MVU NURS 629 EXAM 4 WITH
COMPLETE SOLUTION LATEST
UPDATE(A+ exam)
Course
NURS 629
1. A newborn develops mild jaundice at 3 days of age and is otherwise feeding well and
clinically stable. Which explanation is most consistent with physiologic jaundice?
A. Severe bacterial infection
B. Normal increased bilirubin production combined with immature hepatic processing
C. Complete biliary obstruction
D. Rh incompatibility in every case
Correct Answer: B. Normal increased bilirubin production combined with immature
hepatic processing
Rationale: Physiologic neonatal jaundice commonly occurs during the first several days after
birth because newborns have increased bilirubin production and relatively immature bilirubin-
processing mechanisms.
2. Which finding in a newborn with jaundice requires prompt evaluation?
A. Mild jaundice beginning after the first 24 hours
B. Jaundice appearing during the first 24 hours of life
C. Mild jaundice that is improving
D. Normal feeding and urine output
Correct Answer: B. Jaundice appearing during the first 24 hours of life
Rationale: Jaundice during the first 24 hours is considered abnormal and may indicate
hemolysis, infection, or another pathologic process requiring evaluation.
3. A breastfeeding newborn has poor intake, few wet diapers, and increasing jaundice
during the first week. What is the priority concern?
A. Inadequate intake contributing to dehydration and increased bilirubin
B. Hyperthyroidism
C. Excessive fluid intake
D. Normal growth acceleration
Correct Answer: A. Inadequate intake contributing to dehydration and increased bilirubin
Rationale: Poor feeding can decrease stool and urine output, reducing bilirubin elimination and
contributing to dehydration and worsening jaundice.
,4. Which assessment is most useful when evaluating dehydration in a young child?
A. Skin and mucous membranes, urine output, pulses, and capillary refill
B. Hair color only
C. Hearing acuity only
D. Abdominal circumference only
Correct Answer: A. Skin and mucous membranes, urine output, pulses, and capillary refill
Rationale: Hydration assessment includes mucous membranes, skin turgor, urine output,
peripheral perfusion, pulses, tears, and mental status.
5. Which finding is most concerning for significant dehydration in an infant?
A. Frequent wet diapers
B. Sunken fontanelle and decreased urine output
C. Moist mucous membranes
D. Brisk capillary refill
Correct Answer: B. Sunken fontanelle and decreased urine output
Rationale: A sunken fontanelle and reduced urine output are important clinical indicators of
fluid deficit in infants.
6. A child with acute viral gastroenteritis is alert but has repeated watery diarrhea. Which
intervention is most appropriate initially if the child can drink?
A. Small, frequent amounts of oral rehydration solution
B. Complete restriction of fluids
C. Carbonated beverages as the primary treatment
D. Immediate high-fat meals
Correct Answer: A. Small, frequent amounts of oral rehydration solution
Rationale: Oral rehydration solution replaces water and electrolytes. Small, frequent amounts
can improve tolerance in children with vomiting or diarrhea.
7. What is the most important complication to monitor for in a child with gastroenteritis?
A. Dehydration
B. Hyperthyroidism
C. Cataracts
D. Chronic hypertension
Correct Answer: A. Dehydration
Rationale: Vomiting and diarrhea can cause substantial fluid and electrolyte losses, making
dehydration a major concern in pediatric gastroenteritis.
, 8. Which finding suggests severe dehydration in a child?
A. Normal urine output
B. Lethargy, weak pulses, and markedly decreased urine output
C. Moist mucous membranes
D. Normal capillary refill
Correct Answer: B. Lethargy, weak pulses, and markedly decreased urine output
Rationale: Severe dehydration can compromise circulation and neurologic status, producing
lethargy, weak pulses, prolonged capillary refill, and oliguria.
9. A child presents with right lower-quadrant abdominal pain. Which physical finding is
associated with appendiceal irritation?
A. Rovsing sign
B. Kernig sign
C. Babinski sign
D. Romberg sign
Correct Answer: A. Rovsing sign
Rationale: A positive Rovsing sign occurs when palpation of the left lower quadrant produces
pain in the right lower quadrant, suggesting peritoneal irritation associated with appendicitis.
10. Which finding is most concerning for appendicitis in a child?
A. Progressive right lower-quadrant pain with fever and vomiting
B. Mild generalized itching
C. Isolated ear pain
D. Painless rash
Correct Answer: A. Progressive right lower-quadrant pain with fever and vomiting
Rationale: Appendicitis commonly presents with progressive abdominal pain, often localizing to
the right lower quadrant, accompanied by anorexia, nausea/vomiting, and fever.
11. A physically active adolescent reports pain and swelling over the tibial tubercle. Which
condition should the nurse suspect?
