A child weighs 14 kg. The prescriber orders acetaminophen 280 mg orally every 4 hours as needed for fever. The reference states the usual dose is 10 to 15 mg/kg per dose. What should the nurse do?
Give the dose as ordered, because a prescriber wrote the order and it is the nurse's role to follow it.
Give the dose as ordered and monitor liver function tests for any elevation afterward.
Give half the ordered dose of 140 mg without notifying the prescriber to be safe.
Hold the dose and contact the prescriber to clarify, because the order equals 20 mg/kg per dose.
Show the answer and explanation
Answer: D. Hold the dose and contact the prescriber to clarify, because the order equals 20 mg/kg per dose.
Topic: Acetaminophen dosing check
280 mg divided by 14 kg is 20 mg/kg, above the usual 10 to 15 mg/kg per dose. The nurse must not give a potentially toxic dose and must clarify the order with the prescriber.
Why the others are wrong
A – The nurse remains accountable for questioning an unsafe order.
B – Monitoring after harm is not prevention; the dose should be clarified first.
C – Changing a dose without a new order is outside nursing practice.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
252Question
A nurse must give an intramuscular injection to a 6-month-old. Which site is most appropriate?
Dorsogluteal muscle of the buttock
Deltoid muscle of the upper arm
Vastus lateralis muscle of the thigh
Gastrocnemius muscle of the calf
Show the answer and explanation
Answer: C. Vastus lateralis muscle of the thigh
Topic: Pediatric IM injection site
The vastus lateralis is large, well developed in infants and away from major nerves and vessels, making it the preferred site for infant intramuscular injections.
Why the others are wrong
A – The gluteal muscle is poorly developed before walking, and sciatic nerve injury is a risk.
B – The deltoid is too small in infants to accommodate most injections.
D – The calf is not an accepted site and has sparse muscle and nerve risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
253Question
A nurse selects pain assessment tools for several children. Which pairings are appropriate?
Select all that apply.
The FLACC scale for a 10-month-old after surgery
The Wong-Baker FACES scale for a 5-year-old who can point to the faces
The FLACC scale for a nonverbal child with a cognitive impairment
The Wong-Baker FACES scale for a 3-month-old infant
A 0-to-10 numeric scale for a 3-year-old who cannot count
Asking a 6-month-old to rate pain on a scale
Show the answers and explanation
Answers: A, B and C.
A – The FLACC scale for a 10-month-old after surgery
B – The Wong-Baker FACES scale for a 5-year-old who can point to the faces
C – The FLACC scale for a nonverbal child with a cognitive impairment
Topic: Pediatric pain tools
Behavioral tools such as FLACC suit infants and nonverbal children, while self-report tools such as the Wong-Baker FACES scale suit children who can understand and point. A numeric scale needs counting ability.
Why the others are wrong
D – A 3-month-old cannot understand or point to faces; a behavioral tool is required.
E – A child unable to count cannot use a numeric scale reliably.
F – A 6-month-old cannot self-report; behavioral cues must be observed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
254Question
A child receiving continuous maintenance intravenous fluids is being monitored. Which findings suggest fluid volume overload?
Select all that apply.
Facial or periorbital edema
Crackles and increased work of breathing
Rapid weight gain over 24 hours
Sunken fontanelle
Delayed capillary refill with weak, thready pulses
Poor skin turgor
Show the answers and explanation
Answers: A, B and C.
A – Facial or periorbital edema
B – Crackles and increased work of breathing
C – Rapid weight gain over 24 hours
Topic: IV fluid overload
Overload causes edema, pulmonary congestion and rapid weight gain. Findings of low volume are the opposite and call for different action.
Why the others are wrong
D – A sunken fontanelle is a sign of dehydration.
E – Delayed refill with weak, thready pulses suggests hypovolemia or shock.
F – Poor skin turgor is a sign of fluid deficit.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
255Question
A nurse alone in a hospital room finds an unresponsive 5-month-old who is not breathing normally and has no brachial pulse. After calling for help and the emergency team, what is the nurse's priority action?
Begin chest compressions at a rate of 100 to 120 per minute.
Open the airway and deliver two rescue breaths before doing anything else.
Check for a pulse for about 30 seconds to confirm cardiac arrest before starting.
Deliver back blows and chest thrusts to clear a possible foreign body.
Show the answer and explanation
Answer: A. Begin chest compressions at a rate of 100 to 120 per minute.
