NUR 203/NUR203 Exam 3 V2 | Pediatric
Nursing Q&A with Rationale | Fortis
College
1. A nurse is caring for a 4-year-old child with cystic fibrosis. Which of the following
instructions should the nurse provide the parents regarding the administration of pancreatic
enzymes?
A. Administer enzymes with every meal and snack.
B. Give enzymes 30 minutes after the child has finished eating.
C. Administer enzymes twice daily with breakfast and dinner.
D. Mix the enzymes in a bottle of warm formula or milk.
Correct Answer: A
Expert Explanation: Pancreatic enzymes are essential for children with cystic fibrosis to
ensure proper digestion of fats and proteins. These enzymes must be taken with every
meal and snack to compensate for the lack of natural enzyme production by the pancreas.
Proper timing is critical because the enzymes need to be in the duodenum when food
arrives to prevent malabsorption and fatty stools.
2. A child is admitted with a suspected diagnosis of intussusception. Which of the following
clinical findings should the nurse expect to observe?
A. Projectile vomiting and an olive-shaped mass.
,B. Ribbon-like stools and abdominal distention.
C. Currant jelly-like stools and colicky abdominal pain.
D. Pain in the right lower quadrant and fever.
Correct Answer: C
Expert Explanation: Intussusception occurs when one portion of the bowel telescopes
into another, leading to obstruction and vascular compromise. This often results in the
passage of ‘currant jelly’ stools, which are composed of blood and mucus from the intestinal
wall. The condition is typically characterized by sudden, paroxysmal abdominal pain and a
sausage-shaped mass in the abdomen.
3. The nurse is monitoring an infant with Tetralogy of Fallot who suddenly becomes cyanotic
and dyspneic. Which action should the nurse take first?
A. Place the infant in a knee-chest position.
B. Administer 100% oxygen via a face mask.
C. Prepare to administer a dose of morphine sulfate.
D. Increase the infant’s intravenous fluid rate.
Correct Answer: A
Expert Explanation: A ‘tet spell’ or hypercyanotic spell occurs due to an acute increase in
right-to-left shunting in children with Tetralogy of Fallot. Placing the infant in the knee-
chest position increases systemic vascular resistance, which helps force more blood into
,the pulmonary artery. This simple mechanical maneuver is the priority intervention to
improve oxygenation before proceeding to pharmacological treatments.
4. A 6-year-old child is diagnosed with Nephrotic Syndrome. Which of the following
assessment findings is the nurse most likely to encounter?
A. Massive proteinuria and generalized edema.
B. Gross hematuria and hypertension.
C. Severe dehydration and weight loss.
D. Decreased serum cholesterol levels.
Correct Answer: A
Expert Explanation: Nephrotic syndrome is characterized by increased glomerular
permeability to protein, specifically albumin. This loss of protein leads to hypoproteinemia,
which decreases oncotic pressure and causes fluid to shift into the interstitial spaces,
resulting in edema. Typical labs will show massive proteinuria, hypoalbuminemia, and
hyperlipidemia, rather than gross hematuria.
5. Which of the following is a characteristic sign of pyloric stenosis in an infant?
A. Bile-stained emesis after feeding.
B. Non-projectile vomiting and diarrhea.
C. Projectile vomiting of non-bilious emesis.
D. Persistent cough and wheezing during feeds.
, Correct Answer: C
Expert Explanation: Pyloric stenosis involves the hypertrophy of the pyloric sphincter,
which obstructs gastric outlet flow. The infant typically presents with projectile vomiting
immediately after feeding, which does not contain bile because the obstruction is proximal
to the bile duct. Physical examination often reveals a palpable olive-shaped mass in the
right upper quadrant of the abdomen.
6. The nurse is teaching the parents of a child with sickle cell anemia about preventing a vaso-
occlusive crisis. Which of the following instructions is most important?
A. Maintain adequate hydration throughout the day.
B. Encourage high-altitude travel for better oxygenation.
C. Limit the child’s fluid intake to prevent fluid overload.
D. Perform vigorous aerobic exercise daily.
Correct Answer: A
Expert Explanation: Adequate hydration is the most critical factor in preventing sickle cell
crises because it reduces the viscosity of the blood. Thicker blood increases the likelihood
of red blood cells sickling and clumping together, leading to vascular occlusion. Parents
should be taught to provide frequent fluids, especially during hot weather or when the
child is ill.
