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Galen NSG 3600 (NSG3600) Pediatrics – Exam 3 Review | Complete Questions & Answers | Latest 2026–2027.

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NSG 3600 Pediatrics Exam 3 – Complete Review Questions & Answers | Galen College of Nursing | Updated 2026–2027 1. **A newborn is diagnosed with rectal atresia. Which nursing intervention is the priority after diagnosis?** A. Begin high-fiber oral feedings B. Perform a rectal temperature C. Keep the newborn NPO and initiate IV fluids D. Encourage frequent breastfeeding 2. **Which finding is most characteristic of rectal atresia?** A. Absence of stool passage B. Projectile vomiting after feeding C. Currant-jelly stools D. Ribbon-like stools 3. **What is the first stage of surgical correction for rectal atresia according to the study guide?** A. Pyloromyotomy B. Fundoplication C. Anal dilation only D. Resection and colostomy 4. **After surgical correction of rectal atresia, which complications should the nurse monitor for?** A. Glomerulonephritis and hypertension B. Fistulas and strictures C. Seizures and cerebral edema D. Steatorrhea and anemia 5. **Hypertrophic pyloric stenosis occurs because of:** A. Absence of intestinal ganglion cells B. Thickening of the pyloric sphincter causing obstruction C. Telescoping of one bowel segment into another D. Inflammation of the appendix 6. **Which vomiting pattern is most characteristic of hypertrophic pyloric stenosis?** A. Bilious diarrhea after eating B. Bloody emesis after every feeding C. Regurgitation only when lying down D. Non-bilious projectile vomiting shortly after feeding 7. **Which assessment finding supports a diagnosis of pyloric stenosis?** A. Olive-shaped mass in the right upper quadrant B. Sausage-shaped mass in the right upper quadrant C. Rigid lower-right abdomen D. Bulging fontanelle 8. **An upper GI series in pyloric stenosis is expected to demonstrate which finding?** A. Steeple sign B. Thumb sign C. String sign D. Crescent sign 9. **A dehydrated infant with pyloric stenosis is scheduled for surgery. What should happen first?** A. Begin full-strength formula B. Perform immediate surgery despite electrolyte abnormalities C. Give fruit juice D. Correct dehydration and electrolyte imbalance 10. **Approximately when are oral feedings reintroduced after pyloromyotomy in the study guide?** A. Immediately in recovery B. About 6 hours after surgery C. After 48 hours D. Only after the infant passes stool 11. **Which feeding device is highlighted for an infant with a cleft lip or palate?** A. Haberman feeder B. Standard short nipple C. Nasogastric tube for every infant D. Pacifier feeder 12. **Which position is appropriate when feeding an infant with a cleft palate?** A. Flat supine B. Prone C. Upright D. Trendelenburg 13. **Cleft lip repair is typically performed at approximately:** A. Birth B. 3 months C. 12 months D. 3 years 14. **Which instruction is important following surgical repair of a cleft lip?** A. Encourage frequent pacifier use B. Place toys in the mouth for comfort C. Position the infant flat after feeding D. Avoid placing objects such as pacifiers in the mouth 15. **Intussusception is best described as:** A. Complete closure of the rectum B. Absence of ganglion cells C. One part of the intestine telescoping into another D. Thickening of the pyloric sphincter 16. **Which stool finding is characteristic of intussusception?** A. Currant-jelly stool B. Clay-colored stool C. Ribbon-like stool D. Frothy urine 17. **Which behavior is characteristic of an infant experiencing intussusception?** A. Remaining continuously asleep B. Refusing to move the legs C. Sitting upright after feeding D. Screaming and drawing the legs toward the chest 18. **Which diagnostic/therapeutic intervention is attempted first for intussusception according to the review?