NR 328 Pediatric Nursing Exam 7 Study Guide 2026 |Chamberlain
College
1. A child with Tetralogy of Fallot becomes cyanotic and dyspneic during a crying
episode. Which action should the nurse perform first?
A. Place the child in the knee-chest position
B. Administer 100% oxygen by mask
C. Administer morphine sulfate intravenously
D. Notify the healthcare provider immediately
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves oxygenation during a ‘tet’ spell.
2. The nurse is assessing a 4-week-old infant suspected of having hypertrophic
pyloric stenosis. Which finding is most characteristic of this condition?
A. Currant jelly-like stools
B. Ribbon-like stools
C. Projectile vomiting after feeding
D. Abdominal distention and bile-stained vomitus
Answer: C
Rationale: Projectile, non-bilious vomiting is the classic sign of pyloric stenosis due to the
narrowing of the pyloric sphincter.
,3. A child is admitted with a diagnosis of Intussusception. Which clinical
manifestation should the nurse expect to find?
A. Olive-shaped mass in the epigastrium
B. Persistent constipation from birth
C. Painless rectal bleeding
D. Stools containing blood and mucus (‘currant jelly’)
Answer: D
Rationale: Intussusception causes intestinal obstruction and ischemia, leading to stools
characterized by a mixture of blood and mucus.
4. What is the primary nursing consideration when caring for a child with Wilms
tumor (nephroblastoma)?
A. Frequent abdominal palpation to monitor tumor growth
B. Strict intake and output monitoring
C. Administering high-protein, high-calorie snacks
D. Placing a sign above the bed that says ‘Do Not Palpate Abdomen’
Answer: D
Rationale: Palpation of a Wilms tumor can cause the encapsulated tumor to rupture,
leading to the seeding of cancer cells throughout the abdomen.
5. A nurse is providing discharge instructions to the parents of a child with Celiac
disease. Which food should be avoided?
A. Corn tortillas
B. Rice cereal
C. Fresh fruit
D. Wheat bread
Answer: D
Rationale: Celiac disease is an immune reaction to eating gluten, which is found in wheat,
barley, and rye.
, 6. Which assessment finding in an infant suggests Hirschsprung disease?
A. Projectile vomiting after every feed
B. Failure to pass meconium within the first 24 to 48 hours
C. A palpable sausage-shaped mass in the upper right quadrant
D. Frequent watery diarrhea
Answer: B
Rationale: Hirschsprung disease is characterized by the absence of ganglion cells in the
colon, often resulting in a failure to pass meconium shortly after birth.
7. A child is diagnosed with Epiglottitis. What is a priority nursing action?
A. Examine the throat using a tongue depressor
B. Obtain a throat culture immediately
C. Administer oral antibiotics as soon as possible
D. Keep the child in a calm, upright position and avoid throat inspection
Answer: D
Rationale: Inspection of the throat with a tongue depressor in a child with epiglottitis can
trigger a complete airway obstruction.
8. Which laboratory value is expected in a child with Nephrotic Syndrome?
A. Hypolipidemia
B. Massive proteinuria
C. Hyperalbuminemia
D. Gross hematuria
Answer: B
Rationale: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, and hyperlipidemia due to increased glomerular permeability.
College
1. A child with Tetralogy of Fallot becomes cyanotic and dyspneic during a crying
episode. Which action should the nurse perform first?
A. Place the child in the knee-chest position
B. Administer 100% oxygen by mask
C. Administer morphine sulfate intravenously
D. Notify the healthcare provider immediately
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves oxygenation during a ‘tet’ spell.
2. The nurse is assessing a 4-week-old infant suspected of having hypertrophic
pyloric stenosis. Which finding is most characteristic of this condition?
A. Currant jelly-like stools
B. Ribbon-like stools
C. Projectile vomiting after feeding
D. Abdominal distention and bile-stained vomitus
Answer: C
Rationale: Projectile, non-bilious vomiting is the classic sign of pyloric stenosis due to the
narrowing of the pyloric sphincter.
,3. A child is admitted with a diagnosis of Intussusception. Which clinical
manifestation should the nurse expect to find?
A. Olive-shaped mass in the epigastrium
B. Persistent constipation from birth
C. Painless rectal bleeding
D. Stools containing blood and mucus (‘currant jelly’)
Answer: D
Rationale: Intussusception causes intestinal obstruction and ischemia, leading to stools
characterized by a mixture of blood and mucus.
4. What is the primary nursing consideration when caring for a child with Wilms
tumor (nephroblastoma)?
A. Frequent abdominal palpation to monitor tumor growth
B. Strict intake and output monitoring
C. Administering high-protein, high-calorie snacks
D. Placing a sign above the bed that says ‘Do Not Palpate Abdomen’
Answer: D
Rationale: Palpation of a Wilms tumor can cause the encapsulated tumor to rupture,
leading to the seeding of cancer cells throughout the abdomen.
5. A nurse is providing discharge instructions to the parents of a child with Celiac
disease. Which food should be avoided?
A. Corn tortillas
B. Rice cereal
C. Fresh fruit
D. Wheat bread
Answer: D
Rationale: Celiac disease is an immune reaction to eating gluten, which is found in wheat,
barley, and rye.
, 6. Which assessment finding in an infant suggests Hirschsprung disease?
A. Projectile vomiting after every feed
B. Failure to pass meconium within the first 24 to 48 hours
C. A palpable sausage-shaped mass in the upper right quadrant
D. Frequent watery diarrhea
Answer: B
Rationale: Hirschsprung disease is characterized by the absence of ganglion cells in the
colon, often resulting in a failure to pass meconium shortly after birth.
7. A child is diagnosed with Epiglottitis. What is a priority nursing action?
A. Examine the throat using a tongue depressor
B. Obtain a throat culture immediately
C. Administer oral antibiotics as soon as possible
D. Keep the child in a calm, upright position and avoid throat inspection
Answer: D
Rationale: Inspection of the throat with a tongue depressor in a child with epiglottitis can
trigger a complete airway obstruction.
8. Which laboratory value is expected in a child with Nephrotic Syndrome?
A. Hypolipidemia
B. Massive proteinuria
C. Hyperalbuminemia
D. Gross hematuria
Answer: B
Rationale: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, and hyperlipidemia due to increased glomerular permeability.
