Pediatric Systems Master Mock Exam – SATA Questions

Pediatric Systems Master Mock Exam – SATA Questions This document combines all pediatric system exams: Respiratory, Cardiac, GI/Nutrition, Renal/Urinary, and Diabetes. Each section includes SATA questions with answers and rationales. Respiratory + Cardiac + GI/Nutrition + Renal Sections Diabetes Section Pediatric Respiratory + Cardiac Exam – 42 SATA Questions Respiratory Questions (20) 1. A nurse is assessing an infant with respiratory distress. Which anatomical differences make infants more vulnerable to airway obstruction? A. Smaller airway diameter B. Shorter trachea C. Obligate nose breathing D. Wider nasal passages E. Larger lung capacity Answer: A, B, C Rationale: Infants have smaller, shorter airways and are nose breathers, all of which increase obstruction risk. Wider passages and large lung capacity do not. 2. The nurse is checking normal vital signs. Which respiratory rates are expected for children by age? A. 30–60/min in infants B. 20–30/min in toddlers C. 18–30/min in school-age children D. 12–20/min in adolescents E. 8–10/min in preschoolers Answer: A, B, C, D Rationale: Infants breathe fastest; rates gradually slow as the child grows. Preschoolers also average 20–30, not 8–10. 3. A nurse is assessing a 2-year-old for signs of respiratory distress. Which findings should be reported immediately? A. Nasal flaring B. Retractions C. Grunting D. Head bobbing E. Pink moist mucous membranes Answer: A, B, C, D Rationale: All are classic distress signs. Pink mucous membranes are normal and indicate good oxygenation. 4. The nurse is preparing oxygen delivery for a hypoxemic child. Which methods are appropriate for pediatrics? A. Nasal cannula B. Simple face mask C. Non-rebreather mask D. Oxygen tent E. Venturi mask Answer: A, B, C, D Rationale: NC, masks, and tents are common in children. Venturi masks are more often used for precise oxygen delivery in adults. 5. A toddler with RSV is admitted. Which nursing interventions are appropriate? A. Administer humidified oxygen as ordered B. Provide suctioning as needed C. Give routine antibiotics D. Encourage fluids as tolerated E. Maintain droplet precautions Answer: A, B, D, E Rationale: RSV is viral, so antibiotics are not routine. Supportive care includes oxygen, suctioning, fluids, and precautions. 6. The parent of a child with croup is being taught home management. Which statements indicate understanding? A. “I will use a cool-mist humidifier.” B. “I will give aspirin for fever.” C. “I will avoid tongue depressors in the throat.” D. “I will take my child into cool night air if breathing worsens.” E. “I will encourage crying to clear the airway.” Answer: A, C, D Rationale: Cool mist and exposure to cool air reduce swelling; tongue depressors are unsafe. Aspirin is contraindicated, and crying worsens obstruction. 7. The nurse suspects epiglottitis in a preschooler. Which signs confirm this condition? A. Drooling B. Stridor C. Tripod positioning D. Difficulty swallowing E. Barking cough Answer: A, B, C, D Rationale: Drooling, stridor, tripod posture, and dysphagia are classic signs. Barking cough suggests croup. 8. A school-age child is admitted with pneumonia. Which assessment findings would the nurse expect? A. Crackles B. Fever C. Productive cough D. Tachypnea E. Pink moist mucous membranes Answer: A, B, C, D Rationale: Pneumonia presents with fever, abnormal breath sounds, cough, and increased RR. Pink mucous membranes are normal. 9. The nurse is teaching parents of a child with asthma about common triggers. Which should be included? A. Dust mites B. Pet dander C. Exercise D. Viral infections E. High salt diet Answer: A, B, C, D Rationale: Allergens, exercise, and infections trigger asthma. Diet isn’t a direct trigger. 10. A nurse is reviewing medications with the parents of a child with asthma. Which are used for long-term control? A. Inhaled corticosteroids (fluticasone) B. Leukotriene modifiers (montelukast) C. Cromolyn sodium D. Short-acting beta agonists (albuterol) E. Oral prednisone daily Answer: A, B, C Rationale: Inhaled steroids, leukotriene modifiers, and cromolyn are long-term. Albuterol is rescue, and daily prednisone is not standard maintenance. 