NR 328 Pediatric Nursing Exam 3 Comprehensive Study Guide 2026
|Chamberlain College
1. A nurse is caring for an infant with Tetralogy of Fallot who begins to have a
hypercyanotic ‘tet spell’ during a procedure. Which action should the nurse take
first?
A. Place the infant in the knee-chest position
B. Administer 100% oxygen via non-rebreather mask
C. Prepare to administer morphine sulfate
D. Notify the pediatric cardiologist immediately
Answer: A
Rationale: The knee-chest position is the immediate priority because it increases systemic
vascular resistance, which forces more blood through the pulmonary artery and improves
oxygenation.
2. A child with cystic fibrosis (CF) is receiving pancreatic enzyme replacement
therapy. How should the nurse instruct the parents to administer these
enzymes?
A. Administer enzymes once daily in the morning
B. Give enzymes only if the child has a bowel movement
C. Administer enzymes with every meal and snack
D. Mix the enzymes in a hot bowl of oatmeal
Answer: C
Rationale: Pancreatic enzymes must be taken with all meals and snacks to ensure the
digestion and absorption of fats and proteins in children with CF.
,3. The nurse is assessing a child with suspected epiglottitis. Which clinical
manifestation should the nurse expect to find?
A. Barking, brassy cough
B. Low-grade fever and runny nose
C. Drooling and tripod positioning
D. Diffuse wheezing on expiration
Answer: C
Rationale: Epiglottitis is a medical emergency characterized by the four Ds: Drooling,
Dysphagia, Dysphonia, and Distressed inspiratory efforts (often in a tripod position).
4. A nurse is providing discharge instructions to the parents of a child with a
new diagnosis of Asthma. What is the purpose of using a peak flow meter?
A. To monitor the child’s current level of airway obstruction
B. To measure the child’s heart rate during an attack
C. To deliver a precise dose of bronchodilator
D. To identify specific environmental allergens
Answer: A
Rationale: A peak flow meter measures the maximum flow of air that can be forcefully
exhaled, helping families monitor the child’s asthma control and identify early airway
narrowing.
5. A child is admitted with a vaso-occlusive sickle cell crisis. Which of the
following is the priority nursing intervention?
A. Maintaining strict bed rest
B. Administering meperidine for pain
C. Providing aggressive intravenous hydration
D. Applying cold compresses to painful joints
Answer: C
, Rationale: Hydration is the priority because it reduces blood viscosity and prevents
further sickling of red blood cells during a vaso-occlusive crisis.
6. The nurse is evaluating a 2-year-old child with suspected pyloric stenosis.
Which finding is most characteristic of this condition?
A. Projectile vomiting after feedings
B. Currant jelly-like stools
C. Chronic diarrhea and weight loss
D. Absence of bowel sounds in the lower quadrants
Answer: A
Rationale: Hypertrophic pyloric stenosis causes a narrowing of the pyloric sphincter,
leading to forceful, projectile vomiting immediately after feedings.
7. A school-age child is diagnosed with Acute Glomerulonephritis (AGN). Which
historical finding is most commonly associated with this diagnosis?
A. Recent urinary tract infection
B. Exposure to hepatitis B
C. Family history of polycystic kidney disease
D. A recent streptococcal throat infection
Answer: D
Rationale: Acute post-streptococcal glomerulonephritis typically occurs 1 to 2 weeks after
a Group A beta-hemolytic streptococcal infection of the throat or skin.
8. A child with Nephrotic Syndrome is receiving prednisone. Which side effect
should the nurse monitor for?
A. Weight loss and hypoglycemia
B. Hypotension and bradycardia
C. Increased risk of infection
D. Thinning of the hair
Answer: C
|Chamberlain College
1. A nurse is caring for an infant with Tetralogy of Fallot who begins to have a
hypercyanotic ‘tet spell’ during a procedure. Which action should the nurse take
first?
A. Place the infant in the knee-chest position
B. Administer 100% oxygen via non-rebreather mask
C. Prepare to administer morphine sulfate
D. Notify the pediatric cardiologist immediately
Answer: A
Rationale: The knee-chest position is the immediate priority because it increases systemic
vascular resistance, which forces more blood through the pulmonary artery and improves
oxygenation.
2. A child with cystic fibrosis (CF) is receiving pancreatic enzyme replacement
therapy. How should the nurse instruct the parents to administer these
enzymes?
A. Administer enzymes once daily in the morning
B. Give enzymes only if the child has a bowel movement
C. Administer enzymes with every meal and snack
D. Mix the enzymes in a hot bowl of oatmeal
Answer: C
Rationale: Pancreatic enzymes must be taken with all meals and snacks to ensure the
digestion and absorption of fats and proteins in children with CF.
,3. The nurse is assessing a child with suspected epiglottitis. Which clinical
manifestation should the nurse expect to find?
A. Barking, brassy cough
B. Low-grade fever and runny nose
C. Drooling and tripod positioning
D. Diffuse wheezing on expiration
Answer: C
Rationale: Epiglottitis is a medical emergency characterized by the four Ds: Drooling,
Dysphagia, Dysphonia, and Distressed inspiratory efforts (often in a tripod position).
4. A nurse is providing discharge instructions to the parents of a child with a
new diagnosis of Asthma. What is the purpose of using a peak flow meter?
A. To monitor the child’s current level of airway obstruction
B. To measure the child’s heart rate during an attack
C. To deliver a precise dose of bronchodilator
D. To identify specific environmental allergens
Answer: A
Rationale: A peak flow meter measures the maximum flow of air that can be forcefully
exhaled, helping families monitor the child’s asthma control and identify early airway
narrowing.
5. A child is admitted with a vaso-occlusive sickle cell crisis. Which of the
following is the priority nursing intervention?
A. Maintaining strict bed rest
B. Administering meperidine for pain
C. Providing aggressive intravenous hydration
D. Applying cold compresses to painful joints
Answer: C
, Rationale: Hydration is the priority because it reduces blood viscosity and prevents
further sickling of red blood cells during a vaso-occlusive crisis.
6. The nurse is evaluating a 2-year-old child with suspected pyloric stenosis.
Which finding is most characteristic of this condition?
A. Projectile vomiting after feedings
B. Currant jelly-like stools
C. Chronic diarrhea and weight loss
D. Absence of bowel sounds in the lower quadrants
Answer: A
Rationale: Hypertrophic pyloric stenosis causes a narrowing of the pyloric sphincter,
leading to forceful, projectile vomiting immediately after feedings.
7. A school-age child is diagnosed with Acute Glomerulonephritis (AGN). Which
historical finding is most commonly associated with this diagnosis?
A. Recent urinary tract infection
B. Exposure to hepatitis B
C. Family history of polycystic kidney disease
D. A recent streptococcal throat infection
Answer: D
Rationale: Acute post-streptococcal glomerulonephritis typically occurs 1 to 2 weeks after
a Group A beta-hemolytic streptococcal infection of the throat or skin.
8. A child with Nephrotic Syndrome is receiving prednisone. Which side effect
should the nurse monitor for?
A. Weight loss and hypoglycemia
B. Hypotension and bradycardia
C. Increased risk of infection
D. Thinning of the hair
Answer: C
