2026/2027 Galen College
Q1. Which finding is most characteristic of pyloric stenosis in an
infant?
A) Projectile, nonbilious vomiting after feeding
B) Bilious vomiting with abdominal distention
C) Bloody diarrhea with fever
D) Barking cough with stridor
Correct Answer: A) Projectile, nonbilious vomiting after feeding
Rationale: Pyloric stenosis causes narrowing of the pyloric outlet, producing
forceful nonbilious vomiting, often shortly after feeding.
Q2. Which physical finding may support a diagnosis of pyloric
stenosis?
A) Palpable olive-shaped mass in the upper abdomen
B) Rigid abdomen with rebound tenderness
C) Enlarged cervical lymph nodes
D) Bilateral pedal edema
Correct Answer: A) Palpable olive-shaped mass in the upper abdomen
Rationale: Hypertrophy of the pyloric muscle can produce a small, firm, olive-
shaped mass that may be palpated in the upper abdomen.
Q3. Which acid-base imbalance is most likely in an infant with
prolonged vomiting from pyloric stenosis?
A) Metabolic alkalosis
B) Respiratory acidosis
C) Metabolic acidosis
D) Respiratory alkalosis
Correct Answer: A) Metabolic alkalosis
Rationale: Repeated loss of gastric hydrochloric acid through vomiting can
produce metabolic alkalosis.
Q4. Which intervention is the priority before surgical correction of
pyloric stenosis?
A) Correct dehydration and electrolyte abnormalities
B) Begin solid foods
, C) Encourage unrestricted oral feeding
D) Administer antidiarrheal medication
Correct Answer: A) Correct dehydration and electrolyte abnormalities
Rationale: Fluid and electrolyte abnormalities must be corrected before
surgery to stabilize the infant and reduce perioperative risk.
Q5. Which congenital gastrointestinal disorder commonly presents
with failure to pass meconium shortly after birth?
A) Hirschsprung disease
B) Pyloric stenosis
C) Intussusception
D) Appendicitis
Correct Answer: A) Hirschsprung disease
Rationale: Hirschsprung disease involves absence of ganglion cells in a
portion of the bowel, preventing normal relaxation and movement of
intestinal contents.
Q6. Which stool pattern is associated with Hirschsprung disease?
A) Ribbon-like, foul-smelling stools
B) Currant-jelly stools
C) Clay-colored stools
D) Black tarry stools
Correct Answer: A) Ribbon-like, foul-smelling stools
Rationale: Narrowing of the affected bowel can produce thin, ribbon-like
stools and chronic constipation.
Q7. Which infant finding should raise concern for Hirschsprung
disease?
A) Delayed passage of meconium
B) Projectile vomiting after every feeding
C) Excessive drooling
D) Frequent urination
Correct Answer: A) Delayed passage of meconium
Rationale: Failure to pass meconium within the expected period after birth
can indicate an intestinal obstruction such as Hirschsprung disease.