11. A child with cystic fibrosis is admitted. Which interventions are expected? A. High-calorie, high-protein diet B. Pancreatic enzymes with meals C. Daily chest physiotherapy D. Avoiding vaccines E. Encouraging fluids Answer: A, B, C, E Rationale: CF care includes nutrition, enzymes, airway clearance, and hydration. Vaccines are very important. 12. A 6-year-old is recovering from a tonsillectomy. Which findings should the nurse report immediately? A. Frequent swallowing B. Bright red bleeding C. Vomiting blood clots D. Severe throat pain E. Low-grade fever Answer: A, B, C Rationale: Frequent swallowing and active bleeding indicate hemorrhage, a surgical emergency. Pain and low fever are expected. 13. The nurse is teaching a child how to use an MDI with a spacer. Which steps are correct? A. Shake inhaler before use B. Place lips tightly around mouthpiece C. Press inhaler and breathe in slowly D. Hold breath for 10 seconds E. Blow into spacer before inhaling Answer: A, B, C, D Rationale: Shake, seal lips, slow inhale, and breath hold = correct use. Blowing into spacer is wrong. 14. The nurse is suctioning a child with a trach. Which complications should the nurse watch for? A. Hypoxia B. Bradycardia C. Increased intracranial pressure D. Bronchospasm E. Hypothermia Answer: A, B, C, D Rationale: Suctioning can cause vagal stimulation, low O?, ICP rise, and bronchospasm. Hypothermia is unrelated. 15. Which laboratory tests are priorities in pediatric respiratory care? A. CBC B. Sweat chloride test C. ABGs D. Rapid strep test E. Sputum culture Answer: A, B Rationale: CBC checks for infection; sweat chloride is diagnostic for CF. ABG, strep, and sputum may be used but not routine priorities. 16. A nurse is performing CPR on an infant with two rescuers present. Which steps are correct? A. Compression-to-breath ratio 15:2 B. Use two thumbs encircling the chest C. Depth of compressions is about 1½ inches D. Allow chest recoil between compressions E. Ventilate once every 2 seconds Answer: A, B, C, D Rationale: Correct technique is 15:2, two-thumb encircling, 1½ inch depth, and recoil. Breaths are every 3–5 sec (not every 2). 17. The nurse is caring for a child with status asthmaticus. Which findings are concerning? A. Severe wheezing B. No improvement after albuterol C. Silent chest D. Tachypnea with retractions E. Bradycardia Answer: A, B, C, D Rationale: Severe unrelieved asthma with absent breath sounds is life-threatening. Bradycardia is a late ominous sign, not initial. 18. The nurse is teaching parents about infection prevention. Which strategies reduce risk of respiratory illness in children? A. Annual flu vaccine B. Pertussis (Tdap) vaccine C. Pneumococcal vaccine D. Frequent handwashing E. Avoiding dairy products Answer: A, B, C, D Rationale: Vaccines and hygiene prevent infection. Dairy avoidance is not evidence-based. 19. Parents ask about airway clearance for their child with CF. Which statements are correct? A. Perform CPT before meals B. Position prone or side-lying for drainage C. Encourage coughing afterward D. Perform several sessions per day E. Stop CPT if child starts coughing Answer: A, B, C, D Rationale: CPT is done before meals, in drainage positions, followed by coughing, and multiple times daily. Coughing is expected. 20. The nurse is teaching a parent of a child with chronic asthma about environmental controls. Which actions are appropriate? A. Avoid cigarette smoke B. Use dust-proof mattress covers C. Remove carpets and heavy drapes if possible D. Wash bedding weekly in hot water E. Keep pets in the child’s bedroom Answer: A, B, C, D Rationale: Reducing smoke, dust, and allergens prevents asthma attacks. Pets in the bedroom worsen symptoms. Cardiac Questions (22) See included Pediatric_Cardiac_Exam.docx file (already created). Gastrointestinal & Nutrition Questions (22) 1. The nurse is caring for an infant with failure to thrive. Which findings are expected? A. Poor weight gain B. Irritability C. Developmental delay D. Adequate growth despite poor appetite E. Malnutrition signs Answer: A, B, C, E Rationale: Failure to thrive = poor growth, irritability, developmental delay, malnutrition. Adequate growth is not expected. 