NSG 3600 Exam 3: Comprehensive
Pediatric Nursing Assessment 2026
Question 1: A 6-year-old child is admitted to the pediatric unit with a diagnosis of acute
glomerulonephritis. Which assessment finding would the nurse expect to observe?
A) Hypotension and bradycardia
B) Gross hematuria and periorbital edema
C) Polyuria and polydipsia
D) Hypertension and hyperglycemia
Correct ANSWER: B) Gross hematuria and periorbital edema
Rationale: Acute glomerulonephritis is characterized by inflammation of the glomeruli, leading to
increased glomerular permeability. This results in hematuria (gross or microscopic), proteinuria, and
fluid retention causing periorbital edema. Hypertension occurs due to fluid overload, not hypotension.
Polyuria and polydipsia are associated with diabetes insipidus or diabetes mellitus. Hyperglycemia is not
a feature of glomerulonephritis. The classic presentation includes sudden onset of dark, cola-colored
urine, facial edema (especially in the morning), and elevated blood pressure.
A) Hypotension and bradycardia are incorrect as hypertension is the typical blood pressure finding due
to fluid retention and activation of the renin-angiotensin system.
,C) Polyuria and polydipsia are incorrect as these findings suggest diabetes mellitus or diabetes insipidus,
not renal inflammation.
D) Hypertension is correct, but hyperglycemia is not associated with glomerulonephritis. The primary
metabolic disturbance involves fluid and electrolyte balance, not glucose metabolism.
Question 2: The nurse is caring for a child with nephrotic syndrome. Which laboratory finding is most
consistent with this diagnosis?
A) Decreased serum albumin and proteinuria
B) Elevated serum albumin and decreased urine protein
C) Normal serum albumin and microscopic hematuria
D) Elevated BUN and creatinine with low urine output
Correct ANSWER: A) Decreased serum albumin and proteinuria
Rationale: Nephrotic syndrome is characterized by massive proteinuria (>40 mg/m²/hour or >1 g/m²/24
hours), hypoalbuminemia (<2.5 g/dL), generalized edema, and hyperlipidemia. The primary pathology
involves increased glomerular permeability to proteins, leading to significant protein loss in the urine.
This causes a decrease in serum albumin, which reduces plasma oncotic pressure and leads to fluid
shifting into interstitial spaces, causing edema.
B) Elevated serum albumin and decreased urine protein are incorrect as nephrotic syndrome causes
hypoalbuminemia and massive proteinuria.
C) Normal serum albumin and microscopic hematuria are incorrect because albumin is significantly
decreased in nephrotic syndrome, and while hematuria can occur, it is not the hallmark finding.
,D) Elevated BUN and creatinine with low urine output are more characteristic of acute kidney injury or
renal failure, not the classic presentation of nephrotic syndrome.
Question 3: The nurse is assessing a child with a suspected diagnosis of hypertrophic pyloric stenosis.
Which clinical manifestation would the nurse expect to find?
A) Projectile vomiting and olive-shaped mass in the right upper quadrant
B) Bile-stained vomiting and abdominal distention
C) Watery diarrhea and failure to thrive
D) Constipation and ribbon-like stools
Correct ANSWER: A) Projectile vomiting and olive-shaped mass in the right upper quadrant
Rationale: Hypertrophic pyloric stenosis is a condition characterized by thickening of the pyloric muscle,
obstructing the gastric outlet. Classic clinical manifestations include non-bilious projectile vomiting that
occurs shortly after feeding, which can lead to dehydration, weight loss, and failure to thrive. On
physical examination, an olive-shaped mass is often palpable in the right upper quadrant. The condition
typically presents in infants between 2-8 weeks of age.
B) Bile-stained vomiting and abdominal distention are incorrect as these findings suggest intestinal
obstruction distal to the ampulla of Vater, such as duodenal atresia or malrotation, not pyloric stenosis
where vomiting is non-bilious.
C) Watery diarrhea and failure to thrive are incorrect as these findings suggest malabsorption
syndromes or infectious gastroenteritis, not pyloric stenosis.
D) Constipation and ribbon-like stools are incorrect as these findings suggest Hirschsprung's disease or
other lower intestinal obstructions.
, Question 4: A child is diagnosed with intussusception. The nurse understands that which characteristic
finding is associated with this condition?
A) Continuous abdominal pain with board-like rigidity
B) Intermittent abdominal pain with currant jelly stools
C) Constant severe pain with rebound tenderness
D) Dull, achy pain with visible peristaltic waves
Correct ANSWER: B) Intermittent abdominal pain with currant jelly stools
Rationale: Intussusception occurs when one segment of the intestine telescopes into another, causing
obstruction and ischemia. The classic presentation includes sudden onset of intermittent, severe
abdominal pain in a previously healthy infant who draws their knees to the chest during painful
episodes. Between episodes, the child may appear comfortable. Currant jelly stools (stools containing
blood and mucus) are a hallmark sign that occurs later in the progression. Vomiting may also occur.
A) Continuous abdominal pain with board-like rigidity suggests peritonitis or perforation, which is a
complication of advanced intussusception but not the initial presentation.
C) Constant severe pain with rebound tenderness suggests appendicitis or peritoneal irritation, not the
intermittent pattern typical of intussusception.
D) Dull, achy pain with visible peristaltic waves suggests pyloric stenosis or other obstructive processes
where peristalsis is visible through the abdominal wall.
Question 5: The nurse is preparing a child for surgery after a diagnosis of intussusception. Which
assessment finding would require the nurse to notify the surgeon immediately?
