NSG 3600 Pediatrics Exam 3 (GI, GU &
Neurology) | Verified Questions & Correct
Answers with Rationales | Complete
Pediatric Nursing Study Guide for
Guaranteed Exam Prep Success
• This is a question multiple-choice study guide for NSG 3600 Pediatrics Exam 3,
featuring verified questions with bolded correct answers and evidence-based
EXPERT RATIONALE — use it by attempting each question, then reviewing the
EXPERT RATIONALE to reinforce clinical reasoning.
• Each question is structured with 5 options (A–E), one correct answer bolded and
clearly marked, followed immediately by the EXPERT RATIONALE — ideal for timed
self-quizzing, group review, or last-minute exam prep across all three systems.
NSG 3600 PEDIATRICS EXAM 3
GI · GU · NEUROLOGY | Questions
1. A nurse is assessing a 3-week-old infant who presents with projectile
vomiting after feedings. The vomiting is non-bilious. Which condition does the
nurse suspect?
A. Intussusception
B. Gastroesophageal reflux disease (GERD)
C. Pyloric stenosis
D. Hirschsprung's disease
E. Duodenal atresia
✓ Correct Answer: C. Pyloric stenosis
EXPERT RATIONALE: Pyloric stenosis presents in infants typically between 2–8
weeks of age with forceful, projectile, non-bilious vomiting after feedings. It is
caused by hypertrophy of the pyloric sphincter, which obstructs gastric emptying.
GERD also causes vomiting but it is not projectile.
,2. A nurse is caring for an infant diagnosed with pyloric stenosis. Which
electrolyte imbalance does the nurse anticipate?
A. Hyperkalemia and metabolic acidosis
B. Hypernatremia and respiratory alkalosis
C. Hypokalemia and metabolic alkalosis
D. Hyponatremia and metabolic acidosis
E. Hypercalcemia and respiratory acidosis
✓ Correct Answer: C. Hypokalemia and metabolic alkalosis
EXPERT RATIONALE: Persistent vomiting in pyloric stenosis causes loss of
hydrochloric acid (HCl), leading to metabolic alkalosis. The loss of potassium
through vomiting and renal compensation leads to hypokalemia. This is the classic
electrolyte pattern associated with pyloric stenosis.
3. A nurse is preparing a 6-week-old for pyloromyotomy. Which finding on
assessment confirms pyloric stenosis?
A. Distended abdomen with visible peristaltic waves from right to left
B. Olive-shaped mass palpated in the right upper quadrant
C. Abdominal rigidity with rebound tenderness
D. Currant jelly stools
E. Bilious vomiting immediately after birth
✓ Correct Answer: B. Olive-shaped mass palpated in the right upper quadrant
EXPERT RATIONALE: The classic physical finding in pyloric stenosis is a palpable
olive-shaped mass in the epigastric/right upper quadrant area, representing the
hypertrophied pylorus. Visible peristaltic waves may also be seen, but the olive-
shaped mass is the definitive sign.
,4. A 2-month-old is diagnosed with GERD. Which nursing instruction is most
appropriate for the parents?
A. Position the infant prone after feedings
B. Feed the infant every 4–6 hours to reduce acid production
C. Thicken feedings and keep the infant upright for 30 minutes after feeding
D. Administer antacids before every feeding
E. Switch from breast milk to soy formula immediately
✓ Correct Answer: C. Thicken feedings and keep the infant upright for 30
minutes after feeding
EXPERT RATIONALE: For GERD management in infants, thickening feeds and
positioning the infant upright for 20–30 minutes post-feeding helps reduce reflux
by gravity. Prone positioning increases SIDS risk and is contraindicated in infants.
5. A nurse is assessing a 9-month-old infant who has been crying inconsolably
and drawing up the knees to the abdomen. The stool appears like "currant
jelly." Which condition does the nurse suspect?
A. Pyloric stenosis
B. Appendicitis
C. Hirschsprung's disease
D. Intussusception
E. Necrotizing enterocolitis
✓ Correct Answer: D. Intussusception
EXPERT RATIONALE: Intussusception classically presents in infants 6 months to 2
years with sudden onset of colicky abdominal pain, the child drawing up the knees,
and "currant jelly" stools (a mixture of blood and mucus). This occurs when one
portion of the intestine telescopes into another.
, 6. Which is the initial treatment of choice for intussusception?
A. Emergency surgical resection
B. Oral laxatives and increased fluid intake
C. Air or hydrostatic enema reduction
D. Nasogastric tube decompression
E. IV antibiotics and bowel rest
✓ Correct Answer: C. Air or hydrostatic enema reduction
EXPERT RATIONALE: The first-line treatment for intussusception is a non-surgical
hydrostatic or pneumatic (air) enema, which can reduce the telescoped bowel in
the majority of cases. Surgery is reserved for cases where enema reduction is
unsuccessful or bowel perforation has occurred.
7. A newborn has not passed meconium within 48 hours of birth and has a
distended abdomen. Which condition should the nurse suspect?
A. Pyloric stenosis
B. Hirschsprung's disease
C. Intussusception
D. Duodenal atresia
E. GERD
✓ Correct Answer: B. Hirschsprung's disease
EXPERT RATIONALE: Hirschsprung's disease (congenital aganglionic megacolon)
presents with failure to pass meconium within 48 hours of birth and abdominal
distension. It results from the absence of ganglion cells in a segment of the colon,
preventing peristalsis in that area.
