NSG 3600 Exam 4 Pediatrics Review questions
and correct answers with Rationales/ Galen
NSG 3600 Nursing Practice in Children’s Health
Exam 4 Latest Prep Guide
In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which
intervention?
Prepare the infant for surgery.
Medicate the infant with analgesics.
Change the infant's diet to one that is lactose-free.
Assist in doing a barium enema procedure on the infant. –
Correct Answer :Prepare the infant for surgery.
Explanation:
A+ TEST BANK 1
, NSG 3600 Exam
In pyloric stenosis, the thickened muscle of the pylorus causes gastric outlet obstruction. The
treatment is a surgical correction called a pyloromyotomy. The condition is not painful, so no
analgesics would be needed until after surgical repair. The condition is not related to lactose
in the diet, so changing to lactose-free formula would not correct the condition. A barium
enema would be used to diagnose intussusception
A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately
after every feeding. In the past week, the vomiting has grown more forceful, with the vomit
projecting several feet from his mouth. He is always hungry again just after vomiting. At the
physician's office, the nurse holds the child and offers him a bottle. While he drinks, the nurse
notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in
this child?
pyloric stenosis
peptic ulcer disease
gastroesophageal reflux
appendicitis –
Correct Answer :pyloric stenosis
Explanation:
With pyloric stenosis, at 4 to 6 weeks of age, infants typically begin to vomit almost
immediately after each feeding. The vomiting grows increasingly forceful until it is projectile,
possibly projecting as much as 3 to 4 feet. Infants are usually hungry immediately after
vomiting because they are not nauseated. A definitive diagnosis can be made by watching the
infant drink. If pyloric stenosis is present, the sphincter feels round and firm, approximately
the size of an olive in the right abdomen. Peptic ulcer disease in neonates usually presents
with hematemesis (blood in vomitus) or melena (blood in the stool). Gastroesophageal reflux
involves a small (1-2 tsp) volume and is not forceful. Appendicitis typically begins with anorexia
for 12 to 24 hours; children do not eat and do not act like their usual selves. Nausea and
vomiting may then occur, followed by diffuse abdominal pain.
A+ TEST BANK 2
, NSG 3600 Exam
A toddler requires an enema. After explaining the procedure to the parent and preparing the
supplies, what action will the nurse take?
Place the toddler on the left side.
Place the toddler on the abdomen.
Place the toddler on the right side.
Place the toddler on the back. –
Correct Answer :Place the toddler on the abdomen.
Explanation:
The best position for administering an enema to an infant or toddler is on the abdomen with
the knees bent (knee-chest position). For a child or adolescent, the nurse places the child on
the left side with the right leg flexed toward the chest. To provide atraumatic care, the
parents need to be educated on the procedure and its purpose. A child-life specialist can also
be involved for diversionary activities. The nurse should also ascertain, before administering
the enema, if the toddler is potty trained or is in diapers.
A nurse taking a health history of a newborn notes that there is a maternal history of
polyhydramnios. What GI condition might this history precipitate?
esophageal atresia (EA)
cleft palate
pyloric stenosis
hernia –
Correct Answer :sophageal atresia (EA)
Explanation:
A maternal history of polyhydramnios is usually present in one-third of cases of EA and in
some cases of tracheoesophageal fistula (TEF).
Reference:
A+ TEST BANK 3
, NSG 3600 Exam
The nurse is administering an enteral feeding to a child with a gastrostomy tube (G-tube).
Which action will the nurse take when administering a prescribed feeding through the client's
G-tube?
Check for gastric residual before starting feeding.
Position the client with the head of the bed at a 20° angle.
Use a syringe plunger to administer the feeding.
After feeding, flush the tube with a small amount of saline and leave the G-tube open for 2
minutes. –
Correct Answer :Check for gastric residual before starting feeding.
the nurse should check for gastric residual before starting feeding by gently aspirating from
the tube with a syringe or positioning the tube below the level of the stomach with only the
barrel of the syringe attached. The client should be positioned with his or her head elevated
30° to 45° and the formula should be allowed to flow with gravity, not plunged unless the
tube is clogged. After feeding, the nurse should flush the tube with a small amount of water,
unless contraindicated, and leave the G-tube open for 5 to 10 minutes after feeding to allow
for escape of air.
he nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe
dehydration?
Pale and slightly dry mucosa
Blood pressure of 80/42 mm Hg
Tenting of skin
Soft and flat fontanels (fontanelles) - Correct Answer :enting of skin
Explanation:
Tenting of skin is an indicator of severe dehydration. Soft and flat fontanels (fontanelles)
indicate mild dehydration. Pale and slightly dry mucosa indicates mild or moderate
dehydration. Blood pressure of 80/42 mm Hg is a normal finding for an infant.
A+ TEST BANK 4