solely on the surgeon may limit access to information from other essential disciplines involved in pre-operative and post-operative care. Suggesting that they speak to other families, though potentially supportive, does not guarantee that they will receive medically accurate information or that their specific concerns will be addressed.

95.

A 5-year-old child presents with a history of frequent upper respiratory infections. The nurse is obtaining a comprehensive health history. Which of the following questions is most important to determine potential underlying causes?

  • "Has your child been vaccinated according to the recommended schedule?”

  • "Does your child have any favorite activities at school?”

  • "Can you tell me about your child's sleep habits?”

  • "What does your child's diet consist of?”

Correct answer: ”Has your child been vaccinated according to the recommended schedule?”

Assessing vaccination status is crucial in determining a child's susceptibility to infectious diseases, as vaccinations significantly reduce the risk of many infections. By asking if the child has been vaccinated according to the recommended schedule, the nurse can identify any gaps in immunization that may explain frequent infections.

While knowing a child's favorite activities can provide insight into their social and cognitive development, it does not directly help in determining the underlying causes of frequent upper respiratory infections. Information about a child's sleep habits can be relevant to overall health but is not the most crucial factor in identifying the cause of recurrent respiratory infections. Understanding a child's diet is important for nutritional assessment but does not directly address important potential underlying causes of frequent respiratory infections.

96.

A 4-year-old child with a family history of type 2 diabetes comes in for a wellness visit. Which of the following recommendations would be most appropriate for preventing diabetes in this child?

  • Encourage physical activity every day

  • Limit reading and screen time to 30 minutes per day

  • Increase intake of dietary fats for better growth

  • Begin an insulin-regulated diet immediately

Correct answer: Encourage physical activity every day

Regular physical activity is essential for maintaining a healthy weight and improving insulin sensitivity, which are key factors in preventing type 2 diabetes. Encouraging daily physical activity aligns with pediatric guidelines for health promotion in children.

Limiting reading and screen time, while beneficial for overall development and reducing sedentary behavior, does not directly influence diabetes prevention as significantly as physical activity does. Increasing dietary fats does not directly contribute to diabetes prevention and may, depending on the type of fats and overall diet quality, increase the risk of obesity and diabetes risk. Starting an insulin-regulated diet is premature and unnecessary for a child without any symptoms or diagnosis of diabetes.

97.

During a consultation, a 17-year-old patient reluctantly mentions having multiple sexual partners. What should the nurse assess next to evaluate risk-taking behaviors?

  • Attitude toward using protection during sexual activity

  • Total number of partners in the past year

  • Peer group influence on his behavior

  • Whether he has used alcohol within the past 6 months

Correct answer: Attitude toward using protection during sexual activity

Assessing attitudes toward protection is directly relevant to immediate health risks such as sexually transmitted infections and unplanned pregnancy. This question helps identify the level of risk the patient is currently experiencing and their awareness of protective measures.

While the number of partners does impact risk, it doesn't provide immediate context about preventive behaviors or current risks. Peer influence is a broader issue that might explain behavior but doesn't address the immediate health risks or protective behaviors. Alcohol use is relevant to risk-taking behavior, but the direct risk associated with sexual behavior is better assessed by understanding protection use.

98.

For a child living in a densely populated urban area, which of the following is the most important health promotion advice?

  • Frequent handwashing to prevent the spread of infections

  • Yearly trips to less populated areas

  • Regular use of antibacterial lotions

  • Strict avoidance of public transportation

Correct answer: Frequent handwashing to prevent the spread of infections

In densely populated urban areas, frequent handwashing is crucial to prevent the spread of infections, which can be transmitted easily in crowded environments. This practice is simple, effective, and directly reduces the risk of illness.

Yearly trips to less populated areas might provide temporary relief from urban stressors but do not prevent infections or promote health in the urban environment where the child lives most of the time. Regular use of antibacterial lotions can contribute to antibiotic resistance and is not as effective as handwashing with soap and water in reducing the spread of all types of pathogens. Strict avoidance of public transportation is impractical and unnecessary for most individuals. It does not address the root of health promotion, which is to manage exposure to pathogens while continuing normal activities.

99.

A pediatric nurse needs to monitor the brain activity of a child with suspected non-convulsive seizures. Which technology is most appropriate for this purpose?

  • Electroencephalogram (EEG)

  • Electrocardiogram (ECG)

  • Magnetic resonance imaging (MRI)

  • Ultrasound imaging

Correct answer: Electroencephalogram (EEG)

An EEG is specifically used to record electrical activity in the brain and is the standard diagnostic tool for identifying seizure activity, including non-convulsive types.

An ECG monitors heart activity and is not used for assessing brain activity or detecting seizures. An MRI is useful for detailed imaging of brain structures but does not track real-time electrical activity or diagnose active seizures. Ultrasound imaging is not capable of monitoring brain activity or detecting seizures; it is generally used for imaging soft tissues and internal organs.

100.

A pediatric nurse starts a shift and must prioritize care for four patients. Which patient should the nurse assess first?

  • An infant with a fever of 39.5°C and irritability

  • A child admitted with asthma showing mild wheezing and scheduled for a routine nebulizer treatment

  • A child recently post-op from an appendectomy, resting comfortably with pain rated as 3/10

  • A teenager recovering from a migraine who fell asleep after receiving medication

Correct answer: An infant with a fever of 39.5 °C and irritability

An infant with a high fever and irritability represents a potentially serious condition requiring immediate assessment to determine the cause of the fever and appropriate interventions. This patient should be prioritized due to the high risk associated with high fever in infants.

A child with asthma showing mild wheezing and scheduled for routine treatment is stable and does not require immediate intervention compared to an infant with a high fever. A child recently post-op from an appendectomy, resting comfortably with pain rated as 3/10, is stable and does not present an immediate concern. A teenager recovering from a migraine who has fallen asleep after receiving medication is likely stable and recovering, requiring less immediate attention than the febrile infant.

×