2. The nurse is assessing a dehydrated infant. Which signs suggest moderate to severe dehydration? A. Sunken fontanel B. No tears when crying C. Dry mucous membranes D. Decreased urine output E. Moist skin with good turgor Answer: A, B, C, D Rationale: These are dehydration signs. Moist skin/turgor = hydration. 3. The nurse is teaching about I&O monitoring in pediatrics. Which are accurate points? A. Weigh diapers for infants B. Document vomit and stool if watery C. Record IV fluids D. Count insensible losses (sweat) precisely E. Measure oral intake Answer: A, B, C, E Rationale: Diapers, GI losses, IV, and oral fluids count. Insensible losses are estimated, not measured. 4. A nurse cares for a child with a cleft lip/palate. Which feeding techniques are recommended? A. Special nipples or feeders B. Upright positioning during feeds C. Frequent burping D. Use of spoon-feeding in infants E. Forceful suctioning after feeds Answer: A, B, C Rationale: Special nipples, upright positioning, and burping reduce aspiration risk. Spoon-feeding infants and forceful suctioning are unsafe. 5. The nurse provides post-op care for a child with cleft palate repair. Which interventions are appropriate? A. No hard suctioning in the mouth B. Elbow restraints to protect the site C. Supine or side-lying positioning D. Clear liquid diet initially E. Allow child to place objects in mouth for comfort Answer: A, B, C, D Rationale: Avoid trauma to repair site (no suction, objects). Restraints, diet progression, and positioning are correct. 6. The nurse assesses an infant with pyloric stenosis. Which findings are expected? A. Projectile vomiting after feeds B. Olive-shaped mass in RUQ C. Metabolic alkalosis D. Steatorrhea E. Weight loss Answer: A, B, C, E Rationale: Classic signs include projectile vomiting, palpable olive mass, alkalosis, and weight loss. Steatorrhea is celiac disease. 7. The nurse is reviewing a child’s chart with Hirschsprung’s disease. Which findings are typical? A. Ribbon-like stool B. Abdominal distension C. Failure to pass meconium in newborn D. High risk for enterocolitis E. Diarrhea with mucus Answer: A, B, C, D Rationale: Absence of ganglion cells causes obstruction ? ribbon stools, distension, no meconium, enterocolitis risk. Diarrhea is not typical. 8. The nurse is caring for a child with gastroenteritis. Which interventions are appropriate? A. Oral rehydration solution (ORS) for mild dehydration B. Avoiding juice and soda C. IV fluids for severe dehydration D. Give anti-diarrheal medications routinely E. Monitor electrolytes Answer: A, B, C, E Rationale: ORS first, IV fluids if severe, avoid juice/soda, monitor labs. Antidiarrheals are not recommended for children. 9. The nurse suspects appendicitis in a school-aged child. Which findings support this? A. RLQ pain B. Guarding C. Sudden relief of pain D. Rebound tenderness E. Productive cough Answer: A, B, C, D Rationale: RLQ pain, guarding, rebound tenderness are classic. Sudden relief may mean rupture. Cough is unrelated. 10. The nurse is teaching parents about hepatitis prevention. Which are correct? A. Hepatitis A is spread by fecal-oral route B. Handwashing prevents hepatitis A C. Hepatitis B can be prevented by vaccine D. Hepatitis C has no vaccine E. Sharing needles can spread hepatitis B & C Answer: A, B, C, D, E Rationale: All are true prevention/transmission points. 11. A nurse is assessing a toddler with intussusception. Which findings are expected? A. Sausage-shaped mass B. Currant-jelly stool C. Intermittent severe abdominal pain D. High-pitched bowel sounds E. Ribbon-like stool Answer: A, B, C, D Rationale: Classic signs include abdominal mass, bloody mucus stool, pain, and abnormal sounds. Ribbon stool = Hirschsprung’s. 12. The nurse is teaching a family about constipation management. Which interventions are helpful? A. Encourage fluids B. High-fiber diet C. Scheduled toilet time D. Positive reinforcement E. Stool withholding as discipline Answer: A, B, C, D Rationale: Fluids, fiber, routine, and encouragement help. Stool withholding worsens constipation. 