NSG PN 223 - Peds Exam 2 Complete
2026 (100% correct).
Question 1
An infant with pyloric stenosis experiences excessive vomiting that can result in:
• Metabolic alkalosis
Rationale: Pyloric stenosis causes persistent vomiting of gastric contents, which
are rich in hydrochloric acid. Loss of stomach acid leads to metabolic alkalosis
(increased pH, increased bicarbonate) .
Question 2
Enemas are ordered to empty the bowel preoperatively for a child with
Hirschsprung disease. The enema solution should be:
• Normal saline
Rationale: Tap water enemas can cause water intoxication and electrolyte
imbalances in children. Normal saline (0.9% NaCl) is isotonic and safe for bowel
preparation in Hirschsprung disease patients .
,Question 3
The nurse is caring for an infant whose cleft lip was repaired. Important aspects of
this infant's postoperative care include:
• Cleansing the suture line, supine and side-lying positions, arm restraints
Rationale: Postoperative cleft lip repair care focuses on protecting the surgical
site: cleansing sutures prevents infection, supine/side-lying prevents trauma, and
arm restraints prevent the infant from touching or disrupting sutures .
Question 4
A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine
(Zantac) is ordered for an infant with GER. The purpose of this is to:
• Reduce gastric acid production
Rationale: H2-receptor antagonists block histamine receptors on gastric parietal
cells, decreasing gastric acid secretion. This reduces esophageal irritation from
reflux in infants with GERD .
Question 5
The Physician ordered an IV fluid bolus to be followed by IV rehydration
maintenance. The directions in the policy for rehydration maintenance are as
, follows: Give 100ml/kg/day for the first 10 kg, then give 50ml/kg/day for the next
10 kg and then give 20ml/kg/day for each of the remaining kg. The child weighs
36 kg. What will the nurse set the IV pump at (mL/hr)? (Enter a numeric value
only, tenth space)
• 75.8 mL/hr
Rationale:
• First 10 kg: 10 kg × 100 mL = 1000 mL/day
• Next 10 kg: 10 kg × 50 mL = 500 mL/day
• Remaining 16 kg: 16 kg × 20 mL = 320 mL/day
• Total = 1000 + 500 + 320 = 1820 mL/day
• Hourly rate: 1820 ÷ 24 = 75.833 → 75.8 mL/hr
Question 6
The nurse is caring for a child with Wilm's tumor. What is the most important
nursing intervention preoperatively?
• Avoid abdominal palpation
Rationale: Wilm's tumor (nephroblastoma) is highly vascular and prone to rupture.
Palpating the abdomen can cause tumor rupture and spread of malignant cells.
Preoperative care includes placing a "No abdominal palpation" sign .
Question 7
2026 (100% correct).
Question 1
An infant with pyloric stenosis experiences excessive vomiting that can result in:
• Metabolic alkalosis
Rationale: Pyloric stenosis causes persistent vomiting of gastric contents, which
are rich in hydrochloric acid. Loss of stomach acid leads to metabolic alkalosis
(increased pH, increased bicarbonate) .
Question 2
Enemas are ordered to empty the bowel preoperatively for a child with
Hirschsprung disease. The enema solution should be:
• Normal saline
Rationale: Tap water enemas can cause water intoxication and electrolyte
imbalances in children. Normal saline (0.9% NaCl) is isotonic and safe for bowel
preparation in Hirschsprung disease patients .
,Question 3
The nurse is caring for an infant whose cleft lip was repaired. Important aspects of
this infant's postoperative care include:
• Cleansing the suture line, supine and side-lying positions, arm restraints
Rationale: Postoperative cleft lip repair care focuses on protecting the surgical
site: cleansing sutures prevents infection, supine/side-lying prevents trauma, and
arm restraints prevent the infant from touching or disrupting sutures .
Question 4
A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine
(Zantac) is ordered for an infant with GER. The purpose of this is to:
• Reduce gastric acid production
Rationale: H2-receptor antagonists block histamine receptors on gastric parietal
cells, decreasing gastric acid secretion. This reduces esophageal irritation from
reflux in infants with GERD .
Question 5
The Physician ordered an IV fluid bolus to be followed by IV rehydration
maintenance. The directions in the policy for rehydration maintenance are as
, follows: Give 100ml/kg/day for the first 10 kg, then give 50ml/kg/day for the next
10 kg and then give 20ml/kg/day for each of the remaining kg. The child weighs
36 kg. What will the nurse set the IV pump at (mL/hr)? (Enter a numeric value
only, tenth space)
• 75.8 mL/hr
Rationale:
• First 10 kg: 10 kg × 100 mL = 1000 mL/day
• Next 10 kg: 10 kg × 50 mL = 500 mL/day
• Remaining 16 kg: 16 kg × 20 mL = 320 mL/day
• Total = 1000 + 500 + 320 = 1820 mL/day
• Hourly rate: 1820 ÷ 24 = 75.833 → 75.8 mL/hr
Question 6
The nurse is caring for a child with Wilm's tumor. What is the most important
nursing intervention preoperatively?
• Avoid abdominal palpation
Rationale: Wilm's tumor (nephroblastoma) is highly vascular and prone to rupture.
Palpating the abdomen can cause tumor rupture and spread of malignant cells.
Preoperative care includes placing a "No abdominal palpation" sign .
Question 7
