1
NSG 3600 PEDS EXAM 3 – GI, GU & NEURO EXAM PRE &
POST-OPERATIVE CARE | 150 QUESTIONS WITH
CORRECT ANSWERS & RATIONALES.
1.
A nurse is assessing a 3-week-old infant whose parents report that the infant has progressively
worsening vomiting after feeding. The vomiting is forceful, occurs shortly after eating, and the
parents state that the infant appears hungry again immediately afterward. Physical assessment
reveals signs of mild dehydration and a small olive-shaped mass in the upper abdomen. Which
condition should the nurse suspect?
A. Gastroesophageal reflux disease
B. Hypertrophic pyloric stenosis
C. Intussusception
D. Hirschsprung disease
Answer: B. Hypertrophic pyloric stenosis
2.
A nurse is caring for an infant admitted with suspected hypertrophic pyloric stenosis who has
repeated episodes of projectile vomiting. Which laboratory abnormality would the nurse most
likely expect as a result of prolonged vomiting?
A. Metabolic acidosis with hyperkalemia
B. Respiratory acidosis with hypernatremia
C. Metabolic alkalosis with hypokalemia
D. Respiratory alkalosis with hypocalcemia
Answer: C. Metabolic alkalosis with hypokalemia
3.
A child is admitted with suspected intussusception after experiencing sudden episodes of severe
abdominal pain during which the child pulls the knees toward the chest and cries intensely.
Which additional finding is most characteristic of this condition?
A. Clay-colored stools
B. Currant jelly-like stools
C. Steatorrhea
D. Bloody emesis
Answer: B. Currant jelly-like stools
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4.
A nurse is caring for a child with confirmed intussusception. The provider prescribes an air or
contrast enema. The nurse understands that this procedure is performed primarily because it may:
A. Permanently prevent future food allergies
B. Diagnose and reduce the intestinal obstruction
C. Eliminate the need for fluid replacement
D. Treat dehydration caused by vomiting
Answer: B. Diagnose and reduce the intestinal obstruction
5.
A newborn has failed to pass meconium within the expected period after birth and develops
abdominal distention and bilious vomiting. The nurse suspects Hirschsprung disease. Which
underlying abnormality is associated with this disorder?
A. Absence of intestinal ganglion cells
B. Excessive production of digestive enzymes
C. Increased absorption of water from the colon
D. Obstruction caused by an abdominal tumor
Answer: A. Absence of intestinal ganglion cells
6.
A nurse is assessing an infant diagnosed with Hirschsprung disease. Which assessment finding
requires immediate reporting because it may indicate the development of a serious complication?
A. Mild hunger before feeding
B. Explosive diarrhea and fever
C. Increased interest in toys
D. Small amount of clear nasal drainage
Answer: B. Explosive diarrhea and fever
7.
A child with a history of chronic constipation is being evaluated for possible Hirschsprung
disease. Which intervention should the nurse anticipate as part of the diagnostic evaluation?
A. Rectal biopsy
B. Electroencephalogram
C. Bone marrow aspiration
D. Cardiac catheterization
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Answer: A. Rectal biopsy
8.
A nurse provides discharge teaching to the parents of a child who has undergone surgery for
Hirschsprung disease. Which finding should the parents be instructed to report promptly?
A. Fever and increasing abdominal distention
B. Increased appetite after recovery
C. Sleeping longer after a busy day
D. Requesting fluids between meals
Answer: A. Fever and increasing abdominal distention
9.
A child is admitted with suspected appendicitis and reports pain that began around the umbilicus
before moving to the right lower quadrant. Which nursing action is most appropriate?
A. Administer a laxative
B. Apply a heating pad to the abdomen
C. Keep the child NPO and monitor closely
D. Encourage a large meal before diagnostic testing
Answer: C. Keep the child NPO and monitor closely
10.
A nurse is caring for a child with suspected appendicitis. Which action should the nurse avoid
because it could increase the risk of appendiceal rupture?
A. Maintaining NPO status
B. Applying heat to the abdomen
C. Monitoring temperature
D. Establishing intravenous access
Answer: B. Applying heat to the abdomen
11.
A child recovering after an appendectomy suddenly develops increasing abdominal pain, fever,
tachycardia, and a rigid abdomen. Which complication should the nurse suspect?
A. Peritonitis
B. Mild dehydration
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C. Seasonal allergy
D. Otitis media
Answer: A. Peritonitis
12.
A nurse is caring for an infant with gastroesophageal reflux. Which intervention should the nurse
recommend to help decrease reflux symptoms?
A. Feeding one very large meal daily
B. Keeping the infant flat immediately after feeding
C. Providing smaller, more frequent feedings
D. Restricting all fluids between feedings
Answer: C. Providing smaller, more frequent feedings
13.
A nurse is teaching parents about signs of dehydration in an infant experiencing repeated
vomiting and diarrhea. Which finding indicates severe dehydration requiring immediate
evaluation?
A. Increased tears when crying
B. Moist mucous membranes
C. Decreased urine output and lethargy
D. Increased interest in feeding
Answer: C. Decreased urine output and lethargy
14.
A child is admitted with acute gastroenteritis and moderate dehydration. Which assessment
finding would the nurse expect?
A. Increased urine output
B. Dry mucous membranes and decreased tears
C. Bradycardia with bounding pulses
D. Moist skin with normal capillary refill
Answer: B. Dry mucous membranes and decreased tears
15.
A nurse is caring for a child receiving oral rehydration therapy after acute diarrhea. Which fluid
should the nurse recognize as most appropriate for replacing fluids and electrolytes?