13. The nurse cares for a child with celiac disease. Which findings are expected? A. Steatorrhea B. Failure to thrive C. Abdominal distension D. Gluten-free diet required E. High-protein gluten diet is encouraged Answer: A, B, C, D Rationale: Gluten damages villi, leading to malabsorption, FTT, steatorrhea, distension. Gluten must be avoided. 14. The nurse is teaching about lactose intolerance. Which signs should parents monitor for? A. Bloating B. Gas C. Diarrhea after milk products D. Constipation E. Abdominal cramps Answer: A, B, C, E Rationale: Lactose intolerance ? gas, bloating, cramps, diarrhea. Constipation is not typical. 15. The nurse performs an abdominal exam. Which is the correct sequence? A. Inspection B. Auscultation C. Percussion D. Palpation E. Percussion after palpation Answer: A, B, C, D Rationale: Always inspect ? auscultate ? percuss ? palpate. Palpation last to avoid altering bowel sounds. 16. The nurse is caring for a child with an NG tube. Which interventions are appropriate? A. Confirm placement with pH testing B. Secure tube to prevent displacement C. Irrigate with sterile water as ordered D. Check residuals before feeding E. Use petroleum jelly at nares Answer: A, B, C, D Rationale: Placement confirmation, securement, irrigation, and residuals are correct. Petroleum jelly can harm mucosa; use water-soluble lubricant. 17. The nurse is monitoring a child receiving TPN. Which interventions are correct? A. Use central line B. Monitor blood glucose C. Strict aseptic technique D. Taper rate to discontinue E. Use same line for antibiotics Answer: A, B, C, D Rationale: TPN requires central line, glucose monitoring, sterile technique, tapering. Antibiotics shouldn’t run through same line. 18. The nurse provides education on oral rehydration therapy (ORT). Which are correct? A. Use Pedialyte or ORS B. Avoid soda and juice C. Give small frequent sips D. Resume normal diet early E. Restrict oral intake for 24 hrs Answer: A, B, C, D Rationale: ORT = Pedialyte, small sips, avoid soda/juice, continue diet. Restriction delays recovery. 19. The nurse is counseling a family on gluten-free diet for a child with celiac disease. Which foods are safe? A. Rice B. Corn C. Meat and poultry D. Barley E. Wheat Answer: A, B, C Rationale: Gluten = wheat, rye, barley. Rice, corn, and meats are safe. 20. The nurse is teaching about lactose-free diet. Which foods are appropriate? A. Lactose-free milk B. Hard cheeses C. Yogurt with live cultures D. Ice cream E. Soy products Answer: A, B, C, E Rationale: Lactose-free and soy are safe; some hard cheeses/yogurts are tolerated. Ice cream has lactose. 21. The nurse assesses a dehydrated infant. Which signs confirm severe dehydration? A. Sunken eyes B. No urine for >6 hours C. Weak pulse D. Lethargy E. Flat fontanel Answer: A, B, C, D Rationale: Severe dehydration = sunken eyes, anuria, weak pulse, lethargy. Flat fontanel is normal. 22. The nurse is reinforcing parent teaching for hydration & electrolyte replacement. Which interventions are correct? A. Isotonic IV fluids for severe dehydration B. Monitor electrolytes C. Use potassium only after urine output established D. Use hypotonic fluids first-line E. Oral rehydration preferred for mild cases Answer: A, B, C, E Rationale: Isotonic fluids (NS, LR) are first-line IV; potassium only after urine output; ORT first for mild cases. Hypotonic fluids are not first choice. Renal & Urinary Questions (22) 1. The nurse is teaching parents about pediatric kidney differences. Which characteristics put infants at risk for fluid imbalance? A. Immature kidneys B. Decreased concentrating ability C. Higher metabolic rate D. Larger extracellular fluid volume E. Strong ability to conserve sodium Answer: A, B, C, D Rationale: Infants’ kidneys are immature, can’t concentrate urine well, and higher metabolism increases fluid needs. They have proportionally more extracellular fluid. They cannot conserve sodium well. 