A. Osgood-Schlatter disease
B. Legg-Calvé-Perthes disease
C. Scoliosis
D. Developmental dysplasia of the hip
Correct Answer: A. Osgood-Schlatter disease
COMPLETE SOLUTION LATEST
UPDATE(A+ exam)
Course
NURS 629
1. A newborn develops mild jaundice at 3 days of age and is otherwise feeding well and
clinically stable. Which explanation is most consistent with physiologic jaundice?
A. Severe bacterial infection
B. Normal increased bilirubin production combined with immature hepatic processing
C. Complete biliary obstruction
D. Rh incompatibility in every case
Correct Answer: B. Normal increased bilirubin production combined with immature
hepatic processing
Rationale: Physiologic neonatal jaundice commonly occurs during the first several days after
birth because newborns have increased bilirubin production and relatively immature bilirubin-
processing mechanisms.
2. Which finding in a newborn with jaundice requires prompt evaluation?
A. Mild jaundice beginning after the first 24 hours
B. Jaundice appearing during the first 24 hours of life
C. Mild jaundice that is improving
D. Normal feeding and urine output
Correct Answer: B. Jaundice appearing during the first 24 hours of life
Rationale: Jaundice during the first 24 hours is considered abnormal and may indicate
hemolysis, infection, or another pathologic process requiring evaluation.
3. A breastfeeding newborn has poor intake, few wet diapers, and increasing jaundice
during the first week. What is the priority concern?
A. Inadequate intake contributing to dehydration and increased bilirubin
B. Hyperthyroidism
C. Excessive fluid intake
D. Normal growth acceleration
Correct Answer: A. Inadequate intake contributing to dehydration and increased bilirubin
Rationale: Poor feeding can decrease stool and urine output, reducing bilirubin elimination and
contributing to dehydration and worsening jaundice.
,4. Which assessment is most useful when evaluating dehydration in a young child?
A. Skin and mucous membranes, urine output, pulses, and capillary refill
B. Hair color only
C. Hearing acuity only
D. Abdominal circumference only
Correct Answer: A. Skin and mucous membranes, urine output, pulses, and capillary refill
Rationale: Hydration assessment includes mucous membranes, skin turgor, urine output,
peripheral perfusion, pulses, tears, and mental status.
5. Which finding is most concerning for significant dehydration in an infant?
A. Frequent wet diapers
B. Sunken fontanelle and decreased urine output
C. Moist mucous membranes
D. Brisk capillary refill
Correct Answer: B. Sunken fontanelle and decreased urine output
Rationale: A sunken fontanelle and reduced urine output are important clinical indicators of
fluid deficit in infants.
6. A child with acute viral gastroenteritis is alert but has repeated watery diarrhea. Which
intervention is most appropriate initially if the child can drink?
A. Small, frequent amounts of oral rehydration solution
B. Complete restriction of fluids
C. Carbonated beverages as the primary treatment
D. Immediate high-fat meals
Correct Answer: A. Small, frequent amounts of oral rehydration solution
Rationale: Oral rehydration solution replaces water and electrolytes. Small, frequent amounts
can improve tolerance in children with vomiting or diarrhea.
7. What is the most important complication to monitor for in a child with gastroenteritis?
A. Dehydration
B. Hyperthyroidism
C. Cataracts
D. Chronic hypertension
Correct Answer: A. Dehydration
Rationale: Vomiting and diarrhea can cause substantial fluid and electrolyte losses, making
dehydration a major concern in pediatric gastroenteritis.
, 8. Which finding suggests severe dehydration in a child?
A. Normal urine output
B. Lethargy, weak pulses, and markedly decreased urine output
C. Moist mucous membranes
D. Normal capillary refill
Correct Answer: B. Lethargy, weak pulses, and markedly decreased urine output
Rationale: Severe dehydration can compromise circulation and neurologic status, producing
lethargy, weak pulses, prolonged capillary refill, and oliguria.
9. A child presents with right lower-quadrant abdominal pain. Which physical finding is
associated with appendiceal irritation?
A. Rovsing sign
B. Kernig sign
C. Babinski sign
D. Romberg sign
Correct Answer: A. Rovsing sign
Rationale: A positive Rovsing sign occurs when palpation of the left lower quadrant produces
pain in the right lower quadrant, suggesting peritoneal irritation associated with appendicitis.
10. Which finding is most concerning for appendicitis in a child?
A. Progressive right lower-quadrant pain with fever and vomiting
B. Mild generalized itching
C. Isolated ear pain
D. Painless rash
Correct Answer: A. Progressive right lower-quadrant pain with fever and vomiting
Rationale: Appendicitis commonly presents with progressive abdominal pain, often localizing to
the right lower quadrant, accompanied by anorexia, nausea/vomiting, and fever.
11. A physically active adolescent reports pain and swelling over the tibial tubercle. Which
condition should the nurse suspect?
A. Osgood-Schlatter disease
B. Legg-Calvé-Perthes disease
C. Scoliosis
D. Developmental dysplasia of the hip
Correct Answer: A. Osgood-Schlatter disease
