NR 328 Pediatric Nursing Exam 4 Practice Questions 2026
|Chamberlain College
1. A 4-week-old infant is brought to the clinic with a history of projectile, non-
bile-stained vomiting after feedings. The nurse notes an olive-shaped mass in
the epigastrium. Which condition is most likely?
A. Intussusception
B. Gastroesophageal Reflux
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung Disease
Answer: C
Rationale: Hypertrophic pyloric stenosis is characterized by projectile vomiting and a
palpable olive-shaped mass in the right upper quadrant.
2. Which clinical manifestation is a classic sign of intussusception in an infant?
A. Ribbon-like stools
B. Steatorrhea
C. Currant jelly-like stools
D. Projectile vomiting
Answer: C
Rationale: Intussusception causes the passage of red, jelly-like stools containing blood and
mucus due to intestinal wall ischemia.
,3. A child is diagnosed with Hirschsprung disease. Which finding should the
nurse expect in the child’s history?
A. Failure to pass meconium in the first 24-48 hours
B. Frequent watery diarrhea
C. Severe epigastric pain
D. Hyperactive bowel sounds in all quadrants
Answer: A
Rationale: Hirschsprung disease is a congenital aganglionic megacolon; failure to pass
meconium is the most common neonatal sign.
4. A nurse is teaching the parents of a child with Celiac disease. Which food
choice indicates the parents understand the dietary restrictions?
A. Wheat crackers
B. Rye bread
C. Rice cakes
D. Barley soup
Answer: C
Rationale: Celiac disease requires a gluten-free diet, which excludes wheat, rye, barley, and
oats. Rice is safe.
5. A 5-year-old is admitted with Acute Post-Streptococcal Glomerulonephritis
(APSGN). Which assessment finding is most characteristic of this condition?
A. Hematuria (cola-colored urine)
B. Massive proteinuria
C. Hypotension
D. Weight loss
Answer: A
Rationale: APSGN presents with tea-colored or cola-colored urine due to hematuria, along
with hypertension and periorbital edema.
, 6. Which lab result is most consistent with a diagnosis of Nephrotic Syndrome?
A. Low serum cholesterol
B. Hypoalbuminemia
C. Hematuria
D. Hypernatremia
Answer: B
Rationale: Nephrotic syndrome is characterized by massive proteinuria, leading to low
serum albumin (hypoalbuminemia) and edema.
7. A nurse is caring for a child with Type 1 Diabetes Mellitus who is sweating,
shaky, and pale. What is the priority action?
A. Administer regular insulin
B. Give 15g of a fast-acting carbohydrate
C. Check the blood glucose level
D. Call the physician immediately
Answer: B
Rationale: The child is showing signs of hypoglycemia. The priority is to treat with a fast-
acting carbohydrate like 4 oz of juice.
8. In a child with Diabetic Ketoacidosis (DKA), which respiratory pattern does
the nurse expect to observe?
A. Cheyne-Stokes respirations
B. Kussmaul respirations
C. Apneic episodes
D. Shallow, slow breathing
Answer: B
Rationale: Kussmaul respirations (deep, rapid breathing) occur in DKA as the body
attempts to blow off excess CO2 to compensate for metabolic acidosis.
|Chamberlain College
1. A 4-week-old infant is brought to the clinic with a history of projectile, non-
bile-stained vomiting after feedings. The nurse notes an olive-shaped mass in
the epigastrium. Which condition is most likely?
A. Intussusception
B. Gastroesophageal Reflux
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung Disease
Answer: C
Rationale: Hypertrophic pyloric stenosis is characterized by projectile vomiting and a
palpable olive-shaped mass in the right upper quadrant.
2. Which clinical manifestation is a classic sign of intussusception in an infant?
A. Ribbon-like stools
B. Steatorrhea
C. Currant jelly-like stools
D. Projectile vomiting
Answer: C
Rationale: Intussusception causes the passage of red, jelly-like stools containing blood and
mucus due to intestinal wall ischemia.
,3. A child is diagnosed with Hirschsprung disease. Which finding should the
nurse expect in the child’s history?
A. Failure to pass meconium in the first 24-48 hours
B. Frequent watery diarrhea
C. Severe epigastric pain
D. Hyperactive bowel sounds in all quadrants
Answer: A
Rationale: Hirschsprung disease is a congenital aganglionic megacolon; failure to pass
meconium is the most common neonatal sign.
4. A nurse is teaching the parents of a child with Celiac disease. Which food
choice indicates the parents understand the dietary restrictions?
A. Wheat crackers
B. Rye bread
C. Rice cakes
D. Barley soup
Answer: C
Rationale: Celiac disease requires a gluten-free diet, which excludes wheat, rye, barley, and
oats. Rice is safe.
5. A 5-year-old is admitted with Acute Post-Streptococcal Glomerulonephritis
(APSGN). Which assessment finding is most characteristic of this condition?
A. Hematuria (cola-colored urine)
B. Massive proteinuria
C. Hypotension
D. Weight loss
Answer: A
Rationale: APSGN presents with tea-colored or cola-colored urine due to hematuria, along
with hypertension and periorbital edema.
, 6. Which lab result is most consistent with a diagnosis of Nephrotic Syndrome?
A. Low serum cholesterol
B. Hypoalbuminemia
C. Hematuria
D. Hypernatremia
Answer: B
Rationale: Nephrotic syndrome is characterized by massive proteinuria, leading to low
serum albumin (hypoalbuminemia) and edema.
7. A nurse is caring for a child with Type 1 Diabetes Mellitus who is sweating,
shaky, and pale. What is the priority action?
A. Administer regular insulin
B. Give 15g of a fast-acting carbohydrate
C. Check the blood glucose level
D. Call the physician immediately
Answer: B
Rationale: The child is showing signs of hypoglycemia. The priority is to treat with a fast-
acting carbohydrate like 4 oz of juice.
8. In a child with Diabetic Ketoacidosis (DKA), which respiratory pattern does
the nurse expect to observe?
A. Cheyne-Stokes respirations
B. Kussmaul respirations
C. Apneic episodes
D. Shallow, slow breathing
Answer: B
Rationale: Kussmaul respirations (deep, rapid breathing) occur in DKA as the body
attempts to blow off excess CO2 to compensate for metabolic acidosis.
