NR328/NR 328 Exam 4 V1 | Pediatric Nursing Q&A
with Rationale | Chamberlain University
1. A nurse is assessing a child with suspected acute glomerulonephritis (AGN). Which clinical
manifestation is most characteristic of this condition?
A. Increased appetite and weight loss
B. Massive proteinuria and hypoalbuminemia
C. Severe hypotension and tachycardia
D. Gross hematuria and tea-colored urine
Correct Answer: D
Explanation: Acute glomerulonephritis is commonly associated with tea-colored or smoky
urine due to the presence of red blood cells. The nurse should also monitor for
hypertension and periorbital edema as key findings. This condition typically occurs after a
streptococcal infection and requires monitoring of kidney function.
2. When providing discharge teaching for the parents of a child with a ventriculoperitoneal
(VP) shunt, which sign of malfunction should the nurse emphasize?
A. Increased irritability and projectile vomiting
B. Increased urine output and thirst
C. Decreased heart rate and low blood pressure
D. Fine tremors and hyperactive reflexes
,Correct Answer: A
Explanation: Irritability and projectile vomiting are classic signs of increased intracranial
pressure resulting from shunt failure. Parents must be educated to report these symptoms
immediately to prevent neurological deterioration. Prompt assessment by a neurosurgeon
is vital to ensure the shunt is functioning properly.
3. A child is admitted with a diagnosis of intussusception. Which finding should the nurse
expect to document in the patient’s record?
A. Ribbon-like, foul-smelling stools
B. Currant jelly-like stools containing blood and mucus
C. Persistent, watery, green diarrhea
D. Steatorrhea and greasy, floating stools
Correct Answer: B
Explanation: Intussusception typically presents with ‘currant jelly’ stools which are
composed of blood and intestinal mucus. The nurse should also observe for sudden,
episodic abdominal pain and a sausage-shaped mass in the right upper quadrant.
Immediate management often involves an air or barium enema for reduction.
4. A nurse is caring for an adolescent with scoliosis who is wearing a Boston brace. Which
instruction should the nurse provide to the client?
A. Wear the brace only while sleeping at night.
B. Wear the brace for 23 hours a day as prescribed.
, C. Avoid wearing a shirt under the brace to prevent sweating.
D. The brace will completely correct the spinal curvature.
Correct Answer: B
Explanation: For maximum effectiveness, the Boston brace should be worn for
approximately 23 hours a day to slow the progression of scoliosis. The nurse should
instruct the client to wear a thin cotton shirt underneath the brace to protect the skin from
breakdown. It is important to emphasize that the brace prevents further curvature rather
than correcting existing deformity.
5. Which assessment finding should a nurse prioritize for a child immediately following a
tonsillectomy?
A. Occasional throat clearing and mild pain
B. Frequent, continuous swallowing and restlessness
C. A small amount of dried blood on the tongue
D. Refusal to drink citrus juices or milk
Correct Answer: B
Explanation: Frequent swallowing is a hallmark sign of post-operative hemorrhage
following a tonsillectomy. The nurse must notify the provider immediately as this indicates
active bleeding from the surgical site. Close monitoring of vital signs and airway patency is
the highest priority during the first 24 hours.
with Rationale | Chamberlain University
1. A nurse is assessing a child with suspected acute glomerulonephritis (AGN). Which clinical
manifestation is most characteristic of this condition?
A. Increased appetite and weight loss
B. Massive proteinuria and hypoalbuminemia
C. Severe hypotension and tachycardia
D. Gross hematuria and tea-colored urine
Correct Answer: D
Explanation: Acute glomerulonephritis is commonly associated with tea-colored or smoky
urine due to the presence of red blood cells. The nurse should also monitor for
hypertension and periorbital edema as key findings. This condition typically occurs after a
streptococcal infection and requires monitoring of kidney function.
2. When providing discharge teaching for the parents of a child with a ventriculoperitoneal
(VP) shunt, which sign of malfunction should the nurse emphasize?
A. Increased irritability and projectile vomiting
B. Increased urine output and thirst
C. Decreased heart rate and low blood pressure
D. Fine tremors and hyperactive reflexes
,Correct Answer: A
Explanation: Irritability and projectile vomiting are classic signs of increased intracranial
pressure resulting from shunt failure. Parents must be educated to report these symptoms
immediately to prevent neurological deterioration. Prompt assessment by a neurosurgeon
is vital to ensure the shunt is functioning properly.
3. A child is admitted with a diagnosis of intussusception. Which finding should the nurse
expect to document in the patient’s record?
A. Ribbon-like, foul-smelling stools
B. Currant jelly-like stools containing blood and mucus
C. Persistent, watery, green diarrhea
D. Steatorrhea and greasy, floating stools
Correct Answer: B
Explanation: Intussusception typically presents with ‘currant jelly’ stools which are
composed of blood and intestinal mucus. The nurse should also observe for sudden,
episodic abdominal pain and a sausage-shaped mass in the right upper quadrant.
Immediate management often involves an air or barium enema for reduction.
4. A nurse is caring for an adolescent with scoliosis who is wearing a Boston brace. Which
instruction should the nurse provide to the client?
A. Wear the brace only while sleeping at night.
B. Wear the brace for 23 hours a day as prescribed.
, C. Avoid wearing a shirt under the brace to prevent sweating.
D. The brace will completely correct the spinal curvature.
Correct Answer: B
Explanation: For maximum effectiveness, the Boston brace should be worn for
approximately 23 hours a day to slow the progression of scoliosis. The nurse should
instruct the client to wear a thin cotton shirt underneath the brace to protect the skin from
breakdown. It is important to emphasize that the brace prevents further curvature rather
than correcting existing deformity.
5. Which assessment finding should a nurse prioritize for a child immediately following a
tonsillectomy?
A. Occasional throat clearing and mild pain
B. Frequent, continuous swallowing and restlessness
C. A small amount of dried blood on the tongue
D. Refusal to drink citrus juices or milk
Correct Answer: B
Explanation: Frequent swallowing is a hallmark sign of post-operative hemorrhage
following a tonsillectomy. The nurse must notify the provider immediately as this indicates
active bleeding from the surgical site. Close monitoring of vital signs and airway patency is
the highest priority during the first 24 hours.
