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NR 328 EXAM #2 PRACTICE EXAM | {LATEST
2026/ 2027 UPDATE} COMPLETE ACTUAL AND
AUTHENTIC EXAM | BRAND NEW!
A 3-day-old infant presents with abdominal distention, is vomiting,
and has not passed any meconium stools. What disease should the
nurse suspect?
a. Hirschsprung disease
b. Intussusception
c. Celiac disease
d. Pyloric stenosis
Answer: A
Rationale: The clinical manifestations of Hirschsprung disease in a 3-
day-old infant include abdominal distention, vomiting, and failure to
pass meconium stools. Pyloric stenosis would present with vomiting
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but not distention or failure to pass meconium stools. Intussusception
presents with abdominal cramping and celiac disease presents with
malabsorption.
The parents of a newborn with an umbilical hernia ask about
treatment options. The nurse’s response should be based on which
knowledge?
a. The defect usually resolves spontaneously by 3 to 5 years of age.
b. Surgery is recommended as soon as possible.
c. Aggressive treatment is necessary to reduce its high mortality.
d. Taping the abdomen to flatten the protrusion is sometimes helpful.
Answer: A
Rationale: The umbilical hernia usually resolves by ages 3 to 5 years of
age without intervention. Umbilical hernias rarely become
problematic. Incarceration, where the hernia is constricted and cannot
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be reduced manually, is rare. Umbilical hernias are not associated
with a high mortality rate. Taping the abdomen flat does not help heal
the hernia; it can cause skin irritation.
A child with pyloric stenosis is having excessive vomiting. The nurse
should assess for what potential complication?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Hyperchloremia
d. Hyperkalemia
Answer: A
Rationale: Infants with excessive vomiting are prone to metabolic
alkalosis from the loss of hydrogen ions. Potassium and chloride ions
are lost with vomiting. Metabolic alkalosis, not acidosis, is likely.
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When caring for a child with probable appendicitis, the nurse should
be alert to recognize which sign or symptom as a manifestation of
perforation?
a. Sudden relief from pain
b. Anorexia
c. Bradycardia
d. Decreased abdominal distention
Answer: A
Rationale: Signs of peritonitis, in addition to fever, include sudden
relief from pain after perforation. Anorexia is already a clinical
manifestation of appendicitis. Tachycardia, not bradycardia, is a
manifestation of peritonitis. Abdominal distention usually increases in
addition to an increase in pain (usually diffuse and accompanied by
rigid guarding of the abdomen).
NR 328 EXAM #2 PRACTICE EXAM | {LATEST
2026/ 2027 UPDATE} COMPLETE ACTUAL AND
AUTHENTIC EXAM | BRAND NEW!
A 3-day-old infant presents with abdominal distention, is vomiting,
and has not passed any meconium stools. What disease should the
nurse suspect?
a. Hirschsprung disease
b. Intussusception
c. Celiac disease
d. Pyloric stenosis
Answer: A
Rationale: The clinical manifestations of Hirschsprung disease in a 3-
day-old infant include abdominal distention, vomiting, and failure to
pass meconium stools. Pyloric stenosis would present with vomiting
,Page 2 of 122
but not distention or failure to pass meconium stools. Intussusception
presents with abdominal cramping and celiac disease presents with
malabsorption.
The parents of a newborn with an umbilical hernia ask about
treatment options. The nurse’s response should be based on which
knowledge?
a. The defect usually resolves spontaneously by 3 to 5 years of age.
b. Surgery is recommended as soon as possible.
c. Aggressive treatment is necessary to reduce its high mortality.
d. Taping the abdomen to flatten the protrusion is sometimes helpful.
Answer: A
Rationale: The umbilical hernia usually resolves by ages 3 to 5 years of
age without intervention. Umbilical hernias rarely become
problematic. Incarceration, where the hernia is constricted and cannot
,Page 3 of 122
be reduced manually, is rare. Umbilical hernias are not associated
with a high mortality rate. Taping the abdomen flat does not help heal
the hernia; it can cause skin irritation.
A child with pyloric stenosis is having excessive vomiting. The nurse
should assess for what potential complication?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Hyperchloremia
d. Hyperkalemia
Answer: A
Rationale: Infants with excessive vomiting are prone to metabolic
alkalosis from the loss of hydrogen ions. Potassium and chloride ions
are lost with vomiting. Metabolic alkalosis, not acidosis, is likely.
, Page 4 of 122
When caring for a child with probable appendicitis, the nurse should
be alert to recognize which sign or symptom as a manifestation of
perforation?
a. Sudden relief from pain
b. Anorexia
c. Bradycardia
d. Decreased abdominal distention
Answer: A
Rationale: Signs of peritonitis, in addition to fever, include sudden
relief from pain after perforation. Anorexia is already a clinical
manifestation of appendicitis. Tachycardia, not bradycardia, is a
manifestation of peritonitis. Abdominal distention usually increases in
addition to an increase in pain (usually diffuse and accompanied by
rigid guarding of the abdomen).
