NUR 242 PRACTICE EXAM 3
(PEDIATRICS & ADVANCED MED-
SURG) QUESTIONS & VERIFIED
ANSWERS | GALEN COLLEGE (A+
GUARANTEE)
1. A 2-year-old child with Tetralogy of Fallot experiences a ‘tet spell’ during a blood draw.
Which nursing action should be prioritized first?
A. Administer 100% oxygen via face mask.
B. Place the child in a knee-chest position.
C. Administer intramuscular morphine sulfate.
D. Increase the rate of intravenous fluids.
Answer: B
Conceptual Explanation: The knee-chest position reduces venous return from the lower
extremities and increases systemic vascular resistance, which helps force blood into the
pulmonary artery to improve oxygenation.
2. A nurse is caring for a 4-year-old child suspected of having epiglottitis. Which assessment
finding requires immediate intervention?
A. A barking, seal-like cough.
,B. The child is leaning forward with the chin thrusted out (tripod position).
C. A low-grade fever of 100.2 F.
D. Scattered wheezing heard in the lower lobes.
Answer: B
Conceptual Explanation: The tripod position is a classic sign of respiratory distress in
epiglottitis, indicating the child is attempting to keep the airway open. This is a medical
emergency.
3. A child is admitted with a diagnosis of Nephrotic Syndrome. Which clinical manifestation
should the nurse expect to observe?
A. Gross hematuria and hypertension.
B. Increased urine output and weight loss.
C. Elevated serum albumin levels.
D. Massive proteinuria and generalized edema.
Answer: D
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, and severe edema (anasarca) due to increased glomerular permeability.
4. A 6-week-old infant is brought to the clinic with projectile vomiting after feedings. The
nurse notes an olive-shaped mass in the epigastrium. What is the likely diagnosis?
A. Intussusception.
, B. Gastroesophageal reflux disease (GERD).
C. Hirschsprung disease.
D. Hypertrophic pyloric stenosis.
Answer: D
Conceptual Explanation: Hypertrophic pyloric stenosis typically presents at 3-6 weeks of
age with non-bilious projectile vomiting and a palpable olive-shaped mass in the right
upper quadrant.
5. Which clinical finding is most characteristic of Hirschsprung disease in a neonate?
A. Steatorrhea and foul-smelling stools.
B. Currant jelly-like stools containing blood and mucus.
C. Failure to pass meconium within the first 24 to 48 hours of life.
D. Visible peristaltic waves moving from left to right.
Answer: C
Conceptual Explanation: Hirschsprung disease is characterized by a lack of ganglion cells
in the colon, leading to an inability to relax the anal sphincter and pass meconium.
6. A nurse is providing discharge teaching for the parents of a child with Cystic Fibrosis. Which
instruction regarding pancreatic enzyme replacement is correct?
A. Enzymes should be taken only with the morning and evening meals.
B. The capsules should be crushed to improve absorption.
(PEDIATRICS & ADVANCED MED-
SURG) QUESTIONS & VERIFIED
ANSWERS | GALEN COLLEGE (A+
GUARANTEE)
1. A 2-year-old child with Tetralogy of Fallot experiences a ‘tet spell’ during a blood draw.
Which nursing action should be prioritized first?
A. Administer 100% oxygen via face mask.
B. Place the child in a knee-chest position.
C. Administer intramuscular morphine sulfate.
D. Increase the rate of intravenous fluids.
Answer: B
Conceptual Explanation: The knee-chest position reduces venous return from the lower
extremities and increases systemic vascular resistance, which helps force blood into the
pulmonary artery to improve oxygenation.
2. A nurse is caring for a 4-year-old child suspected of having epiglottitis. Which assessment
finding requires immediate intervention?
A. A barking, seal-like cough.
,B. The child is leaning forward with the chin thrusted out (tripod position).
C. A low-grade fever of 100.2 F.
D. Scattered wheezing heard in the lower lobes.
Answer: B
Conceptual Explanation: The tripod position is a classic sign of respiratory distress in
epiglottitis, indicating the child is attempting to keep the airway open. This is a medical
emergency.
3. A child is admitted with a diagnosis of Nephrotic Syndrome. Which clinical manifestation
should the nurse expect to observe?
A. Gross hematuria and hypertension.
B. Increased urine output and weight loss.
C. Elevated serum albumin levels.
D. Massive proteinuria and generalized edema.
Answer: D
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, and severe edema (anasarca) due to increased glomerular permeability.
4. A 6-week-old infant is brought to the clinic with projectile vomiting after feedings. The
nurse notes an olive-shaped mass in the epigastrium. What is the likely diagnosis?
A. Intussusception.
, B. Gastroesophageal reflux disease (GERD).
C. Hirschsprung disease.
D. Hypertrophic pyloric stenosis.
Answer: D
Conceptual Explanation: Hypertrophic pyloric stenosis typically presents at 3-6 weeks of
age with non-bilious projectile vomiting and a palpable olive-shaped mass in the right
upper quadrant.
5. Which clinical finding is most characteristic of Hirschsprung disease in a neonate?
A. Steatorrhea and foul-smelling stools.
B. Currant jelly-like stools containing blood and mucus.
C. Failure to pass meconium within the first 24 to 48 hours of life.
D. Visible peristaltic waves moving from left to right.
Answer: C
Conceptual Explanation: Hirschsprung disease is characterized by a lack of ganglion cells
in the colon, leading to an inability to relax the anal sphincter and pass meconium.
6. A nurse is providing discharge teaching for the parents of a child with Cystic Fibrosis. Which
instruction regarding pancreatic enzyme replacement is correct?
A. Enzymes should be taken only with the morning and evening meals.
B. The capsules should be crushed to improve absorption.