2. A nurse is monitoring urine output in an infant. Which values are considered normal? A. 1–2 mL/kg/hr B. At least 1 wet diaper every 8 hours C. Consistent clear yellow urine D. Less than 0.5 mL/kg/hr is normal E. Weight-based calculation is preferred Answer: A, C, E Rationale: Normal output is 1–2 mL/kg/hr. Weight-based monitoring is best. Clear urine is expected. <0.5 mL/kg/hr = oliguria, and one diaper per 8 hrs is too low. 3. The nurse is assessing a child for fluid imbalance. Which findings indicate problems? A. Edema B. Weight gain or loss C. Changes in blood pressure D. Strong urine stream E. Daily weight fluctuations Answer: A, B, C, E Rationale: Fluid imbalance presents as swelling, weight changes, BP changes, and daily weight differences. A strong stream is normal. 4. The nurse is reviewing common renal labs. Which are expected for monitoring? A. BUN B. Creatinine C. Electrolytes D. Urinalysis (UA) E. Urine culture Answer: A, B, C, D, E Rationale: All are standard labs for renal function and infection. 5. The nurse is teaching about hypospadias/epispadias surgical repair. Which statements are correct? A. Surgery is usually done before toilet training B. A catheter or stent may remain in place C. Circumcision should be delayed until after repair D. Parents should avoid tub baths until cleared E. Apply petroleum jelly to the site routinely Answer: A, B, C, D Rationale: Surgery before toilet training ensures function. Stents/catheters protect repair. No circumcision before surgery. Tub baths avoided until cleared. Petroleum jelly is not routine. 6. The nurse is caring for a child with a UTI. Which findings are typical? A. Fever B. Irritability C. Foul-smelling urine D. Back pain E. Productive cough Answer: A, B, C, D Rationale: Fever, irritability, odor, and back pain (pyelonephritis) are signs. Cough is unrelated. 7. A parent asks how to prevent UTIs in their toddler. Which teaching points are correct? A. Wipe front to back B. Increase fluid intake C. Change diapers frequently D. Avoid bubble baths E. Encourage regular voiding Answer: A, B, C, D, E Rationale: All of these are prevention strategies. 8. A child with acute glomerulonephritis is admitted. Which findings are expected? A. Hematuria (tea-colored urine) B. Hypertension C. Edema D. Decreased urine output E. Massive proteinuria Answer: A, B, C, D Rationale: AGN = hematuria, HTN, edema, ? output. Massive proteinuria = nephrotic syndrome. 9. A nurse cares for a child with nephrotic syndrome. Which findings are classic? A. Massive proteinuria B. Hypoalbuminemia C. Generalized edema D. Hyperlipidemia E. Hypertension as the first sign Answer: A, B, C, D Rationale: Nephrotic syndrome = protein loss, low albumin, edema, and hyperlipidemia. HTN is not always first. 10. The nurse is assessing a child with dehydration. Which are severe signs? A. Sunken fontanel B. Very dry mucous membranes C. Minimal urine output D. Lethargy E. Weight loss >10% Answer: A, B, C, D, E Rationale: All listed are severe dehydration signs. 11. The nurse is reviewing electrolyte results. Which are common imbalances in renal disease? A. Hyperkalemia B. Hyponatremia C. Hypercalcemia D. Metabolic acidosis E. Hypokalemia Answer: A, B, D Rationale: Renal failure ? high K, low Na, acidosis. Hypercalcemia and hypokalemia are not typical. 12. A nurse is caring for a child undergoing dialysis. Which statements are correct? A. Peritoneal dialysis uses abdominal lining as a filter B. Hemodialysis requires vascular access C. Peritoneal dialysis can be done at home D. Hemodialysis is less effective than peritoneal E. Both remove waste and fluid Answer: A, B, C, E Rationale: Peritoneal uses peritoneum, can be home-based. Hemodialysis uses vascular access. Both remove wastes/fluids. Hemodialysis is effective. 13. The nurse suspects acute kidney injury (AKI). Which findings are consistent? A. Oliguria B. Fluid overload C. Electrolyte imbalances D. Rapid improvement in urine output E. Hypertension Answer: A, B, C, E Rationale: AKI ? low urine, fluid overload, imbalances, high BP. Rapid improvement is not typical. 