NR 602 WEEK 8 FINAL 2026/2027 PRACTICE EXAM VERIFIED WITH CORRECT
ANSWERS PLUS RATIONALES
1.Which finding in an infant with vomiting and diarrhea is most concerning for significant
dehydration?
A. Moist mucous membranes and normal urine output
B. Lethargy, markedly decreased urine output, and delayed capillary refill
C. Normal activity and frequent wet diapers
D. Mild thirst with normal skin perfusion
Correct Answer: B
Rationale: Lethargy, oliguria, and delayed capillary refill are concerning signs of significant
dehydration and impaired perfusion.
2.A child with acute gastroenteritis is able to drink and has mild dehydration. What is the
preferred initial treatment?
A. Oral rehydration solution
B. Plain water only
C. Immediate IV antibiotics
D. Complete restriction of fluids
Correct Answer: A
Rationale: Oral rehydration solution provides appropriate amounts of water and electrolytes
and is preferred for children with mild to moderate dehydration who can tolerate oral fluids.
3.Which finding is most characteristic of pyloric stenosis?
A. Bilious vomiting with abdominal distention
B. Projectile nonbilious vomiting in a young infant
C. Bloody diarrhea in a toddler
D. Persistent cough after feeding
Correct Answer: B
Rationale: Hypertrophic pyloric stenosis typically presents in early infancy with progressive
projectile, nonbilious vomiting and may produce an olive-shaped abdominal mass.
4.An infant with suspected pyloric stenosis has repeated vomiting. Which acid-base
abnormality is classically associated with this condition?
A. Metabolic alkalosis
B. Respiratory acidosis
,C. Metabolic acidosis
D. Respiratory alkalosis
Correct Answer: A
Rationale: Repeated loss of gastric hydrochloric acid can produce hypochloremic, hypokalemic
metabolic alkalosis.
5.Which symptom is most concerning for intussusception?
A. Intermittent severe abdominal pain with episodes of drawing the knees toward the chest
B. Mild chronic constipation
C. Painless increased appetite
D. Occasional hiccups
Correct Answer: A
Rationale: Intussusception commonly causes episodic, severe abdominal pain with periods of
relative calm between episodes.
6.A child with suspected intussusception develops lethargy and currant-jelly stool. What
does this finding suggest?
A. Possible intestinal ischemia associated with intussusception
B. Normal stool variation
C. Simple lactose intolerance
D. Uncomplicated viral infection
Correct Answer: A
Rationale: Currant-jelly stool results from blood and mucus and is a concerning finding
associated with intestinal compromise in intussusception.
7.Which finding is characteristic of Hirschsprung disease?
A. Delayed passage of meconium followed by chronic constipation and abdominal distention
B. Frequent painless diarrhea from birth
C. Persistent projectile vomiting only
D. Isolated jaundice
Correct Answer: A
Rationale: Hirschsprung disease results from absence of enteric ganglion cells in a segment of
bowel, causing functional obstruction and delayed meconium passage.
8.What is a typical clinical feature of celiac disease in a child?
, A. Chronic diarrhea, abdominal distention, and poor growth
B. Acute unilateral ear pain
C. Persistent wheezing only
D. Sudden severe headache
Correct Answer: A
Rationale: Celiac disease causes intestinal inflammation after gluten exposure and can result in
diarrhea, abdominal distention, malabsorption, and impaired growth.
9.What is the primary treatment for confirmed celiac disease?
A. Lifelong gluten-free diet
B. High-gluten diet
C. Complete dairy elimination in every patient
D. Long-term antibiotics
Correct Answer: A
Rationale: Strict lifelong avoidance of gluten is the cornerstone of treatment for celiac disease.
10.Which presentation is most consistent with appendicitis in a child?
A. Progressive abdominal pain with anorexia, nausea, and localized right-lower-quadrant
tenderness
B. Painless generalized edema
C. Chronic cough and wheezing
D. Isolated urinary frequency
Correct Answer: A
Rationale: Appendicitis commonly begins with nonspecific abdominal symptoms and progresses
to localized right-lower-quadrant pain with anorexia, nausea, and sometimes fever.
11.A child has right-lower-quadrant abdominal pain with guarding and rebound
tenderness. What should the clinician do?
A. Arrange prompt evaluation for possible surgical abdomen
B. Recommend unrestricted activity
C. Delay assessment for several weeks
D. Assume constipation without further evaluation
Correct Answer: A
Rationale: Guarding and rebound tenderness can indicate peritoneal irritation and require
urgent assessment.
