ESSENTIALS OF PEDIATRIC NURSING
ACTUAL EXAM SCRIPT 2026 QUESTIONS
AND SOLUTIONS GRADED A+
◉An 18-month-old infant is brought to the emergency department
with flu-like symptoms. The infant is diagnosed with pneumonia
secondary to aspiration of stomach contents. The nurse explains to
the parents that pneumonia is a condition that often occurs
secondary to: Answer: gastroesophageal reflux disease.
Explanation:
Gastroesophageal reflux (GER) is the passage of gastric contents into
the esophagus. These refluxed contents may be aspirated into the
lungs. The child with gastroesophageal reflux disease may present
with the physical findings of pneumonia or GER-induced asthma.
GER may cause apnea or an apparent life-threatening event in the
younger infant. Pneumonia can occur in children with cystic fibrosis,
but the child would need to have the cystic fibrosis diagnosis first.
Hirschprung and inflammatory bowel diseases are diseases of the
gastrointestinal tract that do not have respiratory symptoms as part
of the diseases.
◉A nurse taking a health history of a newborn notes that there is a
maternal history of polyhydramnios. What GI condition might this
history precipitate? Answer: Esophageal atresia (EA)
,Explanation:
A maternal history of polyhydramnios is usually present in one-third
of cases of EA and in some cases of tracheoesophageal fistula (TEF).
◉A physician recommends a gastrostomy for a 4-year-old client
with an obstruction. The parents ask the certified wound, ostomy,
and continence nurse (CWOCN) what the surgery entails. What is
the nurse's best response? Answer: "The surgery creates an opening
between the stomach and abdominal wall."
Explanation:
Ostomies can be created at various sites in the GI tract, depending
on the child's clinical condition. A gastrostomy provides an opening
between the stomach and the abdominal wall, and an
esophagostomy communicates between the esophagus and an
external site on the neck. Ostomies may be created at various sites in
the small intestine (e.g., jejunostomy, ileostomy) or in the large
intestine (e.g., colostomy).
◉A neonatal nurse teaches students how to recognize
gastrointestinal disorders in infants. The nurse tells the students
that failure of the newborn to pass meconium in the first 24 hours
after birth may indicate what disease? Answer: Hirschsprung
disease
, Explanation:
The nurse should suspect Hirschsprung disease when the newborn
does not pass meconium in the first 24 hours after birth, and has
bilious vomiting or abdominal distention and feeding intolerance
with bilious aspirates and vomiting. Typical signs and symptoms of
gastroenteritis include diarrhea, nausea, vomiting, and abdominal
pain. The characteristic GI manifestation of UC is bloody diarrhea
accompanied by crampy, typically left-sided lower abdominal pain.
Clinical manifestations of untreated SBS include profuse watery
diarrhea, malabsorption, and failure to thrive.
◉The nurse is discussing the treatment of congenital aganglionic
megacolon with the caregivers of a child diagnosed with this
disorder. Which statement is the best explanation of the treatment
for this diagnosis? Answer: "The treatment for the disorder will be a
surgical procedure."
Explanation:
Treatment of congenital aganglionic megacolon involves surgery
with the ultimate resection of the aganglionic portion of the bowel.
Chronic anemia may be present, but iron will not correct the
disorder. Enemas may be given to initially achieve bowel elimination,
but they will not treat the disorder. Differentiation must be made
between this condition and psychogenic megacolon because of
coercive toileting or other emotional problems. The child with
aganglionic megacolon does not withhold stools or defecate in
inappropriate places, and no soiling occurs.
ACTUAL EXAM SCRIPT 2026 QUESTIONS
AND SOLUTIONS GRADED A+
◉An 18-month-old infant is brought to the emergency department
with flu-like symptoms. The infant is diagnosed with pneumonia
secondary to aspiration of stomach contents. The nurse explains to
the parents that pneumonia is a condition that often occurs
secondary to: Answer: gastroesophageal reflux disease.
Explanation:
Gastroesophageal reflux (GER) is the passage of gastric contents into
the esophagus. These refluxed contents may be aspirated into the
lungs. The child with gastroesophageal reflux disease may present
with the physical findings of pneumonia or GER-induced asthma.
GER may cause apnea or an apparent life-threatening event in the
younger infant. Pneumonia can occur in children with cystic fibrosis,
but the child would need to have the cystic fibrosis diagnosis first.
Hirschprung and inflammatory bowel diseases are diseases of the
gastrointestinal tract that do not have respiratory symptoms as part
of the diseases.
◉A nurse taking a health history of a newborn notes that there is a
maternal history of polyhydramnios. What GI condition might this
history precipitate? Answer: Esophageal atresia (EA)
,Explanation:
A maternal history of polyhydramnios is usually present in one-third
of cases of EA and in some cases of tracheoesophageal fistula (TEF).
◉A physician recommends a gastrostomy for a 4-year-old client
with an obstruction. The parents ask the certified wound, ostomy,
and continence nurse (CWOCN) what the surgery entails. What is
the nurse's best response? Answer: "The surgery creates an opening
between the stomach and abdominal wall."
Explanation:
Ostomies can be created at various sites in the GI tract, depending
on the child's clinical condition. A gastrostomy provides an opening
between the stomach and the abdominal wall, and an
esophagostomy communicates between the esophagus and an
external site on the neck. Ostomies may be created at various sites in
the small intestine (e.g., jejunostomy, ileostomy) or in the large
intestine (e.g., colostomy).
◉A neonatal nurse teaches students how to recognize
gastrointestinal disorders in infants. The nurse tells the students
that failure of the newborn to pass meconium in the first 24 hours
after birth may indicate what disease? Answer: Hirschsprung
disease
, Explanation:
The nurse should suspect Hirschsprung disease when the newborn
does not pass meconium in the first 24 hours after birth, and has
bilious vomiting or abdominal distention and feeding intolerance
with bilious aspirates and vomiting. Typical signs and symptoms of
gastroenteritis include diarrhea, nausea, vomiting, and abdominal
pain. The characteristic GI manifestation of UC is bloody diarrhea
accompanied by crampy, typically left-sided lower abdominal pain.
Clinical manifestations of untreated SBS include profuse watery
diarrhea, malabsorption, and failure to thrive.
◉The nurse is discussing the treatment of congenital aganglionic
megacolon with the caregivers of a child diagnosed with this
disorder. Which statement is the best explanation of the treatment
for this diagnosis? Answer: "The treatment for the disorder will be a
surgical procedure."
Explanation:
Treatment of congenital aganglionic megacolon involves surgery
with the ultimate resection of the aganglionic portion of the bowel.
Chronic anemia may be present, but iron will not correct the
disorder. Enemas may be given to initially achieve bowel elimination,
but they will not treat the disorder. Differentiation must be made
between this condition and psychogenic megacolon because of
coercive toileting or other emotional problems. The child with
aganglionic megacolon does not withhold stools or defecate in
inappropriate places, and no soiling occurs.
