NSG 3600 Pediatrics Exam 3 (GI, GU & Neuro)
2026 | Verified Questions & Answers with
Rationales | Nursing Study Guide
NSG 3600 PEDIATRICS EXAM 3 (GI, GU & NEURO)
2026 | Verified Questions & Answers with EXPERT RATIONALE | Nursing Study
Guide
DOCUMENT OVERVIEW
• This comprehensive study guide contains verified multiple-choice questions
designed to prepare you for NSG 3600 Pediatrics Exam 3, covering all critical
content on GI, GU, and Neurological systems in pediatric nursing.
• Use this material for active recall practice, concept reinforcement, and exam
preparation by reviewing each question, attempting answers before checking the
EXPERT RATIONALE, and noting weak areas for focused review.
1. A 6-year-old child with gastroesophageal reflux disease (GERD) is being
evaluated. Which clinical manifestation is MOST characteristic of GERD in
children?
A) Severe projectile vomiting immediately after birth
B) Chronic regurgitation of food after meals
C) Blood-tinged sputum
D) Constipation with abdominal distention
E) Fever and irritability
✓✓✓ CORRECT ANSWER: B) Chronic regurgitation of food after meals
EXPERT RATIONALE: Chronic regurgitation of food after meals is the hallmark
presentation of GERD in older children. While infants may have projectile vomiting
(suggestive of pyloric stenosis), school-age children typically present with repeated
regurgitation, particularly after eating. This symptom distinguishes GERD from
other GI conditions and is the most characteristic finding.
,2. A 3-year-old presents with acute onset of crampy abdominal pain, vomiting,
and bloody "currant jelly" stools. The child appears to have a mass in the right
upper quadrant. What is the MOST likely diagnosis?
A) Appendicitis
B) Gastroenteritis
C) Intussusception
D) Pyloric stenosis
E) Crohn's disease
✓✓✓ CORRECT ANSWER: C) Intussusception
EXPERT RATIONALE: Intussusception is the most common cause of intestinal
obstruction in children ages 6 months to 3 years. The classic presentation includes
intermittent crampy abdominal pain, vomiting, a palpable sausage-like mass
(usually right upper quadrant), and "currant jelly" stools (mixture of blood and
mucus). This combination of findings is pathognomonic for intussusception.
3. Which nursing intervention is the PRIORITY when a child with
intussusception is admitted to the unit?
A) Administer laxatives to promote bowel movements
B) Keep child NPO and establish IV access
C) Encourage oral fluids to maintain hydration
D) Apply heat to the abdomen for pain relief
E) Initiate aggressive bowel training program
✓✓✓ CORRECT ANSWER: B) Keep child NPO and establish IV access
EXPERT RATIONALE: Upon admission with suspected intussusception, the child
must be kept NPO to prevent aspiration and prepare for possible surgical
intervention. IV access is essential for fluid replacement (as the child is losing fluids
,from vomiting), medication administration, and preparation for emergency
procedures. This stabilizes the child while diagnostic imaging (ultrasound or
air/contrast enema) is obtained.
4. A 4-week-old infant presents with progressive projectile vomiting shortly
after feeding but appears hungry immediately afterward. The infant has
visible peristaltic waves and a palpable "olive-shaped" mass in the
epigastrium. What is the primary nursing consideration?
A) Risk for aspiration pneumonia
B) Electrolyte imbalance and dehydration
C) Nutritional deficiency
D) Abdominal distention
E) Constipation
✓✓✓ CORRECT ANSWER: B) Electrolyte imbalance and dehydration
EXPERT RATIONALE: Pyloric stenosis causes projectile vomiting of gastric contents,
leading to loss of hydrochloric acid, sodium, potassium, and chloride. This results in
hypochloremic, hypokalemic metabolic alkalosis and significant dehydration. The
infant appears hungry because the stomach empties incompletely, so nutrition is
not absorbed. The priority is correcting fluid and electrolyte abnormalities before
surgical intervention.
5. What is the gold standard diagnostic test for pyloric stenosis?
A) Abdominal X-ray
B) CT scan of abdomen
C) Ultrasound of the abdomen
D) Barium swallow study
E) Upper endoscopy
, ✓✓✓ CORRECT ANSWER: C) Ultrasound of the abdomen
EXPERT RATIONALE: Abdominal ultrasound is the gold standard diagnostic test for
pyloric stenosis. It is non-invasive, does not expose the child to radiation, and can
directly visualize the pyloric muscle thickness (>3-4 mm is diagnostic) and the
elongated pyloric channel. It has a sensitivity and specificity greater than 95%,
making it the preferred initial imaging modality.
6. A 5-year-old with acute gastroenteritis presents with diarrhea, vomiting,
and abdominal cramping. The child has lost 5% of body weight and has
decreased skin turgor. What degree of dehydration is this child experiencing?
A) Mild dehydration (3-5% loss)
B) Moderate dehydration (6-9% loss)
C) Severe dehydration (≥10% loss)
D) No significant dehydration
E) Hypervolemic state
✓✓✓ CORRECT ANSWER: A) Mild dehydration (3-5% loss)
EXPERT RATIONALE: The child has lost 5% of body weight, which falls within the
mild dehydration category (3-5% loss). Clinical signs of mild dehydration include
slightly decreased skin turgor, slightly dry mucous membranes, and normal or
slightly increased heart rate. Moderate dehydration (6-9%) presents with more
obvious skin tenting, dry mucous membranes, and tachycardia. Severe dehydration
(≥10%) presents with prolonged skin turgor, very dry mucous membranes, and
signs of shock.
7. Which type of oral rehydration solution (ORS) is recommended by the WHO
for treating dehydration in children with gastroenteritis?