14. A child with chronic kidney disease (CKD) is being assessed. Which findings are expected? A. Growth failure B. Anemia C. Bone disease D. Need for dialysis or transplant E. Productive cough Answer: A, B, C, D Rationale: CKD ? poor growth, anemia, renal osteodystrophy, need for renal replacement. Cough is unrelated. 15. The nurse is teaching about urine culture & sensitivity. Which statements are correct? A. Clean catch or catheterization preferred B. Collect before antibiotics are started C. Send specimen to lab quickly D. Use sterile container E. Diaper squeeze method is most accurate Answer: A, B, C, D Rationale: Clean catch/sterile cath best, before antibiotics, sterile container, fast lab transport. Diaper squeeze is not accurate. 16. The nurse explains why daily weights are important. Which points are correct? A. Best indicator of fluid balance B. Should be done at the same time daily C. Use same scale and clothing D. Weight gain may indicate fluid retention E. Weight loss may reflect dehydration Answer: A, B, C, D, E Rationale: All listed are correct nursing principles. 17. A child with renal disease is on fluid & sodium restrictions. Which interventions are appropriate? A. Strict I&O B. Daily weights C. Limit salty snacks and processed foods D. Space fluids throughout the day E. Encourage free water without restriction Answer: A, B, C, D Rationale: Strict monitoring and limiting salt/fluids are essential. Unlimited free water is unsafe. 18. The nurse reviews medications for a child with renal disease. Which are commonly prescribed? A. Corticosteroids for nephrotic syndrome B. Antihypertensives C. Diuretics D. Antibiotics E. Insulin Answer: A, B, C, D Rationale: Steroids, BP meds, diuretics, and antibiotics are common. Insulin is not a renal med unless diabetic. 19. The nurse reinforces prevention teaching for UTIs. Which strategies are helpful? A. Wipe front-to-back B. Avoid bubble baths C. Encourage fluids D. Change diapers often E. Teach voiding after sex in adolescents Answer: A, B, C, D, E Rationale: All are correct preventive strategies. 20. The nurse is caring for a child with nephrotic syndrome. Which diet is appropriate? A. Low-salt diet B. High-protein diet C. Gluten-free diet D. Normal fluid intake E. Low-fat diet Answer: A, B, D, E Rationale: Low salt, adequate protein, normal fluids, low fat help. Gluten-free is only for celiac. 21. A child with nephrotic syndrome is being discharged. Parents should be taught to monitor for relapse. Which signs should they watch for? A. Protein in urine (dipstick) B. Weight gain C. Swelling/edema D. Increased urine output E. Fatigue Answer: A, B, C, E Rationale: Proteinuria, weight gain, swelling, and fatigue signal relapse. Increased urine output indicates improvement. 22. The nurse emphasizes importance of follow-up in renal disease. Which are correct teaching points? A. Regular lab monitoring B. Growth checks C. Medication adherence D. Immunizations as recommended E. Avoiding medical care unless symptoms worsen Answer: A, B, C, D Rationale: Labs, growth, med compliance, and vaccines are critical. Avoiding care is unsafe. Pediatric Diabetes Exam – 24 SATA Questions 1. The nurse is teaching parents the difference between Type 1 and Type 2 diabetes in children. Which statements are correct? A. Type 1 is caused by autoimmune destruction of beta cells B. Type 1 usually has sudden onset of symptoms C. Type 2 is related to insulin resistance and obesity D. Type 2 has a gradual onset E. Both require insulin therapy from diagnosis Answer: A, B, C, D Rationale: Type 1 = autoimmune, sudden onset, always insulin-dependent. Type 2 = insulin resistance, obesity, gradual onset. Not all Type 2 children need insulin at diagnosis. 2. The nurse is reviewing risk factors for Type 2 diabetes in pediatrics. Which apply? A. Family history B. Obesity C. Sedentary lifestyle D. Certain ethnicities (Hispanic, Native American, African American) E. Regular physical activity Answer: A, B, C, D Rationale: Family history, obesity, inactivity, and ethnicity increase risk. Regular physical activity is protective. 