A) The child passes a normal brown stool
Pediatric Nursing Assessment 2026
Question 1: A 6-year-old child is admitted to the pediatric unit with a diagnosis of acute
glomerulonephritis. Which assessment finding would the nurse expect to observe?
A) Hypotension and bradycardia
B) Gross hematuria and periorbital edema
C) Polyuria and polydipsia
D) Hypertension and hyperglycemia
Correct ANSWER: B) Gross hematuria and periorbital edema
Rationale: Acute glomerulonephritis is characterized by inflammation of the glomeruli, leading to
increased glomerular permeability. This results in hematuria (gross or microscopic), proteinuria, and
fluid retention causing periorbital edema. Hypertension occurs due to fluid overload, not hypotension.
Polyuria and polydipsia are associated with diabetes insipidus or diabetes mellitus. Hyperglycemia is not
a feature of glomerulonephritis. The classic presentation includes sudden onset of dark, cola-colored
urine, facial edema (especially in the morning), and elevated blood pressure.
A) Hypotension and bradycardia are incorrect as hypertension is the typical blood pressure finding due
to fluid retention and activation of the renin-angiotensin system.
,C) Polyuria and polydipsia are incorrect as these findings suggest diabetes mellitus or diabetes insipidus,
not renal inflammation.
D) Hypertension is correct, but hyperglycemia is not associated with glomerulonephritis. The primary
metabolic disturbance involves fluid and electrolyte balance, not glucose metabolism.
Question 2: The nurse is caring for a child with nephrotic syndrome. Which laboratory finding is most
consistent with this diagnosis?
A) Decreased serum albumin and proteinuria
B) Elevated serum albumin and decreased urine protein
C) Normal serum albumin and microscopic hematuria
D) Elevated BUN and creatinine with low urine output
Correct ANSWER: A) Decreased serum albumin and proteinuria
Rationale: Nephrotic syndrome is characterized by massive proteinuria (>40 mg/m²/hour or >1 g/m²/24
hours), hypoalbuminemia (<2.5 g/dL), generalized edema, and hyperlipidemia. The primary pathology
involves increased glomerular permeability to proteins, leading to significant protein loss in the urine.
This causes a decrease in serum albumin, which reduces plasma oncotic pressure and leads to fluid
shifting into interstitial spaces, causing edema.
B) Elevated serum albumin and decreased urine protein are incorrect as nephrotic syndrome causes
hypoalbuminemia and massive proteinuria.
C) Normal serum albumin and microscopic hematuria are incorrect because albumin is significantly
decreased in nephrotic syndrome, and while hematuria can occur, it is not the hallmark finding.
,D) Elevated BUN and creatinine with low urine output are more characteristic of acute kidney injury or
renal failure, not the classic presentation of nephrotic syndrome.
Question 3: The nurse is assessing a child with a suspected diagnosis of hypertrophic pyloric stenosis.
Which clinical manifestation would the nurse expect to find?
A) Projectile vomiting and olive-shaped mass in the right upper quadrant
B) Bile-stained vomiting and abdominal distention
C) Watery diarrhea and failure to thrive
D) Constipation and ribbon-like stools
Correct ANSWER: A) Projectile vomiting and olive-shaped mass in the right upper quadrant
Rationale: Hypertrophic pyloric stenosis is a condition characterized by thickening of the pyloric muscle,
obstructing the gastric outlet. Classic clinical manifestations include non-bilious projectile vomiting that
occurs shortly after feeding, which can lead to dehydration, weight loss, and failure to thrive. On
physical examination, an olive-shaped mass is often palpable in the right upper quadrant. The condition
typically presents in infants between 2-8 weeks of age.
B) Bile-stained vomiting and abdominal distention are incorrect as these findings suggest intestinal
obstruction distal to the ampulla of Vater, such as duodenal atresia or malrotation, not pyloric stenosis
where vomiting is non-bilious.
C) Watery diarrhea and failure to thrive are incorrect as these findings suggest malabsorption
syndromes or infectious gastroenteritis, not pyloric stenosis.
D) Constipation and ribbon-like stools are incorrect as these findings suggest Hirschsprung's disease or
other lower intestinal obstructions.
, Question 4: A child is diagnosed with intussusception. The nurse understands that which characteristic
finding is associated with this condition?
A) Continuous abdominal pain with board-like rigidity
B) Intermittent abdominal pain with currant jelly stools
C) Constant severe pain with rebound tenderness
D) Dull, achy pain with visible peristaltic waves
Correct ANSWER: B) Intermittent abdominal pain with currant jelly stools
Rationale: Intussusception occurs when one segment of the intestine telescopes into another, causing
obstruction and ischemia. The classic presentation includes sudden onset of intermittent, severe
abdominal pain in a previously healthy infant who draws their knees to the chest during painful
episodes. Between episodes, the child may appear comfortable. Currant jelly stools (stools containing
blood and mucus) are a hallmark sign that occurs later in the progression. Vomiting may also occur.
A) Continuous abdominal pain with board-like rigidity suggests peritonitis or perforation, which is a
complication of advanced intussusception but not the initial presentation.
C) Constant severe pain with rebound tenderness suggests appendicitis or peritoneal irritation, not the
intermittent pattern typical of intussusception.
D) Dull, achy pain with visible peristaltic waves suggests pyloric stenosis or other obstructive processes
where peristalsis is visible through the abdominal wall.
Question 5: The nurse is preparing a child for surgery after a diagnosis of intussusception. Which
assessment finding would require the nurse to notify the surgeon immediately?
A) The child passes a normal brown stool
