PNR 204/PNR204 Exam 3 V3 | Pediatric
Nursing Q&A with Rationale | Fortis
College
1. A nurse is assessing a 4-week-old infant who has projectile vomiting after feedings and an
olive-shaped mass in the right upper quadrant. Which condition should the nurse suspect?
A. Intussusception
B. Hirschsprung disease
C. Gastroesophageal reflux
D. Hypertrophic pyloric stenosis
Correct Answer: D
Expert Explanation: Hypertrophic pyloric stenosis is characterized by the thickening of
the pyloric sphincter, which obstructs gastric outlet. The classic clinical signs include non-
bilious projectile vomiting and a palpable olive-shaped mass in the epigastrium. Surgical
intervention via pyloromyotomy is the definitive treatment for this condition.
2. Which intervention is the priority for a child admitted with Epiglottitis?
A. Obtaining a throat culture
B. Assessing the throat with a tongue blade
C. Ensuring emergency airway equipment is at the bedside
D. Administering oral antibiotics immediately
,Correct Answer: C
Expert Explanation: Epiglottitis is a medical emergency that can lead to rapid airway
obstruction. The nurse must never visualize the throat with a tongue blade as it can trigger
a laryngospasm. Having intubation and tracheostomy equipment ready is the most critical
safety action.
3. A child with Tetralogy of Fallot becomes acutely cyanotic and dyspneic. Which action
should the nurse perform first?
A. Administer morphine sulfate
B. Place the child in a knee-chest position
C. Apply high-flow oxygen via mask
D. Start an intravenous line for fluids
Correct Answer: B
Expert Explanation: The knee-chest position increases systemic vascular resistance,
which helps reduce the right-to-left shunt in Tetralogy of Fallot. This maneuver improves
pulmonary blood flow and increases oxygen saturation during a ‘tet spell’. It is the
immediate non-pharmacological nursing intervention recommended.
4. A nurse is providing teaching to the parents of a child with Cystic Fibrosis. When should
pancreatic enzymes be administered?
A. With all meals and snacks
B. Immediately following every bowel movement
, C. Once daily in the morning
D. Only when the child consumes high-fat meals
Correct Answer: A
Expert Explanation: Children with Cystic Fibrosis suffer from pancreatic insufficiency,
meaning they cannot digest fats and proteins properly. Pancreatic enzymes must be taken
with every meal and snack to facilitate nutrient absorption. Failure to do so leads to
steatorrhea and failure to thrive.
5. Which laboratory finding is expected in a child with Nephrotic Syndrome?
A. Low serum cholesterol
B. Gross hematuria
C. High serum albumin
D. Severe proteinuria
Correct Answer: D
Expert Explanation: Nephrotic syndrome is characterized by massive proteinuria due to
increased glomerular permeability. This loss of protein leads to hypoalbuminemia and
subsequent generalized edema. Hyperlipidemia is also a common compensatory finding in
these patients.
Nursing Q&A with Rationale | Fortis
College
1. A nurse is assessing a 4-week-old infant who has projectile vomiting after feedings and an
olive-shaped mass in the right upper quadrant. Which condition should the nurse suspect?
A. Intussusception
B. Hirschsprung disease
C. Gastroesophageal reflux
D. Hypertrophic pyloric stenosis
Correct Answer: D
Expert Explanation: Hypertrophic pyloric stenosis is characterized by the thickening of
the pyloric sphincter, which obstructs gastric outlet. The classic clinical signs include non-
bilious projectile vomiting and a palpable olive-shaped mass in the epigastrium. Surgical
intervention via pyloromyotomy is the definitive treatment for this condition.
2. Which intervention is the priority for a child admitted with Epiglottitis?
A. Obtaining a throat culture
B. Assessing the throat with a tongue blade
C. Ensuring emergency airway equipment is at the bedside
D. Administering oral antibiotics immediately
,Correct Answer: C
Expert Explanation: Epiglottitis is a medical emergency that can lead to rapid airway
obstruction. The nurse must never visualize the throat with a tongue blade as it can trigger
a laryngospasm. Having intubation and tracheostomy equipment ready is the most critical
safety action.
3. A child with Tetralogy of Fallot becomes acutely cyanotic and dyspneic. Which action
should the nurse perform first?
A. Administer morphine sulfate
B. Place the child in a knee-chest position
C. Apply high-flow oxygen via mask
D. Start an intravenous line for fluids
Correct Answer: B
Expert Explanation: The knee-chest position increases systemic vascular resistance,
which helps reduce the right-to-left shunt in Tetralogy of Fallot. This maneuver improves
pulmonary blood flow and increases oxygen saturation during a ‘tet spell’. It is the
immediate non-pharmacological nursing intervention recommended.
4. A nurse is providing teaching to the parents of a child with Cystic Fibrosis. When should
pancreatic enzymes be administered?
A. With all meals and snacks
B. Immediately following every bowel movement
, C. Once daily in the morning
D. Only when the child consumes high-fat meals
Correct Answer: A
Expert Explanation: Children with Cystic Fibrosis suffer from pancreatic insufficiency,
meaning they cannot digest fats and proteins properly. Pancreatic enzymes must be taken
with every meal and snack to facilitate nutrient absorption. Failure to do so leads to
steatorrhea and failure to thrive.
5. Which laboratory finding is expected in a child with Nephrotic Syndrome?
A. Low serum cholesterol
B. Gross hematuria
C. High serum albumin
D. Severe proteinuria
Correct Answer: D
Expert Explanation: Nephrotic syndrome is characterized by massive proteinuria due to
increased glomerular permeability. This loss of protein leads to hypoalbuminemia and
subsequent generalized edema. Hyperlipidemia is also a common compensatory finding in
these patients.
