NR 328 Pediatrics Exam 2 Preparation
NR 328 PEDIATRICS EXAM 2 PREPARATION FOR 2025/2026
COMPLETE 200 QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES |ALREADY GRADED A+||BRAND NEW!!
The nurse should instruct parents to administer a daily proton pump inhibitor to
their child with gastroesophageal reflux at which time?
a. 30 minutes before breakfast
b. Midmorning
c. Bedtime
d. With a meal
Answer: A
Rationale: Proton pump inhibitors are most effective when administered 30
minutes before breakfast so that the peak plasma concentrations occur with
mealtime. If they are given twice a day, the second best time for administration is
30 minutes before the evening meal.
The nurse is assisting a child with celiac disease to select foods from a menu.
What foods should the nurse suggest?
a. Corn on the cob with butter
b. Hamburger on a bun
c. Spaghetti with meat sauce
d. Peanut butter and crackers
Answer: A
Rationale: Treatment of celiac disease consists primarily of dietary management.
Although a gluten-free diet is prescribed, it is difficult to remove every source of
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, NR 328 Pediatrics Exam 2 Preparation
this protein. Some patients are able to tolerate restricted amounts of gluten.
Because gluten occurs mainly in the grains of wheat and rye but also in smaller
quantities in barley and oats, these foods are eliminated. Corn, rice, and millet are
substitute grain foods. Corn on the cob with butter would be gluten free.
An infant is born with a gastroschisis. Care preoperatively should include which
priority intervention?
a. Covering the defect with a sterile bowel bag
b. Monitoring serum laboratory electrolytes
c. Sterile water feedings
d. Prone position
Answer: A
Rationale: Initial management of a gastroschisis involves covering the exposed
bowel with a transparent plastic bowel bag or loose, moist dressings. The infant
cannot be placed prone, and feedings will be withheld until surgery is performed.
Electrolyte laboratory values will be monitored but not before covering the defect
with a sterile bowel bag.
A 3-day-old infant presents with abdominal distention, is vomiting, and has not
passed any meconium stools. What disease should the nurse suspect?
a. Hirschsprung disease
b. Intussusception
c. Celiac disease
d. Pyloric stenosis
Answer: A
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, NR 328 Pediatrics Exam 2 Preparation
Rationale: The clinical manifestations of Hirschsprung disease in a 3-day-old infant
include abdominal distention, vomiting, and failure to pass meconium stools.
Pyloric stenosis would present with vomiting but not distention or failure to pass
meconium stools. Intussusception presents with abdominal cramping and celiac
disease presents with malabsorption.
The parents of a newborn with an umbilical hernia ask about treatment options.
The nurse’s response should be based on which knowledge?
a. The defect usually resolves spontaneously by 3 to 5 years of age.
b. Surgery is recommended as soon as possible.
c. Aggressive treatment is necessary to reduce its high mortality.
d. Taping the abdomen to flatten the protrusion is sometimes helpful.
Answer: A
Rationale: The umbilical hernia usually resolves by ages 3 to 5 years of age
without intervention. Umbilical hernias rarely become problematic. Incarceration,
where the hernia is constricted and cannot be reduced manually, is rare. Umbilical
hernias are not associated with a high mortality rate. Taping the abdomen flat
does not help heal the hernia; it can cause skin irritation.
A child with pyloric stenosis is having excessive vomiting. The nurse should
assess for what potential complication?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Hyperchloremia
d. Hyperkalemia
Answer: A
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, NR 328 Pediatrics Exam 2 Preparation
Rationale: Infants with excessive vomiting are prone to metabolic alkalosis from
the loss of hydrogen ions. Potassium and chloride ions are lost with vomiting.
Metabolic alkalosis, not acidosis, is likely.
When caring for a child with probable appendicitis, the nurse should be alert to
recognize which sign or symptom as a manifestation of perforation?
a. Sudden relief from pain
b. Anorexia
c. Bradycardia
d. Decreased abdominal distention
Answer: A
Rationale: Signs of peritonitis, in addition to fever, include sudden relief from pain
after perforation. Anorexia is already a clinical manifestation of appendicitis.
Tachycardia, not bradycardia, is a manifestation of peritonitis. Abdominal
distention usually increases in addition to an increase in pain (usually diffuse and
accompanied by rigid guarding of the abdomen).
A child is admitted with acute glomerulonephritis. What should the nurse expect
the urinalysis during this acute phase to show?
a. Hematuria and proteinuria
b. Bacteriuria and hematuria
c. Bacteriuria and increased specific gravity
d. Proteinuria and decreased specific gravity
Answer: A
Rationale: Urinalysis during the acute phase characteristically shows hematuria,
proteinuria, and increased specific gravity. Proteinuria generally parallels the
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NR 328 PEDIATRICS EXAM 2 PREPARATION FOR 2025/2026
COMPLETE 200 QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES |ALREADY GRADED A+||BRAND NEW!!