Topic: Pediatric BLS priority
In pediatric cardiac arrest the priority is to start high-quality chest compressions immediately, with a rate of 100 to 120 per minute, after calling for help.
Why the others are wrong
B – Current guidance prioritizes compressions first in the compression, airway, breathing sequence.
C – Pulse checks should take no more than 10 seconds; delay worsens outcome.
D – This sequence is for a conscious choking infant, not an unresponsive one without pulse.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
256Question
A 14-month-old hospitalized for dehydration clings and screams whenever the parent moves toward the door. Which intervention is best?
Teach the parent to say goodbye, state when the parent will return, and return as promised.
Advise the parent to leave quietly while the child is distracted so that the child does not become upset.
Limit visiting hours so that the child gets used to being cared for by unfamiliar nurses.
Have the parent stay out of sight until the child stops crying, then enter the room.
Show the answer and explanation
Answer: A. Teach the parent to say goodbye, state when the parent will return, and return as promised.
Topic: Separation anxiety
Toddlers show protest, despair and detachment when separated. Family-centered care supports parental presence and honest, brief goodbyes with a reliable return.
Why the others are wrong
B – Sneaking out destroys trust and increases separation anxiety.
C – Reducing family presence heightens distress; family-centered care encourages presence.
D – Repeated disappearance reinforces fear of abandonment.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
257Question
A nurse is screening a 15-year-old with depressive symptoms. Which approach is best for assessing suicide risk?
Avoid mentioning suicide because asking may put the idea in the adolescent's mind.
Ask the parent whether the adolescent seems suicidal and rely on the parent's answer.
Tell the teenager that there is so much to live for and that things will surely get better with time and support.
Ask the teenager privately and directly about thoughts of suicide and whether there is a plan.
Show the answer and explanation
Answer: D. Ask the teenager privately and directly about thoughts of suicide and whether there is a plan.
Topic: Adolescent suicide screening
Direct, private questions about suicidal thoughts and plans are safe and necessary. They allow the nurse to determine risk and initiate safety measures.
Why the others are wrong
A – Asking directly does not increase risk and is necessary for safety.
B – Parents often underestimate risk; the adolescent must be asked.
C – False reassurance blocks disclosure and ignores the teenager's feelings.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
258Question
A nurse admits a 16-year-old with anorexia nervosa. Which assessment finding requires priority attention?
Fine downy hair on the arms and back
Heart rate of 42 beats/min with dizziness on standing
Absence of menstrual periods for four months
Feeling cold in a room that others find comfortable
Show the answer and explanation
Answer: B. Heart rate of 42 beats/min with dizziness on standing
Topic: Anorexia nervosa priority
Severe bradycardia with orthostatic symptoms indicates cardiovascular compromise from malnutrition and may precede fatal arrhythmias. It requires immediate evaluation and monitoring.
Why the others are wrong
A – Lanugo is an expected long-term finding and is not immediately dangerous.
C – Amenorrhea is a chronic effect and not an acute emergency.
D – Cold intolerance is common and not an urgent threat.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
259Question
A nurse teaches the parents of a 9-year-old prescribed extended-release methylphenidate for attention-deficit/hyperactivity disorder. Which instruction is correct?
Give the dose at bedtime so the child is calm and sleeps well through the night.
Crush the extended-release tablet if the child has trouble swallowing it whole.
Give the dose in the morning, offer breakfast first, and plan a later snack because appetite may fall.
Expect the child to be sleepy, so withhold the dose on days when school is planned and the child must be alert.
Show the answer and explanation
Answer: C. Give the dose in the morning, offer breakfast first, and plan a later snack because appetite may fall.
Topic: ADHD medication teaching
Stimulants should be given in the morning, since they can cause insomnia and appetite suppression. Extended-release forms must be swallowed whole and growth and appetite are monitored.
Why the others are wrong
A – Stimulants given late commonly cause insomnia.
B – Crushing destroys the extended-release mechanism and causes overdose.
D – Drowsiness is not expected; stimulants cause alertness and should be given as prescribed.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
260Question
A nurse plans care for a 5-year-old with autism spectrum disorder admitted for an appendectomy. Which communication strategies are appropriate?
Select all that apply.
Use short, concrete phrases.
Use picture cards to show the steps of care.
Allow the child to keep a familiar comfort object.
Keep lights and noise as low as practical.
