NUR 203 /NUR203 Exam 2 Pediatric Nursing
2026/2027/2028 Testing Cycle | Newly Released
50 Questions With Answers & Expert Rationales
Guaranteed Pass | Graded A+ | Fortis College
Complex Pediatric Illness – Respiratory, Cardiac, Hematology, &
Neurodevelopmental Disorders
Q1: A newborn screen returns positive for cystic fibrosis. Which diagnostic test should the nurse
anticipate to confirm the diagnosis?
A. Sweat chloride test with values ≥60 mEq/L
B. Stool sample for reducing substances
C. Chest radiograph for hyperinflation
D. Genetic testing for one CFTR mutation only
Correct Answer: A
Rationale: Correct because the sweat chloride test remains the gold standard for diagnosing
cystic fibrosis, with chloride concentrations of 60 mEq/L or higher indicating a positive result
consistent with CFTR dysfunction. Stool reducing substances and chest radiographs may support
the clinical picture but lack diagnostic specificity. Genetic testing requires identification of two
disease-causing CFTR mutations to confirm the diagnosis, making a single mutation insufficient.
Q2: A nurse is reviewing congenital heart defects with a group of nursing students. Which defect
is classified as a cyanotic right-to-left shunt?
A. Patent ductus arteriosus
B. Ventricular septal defect
C. Atrial septal defect
D. Transposition of the great arteries
Correct Answer: D
,Rationale: Correct because transposition of the great arteries is a cyanotic defect in which
deoxygenated blood is pumped to the body and oxygenated blood recirculates to the lungs,
creating two parallel circuits. Patent ductus arteriosus, ventricular septal defect, and atrial septal
defect are acyanotic left-to-right shunts that cause pulmonary overcirculation rather than
systemic hypoxemia. The nurse must recognize that prostaglandin E1 is essential to maintain
ductal patency until surgical repair.
Q3: A 6-year-old child is brought to the pediatric clinic with thick yellow-green nasal discharge,
foul breath, and periorbital swelling that has persisted for 12 days. The parent reports a daytime
cough that is not improving. Which condition should the nurse suspect?
A. Viral upper respiratory infection
B. Allergic rhinitis
C. Bacterial sinusitis
D. Acute otitis media
Correct Answer: C
Rationale: Correct because persistent thick nasal discharge, halitosis, periorbital swelling, and a
daytime cough lasting more than 10 days are hallmark clinical indicators of bacterial sinusitis in
children. Viral upper respiratory infections typically improve within 7 to 10 days, allergic rhinitis
presents with clear rhinorrhea and sneezing without halitosis, and acute otitis media primarily
involves ear pain and fever. The nurse should anticipate antibiotic therapy and educate parents
about warning signs of orbital cellulitis.
Q4: A nurse is preparing to perform airway clearance therapy for a preschooler with cystic
fibrosis. Which actions should the nurse take to ensure safe and effective therapy? Select all that
apply.
A. Perform chest physiotherapy immediately after the child eats breakfast
B. Administer a bronchodilator 15 minutes before therapy
C. Administer hypertonic saline nebulization prior to therapy
D. Position the child for postural drainage based on affected lung segments
Correct Answer: B, C, D
Rationale: Correct because bronchodilators should be administered before chest physiotherapy
to open airways and improve mucus clearance, hypertonic saline helps hydrate and loosen thick
secretions, and postural drainage positions are selected based on the specific lung segments
requiring drainage. Chest physiotherapy should never be performed immediately after meals due
to aspiration and vomiting risk. The nurse must monitor for increased sputum production and
improved oxygen saturation following therapy.
, Q5: A school-age child with sickle cell disease is admitted in vaso-occlusive crisis with severe
bilateral knee pain rated 8/10. Which intervention should the nurse implement?
A. Apply ice packs to both knees for 20 minutes
B. Apply warm compresses to the affected joints
C. Restrict oral fluids to prevent edema
D. Administer meperidine as the opioid of choice
Correct Answer: B
Rationale: Correct because warm compresses promote vasodilation and improve blood flow to
the affected area, which helps relieve pain and reduce vaso-occlusion in sickle cell crisis. Cold
therapy causes vasoconstriction and can worsen sickling and tissue ischemia. Restricting fluids
increases blood viscosity and promotes further sickling, while meperidine is contraindicated due
to the risk of normeperidine accumulation causing central nervous system toxicity and seizures.
Q6: A newborn with transposition of the great arteries is awaiting surgical repair. Which
medication is essential for the nurse to administer to maintain systemic circulation?
A. Prostaglandin E1
B. Digoxin
C. Furosemide
D. Enalapril
Correct Answer: A
Rationale: Correct because continuous IV prostaglandin E1 is essential to maintain patency of
the ductus arteriosus in transposition of the great arteries, allowing mixing of oxygenated and
deoxygenated blood until surgical correction can be performed. Without prostaglandin E1, the
ductus closes and the infant develops profound hypoxemia due to parallel rather than serial
circulation. Digoxin, furosemide, and enalapril are used in heart failure management but do not
maintain ductal patency.
Q7: During a routine well-child visit, a nurse observes that a 30-month-old child does not make
eye contact, does not respond when called by name, and repeatedly spins the wheels of a toy car
while ignoring the examiner. Which condition should the nurse suspect?