The nurse should instruct parents to administer a daily proton pump inhibitor to
their child with gastroesophageal reflux at which time?
a. 30 minutes before breakfast
b. Midmorning
c. Bedtime
d. With a meal
Answer: A
Rationale: Proton pump inhibitors are most effective when administered 30
minutes before breakfast so that the peak plasma concentrations occur with
mealtime. If they are given twice a day, the second best time for administration is
30 minutes before the evening meal.
The nurse is assisting a child with celiac disease to select foods from a menu.
What foods should the nurse suggest?
a. Corn on the cob with butter
b. Hamburger on a bun
c. Spaghetti with meat sauce
d. Peanut butter and crackers
Answer: A
Rationale: Treatment of celiac disease consists primarily of dietary management.
Although a gluten-free diet is prescribed, it is difficult to remove every source of
1|Page
, NR 328 Pediatrics Exam 2 Preparation
this protein. Some patients are able to tolerate restricted amounts of gluten.
Because gluten occurs mainly in the grains of wheat and rye but also in smaller
quantities in barley and oats, these foods are eliminated. Corn, rice, and millet are
substitute grain foods. Corn on the cob with butter would be gluten free.
An infant is born with a gastroschisis. Care preoperatively should include which
priority intervention?
a. Covering the defect with a sterile bowel bag
b. Monitoring serum laboratory electrolytes
c. Sterile water feedings
d. Prone position
Answer: A
Rationale: Initial management of a gastroschisis involves covering the exposed
bowel with a transparent plastic bowel bag or loose, moist dressings. The infant
cannot be placed prone, and feedings will be withheld until surgery is performed.
Electrolyte laboratory values will be monitored but not before covering the defect
with a sterile bowel bag.
A 3-day-old infant presents with abdominal distention, is vomiting, and has not
passed any meconium stools. What disease should the nurse suspect?
a. Hirschsprung disease
b. Intussusception
c. Celiac disease
d. Pyloric stenosis
Answer: A
2|Page
, NR 328 Pediatrics Exam 2 Preparation
Rationale: The clinical manifestations of Hirschsprung disease in a 3-day-old infant
include abdominal distention, vomiting, and failure to pass meconium stools.
Pyloric stenosis would present with vomiting but not distention or failure to pass
meconium stools. Intussusception presents with abdominal cramping and celiac
disease presents with malabsorption.
The parents of a newborn with an umbilical hernia ask about treatment options.
The nurse’s response should be based on which knowledge?
a. The defect usually resolves spontaneously by 3 to 5 years of age.
b. Surgery is recommended as soon as possible.
c. Aggressive treatment is necessary to reduce its high mortality.
d. Taping the abdomen to flatten the protrusion is sometimes helpful.
Answer: A
Rationale: The umbilical hernia usually resolves by ages 3 to 5 years of age
without intervention. Umbilical hernias rarely become problematic. Incarceration,
where the hernia is constricted and cannot be reduced manually, is rare. Umbilical
hernias are not associated with a high mortality rate. Taping the abdomen flat
does not help heal the hernia; it can cause skin irritation.
A child with pyloric stenosis is having excessive vomiting. The nurse should
assess for what potential complication?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Hyperchloremia
d. Hyperkalemia
Answer: A
3|Page
, NR 328 Pediatrics Exam 2 Preparation
Rationale: Infants with excessive vomiting are prone to metabolic alkalosis from
the loss of hydrogen ions. Potassium and chloride ions are lost with vomiting.
Metabolic alkalosis, not acidosis, is likely.
When caring for a child with probable appendicitis, the nurse should be alert to
recognize which sign or symptom as a manifestation of perforation?
a. Sudden relief from pain
b. Anorexia
c. Bradycardia
d. Decreased abdominal distention
Answer: A
Rationale: Signs of peritonitis, in addition to fever, include sudden relief from pain
after perforation. Anorexia is already a clinical manifestation of appendicitis.
Tachycardia, not bradycardia, is a manifestation of peritonitis. Abdominal
distention usually increases in addition to an increase in pain (usually diffuse and
accompanied by rigid guarding of the abdomen).
A child is admitted with acute glomerulonephritis. What should the nurse expect
the urinalysis during this acute phase to show?
a. Hematuria and proteinuria
b. Bacteriuria and hematuria
c. Bacteriuria and increased specific gravity
d. Proteinuria and decreased specific gravity
Answer: A
Rationale: Urinalysis during the acute phase characteristically shows hematuria,
proteinuria, and increased specific gravity. Proteinuria generally parallels the
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