Nursing Q&A with Rationale | Fortis
College
1. A nurse is caring for a 4-year-old child with cystic fibrosis. Which of the following
instructions should the nurse provide the parents regarding the administration of pancreatic
enzymes?
A. Administer enzymes with every meal and snack.
B. Give enzymes 30 minutes after the child has finished eating.
C. Administer enzymes twice daily with breakfast and dinner.
D. Mix the enzymes in a bottle of warm formula or milk.
Correct Answer: A
Expert Explanation: Pancreatic enzymes are essential for children with cystic fibrosis to
ensure proper digestion of fats and proteins. These enzymes must be taken with every
meal and snack to compensate for the lack of natural enzyme production by the pancreas.
Proper timing is critical because the enzymes need to be in the duodenum when food
arrives to prevent malabsorption and fatty stools.
2. A child is admitted with a suspected diagnosis of intussusception. Which of the following
clinical findings should the nurse expect to observe?
A. Projectile vomiting and an olive-shaped mass.
,B. Ribbon-like stools and abdominal distention.
C. Currant jelly-like stools and colicky abdominal pain.
D. Pain in the right lower quadrant and fever.
Correct Answer: C
Expert Explanation: Intussusception occurs when one portion of the bowel telescopes
into another, leading to obstruction and vascular compromise. This often results in the
passage of ‘currant jelly’ stools, which are composed of blood and mucus from the intestinal
wall. The condition is typically characterized by sudden, paroxysmal abdominal pain and a
sausage-shaped mass in the abdomen.
3. The nurse is monitoring an infant with Tetralogy of Fallot who suddenly becomes cyanotic
and dyspneic. Which action should the nurse take first?
A. Place the infant in a knee-chest position.
B. Administer 100% oxygen via a face mask.
C. Prepare to administer a dose of morphine sulfate.
D. Increase the infant’s intravenous fluid rate.
Correct Answer: A
Expert Explanation: A ‘tet spell’ or hypercyanotic spell occurs due to an acute increase in
right-to-left shunting in children with Tetralogy of Fallot. Placing the infant in the knee-
chest position increases systemic vascular resistance, which helps force more blood into
,the pulmonary artery. This simple mechanical maneuver is the priority intervention to
improve oxygenation before proceeding to pharmacological treatments.
4. A 6-year-old child is diagnosed with Nephrotic Syndrome. Which of the following
assessment findings is the nurse most likely to encounter?
A. Massive proteinuria and generalized edema.
B. Gross hematuria and hypertension.
C. Severe dehydration and weight loss.
D. Decreased serum cholesterol levels.
Correct Answer: A
Expert Explanation: Nephrotic syndrome is characterized by increased glomerular
permeability to protein, specifically albumin. This loss of protein leads to hypoproteinemia,
which decreases oncotic pressure and causes fluid to shift into the interstitial spaces,
resulting in edema. Typical labs will show massive proteinuria, hypoalbuminemia, and
hyperlipidemia, rather than gross hematuria.
5. Which of the following is a characteristic sign of pyloric stenosis in an infant?
A. Bile-stained emesis after feeding.
B. Non-projectile vomiting and diarrhea.
C. Projectile vomiting of non-bilious emesis.
D. Persistent cough and wheezing during feeds.
, Correct Answer: C
Expert Explanation: Pyloric stenosis involves the hypertrophy of the pyloric sphincter,
which obstructs gastric outlet flow. The infant typically presents with projectile vomiting
immediately after feeding, which does not contain bile because the obstruction is proximal
to the bile duct. Physical examination often reveals a palpable olive-shaped mass in the
right upper quadrant of the abdomen.
6. The nurse is teaching the parents of a child with sickle cell anemia about preventing a vaso-
occlusive crisis. Which of the following instructions is most important?
A. Maintain adequate hydration throughout the day.
B. Encourage high-altitude travel for better oxygenation.
C. Limit the child’s fluid intake to prevent fluid overload.
D. Perform vigorous aerobic exercise daily.
Correct Answer: A
Expert Explanation: Adequate hydration is the most critical factor in preventing sickle cell
crises because it reduces the viscosity of the blood. Thicker blood increases the likelihood
of red blood cells sickling and clumping together, leading to vascular occlusion. Parents
should be taught to provide frequent fluids, especially during hot weather or when the
child is ill.