3. A nurse is reviewing normal blood glucose ranges in children. Which values are within expected limits? A. Fasting glucose 70–110 mg/dL B. Random glucose <200 mg/dL C. HbA1c <5.7% D. Postprandial <140 mg/dL E. Fasting >126 mg/dL Answer: A, B, C, D Rationale: Normal values are fasting 70–110, random <200, HbA1c <5.7%, postprandial <140. Fasting >126 is diagnostic for diabetes. 4. The nurse suspects Type 2 diabetes in a child. Which symptoms are expected? A. Polyuria B. Polydipsia C. Polyphagia D. Weight loss despite appetite E. Gradual fatigue Answer: A, B, C, E Rationale: Classic signs include the 3 Ps and fatigue. Weight loss is more typical of Type 1. 5. A child with diabetes is having growth concerns. Which statements are true? A. Poorly controlled diabetes can impair growth B. Puberty may occur later C. Normal growth requires good glucose control D. Excess insulin improves growth E. Malnutrition may worsen diabetes outcomes Answer: A, B, C, E Rationale: Uncontrolled diabetes ? growth delays, delayed puberty, malnutrition worsens control. Excess insulin does not promote healthy growth. 6. The nurse is reviewing diagnostic criteria for diabetes. Which findings confirm the diagnosis? A. Fasting glucose ?126 mg/dL B. HbA1c ?6.5% C. Random glucose ?200 mg/dL with symptoms D. Oral glucose tolerance test ?200 mg/dL at 2 hrs E. Fasting glucose 100 mg/dL Answer: A, B, C, D Rationale: All are diagnostic values. Fasting 100 is prediabetes, not diabetes. 7. The nurse is assessing a child for diabetic ketoacidosis (DKA). Which findings are expected? A. Fruity breath B. Kussmaul respirations C. Severe dehydration D. Altered mental status E. Bradycardia Answer: A, B, C, D Rationale: DKA signs include fruity breath, deep respirations, dehydration, AMS. Bradycardia is not typical. 8. The nurse is planning care for a child in DKA. Which interventions are correct? A. IV fluids B. IV insulin infusion C. Monitor potassium closely D. Restrict all oral fluids E. Cardiac monitoring Answer: A, B, C, E Rationale: Fluids, insulin drip, potassium monitoring, and cardiac monitoring are essential. Oral fluids may be restarted once stable. 9. The nurse is assessing for hypoglycemia in a school-age child. Which findings are typical? A. Shakiness B. Sweating C. Irritability D. Headache E. Seizures Answer: A, B, C, D, E Rationale: All listed can occur in hypoglycemia, seizures in severe cases. 10. The nurse is teaching parents how to treat mild hypoglycemia. Which actions are correct? A. Give 15 g of carbs (juice or glucose tabs) B. Recheck blood sugar in 15 min C. Repeat carbs if still low D. Administer glucagon immediately E. Provide a snack once stable Answer: A, B, C, E Rationale: Rule of 15 = 15g carbs, recheck in 15 min, repeat if low, then snack. Glucagon is for severe cases. 11. The nurse is teaching about hyperglycemia. Which symptoms are expected? A. Polyuria B. Dry skin C. Nausea D. Blurred vision E. Sweating Answer: A, B, C, D Rationale: Hyperglycemia ? polyuria, dry skin, nausea, blurred vision. Sweating is hypoglycemia. 12. The nurse is teaching a family about types of insulin. Which matches are correct? A. Rapid-acting: onset 15 min, peak 1 hr B. Short-acting: onset 30–60 min, peak 2–4 hr C. Intermediate: onset 1–2 hr, peak 6–12 hr D. Long-acting: onset 2–4 hr, no clear peak E. Rapid-acting: duration 24 hr Answer: A, B, C, D Rationale: Rapid, short, intermediate, and long insulins have these onsets/peaks. Rapid does not last 24 hrs. 13. The nurse is teaching about sick day management. Which actions are correct? A. Do not skip insulin doses B. Monitor blood glucose more frequently C. Check urine for ketones D. Encourage fluids E. Stop all insulin if child is vomiting Answer: A, B, C, D Rationale: Insulin should never be skipped. Monitor sugars, ketones, fluids. Stopping insulin is unsafe. 14. The nurse is teaching about carb counting. Which statements are correct? A. Carbs are matched to insulin doses B. One carb choice = 15 g carbs C. Carb counting helps flexibility in diet D. Protein foods are counted as carbs E. Families should learn label reading Answer: A, B, C, E Rationale: Carb counting = 15 g per choice, matched with insulin. Protein not counted as carbs. 