Insist on sustained direct eye contact when speaking.
Use figures of speech such as "hold your horses."
Show the answers and explanation
Answers: A, B, C and D.
A – Use short, concrete phrases.
B – Use picture cards to show the steps of care.
C – Allow the child to keep a familiar comfort object.
D – Keep lights and noise as low as practical.
Topic: Autism communication
Children with autism benefit from literal language, visual supports, routine and a calm sensory environment. Forcing eye contact and using idioms increase distress and confusion.
Why the others are wrong
E – Forcing eye contact can be distressing; a child with autism may not use it to communicate.
F – Children with autism often interpret language literally, so figures of speech confuse them.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
261Question
A nurse teaches a school nurse and family about a child with type 1 diabetes. Which are manifestations of hypoglycemia?
Select all that apply.
Shakiness
Sweating and pallor
Sudden irritability or confusion
Fruity breath odor
Deep, rapid respirations
Excessive thirst with frequent urination
Show the answers and explanation
Answers: A, B and C.
A – Shakiness
B – Sweating and pallor
C – Sudden irritability or confusion
Topic: Hypoglycemia recognition
Hypoglycemia triggers adrenergic symptoms (shakiness, sweating, pallor) and neuroglycopenic symptoms (irritability, confusion). Fruity breath, Kussmaul respirations and polyuria point to hyperglycemia and ketoacidosis.
Why the others are wrong
D – Fruity breath is a sign of diabetic ketoacidosis.
E – Kussmaul respirations indicate ketoacidosis.
F – Polydipsia and polyuria are signs of hyperglycemia.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
262Question
Parents of an 8-year-old whose body mass index is above the 95th percentile ask the nurse what to do. Which approach is best?
Use a family-based plan with small goals, such as fewer sugary drinks and more daily active play.
Place the child alone on a strict calorie-restricted diet and weigh the child every single day to track success closely.
Tell the child directly that being overweight is unhealthy and the child must lose weight quickly.
Allow unlimited snacks since children grow into their weight and treatment is rarely necessary.
Show the answer and explanation
Answer: A. Use a family-based plan with small goals, such as fewer sugary drinks and more daily active play.
Topic: Obesity counselling
Family-based, nonjudgmental, behavior-focused interventions with achievable goals are most effective for childhood obesity. Restriction, shaming and neglect are harmful.
Why the others are wrong
B – Strict restriction and daily weighing risk harm and disordered eating.
C – Blaming and stigmatizing language damages self-esteem and is not effective.
D – Obesity in childhood commonly persists and requires intervention.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
263Question
A 6-year-old is on the evening after a tonsillectomy. Which finding requires the nurse's immediate attention?
Throat pain rated 3 out of 10 after acetaminophen
Refusal of solid foods but acceptance of cool fluids
Temperature of 99.5 degrees F (37.5 degrees C) on the first night
Frequent swallowing and repeated throat clearing
Show the answer and explanation
Answer: D. Frequent swallowing and repeated throat clearing
Topic: Tonsillectomy bleeding
Frequent swallowing, throat clearing or vomiting bright red blood may signal hemorrhage, the most serious complication. Parents and nurses must report it immediately.
Why the others are wrong
A – Mild pain controlled with medication is expected.
B – Reduced appetite for solids is common after surgery.
C – A low-grade temperature is common early after surgery.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
264Question
A parent of a 3-year-old prescribed amoxicillin for acute otitis media asks about care. Which statement by the parent indicates understanding?
"I will clean her ears with cotton swabs to remove any fluid or drainage."
"I will give every dose until the medicine is gone, even if she seems better in two days."
"I will stop the medicine when her ear pain is gone to avoid side effects."
"I will let her sleep with a bottle of juice since it calms her."
Show the answer and explanation
Answer: B. "I will give every dose until the medicine is gone, even if she seems better in two days."
Topic: Otitis media teaching
The antibiotic course should be completed as prescribed to prevent relapse and resistance. Cotton swabs and bedtime bottles are unsafe or harmful.
Why the others are wrong
A – Inserting swabs may injure the canal and push material deeper.
C – Stopping early risks relapse and resistance.
D – Bottles in bed increase the risk of caries and are not recommended.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
265Question
A nurse teaches parents of a 2-year-old about dental care. Which instruction is correct?
Use a pea-sized amount, because larger amounts protect the teeth better at this age.
Delay brushing until the permanent teeth appear because baby teeth fall out anyway.