ANSWERS PLUS RATIONALES
1.Which finding in an infant with vomiting and diarrhea is most concerning for significant
dehydration?
A. Moist mucous membranes and normal urine output
B. Lethargy, markedly decreased urine output, and delayed capillary refill
C. Normal activity and frequent wet diapers
D. Mild thirst with normal skin perfusion
Correct Answer: B
Rationale: Lethargy, oliguria, and delayed capillary refill are concerning signs of significant
dehydration and impaired perfusion.
2.A child with acute gastroenteritis is able to drink and has mild dehydration. What is the
preferred initial treatment?
A. Oral rehydration solution
B. Plain water only
C. Immediate IV antibiotics
D. Complete restriction of fluids
Correct Answer: A
Rationale: Oral rehydration solution provides appropriate amounts of water and electrolytes
and is preferred for children with mild to moderate dehydration who can tolerate oral fluids.
3.Which finding is most characteristic of pyloric stenosis?
A. Bilious vomiting with abdominal distention
B. Projectile nonbilious vomiting in a young infant
C. Bloody diarrhea in a toddler
D. Persistent cough after feeding
Correct Answer: B
Rationale: Hypertrophic pyloric stenosis typically presents in early infancy with progressive
projectile, nonbilious vomiting and may produce an olive-shaped abdominal mass.
4.An infant with suspected pyloric stenosis has repeated vomiting. Which acid-base
abnormality is classically associated with this condition?
A. Metabolic alkalosis
B. Respiratory acidosis
,C. Metabolic acidosis
D. Respiratory alkalosis
Correct Answer: A
Rationale: Repeated loss of gastric hydrochloric acid can produce hypochloremic, hypokalemic
metabolic alkalosis.
5.Which symptom is most concerning for intussusception?
A. Intermittent severe abdominal pain with episodes of drawing the knees toward the chest
B. Mild chronic constipation
C. Painless increased appetite
D. Occasional hiccups
Correct Answer: A
Rationale: Intussusception commonly causes episodic, severe abdominal pain with periods of
relative calm between episodes.
6.A child with suspected intussusception develops lethargy and currant-jelly stool. What
does this finding suggest?
A. Possible intestinal ischemia associated with intussusception
B. Normal stool variation
C. Simple lactose intolerance
D. Uncomplicated viral infection
Correct Answer: A
Rationale: Currant-jelly stool results from blood and mucus and is a concerning finding
associated with intestinal compromise in intussusception.
7.Which finding is characteristic of Hirschsprung disease?
A. Delayed passage of meconium followed by chronic constipation and abdominal distention
B. Frequent painless diarrhea from birth
C. Persistent projectile vomiting only
D. Isolated jaundice
Correct Answer: A
Rationale: Hirschsprung disease results from absence of enteric ganglion cells in a segment of
bowel, causing functional obstruction and delayed meconium passage.
8.What is a typical clinical feature of celiac disease in a child?
, A. Chronic diarrhea, abdominal distention, and poor growth
B. Acute unilateral ear pain
C. Persistent wheezing only
D. Sudden severe headache
Correct Answer: A
Rationale: Celiac disease causes intestinal inflammation after gluten exposure and can result in
diarrhea, abdominal distention, malabsorption, and impaired growth.
9.What is the primary treatment for confirmed celiac disease?
A. Lifelong gluten-free diet
B. High-gluten diet
C. Complete dairy elimination in every patient
D. Long-term antibiotics
Correct Answer: A
Rationale: Strict lifelong avoidance of gluten is the cornerstone of treatment for celiac disease.
10.Which presentation is most consistent with appendicitis in a child?
A. Progressive abdominal pain with anorexia, nausea, and localized right-lower-quadrant
tenderness
B. Painless generalized edema
C. Chronic cough and wheezing
D. Isolated urinary frequency
Correct Answer: A
Rationale: Appendicitis commonly begins with nonspecific abdominal symptoms and progresses
to localized right-lower-quadrant pain with anorexia, nausea, and sometimes fever.
11.A child has right-lower-quadrant abdominal pain with guarding and rebound
tenderness. What should the clinician do?
A. Arrange prompt evaluation for possible surgical abdomen
B. Recommend unrestricted activity
C. Delay assessment for several weeks
D. Assume constipation without further evaluation
Correct Answer: A
Rationale: Guarding and rebound tenderness can indicate peritoneal irritation and require
urgent assessment.