NSG 3600 PEDS EXAM 3 – GI, GU & NEURO EXAM PRE &
POST-OPERATIVE CARE | 150 QUESTIONS WITH
CORRECT ANSWERS & RATIONALES.
1.
A nurse is assessing a 3-week-old infant whose parents report that the infant has progressively
worsening vomiting after feeding. The vomiting is forceful, occurs shortly after eating, and the
parents state that the infant appears hungry again immediately afterward. Physical assessment
reveals signs of mild dehydration and a small olive-shaped mass in the upper abdomen. Which
condition should the nurse suspect?
A. Gastroesophageal reflux disease
B. Hypertrophic pyloric stenosis
C. Intussusception
D. Hirschsprung disease
Answer: B. Hypertrophic pyloric stenosis
2.
A nurse is caring for an infant admitted with suspected hypertrophic pyloric stenosis who has
repeated episodes of projectile vomiting. Which laboratory abnormality would the nurse most
likely expect as a result of prolonged vomiting?
A. Metabolic acidosis with hyperkalemia
B. Respiratory acidosis with hypernatremia
C. Metabolic alkalosis with hypokalemia
D. Respiratory alkalosis with hypocalcemia
Answer: C. Metabolic alkalosis with hypokalemia
3.
A child is admitted with suspected intussusception after experiencing sudden episodes of severe
abdominal pain during which the child pulls the knees toward the chest and cries intensely.
Which additional finding is most characteristic of this condition?
A. Clay-colored stools
B. Currant jelly-like stools
C. Steatorrhea
D. Bloody emesis
Answer: B. Currant jelly-like stools
,2
4.
A nurse is caring for a child with confirmed intussusception. The provider prescribes an air or
contrast enema. The nurse understands that this procedure is performed primarily because it may:
A. Permanently prevent future food allergies
B. Diagnose and reduce the intestinal obstruction
C. Eliminate the need for fluid replacement
D. Treat dehydration caused by vomiting
Answer: B. Diagnose and reduce the intestinal obstruction
5.
A newborn has failed to pass meconium within the expected period after birth and develops
abdominal distention and bilious vomiting. The nurse suspects Hirschsprung disease. Which
underlying abnormality is associated with this disorder?
A. Absence of intestinal ganglion cells
B. Excessive production of digestive enzymes
C. Increased absorption of water from the colon
D. Obstruction caused by an abdominal tumor
Answer: A. Absence of intestinal ganglion cells
6.
A nurse is assessing an infant diagnosed with Hirschsprung disease. Which assessment finding
requires immediate reporting because it may indicate the development of a serious complication?
A. Mild hunger before feeding
B. Explosive diarrhea and fever
C. Increased interest in toys
D. Small amount of clear nasal drainage
Answer: B. Explosive diarrhea and fever
7.
A child with a history of chronic constipation is being evaluated for possible Hirschsprung
disease. Which intervention should the nurse anticipate as part of the diagnostic evaluation?
A. Rectal biopsy
B. Electroencephalogram
C. Bone marrow aspiration
D. Cardiac catheterization
,3
Answer: A. Rectal biopsy
8.
A nurse provides discharge teaching to the parents of a child who has undergone surgery for
Hirschsprung disease. Which finding should the parents be instructed to report promptly?
A. Fever and increasing abdominal distention
B. Increased appetite after recovery
C. Sleeping longer after a busy day
D. Requesting fluids between meals
Answer: A. Fever and increasing abdominal distention
9.
A child is admitted with suspected appendicitis and reports pain that began around the umbilicus
before moving to the right lower quadrant. Which nursing action is most appropriate?
A. Administer a laxative
B. Apply a heating pad to the abdomen
C. Keep the child NPO and monitor closely
D. Encourage a large meal before diagnostic testing
Answer: C. Keep the child NPO and monitor closely
10.
A nurse is caring for a child with suspected appendicitis. Which action should the nurse avoid
because it could increase the risk of appendiceal rupture?
A. Maintaining NPO status
B. Applying heat to the abdomen
C. Monitoring temperature
D. Establishing intravenous access
Answer: B. Applying heat to the abdomen
11.
A child recovering after an appendectomy suddenly develops increasing abdominal pain, fever,
tachycardia, and a rigid abdomen. Which complication should the nurse suspect?
A. Peritonitis
B. Mild dehydration
, 4
C. Seasonal allergy
D. Otitis media
Answer: A. Peritonitis
12.
A nurse is caring for an infant with gastroesophageal reflux. Which intervention should the nurse
recommend to help decrease reflux symptoms?
A. Feeding one very large meal daily
B. Keeping the infant flat immediately after feeding
C. Providing smaller, more frequent feedings
D. Restricting all fluids between feedings
Answer: C. Providing smaller, more frequent feedings
13.
A nurse is teaching parents about signs of dehydration in an infant experiencing repeated
vomiting and diarrhea. Which finding indicates severe dehydration requiring immediate
evaluation?
A. Increased tears when crying
B. Moist mucous membranes
C. Decreased urine output and lethargy
D. Increased interest in feeding
Answer: C. Decreased urine output and lethargy
14.
A child is admitted with acute gastroenteritis and moderate dehydration. Which assessment
finding would the nurse expect?
A. Increased urine output
B. Dry mucous membranes and decreased tears
C. Bradycardia with bounding pulses
D. Moist skin with normal capillary refill
Answer: B. Dry mucous membranes and decreased tears
15.
A nurse is caring for a child receiving oral rehydration therapy after acute diarrhea. Which fluid
should the nurse recognize as most appropriate for replacing fluids and electrolytes?