** A. Immediate bowel resection B. Air enema C. Appendectomy D. Colostomy 19. **Which assessment finding suggests that intussusception has resolved?** A. Passage of normal brown stool B. Persistent currant-jelly stool C. Increasing abdominal rigidity D. Absence of bowel movements 20. **A child with known intussusception passes a normal stool before planned surgery. What should the nurse do?** A. Ignore the finding B. Give a laxative C. Notify the provider D. Prepare the child for immediate colostomy 21. **Failure to thrive is primarily characterized by:** A. Excessive height for age B. Increased head circumference C. Persistent hypertension D. Failure to achieve expected weight gain 22. **Which laboratory value is emphasized for evaluating short-term nutritional status in FTT?** A. Prealbumin B. Potassium C. Creatinine D. Ammonia 23. **Which feeding approach is recommended for a child with failure to thrive?** A. One very large meal daily B. Small frequent high-calorie/high-protein meals C. Restriction of calories D. Avoid parental involvement 24. **What is typically the earliest pain manifestation of appendicitis?** A. Left upper quadrant pain B. Suprapubic pain C. Periumbilical pain D. Flank pain 25. **Which location is the classic site of appendicitis pain?** A. McBurney's point in the RLQ B. Left lower quadrant C. Epigastrium D. Left upper quadrant 26. **A child with appendicitis suddenly reports that severe abdominal pain has stopped. What should the nurse suspect?** A. The child is cured B. The child needs oral food C. The pain medication has permanently corrected the problem D. The appendix may have ruptured 27. **What is the priority preoperative intervention for suspected appendicitis?** A. Give solid food B. Maintain NPO status C. Apply a heating pad to the abdomen D. Encourage vigorous activity 28. **Which finding after appendiceal perforation should the nurse monitor for?** A. Pyloric obstruction B. Cleft palate C. Peritonitis with a stiff, tender abdomen D. Proteinuria 29. **What is the major nursing priority for a child with diarrhea and dehydration?** A. Restrict all oral fluids B. Begin a gluten-free diet C. Give a diuretic D. Restore hydration 30. **If a dehydrated child can tolerate oral fluids, which solution is recommended?** A. Pedialyte/oral rehydration solution B. Carbonated soda C. Undiluted fruit juice D. Sports drinks 31. **Which finding is consistent with dehydration in an infant?** A. Increased tears B. Bulging fontanelle C. Sunken fontanelle and decreased wet diapers D. Increased urine output 32. **What hourly urine output is identified as expected in the Exam 3 review?** A. 0.1 mL/kg/hr B. Approximately 1–3 mL/kg/hr C. 5–8 mL/kg/hr D. 10 mL/kg/hr 33. **What is the daily maintenance fluid requirement for a child weighing 15 kg using the formula provided in the study guide?** A. 1,250 mL/day B. 750 mL/day C. 1,500 mL/day D. 2,000 mL/day 34. **Using the study guide formula, how much maintenance fluid does a 25-kg child require per day?** A. 1,250 mL B. 2,500 mL C. 1,000 mL D. 1,600 mL 35. **Which manifestation is typical of gastroesophageal reflux in an infant?** A. Tea-colored urine B. Spitting up and arching the back C. Currant-jelly stool D. Strawberry tongue 36. **When should a proton-pump inhibitor for GER generally be administered according to the notes?** A. Immediately after a meal B. With the child's entire favorite meal C. About 30 minutes before feeding or in the morning D. Only at bedtime after feeding 37. **Which feeding strategy is appropriate for an infant with GER?** A. Small, thickened feedings with upright positioning B. Large-volume feedings while supine C. Prone positioning immediately after feeds D. Vigorous play after eating 38. **Which foods should an older child with GER avoid according to the study guide?