A. Attention-deficit/hyperactivity disorder
B. Conduct disorder
C. Childhood disintegrative disorder
D. Autism spectrum disorder
2026/2027/2028 Testing Cycle | Newly Released
50 Questions With Answers & Expert Rationales
Guaranteed Pass | Graded A+ | Fortis College
Complex Pediatric Illness – Respiratory, Cardiac, Hematology, &
Neurodevelopmental Disorders
Q1: A newborn screen returns positive for cystic fibrosis. Which diagnostic test should the nurse
anticipate to confirm the diagnosis?
A. Sweat chloride test with values ≥60 mEq/L
B. Stool sample for reducing substances
C. Chest radiograph for hyperinflation
D. Genetic testing for one CFTR mutation only
Correct Answer: A
Rationale: Correct because the sweat chloride test remains the gold standard for diagnosing
cystic fibrosis, with chloride concentrations of 60 mEq/L or higher indicating a positive result
consistent with CFTR dysfunction. Stool reducing substances and chest radiographs may support
the clinical picture but lack diagnostic specificity. Genetic testing requires identification of two
disease-causing CFTR mutations to confirm the diagnosis, making a single mutation insufficient.
Q2: A nurse is reviewing congenital heart defects with a group of nursing students. Which defect
is classified as a cyanotic right-to-left shunt?
A. Patent ductus arteriosus
B. Ventricular septal defect
C. Atrial septal defect
D. Transposition of the great arteries
Correct Answer: D
,Rationale: Correct because transposition of the great arteries is a cyanotic defect in which
deoxygenated blood is pumped to the body and oxygenated blood recirculates to the lungs,
creating two parallel circuits. Patent ductus arteriosus, ventricular septal defect, and atrial septal
defect are acyanotic left-to-right shunts that cause pulmonary overcirculation rather than
systemic hypoxemia. The nurse must recognize that prostaglandin E1 is essential to maintain
ductal patency until surgical repair.
Q3: A 6-year-old child is brought to the pediatric clinic with thick yellow-green nasal discharge,
foul breath, and periorbital swelling that has persisted for 12 days. The parent reports a daytime
cough that is not improving. Which condition should the nurse suspect?
A. Viral upper respiratory infection
B. Allergic rhinitis
C. Bacterial sinusitis
D. Acute otitis media
Correct Answer: C
Rationale: Correct because persistent thick nasal discharge, halitosis, periorbital swelling, and a
daytime cough lasting more than 10 days are hallmark clinical indicators of bacterial sinusitis in
children. Viral upper respiratory infections typically improve within 7 to 10 days, allergic rhinitis
presents with clear rhinorrhea and sneezing without halitosis, and acute otitis media primarily
involves ear pain and fever. The nurse should anticipate antibiotic therapy and educate parents
about warning signs of orbital cellulitis.
Q4: A nurse is preparing to perform airway clearance therapy for a preschooler with cystic
fibrosis. Which actions should the nurse take to ensure safe and effective therapy? Select all that
apply.
A. Perform chest physiotherapy immediately after the child eats breakfast
B. Administer a bronchodilator 15 minutes before therapy
C. Administer hypertonic saline nebulization prior to therapy
D. Position the child for postural drainage based on affected lung segments
Correct Answer: B, C, D
Rationale: Correct because bronchodilators should be administered before chest physiotherapy
to open airways and improve mucus clearance, hypertonic saline helps hydrate and loosen thick
secretions, and postural drainage positions are selected based on the specific lung segments
requiring drainage. Chest physiotherapy should never be performed immediately after meals due
to aspiration and vomiting risk. The nurse must monitor for increased sputum production and
improved oxygen saturation following therapy.
, Q5: A school-age child with sickle cell disease is admitted in vaso-occlusive crisis with severe
bilateral knee pain rated 8/10. Which intervention should the nurse implement?
A. Apply ice packs to both knees for 20 minutes
B. Apply warm compresses to the affected joints
C. Restrict oral fluids to prevent edema
D. Administer meperidine as the opioid of choice
Correct Answer: B
Rationale: Correct because warm compresses promote vasodilation and improve blood flow to
the affected area, which helps relieve pain and reduce vaso-occlusion in sickle cell crisis. Cold
therapy causes vasoconstriction and can worsen sickling and tissue ischemia. Restricting fluids
increases blood viscosity and promotes further sickling, while meperidine is contraindicated due
to the risk of normeperidine accumulation causing central nervous system toxicity and seizures.
Q6: A newborn with transposition of the great arteries is awaiting surgical repair. Which
medication is essential for the nurse to administer to maintain systemic circulation?
A. Prostaglandin E1
B. Digoxin
C. Furosemide
D. Enalapril
Correct Answer: A
Rationale: Correct because continuous IV prostaglandin E1 is essential to maintain patency of
the ductus arteriosus in transposition of the great arteries, allowing mixing of oxygenated and
deoxygenated blood until surgical correction can be performed. Without prostaglandin E1, the
ductus closes and the infant develops profound hypoxemia due to parallel rather than serial
circulation. Digoxin, furosemide, and enalapril are used in heart failure management but do not
maintain ductal patency.
Q7: During a routine well-child visit, a nurse observes that a 30-month-old child does not make
eye contact, does not respond when called by name, and repeatedly spins the wheels of a toy car
while ignoring the examiner. Which condition should the nurse suspect?
A. Attention-deficit/hyperactivity disorder
B. Conduct disorder
C. Childhood disintegrative disorder
D. Autism spectrum disorder
