NURS 307 | NURS307 Final Exam: Pediatrics - WCU
Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse is caring for a 2-year-old child. According to Erikson, which developmental stage is
this child experiencing?
A. Trust vs. Mistrust
B. Initiative vs. Guilt
C. Autonomy vs. Shame and Doubt
D. Industry vs. Inferiority
Correct Answer: C
Rationale: The toddler stage from ages 1 to 3 years focuses on developing a sense of
personal control over physical skills. During this time, children begin to assert their
independence by performing basic actions on their own. The nurse should allow the child
to make simple choices to support this developmental milestone. Failure to develop
autonomy can lead to a lasting sense of inadequacy in the child. Encouraging self-care
activities such as feeding or dressing helps the child gain confidence in their abilities.
2. Which clinical finding is considered a hallmark sign of Intussusception in an infant?
A. Steatorrhea
B. Projectile vomiting
C. Ribbon-like stools
D. Currant jelly-like stools
Correct Answer: D
Rationale: Intussusception occurs when one portion of the intestine slides into an adjacent
part, causing obstruction. This condition often results in the passage of stool mixed with
blood and mucus, resembling currant jelly. The nurse must recognize this as an emergency
because it can lead to bowel ischemia or perforation. Diagnosis is frequently confirmed and
sometimes treated through the use of an air or saline enema. Immediate intervention is
required to prevent serious complications and restore normal bowel function.
3. A child with Tetralogy of Fallot becomes acutely cyanotic and dyspneic. Which action
should the nurse take first?
A. Administer 100% oxygen via mask
B. Administer morphine sulfate intravenously
C. Prepare for immediate intubation
,D. Place the child in a knee-chest position
Correct Answer: D
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt in the heart. This action improves pulmonary blood flow and
increases oxygen saturation during a hypercyanotic or ‘tet’ spell. The nurse should perform
this non-invasive maneuver immediately to alleviate the child’s distress. Providing a calm
environment and supplemental oxygen are also important secondary interventions.
Education for parents includes teaching them how to place the child in this position at
home during emergencies.
4. What is the primary dietary intervention for a child newly diagnosed with Celiac Disease?
A. Low-sodium diet
B. Gluten-free diet
C. High-protein diet
D. Lactose-free diet
Correct Answer: B
Rationale: Celiac disease is an autoimmune disorder where the ingestion of gluten leads to
damage in the small intestine. Patients must strictly avoid wheat, barley, and rye to prevent
malabsorption and clinical symptoms. The nurse should educate the family on reading food
labels carefully to identify hidden sources of gluten. Compliance with this diet allows the
intestinal mucosa to heal and resolves gastrointestinal distress. Nutritional counseling is
essential to ensure the child receives adequate vitamins and minerals from alternative
sources.
5. A nurse is assessing an infant with suspected Pyloric Stenosis. Which finding is most
characteristic of this condition?
A. Watery diarrhea
B. Bile-stained emesis
C. Generalized abdominal tenderness
D. Olive-shaped mass in the epigastrium
Correct Answer: D
Rationale: Pyloric stenosis involves hypertrophy of the pyloric sphincter, leading to a
gastric outlet obstruction. An olive-shaped mass can often be palpated in the right upper
quadrant of the abdomen during physical assessment. Projectile, non-bilious vomiting after
feeding is another classic clinical manifestation of this condition. The nurse must monitor
the infant closely for signs of dehydration and metabolic alkalosis. Surgical repair, known
as a pyloromyotomy, is the definitive treatment for infants diagnosed with this disorder.
, 6. Which medication is the antidote for a child who has ingested a toxic dose of
Acetaminophen?
A. Naloxone
B. Acetylcysteine
C. Activated charcoal
D. Flumazenil
Correct Answer: B
Rationale: Acetylcysteine acts as a hepatoprotective agent by restoring glutathione levels
in the liver. It is most effective when administered shortly after the ingestion of a toxic
amount of acetaminophen. The nurse should monitor liver function tests and coagulation
studies to assess for organ damage. This medication can be administered orally or
intravenously depending on the clinical scenario and patient status. Preventing liver failure
is the primary goal of treatment in pediatric poisoning cases involving this common
analgesic.
7. A 10-year-old child is diagnosed with Type 1 Diabetes Mellitus. Which test provides the
best evaluation of long-term glucose control?
A. Fasting blood glucose
B. Oral glucose tolerance test
C. Urine ketones
D. Glycosylated hemoglobin (HbA1c)
Correct Answer: D
Rationale: The HbA1c test measures the average blood glucose levels over the preceding
two to three months. It reflects how well the diabetes has been managed over time rather
than a single point in time. The nurse should explain to the family that the goal for most
pediatric patients is usually below 7.5%. Regular monitoring of this value helps the
healthcare team adjust insulin therapy and lifestyle interventions. High levels indicate a
need for better management to prevent long-term complications such as neuropathy or
retinopathy.
8. A nurse is preparing to administer Digoxin to an infant. At what heart rate should the nurse
withhold the dose?
