NR 328 Pediatric Nursing Exam 9 Study Guide 2026 |Chamberlain
College
1. A nurse is caring for an infant with Tetralogy of Fallot who begins to have a
‘tet spell.’ Which action should the nurse take first?
A. Administer 100% oxygen via face mask
B. Prepare for immediate surgical intervention
C. Administer morphine sulfate intravenously
D. Place the infant in a knee-chest position
Answer: D
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves oxygenation during a hypercyanotic spell.
2. A child is admitted with a diagnosis of intussusception. Which of the following
stool characteristics is pathognomonic for this condition?
A. Ribbon-like, foul-smelling stools
B. Red currant jelly-like stools
C. Steatorrhea or fatty stools
D. Hard, marble-like stools
Answer: B
Rationale: Intussusception causes intestinal obstruction and ischemia, leading to the
passage of stools mixed with blood and mucus, often described as currant jelly stools.
,3. Which clinical manifestation is most characteristic of pyloric stenosis in a 4-
week-old infant?
A. Chronic diarrhea
B. Abdominal distension and bile-stained emesis
C. Projectile vomiting after feedings
D. Severe dehydration and weight gain
Answer: C
Rationale: Hypertrophic pyloric stenosis typically presents with non-bilious projectile
vomiting immediately after feeding due to the narrowing of the pyloric sphincter.
4. What is the most appropriate first solid food to introduce to a 6-month-old
infant?
A. Iron-fortified rice cereal
B. Strained yellow vegetables
C. Pureed meats
D. Mashed bananas
Answer: A
Rationale: Iron-fortified rice cereal is recommended first because it is easily digested and
has a low allergenic potential, and infant iron stores begin to deplete around 6 months.
5. A child is suspected of having epiglottitis. Which nursing action is
contraindicated?
A. Using a tongue blade to examine the throat
B. Providing humidified oxygen
C. Allowing the child to remain in a sitting position
D. Monitoring continuous pulse oximetry
Answer: A
Rationale: Using a tongue blade or performing a throat culture can cause a laryngospasm,
leading to sudden and complete airway obstruction in a child with epiglottitis.
, 6. In a child with Cystic Fibrosis, which intervention is highest priority for
maintaining respiratory function?
A. Performing chest physiotherapy regularly
B. Encouraging a high-calorie diet
C. Administering fat-soluble vitamin supplements
D. Administering pancreatic enzymes with meals
Answer: A
Rationale: Chest physiotherapy (CPT) is essential for clearing thick, tenacious mucus from
the airways to prevent infection and maintain gas exchange in CF patients.
7. Which lab finding is most consistent with a diagnosis of Nephrotic Syndrome?
A. Gross hematuria
B. Elevated serum albumin
C. Decreased serum cholesterol
D. Massive proteinuria
Answer: D
Rationale: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, and hyperlipidemia due to increased glomerular permeability.
8. A nurse is reviewing the history of a child with Acute Glomerulonephritis
(AGN). Which event is often found in the patient’s recent history?
A. A urinary tract infection
B. A recent fall from a height
C. Exposure to contaminated water
D. A streptococcal throat infection
Answer: D
Rationale: Acute Glomerulonephritis is an immune-complex disease that typically occurs
1-2 weeks after a Group A beta-hemolytic streptococcal infection.
College
1. A nurse is caring for an infant with Tetralogy of Fallot who begins to have a
‘tet spell.’ Which action should the nurse take first?
A. Administer 100% oxygen via face mask
B. Prepare for immediate surgical intervention
C. Administer morphine sulfate intravenously
D. Place the infant in a knee-chest position
Answer: D
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves oxygenation during a hypercyanotic spell.
2. A child is admitted with a diagnosis of intussusception. Which of the following
stool characteristics is pathognomonic for this condition?
A. Ribbon-like, foul-smelling stools
B. Red currant jelly-like stools
C. Steatorrhea or fatty stools
D. Hard, marble-like stools
Answer: B
Rationale: Intussusception causes intestinal obstruction and ischemia, leading to the
passage of stools mixed with blood and mucus, often described as currant jelly stools.
,3. Which clinical manifestation is most characteristic of pyloric stenosis in a 4-
week-old infant?
A. Chronic diarrhea
B. Abdominal distension and bile-stained emesis
C. Projectile vomiting after feedings
D. Severe dehydration and weight gain
Answer: C
Rationale: Hypertrophic pyloric stenosis typically presents with non-bilious projectile
vomiting immediately after feeding due to the narrowing of the pyloric sphincter.
4. What is the most appropriate first solid food to introduce to a 6-month-old
infant?
A. Iron-fortified rice cereal
B. Strained yellow vegetables
C. Pureed meats
D. Mashed bananas
Answer: A
Rationale: Iron-fortified rice cereal is recommended first because it is easily digested and
has a low allergenic potential, and infant iron stores begin to deplete around 6 months.
5. A child is suspected of having epiglottitis. Which nursing action is
contraindicated?
A. Using a tongue blade to examine the throat
B. Providing humidified oxygen
C. Allowing the child to remain in a sitting position
D. Monitoring continuous pulse oximetry
Answer: A
Rationale: Using a tongue blade or performing a throat culture can cause a laryngospasm,
leading to sudden and complete airway obstruction in a child with epiglottitis.
, 6. In a child with Cystic Fibrosis, which intervention is highest priority for
maintaining respiratory function?
A. Performing chest physiotherapy regularly
B. Encouraging a high-calorie diet
C. Administering fat-soluble vitamin supplements
D. Administering pancreatic enzymes with meals
Answer: A
Rationale: Chest physiotherapy (CPT) is essential for clearing thick, tenacious mucus from
the airways to prevent infection and maintain gas exchange in CF patients.
7. Which lab finding is most consistent with a diagnosis of Nephrotic Syndrome?
A. Gross hematuria
B. Elevated serum albumin
C. Decreased serum cholesterol
D. Massive proteinuria
Answer: D
Rationale: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, and hyperlipidemia due to increased glomerular permeability.
8. A nurse is reviewing the history of a child with Acute Glomerulonephritis
(AGN). Which event is often found in the patient’s recent history?
A. A urinary tract infection
B. A recent fall from a height
C. Exposure to contaminated water
D. A streptococcal throat infection
Answer: D
Rationale: Acute Glomerulonephritis is an immune-complex disease that typically occurs
1-2 weeks after a Group A beta-hemolytic streptococcal infection.