15. The nurse is teaching a family about healthy meals for diabetes. Which principles apply? A. Balanced diet with carbs, protein, fats B. Limit simple sugars C. Encourage complex carbs and fiber D. Avoid all carbohydrates completely E. Encourage fruits and vegetables Answer: A, B, C, E Rationale: Balanced diet with limited simple sugars, more fiber, fruits/veggies. Carbs are needed, not avoided. 16. The nurse is teaching about exercise for children with diabetes. Which points are correct? A. Improves insulin sensitivity B. Monitor for hypoglycemia during activity C. Extra snacks may be needed before exercise D. Avoid all activity if Type 1 diabetes E. Encourage regular physical activity Answer: A, B, C, E Rationale: Exercise helps insulin work better, but risk of hypoglycemia requires planning. Avoiding activity is not correct. 17. A nurse is teaching about school planning for a child with diabetes. Which should be included? A. Emergency glucagon kit at school B. Staff trained in diabetes care C. Snacks available before activity D. Child should always skip PE E. Medical alert bracelet worn Answer: A, B, C, E Rationale: Glucagon kit, trained staff, snacks, and bracelet are essential. PE should not be skipped. 18. The nurse is teaching about blood glucose monitoring. Which points are correct? A. Check before meals and at bedtime B. Additional checks during illness C. Target ranges set by provider D. Always use the same finger for consistency E. Ensure proper technique for accuracy Answer: A, B, C, E Rationale: Regular checks before meals/bed, more during illness, provider sets targets. Rotate sites, not same finger. 19. The nurse is teaching about insulin administration in children. Which points are correct? A. Rotate sites (arms, thighs, abdomen, buttocks) B. Avoid giving injections in the same site repeatedly C. Give rapid-acting insulin before meals D. Long-acting insulin given once or twice daily E. Massage injection site to speed absorption Answer: A, B, C, D Rationale: Site rotation is key, rapid-acting given before meals, long-acting once/twice daily. Massage is discouraged. 20. The nurse is teaching how to differentiate hypoglycemia vs. hyperglycemia. Which are hypoglycemia signs? A. Shakiness B. Sweating C. Blurred vision D. Irritability E. Seizures Answer: A, B, D, E Rationale: Shakiness, sweating, irritability, seizures = hypoglycemia. Blurred vision = hyperglycemia. 21. The nurse is teaching about emergency supplies for children with diabetes. Which should be kept available? A. Glucose tablets or gel B. Glucagon emergency kit C. Medical alert bracelet D. Insulin vials E. Extra syringes or pens Answer: A, B, C, D, E Rationale: All listed are essential emergency supplies. 22. The nurse is reviewing education on hypoglycemia treatment at school. Which interventions are correct? A. Give fast-acting carbs immediately B. Notify school nurse/teacher C. Monitor blood glucose D. Allow child to return to activity once stable E. Delay treatment until parent arrives Answer: A, B, C, D Rationale: Immediate treatment with carbs, notify staff, monitor sugar, and return to activity when stable. Waiting for parents is unsafe. 23. The nurse emphasizes importance of routine follow-up in pediatric diabetes. Which are correct? A. Endocrinology visits every 3–6 months B. Regular HbA1c checks C. Growth and development monitoring D. Eye exams as child ages E. Routine checkups only if symptoms worsen Answer: A, B, C, D Rationale: Regular endocrine follow-ups, HbA1c, growth, and eye exams are essential. Care should not wait for symptoms. 24. The nurse is teaching parents about long-term diabetes management. Which points are correct? A. Encourage healthy lifestyle with diet and exercise B. Stress importance of med adherence C. Monitor for complications (kidneys, eyes, nerves) D. Annual flu vaccine recommended E. Skip routine care if child feels well Answer: A, B, C, D Rationale: Long-term care includes healthy lifestyle, med adherence, monitoring for complications, vaccines. Care should never be skipped.