,NR-328 Verified Exam 3 — Pediatric Nursing |
Chamberlain College of Nursing | Q & A |
2026/2027 Edition
1. A nurse is assessing a child with suspected epiglottitis. Which action should the nurse
prioritize?
A) Keep the child upright and avoid throat inspection
B) Obtain a throat culture immediately
C) Apply a warm compress to the neck
D) Administer oral ibuprofen for fever
Correct Answer: Keep the child upright and avoid throat inspection
Rationale: Epiglottitis is a life-threatening airway emergency. Inspecting the throat with a
tongue blade can trigger laryngospasm and complete airway obstruction. The child should be
kept calm and upright until emergency airway equipment is ready .
2. A child with Tetralogy of Fallot becomes cyanotic and agitated during a blood draw. Which
position should the nurse place the child in first?
A) High-Fowler's position
B) Knee-chest position
C) Trendelenburg position
D) Prone position
,Correct Answer: Knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance, which decreases the
right-to-left shunting of blood and improves pulmonary blood flow during a tet spell. This is the
priority intervention for acute cyanosis in Tetralogy of Fallot .
3. A 6-week-old infant is brought to the clinic presenting with non-bilious projectile vomiting
after feedings and a palpable olive-shaped mass in the right upper quadrant. Which condition is
the most likely diagnosis?
A) Intussusception
B) Gastroesophageal reflux
C) Hirschsprung disease
D) Hypertrophic pyloric stenosis
Correct Answer: Hypertrophic pyloric stenosis
Rationale: Hypertrophic pyloric stenosis involves thickening of the pyloric sphincter, leading to
gastric outlet obstruction. Classic findings include projectile vomiting and a firm, olive-shaped
mass in the epigastrium. The infant is often hungry and irritable despite frequent vomiting .
4. A 4-year-old child with Type 1 Diabetes Mellitus presents to the emergency department with
Kussmaul respirations and a blood glucose level of 450 mg/dL. What is the priority nursing
intervention?
A) Administer a bolus of 50% dextrose intravenously
B) Provide a subcutaneous injection of rapid-acting insulin
C) Initiate intravenous fluid resuscitation with normal saline
, D) Administer oral glucose tablets immediately
Correct Answer: Initiate intravenous fluid resuscitation with normal saline
Rationale: DKA is a life-threatening emergency characterized by severe dehydration and
metabolic acidosis. The priority intervention is restoring circulatory volume through IV fluid
resuscitation with isotonic saline. Insulin therapy is started after fluid resuscitation is underway .
5. An infant with a myelomeningocele is awaiting surgical repair. Which nursing action is
essential to maintain the integrity of the sac?
A) Place the infant in a supine position with the head elevated
B) Apply a dry sterile dressing to the sac every 4 hours
C) Wrap the infant's lower extremities tightly in a blanket
D) Keep the infant in a prone position with a sterile, moist, non-adherent dressing
Correct Answer: Keep the infant in a prone position with a sterile, moist, non-adherent dressing
Rationale: The infant must be placed in a prone position to prevent pressure on the exposed
sac. Keeping the sac moist with a sterile, non-adherent saline dressing prevents drying and
reduces infection risk. Frequent neurovascular assessments are required .
6. A 10-year-old child is being evaluated for a possible head injury after a fall. Which finding
would be the earliest sign of increased intracranial pressure (ICP)?
A) Bradycardia and widened pulse pressure
B) Change in the child's level of consciousness
C) Bilateral fixed and dilated pupils
Chamberlain College of Nursing | Q & A |
2026/2027 Edition
1. A nurse is assessing a child with suspected epiglottitis. Which action should the nurse
prioritize?
A) Keep the child upright and avoid throat inspection
B) Obtain a throat culture immediately
C) Apply a warm compress to the neck
D) Administer oral ibuprofen for fever
Correct Answer: Keep the child upright and avoid throat inspection
Rationale: Epiglottitis is a life-threatening airway emergency. Inspecting the throat with a
tongue blade can trigger laryngospasm and complete airway obstruction. The child should be
kept calm and upright until emergency airway equipment is ready .
2. A child with Tetralogy of Fallot becomes cyanotic and agitated during a blood draw. Which
position should the nurse place the child in first?
A) High-Fowler's position
B) Knee-chest position
C) Trendelenburg position
D) Prone position
,Correct Answer: Knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance, which decreases the
right-to-left shunting of blood and improves pulmonary blood flow during a tet spell. This is the
priority intervention for acute cyanosis in Tetralogy of Fallot .
3. A 6-week-old infant is brought to the clinic presenting with non-bilious projectile vomiting
after feedings and a palpable olive-shaped mass in the right upper quadrant. Which condition is
the most likely diagnosis?
A) Intussusception
B) Gastroesophageal reflux
C) Hirschsprung disease
D) Hypertrophic pyloric stenosis
Correct Answer: Hypertrophic pyloric stenosis
Rationale: Hypertrophic pyloric stenosis involves thickening of the pyloric sphincter, leading to
gastric outlet obstruction. Classic findings include projectile vomiting and a firm, olive-shaped
mass in the epigastrium. The infant is often hungry and irritable despite frequent vomiting .
4. A 4-year-old child with Type 1 Diabetes Mellitus presents to the emergency department with
Kussmaul respirations and a blood glucose level of 450 mg/dL. What is the priority nursing
intervention?
A) Administer a bolus of 50% dextrose intravenously
B) Provide a subcutaneous injection of rapid-acting insulin
C) Initiate intravenous fluid resuscitation with normal saline
, D) Administer oral glucose tablets immediately
Correct Answer: Initiate intravenous fluid resuscitation with normal saline
Rationale: DKA is a life-threatening emergency characterized by severe dehydration and
metabolic acidosis. The priority intervention is restoring circulatory volume through IV fluid
resuscitation with isotonic saline. Insulin therapy is started after fluid resuscitation is underway .
5. An infant with a myelomeningocele is awaiting surgical repair. Which nursing action is
essential to maintain the integrity of the sac?
A) Place the infant in a supine position with the head elevated
B) Apply a dry sterile dressing to the sac every 4 hours
C) Wrap the infant's lower extremities tightly in a blanket
D) Keep the infant in a prone position with a sterile, moist, non-adherent dressing
Correct Answer: Keep the infant in a prone position with a sterile, moist, non-adherent dressing
Rationale: The infant must be placed in a prone position to prevent pressure on the exposed
sac. Keeping the sac moist with a sterile, non-adherent saline dressing prevents drying and
reduces infection risk. Frequent neurovascular assessments are required .
6. A 10-year-old child is being evaluated for a possible head injury after a fall. Which finding
would be the earliest sign of increased intracranial pressure (ICP)?
A) Bradycardia and widened pulse pressure
B) Change in the child's level of consciousness
C) Bilateral fixed and dilated pupils