** A. Rice and corn B. Applesauce only C. Lean protein D. Fatty, fried, citrus and spicy foods 39. **Hirschsprung disease results from:** A. An inflamed appendix B. Absence of ganglion cells in part of the colon C. Excess gastric acid D. Gluten intolerance 40. **Which newborn finding strongly suggests Hirschsprung disease?** A. Projectile vomiting immediately after every feed B. Currant-jelly stool C. Failure to pass meconium within 48 hours D. Excessive urine output 41. **Which stool description is associated with Hirschsprung disease?** A. Ribbon-like stool B. Frothy urine C. Currant-jelly stool D. Clay stool 42. **Which test is emphasized for confirming Hirschsprung disease?** A. EEG B. Sweat chloride test C. VCUG D. Rectal biopsy 43. **Celiac disease is described as:** A. A bacterial bowel infection B. An autoimmune disorder with permanent intolerance to gluten C. A urinary disorder D. A congenital rectal obstruction 44. **Which stool abnormality is associated with celiac disease?** A. Tea-colored urine B. Currant-jelly stool C. Steatorrhea D. Hematuria 45. **Which food should be avoided in a gluten-free diet according to the uploaded notes?** A. Rice B. Corn C. Quinoa D. Wheat 46. **Which food is identified as acceptable for a child with celiac disease?** A. Rice B. Wheat bread C. Rye crackers D. Barley cereal 47. **Which organism is emphasized as a common cause of pediatric urinary tract infections?** A. Epstein-Barr virus B. Varicella zoster C. Escherichia coli D. Clostridium tetani 48. **Which finding may indicate a UTI in an infant?** A. Projectile vomiting only B. Crying during urination and foul-smelling diapers C. Steatorrhea D. Currant-jelly stool 49. **Which teaching helps prevent UTIs in girls?** A. Wipe from front to back B. Take frequent bubble baths C. Wear tight clothing D. Remain in wet swimsuits 50. **Which action should occur before antibiotic therapy when obtaining a urine culture?** A. Give antibiotics and obtain the culture the next day B. Use any nonsterile urine specimen C. Give a diuretic first D. Obtain the urine culture before starting the antibiotic 51. **According to the review, which technique provides the best sterile urine specimen when needed?** A. Urine from a diaper B. Straight catheterization C. Stool collection bag D. Bedpan specimen after antibiotics 52. **Vesicoureteral reflux is:** A. Gastric contents entering the esophagus B. Intestine telescoping into another segment C. Backflow of urine from the bladder toward the ureters and kidneys D. Failure of the urethra to form 53. **What is the major long-term concern with vesicoureteral reflux?** A. Cleft palate B. Pyloric stenosis C. Appendicitis D. Pyelonephritis and renal scarring 54. **Which diagnostic procedure is primarily used to diagnose vesicoureteral reflux?** A. Voiding cystourethrogram B. EEG C. Lumbar puncture D. Sweat chloride test 55. **Before a VCUG, which information is particularly important?** A. Favorite food B. Medication and contrast-related allergies, especially iodine C. Shoe size D. Whether the child has celiac disease 56. **Following VCUG, which intervention is appropriate?** A. Restrict all fluids for 24 hours B. Keep the child permanently NPO C. Give no medications D. Encourage fluids and monitor for contrast reaction or infection 57. **Acute glomerulonephritis may occur approximately how long after a streptococcal infection?** A. Several months later only B. At birth C. Within about 2 weeks D. Before the infection occurs 58. **Which urine appearance is associated with acute glomerulonephritis?** A. Tea- or cola-colored urine B. Completely colorless urine C. Currant-jelly urine D. Milky white urine 59. **Which additional finding is common in acute glomerulonephritis?** A. Severe weight loss without edema B. Periorbital edema C. Projectile vomiting after feeding D. Hyperactivity 60. **Which urinalysis findings are expected in acute glomerulonephritis?** A. No protein or blood B. Glucose only C. Hematuria and proteinuria D. Ketones only 61. **Which intervention is appropriate for acute glomerulonephritis according to the notes?