A. Less than 110 beats/min
B. Less than 60 beats/min
C. Less than 70 beats/min
D. Less than 90 beats/min
Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse is caring for a 2-year-old child. According to Erikson, which developmental stage is
this child experiencing?
A. Trust vs. Mistrust
B. Initiative vs. Guilt
C. Autonomy vs. Shame and Doubt
D. Industry vs. Inferiority
Correct Answer: C
Rationale: The toddler stage from ages 1 to 3 years focuses on developing a sense of
personal control over physical skills. During this time, children begin to assert their
independence by performing basic actions on their own. The nurse should allow the child
to make simple choices to support this developmental milestone. Failure to develop
autonomy can lead to a lasting sense of inadequacy in the child. Encouraging self-care
activities such as feeding or dressing helps the child gain confidence in their abilities.
2. Which clinical finding is considered a hallmark sign of Intussusception in an infant?
A. Steatorrhea
B. Projectile vomiting
C. Ribbon-like stools
D. Currant jelly-like stools
Correct Answer: D
Rationale: Intussusception occurs when one portion of the intestine slides into an adjacent
part, causing obstruction. This condition often results in the passage of stool mixed with
blood and mucus, resembling currant jelly. The nurse must recognize this as an emergency
because it can lead to bowel ischemia or perforation. Diagnosis is frequently confirmed and
sometimes treated through the use of an air or saline enema. Immediate intervention is
required to prevent serious complications and restore normal bowel function.
3. A child with Tetralogy of Fallot becomes acutely cyanotic and dyspneic. Which action
should the nurse take first?
A. Administer 100% oxygen via mask
B. Administer morphine sulfate intravenously
C. Prepare for immediate intubation
,D. Place the child in a knee-chest position
Correct Answer: D
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt in the heart. This action improves pulmonary blood flow and
increases oxygen saturation during a hypercyanotic or ‘tet’ spell. The nurse should perform
this non-invasive maneuver immediately to alleviate the child’s distress. Providing a calm
environment and supplemental oxygen are also important secondary interventions.
Education for parents includes teaching them how to place the child in this position at
home during emergencies.
4. What is the primary dietary intervention for a child newly diagnosed with Celiac Disease?
A. Low-sodium diet
B. Gluten-free diet
C. High-protein diet
D. Lactose-free diet
Correct Answer: B
Rationale: Celiac disease is an autoimmune disorder where the ingestion of gluten leads to
damage in the small intestine. Patients must strictly avoid wheat, barley, and rye to prevent
malabsorption and clinical symptoms. The nurse should educate the family on reading food
labels carefully to identify hidden sources of gluten. Compliance with this diet allows the
intestinal mucosa to heal and resolves gastrointestinal distress. Nutritional counseling is
essential to ensure the child receives adequate vitamins and minerals from alternative
sources.
5. A nurse is assessing an infant with suspected Pyloric Stenosis. Which finding is most
characteristic of this condition?
A. Watery diarrhea
B. Bile-stained emesis
C. Generalized abdominal tenderness
D. Olive-shaped mass in the epigastrium
Correct Answer: D
Rationale: Pyloric stenosis involves hypertrophy of the pyloric sphincter, leading to a
gastric outlet obstruction. An olive-shaped mass can often be palpated in the right upper
quadrant of the abdomen during physical assessment. Projectile, non-bilious vomiting after
feeding is another classic clinical manifestation of this condition. The nurse must monitor
the infant closely for signs of dehydration and metabolic alkalosis. Surgical repair, known
as a pyloromyotomy, is the definitive treatment for infants diagnosed with this disorder.
, 6. Which medication is the antidote for a child who has ingested a toxic dose of
Acetaminophen?
A. Naloxone
B. Acetylcysteine
C. Activated charcoal
D. Flumazenil
Correct Answer: B
Rationale: Acetylcysteine acts as a hepatoprotective agent by restoring glutathione levels
in the liver. It is most effective when administered shortly after the ingestion of a toxic
amount of acetaminophen. The nurse should monitor liver function tests and coagulation
studies to assess for organ damage. This medication can be administered orally or
intravenously depending on the clinical scenario and patient status. Preventing liver failure
is the primary goal of treatment in pediatric poisoning cases involving this common
analgesic.
7. A 10-year-old child is diagnosed with Type 1 Diabetes Mellitus. Which test provides the
best evaluation of long-term glucose control?
A. Fasting blood glucose
B. Oral glucose tolerance test
C. Urine ketones
D. Glycosylated hemoglobin (HbA1c)
Correct Answer: D
Rationale: The HbA1c test measures the average blood glucose levels over the preceding
two to three months. It reflects how well the diabetes has been managed over time rather
than a single point in time. The nurse should explain to the family that the goal for most
pediatric patients is usually below 7.5%. Regular monitoring of this value helps the
healthcare team adjust insulin therapy and lifestyle interventions. High levels indicate a
need for better management to prevent long-term complications such as neuropathy or
retinopathy.
8. A nurse is preparing to administer Digoxin to an infant. At what heart rate should the nurse
withhold the dose?
A. Less than 110 beats/min
B. Less than 60 beats/min
C. Less than 70 beats/min
D. Less than 90 beats/min
