NURS 629 Exam 2 V3 | NURS 629 Peds |
Actual Q&A with Rationale (NURS629
Exam 2) | Maryville University
1. A 14-month-old child presents with a barking cough, inspiratory stridor, and low-grade
fever. Which of the following is the most likely diagnosis?
A. Epiglottitis
B. Laryngotracheobronchitis (Croup)
C. Bacterial Tracheitis
D. Foreign Body Aspiration
Correct Answer: B
Croup, or laryngotracheobronchitis, is characterized by the classic barking cough and
stridor resulting from subglottic edema. It is most commonly caused by parainfluenza virus
and affects children between 6 months and 3 years of age. Management typically includes
corticosteroids and, in severe cases, racemic epinephrine.
2. Which of the following are common clinical triggers for an asthma exacerbation in the
pediatric population? (Select All That Apply)
A. Exercise and physical activity
B. Exposure to environmental tobacco smoke
C. High humidity levels
,D. Upper respiratory viral infections
E. Exposure to pet dander or dust mites
Correct Answer: A, B, D, E
Asthma triggers vary significantly between patients but frequently include allergens,
irritants, and viral illnesses. Viral infections are the most common cause of exacerbations in
younger children, while environmental allergens play a larger role in older children.
Identification and avoidance of these triggers are fundamental components of a long-term
asthma management plan.
3. A 4-week-old male infant is brought to the clinic for non-bilious projectile vomiting after
every feeding. On physical examination, a small, firm, mobile mass is palpated in the right
upper quadrant. This finding is highly suggestive of:
A. Intussusception
B. Gastroesophageal Reflux Disease
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung Disease
Correct Answer: C
Hypertrophic pyloric stenosis typically presents in infants between 3 and 6 weeks of age
with forceful, non-bilious vomiting. The ‘olive-shaped’ mass represents the thickened
pylorus muscle and is a hallmark clinical finding. Ultrasonography is the preferred imaging
modality to confirm the diagnosis and measure the pyloric dimensions.
, 4. Which physical examination finding is considered a medical emergency when evaluating a
child with suspected epiglottitis?
A. Barking cough
B. Drooling and leaning forward in a ‘tripod’ position
C. Vesicular breath sounds
D. Hyperresonance on percussion
Correct Answer: B
Drooling, dysphagia, and distress (the three D’s) combined with a tripod position indicate
imminent airway obstruction in epiglottitis. This condition has become rare due to the Hib
vaccine but remains a life-threatening emergency requiring immediate airway stabilization.
Providers must avoid examining the throat with a tongue blade as this may trigger
laryngospasm.
5. A 7-year-old child is being evaluated for Attention-Deficit/Hyperactivity Disorder (ADHD).
According to DSM-5 criteria, symptoms must be present in at least how many settings?
A. One setting (e.g., home or school)
B. Two or more settings (e.g., home and school)
C. Three settings (e.g., home, school, and extracurriculars)
D. Settings are not a requirement for diagnosis
Correct Answer: B
Actual Q&A with Rationale (NURS629
Exam 2) | Maryville University
1. A 14-month-old child presents with a barking cough, inspiratory stridor, and low-grade
fever. Which of the following is the most likely diagnosis?
A. Epiglottitis
B. Laryngotracheobronchitis (Croup)
C. Bacterial Tracheitis
D. Foreign Body Aspiration
Correct Answer: B
Croup, or laryngotracheobronchitis, is characterized by the classic barking cough and
stridor resulting from subglottic edema. It is most commonly caused by parainfluenza virus
and affects children between 6 months and 3 years of age. Management typically includes
corticosteroids and, in severe cases, racemic epinephrine.
2. Which of the following are common clinical triggers for an asthma exacerbation in the
pediatric population? (Select All That Apply)
A. Exercise and physical activity
B. Exposure to environmental tobacco smoke
C. High humidity levels
,D. Upper respiratory viral infections
E. Exposure to pet dander or dust mites
Correct Answer: A, B, D, E
Asthma triggers vary significantly between patients but frequently include allergens,
irritants, and viral illnesses. Viral infections are the most common cause of exacerbations in
younger children, while environmental allergens play a larger role in older children.
Identification and avoidance of these triggers are fundamental components of a long-term
asthma management plan.
3. A 4-week-old male infant is brought to the clinic for non-bilious projectile vomiting after
every feeding. On physical examination, a small, firm, mobile mass is palpated in the right
upper quadrant. This finding is highly suggestive of:
A. Intussusception
B. Gastroesophageal Reflux Disease
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung Disease
Correct Answer: C
Hypertrophic pyloric stenosis typically presents in infants between 3 and 6 weeks of age
with forceful, non-bilious vomiting. The ‘olive-shaped’ mass represents the thickened
pylorus muscle and is a hallmark clinical finding. Ultrasonography is the preferred imaging
modality to confirm the diagnosis and measure the pyloric dimensions.
, 4. Which physical examination finding is considered a medical emergency when evaluating a
child with suspected epiglottitis?
A. Barking cough
B. Drooling and leaning forward in a ‘tripod’ position
C. Vesicular breath sounds
D. Hyperresonance on percussion
Correct Answer: B
Drooling, dysphagia, and distress (the three D’s) combined with a tripod position indicate
imminent airway obstruction in epiglottitis. This condition has become rare due to the Hib
vaccine but remains a life-threatening emergency requiring immediate airway stabilization.
Providers must avoid examining the throat with a tongue blade as this may trigger
laryngospasm.
5. A 7-year-old child is being evaluated for Attention-Deficit/Hyperactivity Disorder (ADHD).
According to DSM-5 criteria, symptoms must be present in at least how many settings?
A. One setting (e.g., home or school)
B. Two or more settings (e.g., home and school)
C. Three settings (e.g., home, school, and extracurriculars)
D. Settings are not a requirement for diagnosis
Correct Answer: B