A) High-carbohydrate sports drinks
B) Low-sodium, high-glucose solutions
2026 | Verified Questions & Answers with
Rationales | Nursing Study Guide
NSG 3600 PEDIATRICS EXAM 3 (GI, GU & NEURO)
2026 | Verified Questions & Answers with EXPERT RATIONALE | Nursing Study
Guide
DOCUMENT OVERVIEW
• This comprehensive study guide contains verified multiple-choice questions
designed to prepare you for NSG 3600 Pediatrics Exam 3, covering all critical
content on GI, GU, and Neurological systems in pediatric nursing.
• Use this material for active recall practice, concept reinforcement, and exam
preparation by reviewing each question, attempting answers before checking the
EXPERT RATIONALE, and noting weak areas for focused review.
1. A 6-year-old child with gastroesophageal reflux disease (GERD) is being
evaluated. Which clinical manifestation is MOST characteristic of GERD in
children?
A) Severe projectile vomiting immediately after birth
B) Chronic regurgitation of food after meals
C) Blood-tinged sputum
D) Constipation with abdominal distention
E) Fever and irritability
✓✓✓ CORRECT ANSWER: B) Chronic regurgitation of food after meals
EXPERT RATIONALE: Chronic regurgitation of food after meals is the hallmark
presentation of GERD in older children. While infants may have projectile vomiting
(suggestive of pyloric stenosis), school-age children typically present with repeated
regurgitation, particularly after eating. This symptom distinguishes GERD from
other GI conditions and is the most characteristic finding.
,2. A 3-year-old presents with acute onset of crampy abdominal pain, vomiting,
and bloody "currant jelly" stools. The child appears to have a mass in the right
upper quadrant. What is the MOST likely diagnosis?
A) Appendicitis
B) Gastroenteritis
C) Intussusception
D) Pyloric stenosis
E) Crohn's disease
✓✓✓ CORRECT ANSWER: C) Intussusception
EXPERT RATIONALE: Intussusception is the most common cause of intestinal
obstruction in children ages 6 months to 3 years. The classic presentation includes
intermittent crampy abdominal pain, vomiting, a palpable sausage-like mass
(usually right upper quadrant), and "currant jelly" stools (mixture of blood and
mucus). This combination of findings is pathognomonic for intussusception.
3. Which nursing intervention is the PRIORITY when a child with
intussusception is admitted to the unit?
A) Administer laxatives to promote bowel movements
B) Keep child NPO and establish IV access
C) Encourage oral fluids to maintain hydration
D) Apply heat to the abdomen for pain relief
E) Initiate aggressive bowel training program
✓✓✓ CORRECT ANSWER: B) Keep child NPO and establish IV access
EXPERT RATIONALE: Upon admission with suspected intussusception, the child
must be kept NPO to prevent aspiration and prepare for possible surgical
intervention. IV access is essential for fluid replacement (as the child is losing fluids
,from vomiting), medication administration, and preparation for emergency
procedures. This stabilizes the child while diagnostic imaging (ultrasound or
air/contrast enema) is obtained.
4. A 4-week-old infant presents with progressive projectile vomiting shortly
after feeding but appears hungry immediately afterward. The infant has
visible peristaltic waves and a palpable "olive-shaped" mass in the
epigastrium. What is the primary nursing consideration?
A) Risk for aspiration pneumonia
B) Electrolyte imbalance and dehydration
C) Nutritional deficiency
D) Abdominal distention
E) Constipation
✓✓✓ CORRECT ANSWER: B) Electrolyte imbalance and dehydration
EXPERT RATIONALE: Pyloric stenosis causes projectile vomiting of gastric contents,
leading to loss of hydrochloric acid, sodium, potassium, and chloride. This results in
hypochloremic, hypokalemic metabolic alkalosis and significant dehydration. The
infant appears hungry because the stomach empties incompletely, so nutrition is
not absorbed. The priority is correcting fluid and electrolyte abnormalities before
surgical intervention.
5. What is the gold standard diagnostic test for pyloric stenosis?
A) Abdominal X-ray
B) CT scan of abdomen
C) Ultrasound of the abdomen
D) Barium swallow study
E) Upper endoscopy
, ✓✓✓ CORRECT ANSWER: C) Ultrasound of the abdomen
EXPERT RATIONALE: Abdominal ultrasound is the gold standard diagnostic test for
pyloric stenosis. It is non-invasive, does not expose the child to radiation, and can
directly visualize the pyloric muscle thickness (>3-4 mm is diagnostic) and the
elongated pyloric channel. It has a sensitivity and specificity greater than 95%,
making it the preferred initial imaging modality.
6. A 5-year-old with acute gastroenteritis presents with diarrhea, vomiting,
and abdominal cramping. The child has lost 5% of body weight and has
decreased skin turgor. What degree of dehydration is this child experiencing?
A) Mild dehydration (3-5% loss)
B) Moderate dehydration (6-9% loss)
C) Severe dehydration (≥10% loss)
D) No significant dehydration
E) Hypervolemic state
✓✓✓ CORRECT ANSWER: A) Mild dehydration (3-5% loss)
EXPERT RATIONALE: The child has lost 5% of body weight, which falls within the
mild dehydration category (3-5% loss). Clinical signs of mild dehydration include
slightly decreased skin turgor, slightly dry mucous membranes, and normal or
slightly increased heart rate. Moderate dehydration (6-9%) presents with more
obvious skin tenting, dry mucous membranes, and tachycardia. Severe dehydration
(≥10%) presents with prolonged skin turgor, very dry mucous membranes, and
signs of shock.
7. Which type of oral rehydration solution (ORS) is recommended by the WHO
for treating dehydration in children with gastroenteritis?
A) High-carbohydrate sports drinks
B) Low-sodium, high-glucose solutions