** A. Encourage unrestricted salt B. Encourage unrestricted extra fluids C. Stop monitoring blood pressure D. Daily weights with salt/fluid restriction as ordered 62. **Which test helps determine whether a recent streptococcal infection occurred?** A. ASO titer B. Sweat chloride test C. EEG D. VCUG 63. **Hemolytic uremic syndrome in the review is associated with:** A. Gluten exposure B. Undercooked meat contaminated with E. coli C. Aspirin use after influenza D. Group A strep only 64. **Which renal complication is strongly associated with HUS?** A. Excessively high urine output B. Improved renal function C. Kidney failure D. Cleft palate 65. **A child with HUS develops hyperkalemia. Which action is emphasized?** A. Discontinue all cardiac monitoring B. Give potassium without monitoring C. Encourage unrestricted potassium D. Place the child on a cardiac monitor 66. **Which treatment may be required in severe HUS?** A. Dialysis B. Pyloromyotomy C. Tonsillectomy D. Fundoplication 67. **Which prevention teaching is appropriate for HUS?** A. Avoid all vegetables B. Cook ground beef thoroughly and use pasteurized products C. Use aspirin during viral infections D. Avoid handwashing 68. **Hypospadias is characterized by the urethral meatus being:** A. In the normal location B. Completely absent C. Above its normal location D. Below its usual location 69. **Why should circumcision be delayed in a child with hypospadias?** A. The foreskin may be needed for surgical reconstruction B. It causes celiac disease C. It worsens appendicitis D. It causes nephrotic syndrome 70. **Epispadias is characterized by:** A. An absent bladder B. Urethral opening superior to its normal position C. Urine reflux into the kidneys D. Absence of ganglion cells 71. **After repair of hypospadias or epispadias, which finding should the nurse monitor closely?** A. Currant-jelly stool B. Pyloric mass C. Urine flowing through the stent/catheter D. Koplik spots 72. **Prerenal acute kidney injury in the study guide is commonly associated with:** A. Excess CSF B. Pyloric narrowing C. Gluten intolerance D. Hypovolemia 73. **Which finding is associated with prerenal AKI due to hypovolemia?** A. Tachycardia and poor skin turgor B. Bounding pulses and fluid overload only C. Strawberry tongue D. Increased tears 74. **Which laboratory abnormality is highlighted with acute kidney injury?** A. Potassium below 2 mEq/L only B. Increased potassium C. Decreased BUN D. Increased sodium 75. **Which dietary pattern is described for chronic kidney disease?** A. High sodium, high phosphorus B. Unlimited protein and fluids C. Fluid restriction with low sodium, low phosphorus and controlled high-quality protein D. High-potassium unrestricted diet 76. **Peritoneal dialysis works primarily by:** A. Using the peritoneal membrane to filter blood B. Filtering through the lungs C. Filtering through the stomach D. Removing the appendix 77. **Which finding in returning peritoneal dialysate should be reported immediately?** A. Clear fluid B. Fluid through which print can be seen C. Normal amount of drainage D. Cloudy or purulent fluid 78. **A child reports discomfort during peritoneal dialysis, but the dialysate remains clear. According to the review, what should the nurse do?** A. Permanently discontinue dialysis B. Slow the flow and assess catheter position while continuing treatment C. Remove the catheter immediately D. Give the child a full meal 79. **Hemodialysis in the Exam 3 guide is generally performed:** A. Once a month B. Daily for 30 minutes C. About 3 times weekly for 3–4 hours D. Only once in childhood 80. **Which action should be avoided in the arm containing an AV fistula?** A. Keeping the site clean B. Monitoring it for infection C. Protecting it from trauma D. Taking a blood pressure on that arm 81. **Nephrotic syndrome is associated with which laboratory pattern?