NSG3600 PEDS (EXAM 3, GI, GU, NEURO) EXAM COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS

NSG3600 PEDS (EXAM 3, GI, GU, NEURO) EXAM COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS Question 1 A 4-year-old is admitted with dehydration due to gastroenteritis. Which assessment finding indicates moderate dehydration? A. Normal pulse and blood pressure B. Sunken fontanelle and no tears C. Capillary refill of 2 seconds D. Urine output of 1–2 mL/kg/hour Correct Answer: B Rationale: Sunken fontanelle (though typically closed by 4 years, in younger children this is key; in a 4-year-old, look for sunken eyes, dry mucous membranes, and no tears) is a sign of moderate to severe dehydration. Normal pulse and BP occur in mild dehydration. Cap refill 2 seconds is moderate. Urine output 1 mL/kg/hr is severe. ________________________________________ Question 2 A child with intussusception is scheduled for an air enema. The nurse knows this procedure is: A. Diagnostic only B. Therapeutic and diagnostic C. Contraindicated in children under 1 year D. Used only for chronic intussusception Correct Answer: B Rationale: Air or barium enema is both diagnostic (confirms intussusception) and therapeutic (often reduces the telescoping bowel). It is first-line treatment in stable children, often under 1 year. ________________________________________ Question 3 Which clinical manifestation is most concerning in a child with acute glomerulonephritis? A. Periorbital edema in the morning B. Tea-colored urine C. Blood pressure of 160/100 mmHg D. Urine output of 1.5 mL/kg/hour Correct Answer: C Rationale: Severe hypertension (160/100) is a medical emergency in acute poststreptococcal glomerulonephritis, risking hypertensive encephalopathy. Tea-colored urine and periorbital edema are common. Urine output 1.5 mL/kg/hr is normal. ________________________________________ Question 4 A 2-year-old with suspected bacterial meningitis is thrashing in the bed. The priority nursing action is: A. Restrain the child to prevent injury B. Dim the lights and reduce stimulation C. Prepare for immediate lumbar puncture D. Administer oral acetaminophen for fever Correct Answer: B Rationale: Meningeal irritation causes photophobia and hyperirritability; reducing stimuli prevents seizure activity and injury. Restraints increase agitation. LP is done after stabilization. Oral meds are avoided if vomiting or decreased LOC. ________________________________________ Question 5 Which finding suggests a neuroblastoma rather than Wilms tumor in a preschooler? A. Firm, non-tender abdominal mass B. Hematuria and hypertension C. Palpable mass crossing the midline D. Age under 12 months Correct Answer: C Rationale: Neuroblastoma often arises from adrenal medulla and crosses midline; Wilms tumor is typically unilateral, smooth, and does not cross midline. Both can present with abdominal mass. Hypertension is more Wilms; hematuria is rare in neuroblastoma. ________________________________________ Question 6 A child receiving chemotherapy for leukemia has a platelet count of 20,000/mm³. Which nursing intervention is most appropriate? A. Encourage vigorous tooth brushing to prevent gum disease B. Use a soft-bristle toothbrush and avoid IM injections C. Administer IM vitamin K as ordered D. Place the child on protective isolation Correct Answer: B Rationale: Platelet count 50,000 indicates bleeding risk; soft toothbrush reduces gum bleeding. IM injections are avoided. Vitamin K is for clotting factors, not low platelets. Protective isolation is for neutropenia, not thrombocytopenia. ________________________________________ Question 7 The parent of a 3-month-old with gastroesophageal reflux (GER) asks about positioning. What is the best recommendation? A. Keep infant supine with head elevated 30 degrees B. Place infant prone with head turned to side C. Position on left side after feeds D. Upright positioning in a car seat for 1 hour after feeds Correct Answer: A Rationale: Supine with head elevated reduces aspiration risk and is safe for sleep. Prone increases SIDS risk. Car seats may increase reflux due to hip flexion; upright in arms is better. ________________________________________ Question 8 A 7-year-old presents with new-onset enuresis, polydipsia, polyuria, and weight loss. The nurse suspects: A. Urinary tract infection B. Type 1 diabetes mellitus C. Diabetes insipidus D. Psychogenic polydipsia Correct Answer: B Rationale: Classic triad of type 1 DM: polydipsia, polyuria, weight loss. Enuresis is a common presenting sign in children. Diabetes insipidus has polyuria but normal glucose and weight. ________________________________________ Question 9 A child with minimal change nephrotic syndrome has massive edema. Which intervention is most effective for initial edema reduction? A. Fluid restriction to 500 mL/day B. Low-sodium diet and albumin infusion C. High-protein diet and furosemide D. Daily albumin and fluid restriction Correct Answer: B Rationale: In nephrotic syndrome, albumin infusion pulls fluid into vascular space, then furosemide helps excrete it. Low sodium reduces edema. Fluid restriction alone is ineffective without diuretics.