Brush twice daily with a smear of fluoride toothpaste, about the size of a grain of rice.
Use fluoride-free toothpaste until age six to avoid any risk of fluorosis.
Show the answer and explanation
Answer: C. Brush twice daily with a smear of fluoride toothpaste, about the size of a grain of rice.
Topic: Dental fluoride
Pediatric guidance recommends brushing twice daily with a smear of fluoride toothpaste under age 3 and a pea-sized amount from ages 3 to 6, with supervision.
Why the others are wrong
A – A pea-sized amount is for children aged three or older; toddlers swallow toothpaste.
B – Primary teeth need care for chewing, speech and spacing and to prevent caries.
D – Guidance supports a smear of fluoride toothpaste as soon as teeth erupt.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
266Question
A 5-year-old is anxious about an upcoming intravenous insertion. Which intervention best uses therapeutic play?
Let the child handle needle-free equipment and practice the procedure on a doll.
Describe the procedure to the child in detail using anatomical terms and avoid showing any equipment.
Distract the child with a television program and avoid any mention of the procedure beforehand.
Show a film of an older child having an insertion and then proceed with the procedure.
Show the answer and explanation
Answer: A. Let the child handle needle-free equipment and practice the procedure on a doll.
Topic: Therapeutic play
Therapeutic play lets children express fears and gain mastery by handling real equipment on a doll or toy. It reduces anxiety and promotes cooperation.
Why the others are wrong
B – Preschoolers need concrete experiences, not abstract detail.
C – Surprise increases fear and damages trust.
D – Passive viewing without play does not let the child process feelings.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
267Question
A nurse is helping a 17-year-old with cystic fibrosis prepare to move from pediatric to adult health care. Which approach is best?
Delay all discussion of the transfer until after the 18th birthday so that the teen is not overwhelmed.
Begin early and gradually teach the teen to manage medications, appointments and questions for the provider.
Let parents take over every health task until the day the teen enters adult care.
Transfer the records on the 18th birthday and expect the teen to find an adult provider alone.
Show the answer and explanation
Answer: B. Begin early and gradually teach the teen to manage medications, appointments and questions for the provider.
Topic: Transition to adult care
Transition is a planned process starting in early adolescence, with graduated responsibility, self-management teaching and a coordinated transfer. It prevents gaps in chronic care.
Why the others are wrong
A – Late planning leaves the teen unprepared and can interrupt care.
C – Without practice the teen will lack the skills to self-manage.
D – A coordinated hand-off with a joint visit prevents lapses in care.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
268Question
A 10-year-old is returning to school after chemotherapy and has lost hair. The child is worried about classmates' reactions. Which intervention is best?
Recommend home tutoring until the hair grows back so the child avoids questions.
Ask the teacher to tell the class the full diagnosis and treatment plan without first consulting the child or the parents.
Tell the child to ignore classmates' comments and not to discuss the illness with anyone at school or at home.
With family consent, work with the school nurse and teacher to prepare classmates, and let the child choose what to share.
Show the answer and explanation
Answer: D. With family consent, work with the school nurse and teacher to prepare classmates, and let the child choose what to share.
Topic: School re-entry
Planned school re-entry with family consent, teacher preparation and the child's control over disclosure supports normal development and reduces anxiety.
Why the others are wrong
A – Prolonged isolation hinders normal development and peer relationships.
B – Disclosure requires the family's and child's consent and respects privacy.
C – This dismisses feelings and gives the child no coping tools.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
269Question
A community health nurse is planning services at a county clinic. Which activity is an example of primary prevention?
Screening adults for colorectal cancer with stool tests at a health fair
Teaching home exercises to a client who had a stroke last month
Checking blood pressure at a pharmacy to find undiagnosed hypertension
Offering seasonal influenza vaccine at a school-based clinic
Show the answer and explanation
Answer: D. Offering seasonal influenza vaccine at a school-based clinic
Topic: levels of prevention
Primary prevention keeps disease from occurring, through measures such as immunization and health education. Screening to detect disease early is secondary prevention, and rehabilitation to limit disability after illness is tertiary prevention.
Why the others are wrong
A – Stool testing looks for disease in people without symptoms, which is secondary prevention.
B – Rehabilitation after a stroke limits disability, which is tertiary prevention.
C – Checking blood pressure to uncover hypertension is screening, a form of secondary prevention.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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