** A. Proteinuria, low serum albumin and elevated cholesterol B. No protein in urine with low cholesterol C. Hyperalbuminemia D. Normal urine protein and no edema 82. **Which assessment finding is characteristic of nephrotic syndrome?** A. Projectile vomiting B. Periorbital edema and weight gain C. Currant-jelly stool D. Nuchal rigidity 83. **Which finding is an early sign of increased intracranial pressure in a child?** A. Cushing's triad B. Fixed dilated pupils only C. Change in level of consciousness D. Complete cardiovascular collapse 84. **Which finding is characteristic of increased ICP in an infant?** A. Sunken fontanelle B. Tense or bulging fontanelle C. Excessive urination D. Ribbon-like stool 85. **Which eye finding is associated with increased intracranial pressure in infants?** A. Setting-sun eyes B. Koplik spots C. Red reflex D. Conjunctival hemorrhage only 86. **Which group makes up Cushing's triad?** A. Hypotension, tachycardia, rapid regular respirations B. Hypertension, tachycardia, fever C. Bradycardia, hypotension, diarrhea D. Hypertension with widened pulse pressure, bradycardia and irregular respirations 87. **How should a child with increased ICP generally be positioned?** A. Flat with the neck flexed B. HOB 15–30 degrees with the head midline C. Trendelenburg D. Head rotated strongly to one side 88. **Which medication is emphasized for decreasing cerebral edema in increased ICP?** A. Penicillin B. Digoxin C. Mannitol D. Indomethacin 89. **Which diagnostic test is considered the gold-standard study for seizure activity in the uploaded review?** A. EEG B. VCUG C. Sweat chloride test D. Upper GI series 90. **During a seizure, which nursing action is appropriate?** A. Place an object in the child's mouth B. Restrain the extremities forcefully C. Leave the child alone D. Turn the child to the side and protect the airway 91. **Which information should the nurse document about a seizure?** A. Only the child's temperature B. Only whether a parent was present C. Duration and behaviors before, during and after the event D. Only the medication list 92. **Which manifestation is considered classic for meningitis?** A. Nuchal rigidity B. Projectile vomiting only after feeding C. Olive-shaped abdominal mass D. Frothy urine 93. **Which procedure is used to analyze cerebrospinal fluid when meningitis is suspected?** A. Cardiac catheterization B. Lumbar puncture C. VCUG D. Barium enema 94. **Which treatment is emphasized when bacterial meningitis is suspected?** A. Wait several days before starting therapy B. Treat only with oral fluids C. Give pancreatic enzymes D. Start broad-spectrum IV antibiotics after obtaining cultures/CSF specimens 95. **Which findings can support a diagnosis of meningitis?** A. String and steeple signs B. McBurney and Dance signs C. Positive Kernig or Brudzinski signs D. Olive mass and projectile vomiting 96. **Encephalitis is inflammation of:** A. The meninges only B. Brain tissue C. The kidney glomeruli D. The pyloric sphincter 97. **Which organisms/exposures are highlighted as possible causes of viral encephalitis?** A. Mosquito-borne viruses and herpes simplex type I B. E. coli from undercooked meat only C. Gluten exposure D. Group A strep only 98. **Which nursing action is essential for an infant with myelomeningocele before surgical repair?** A. Place the infant supine on the sac B. Apply a dry dressing and allow the sac to dry C. Use latex equipment freely D. Keep the infant prone and cover the sac with sterile normal-saline-moistened dressing 99. **A ventriculoperitoneal shunt for hydrocephalus drains excess CSF from the brain into the:** A. Lungs B. Bladder C. Abdomen D. Small intestine directly 100. **Reye syndrome is strongly associated in the Exam 3 material with:** A. Penicillin use during bacterial infection B. Aspirin/salicylate use following a viral illness C. Gluten exposure D. High-potassium foods