Neurology) | Verified Questions & Correct
Answers with Rationales | Complete
Pediatric Nursing Study Guide for
Guaranteed Exam Prep Success
• This is a question multiple-choice study guide for NSG 3600 Pediatrics Exam 3,
featuring verified questions with bolded correct answers and evidence-based
EXPERT RATIONALE — use it by attempting each question, then reviewing the
EXPERT RATIONALE to reinforce clinical reasoning.
• Each question is structured with 5 options (A–E), one correct answer bolded and
clearly marked, followed immediately by the EXPERT RATIONALE — ideal for timed
self-quizzing, group review, or last-minute exam prep across all three systems.
NSG 3600 PEDIATRICS EXAM 3
GI · GU · NEUROLOGY | Questions
1. A nurse is assessing a 3-week-old infant who presents with projectile
vomiting after feedings. The vomiting is non-bilious. Which condition does the
nurse suspect?
A. Intussusception
B. Gastroesophageal reflux disease (GERD)
C. Pyloric stenosis
D. Hirschsprung's disease
E. Duodenal atresia
✓ Correct Answer: C. Pyloric stenosis
EXPERT RATIONALE: Pyloric stenosis presents in infants typically between 2–8
weeks of age with forceful, projectile, non-bilious vomiting after feedings. It is
caused by hypertrophy of the pyloric sphincter, which obstructs gastric emptying.
GERD also causes vomiting but it is not projectile.
,2. A nurse is caring for an infant diagnosed with pyloric stenosis. Which
electrolyte imbalance does the nurse anticipate?
A. Hyperkalemia and metabolic acidosis
B. Hypernatremia and respiratory alkalosis
C. Hypokalemia and metabolic alkalosis
D. Hyponatremia and metabolic acidosis
E. Hypercalcemia and respiratory acidosis
✓ Correct Answer: C. Hypokalemia and metabolic alkalosis
EXPERT RATIONALE: Persistent vomiting in pyloric stenosis causes loss of
hydrochloric acid (HCl), leading to metabolic alkalosis. The loss of potassium
through vomiting and renal compensation leads to hypokalemia. This is the classic
electrolyte pattern associated with pyloric stenosis.
3. A nurse is preparing a 6-week-old for pyloromyotomy. Which finding on
assessment confirms pyloric stenosis?
A. Distended abdomen with visible peristaltic waves from right to left
B. Olive-shaped mass palpated in the right upper quadrant
C. Abdominal rigidity with rebound tenderness
D. Currant jelly stools
E. Bilious vomiting immediately after birth
✓ Correct Answer: B. Olive-shaped mass palpated in the right upper quadrant
EXPERT RATIONALE: The classic physical finding in pyloric stenosis is a palpable
olive-shaped mass in the epigastric/right upper quadrant area, representing the
hypertrophied pylorus. Visible peristaltic waves may also be seen, but the olive-
shaped mass is the definitive sign.
,4. A 2-month-old is diagnosed with GERD. Which nursing instruction is most
appropriate for the parents?
A. Position the infant prone after feedings
B. Feed the infant every 4–6 hours to reduce acid production
C. Thicken feedings and keep the infant upright for 30 minutes after feeding
D. Administer antacids before every feeding
E. Switch from breast milk to soy formula immediately
✓ Correct Answer: C. Thicken feedings and keep the infant upright for 30
minutes after feeding
EXPERT RATIONALE: For GERD management in infants, thickening feeds and
positioning the infant upright for 20–30 minutes post-feeding helps reduce reflux
by gravity. Prone positioning increases SIDS risk and is contraindicated in infants.
5. A nurse is assessing a 9-month-old infant who has been crying inconsolably
and drawing up the knees to the abdomen. The stool appears like "currant
jelly." Which condition does the nurse suspect?
A. Pyloric stenosis
B. Appendicitis
C. Hirschsprung's disease
D. Intussusception
E. Necrotizing enterocolitis
✓ Correct Answer: D. Intussusception
EXPERT RATIONALE: Intussusception classically presents in infants 6 months to 2
years with sudden onset of colicky abdominal pain, the child drawing up the knees,
and "currant jelly" stools (a mixture of blood and mucus). This occurs when one
portion of the intestine telescopes into another.
, 6. Which is the initial treatment of choice for intussusception?
A. Emergency surgical resection
B. Oral laxatives and increased fluid intake
C. Air or hydrostatic enema reduction
D. Nasogastric tube decompression
E. IV antibiotics and bowel rest
✓ Correct Answer: C. Air or hydrostatic enema reduction
EXPERT RATIONALE: The first-line treatment for intussusception is a non-surgical
hydrostatic or pneumatic (air) enema, which can reduce the telescoped bowel in
the majority of cases. Surgery is reserved for cases where enema reduction is
unsuccessful or bowel perforation has occurred.
7. A newborn has not passed meconium within 48 hours of birth and has a
distended abdomen. Which condition should the nurse suspect?
A. Pyloric stenosis
B. Hirschsprung's disease
C. Intussusception
D. Duodenal atresia
E. GERD
✓ Correct Answer: B. Hirschsprung's disease
EXPERT RATIONALE: Hirschsprung's disease (congenital aganglionic megacolon)
presents with failure to pass meconium within 48 hours of birth and abdominal
distension. It results from the absence of ganglion cells in a segment of the colon,
preventing peristalsis in that area.