Content preview

NSG 3600: Pediatrics — Exam 3
Galen College of Nursing | Q&A 2026-2027 Complete Review Guide.

Gastrointestinal System
1. A newborn is diagnosed with rectal atresia. Which nursing intervention is the
priority after diagnosis?

A. Begin high-fiber oral feedings
B. Perform a rectal temperature
C. Keep the newborn NPO and initiate IV fluids
D. Encourage frequent breastfeeding

Correct Answer: C. Keep the newborn NPO and initiate IV fluids

Rationale: Rectal atresia causes complete obstruction, so the child is kept NPO and IV
fluids are started in preparation for immediate surgical intervention.



2. Which finding is most characteristic of rectal atresia?

A. Absence of stool passage
B. Projectile vomiting after feeding
C. Currant-jelly stools
D. Ribbon-like stools

Correct Answer: A. Absence of stool passage

Rationale: Rectal atresia is closure of the rectal passage, preventing stool from passing.



3. What is the first stage of surgical correction for rectal atresia according to the
study guide?

A. Pyloromyotomy
B. Fundoplication
C. Anal dilation only
D. Resection and colostomy

Correct Answer: D. Resection and colostomy

, Rationale: The guide describes a two-stage repair, beginning with resection and colostomy
before later pull-through and colostomy closure.



4. After surgical correction of rectal atresia, which complications should the
nurse monitor for?

A. Glomerulonephritis and hypertension
B. Fistulas and strictures
C. Seizures and cerebral edema
D. Steatorrhea and anemia

Correct Answer: B. Fistulas and strictures

Rationale: Fistula formation and stricture are specifically identified postoperative
complications of rectal atresia repair.



5. Hypertrophic pyloric stenosis occurs because of:

A. Absence of intestinal ganglion cells
B. Thickening of the pyloric sphincter causing obstruction
C. Telescoping of one bowel segment into another
D. Inflammation of the appendix

Correct Answer: B. Thickening of the pyloric sphincter causing obstruction

Rationale: Hypertrophic pyloric stenosis involves thickening of the pyloric sphincter,
narrowing the pyloric canal.



6. Which vomiting pattern is most characteristic of hypertrophic pyloric
stenosis?

A. Bilious diarrhea after eating
B. Bloody emesis after every feeding
C. Regurgitation only when lying down
D. Non-bilious projectile vomiting shortly after feeding

Correct Answer: D. Non-bilious projectile vomiting shortly after feeding

, Rationale: The study guide repeatedly emphasizes new-onset, non-bilious projectile
vomiting shortly after feeding.



7. Which assessment finding supports a diagnosis of pyloric stenosis?

A. Olive-shaped mass in the right upper quadrant
B. Sausage-shaped mass in the right upper quadrant
C. Rigid lower-right abdomen
D. Bulging fontanelle

Correct Answer: A. Olive-shaped mass in the right upper quadrant

Rationale: An olive-shaped pyloric mass is a classic finding listed for hypertrophic pyloric
stenosis.



8. An upper GI series in pyloric stenosis is expected to demonstrate which
finding?

A. Steeple sign
B. Thumb sign
C. String sign
D. Crescent sign

Correct Answer: C. String sign

Rationale: The “string sign” occurs when barium passes through the narrowed pylorus.



9. A dehydrated infant with pyloric stenosis is scheduled for surgery. What
should happen first?

A. Begin full-strength formula
B. Perform immediate surgery despite electrolyte abnormalities
C. Give fruit juice
D. Correct dehydration and electrolyte imbalance

Correct Answer: D. Correct dehydration and electrolyte imbalance

Rationale: The notes state that surgery may be delayed until dehydration and electrolyte
imbalance are corrected.

, 10. Approximately when are oral feedings reintroduced after pyloromyotomy in
the study guide?

A. Immediately in recovery
B. About 6 hours after surgery
C. After 48 hours
D. Only after the infant passes stool

Correct Answer: B. About 6 hours after surgery

Rationale: PO feedings are restarted incrementally about 6 hours after surgery rather than
waiting for bowel sounds.



11. Which feeding device is highlighted for an infant with a cleft lip or palate?

A. Haberman feeder
B. Standard short nipple
C. Nasogastric tube for every infant
D. Pacifier feeder

Correct Answer: A. Haberman feeder

Rationale: The special elongated Haberman nipple helps regulate formula flow and reduce
aspiration risk.



12. Which position is appropriate when feeding an infant with a cleft palate?

A. Flat supine
B. Prone
C. Upright
D. Trendelenburg

Correct Answer: C. Upright

Rationale: Upright positioning decreases regurgitation and aspiration risk during feeding.



13. Cleft lip repair is typically performed at approximately:

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