,Galen NSG 3600 Exam 3 – Children's Health
(2026) Actual Q&A PDF
1. An infant presents with projectile non‑bilious vomiting, visible gastric peristalsis, and an
olive‑shaped mass in the right upper quadrant. Which condition does the nurse suspect?
A) Intussusception
B) Pyloric stenosis
C) Hirschsprung disease
D) Gastroesophageal reflux
Correct Answer: Pyloric stenosis
Rationale: Hypertrophic pyloric stenosis classically presents at 2–8 weeks with projectile vomiting, a
palpable “olive” mass in the epigastrium, and visible peristalsis. It is not associated with bilious
vomiting; intussusception involves currant‑jelly stools and episodic pain.
2. The nurse is reviewing the lab results of an infant with hypertrophic pyloric stenosis. Which finding
is most expected?
A) Hypochloremic metabolic alkalosis
B) Hyperkalemia
C) Metabolic acidosis
D) Hypernatremia
Correct Answer: Hypochloremic metabolic alkalosis
Rationale: Loss of gastric hydrochloric acid from vomiting leads to hypochloremia, hypokalemia, and
metabolic alkalosis. This classic electrolyte pattern distinguishes pyloric stenosis from other causes of
vomiting.
3. A 9‑month‑old infant is admitted with episodic screaming, drawing up of the legs, and passage of
“red currant jelly” stools. The nurse anticipates which diagnostic test?
,A) Upper GI series
B) Barium or air enema
C) Abdominal ultrasound
D) CT scan of the abdomen
Correct Answer: Barium or air enema
Rationale: Intussusception is confirmed and often reduced by barium or air enema. This procedure is
both diagnostic and therapeutic. Ultrasound may be used initially, but enema is definitive for
reduction.
4. A child with intussusception develops a fever of 100.5°F (38.1°C) and increasing abdominal
tenderness. What is the priority nursing action?
A) Prepare for discharge with oral antibiotics
B) Notify the provider immediately; these signs may indicate perforation
C) Apply a heating pad to the abdomen
D) Offer clear liquids and reassess in 1 hour
Correct Answer: Notify the provider immediately; these signs may indicate perforation
Rationale: Fever, worsening pain, and tenderness suggest bowel perforation and peritonitis, a surgical
emergency. The provider must be notified immediately for possible surgical intervention.
5. A newborn has not passed meconium within 48 hours of birth. The nurse suspects which condition?
A) Celiac disease
B) Intussusception
C) Hirschsprung disease
D) Pyloric stenosis
Correct Answer: Hirschsprung disease
, Rationale: Failure to pass meconium within the first 48 hours is a hallmark of Hirschsprung disease,
caused by the absence of ganglion cells in the distal colon, leading to functional obstruction.
6. Which statement by the parent of an infant with Hirschsprung disease indicates a need for further
teaching?
A) “I will watch for signs of enterocolitis like fever and explosive diarrhea.”
B) “My child will need surgery to remove the affected part of the colon.”
C) “Once the colostomy is closed, my child will not need any more follow‑up.”
D) “I should report any abdominal distension to the provider.”
Correct Answer: “Once the colostomy is closed, my child will not need any more follow‑up.”
Rationale: Children with Hirschsprung disease require long‑term follow‑up to monitor for
complications such as enterocolitis, strictures, or bowel dysfunction. Stating no further follow‑up is
needed indicates misunderstanding.
7. The nurse is teaching parents of a newborn with a cleft lip about feeding. Which statement by the
parents indicates correct understanding?
A) “We will use a regular nipple and bottle.”
B) “We should feed the baby in a supine position.”
C) “We will use a Haberman feeder and keep the baby upright during feedings.”
D) “Breastfeeding is impossible for our baby.”
Correct Answer: “We will use a Haberman feeder and keep the baby upright during feedings.”
Rationale: A Haberman feeder (or other specialized nipple) allows the infant to feed without creating
suction, and an upright position reduces the risk of aspiration. Breastfeeding may be possible with
modifications and support.
8. An infant returns from surgical repair of a cleft lip. Which postoperative order should the nurse
implement?
(2026) Actual Q&A PDF
1. An infant presents with projectile non‑bilious vomiting, visible gastric peristalsis, and an
olive‑shaped mass in the right upper quadrant. Which condition does the nurse suspect?
A) Intussusception
B) Pyloric stenosis
C) Hirschsprung disease
D) Gastroesophageal reflux
Correct Answer: Pyloric stenosis
Rationale: Hypertrophic pyloric stenosis classically presents at 2–8 weeks with projectile vomiting, a
palpable “olive” mass in the epigastrium, and visible peristalsis. It is not associated with bilious
vomiting; intussusception involves currant‑jelly stools and episodic pain.
2. The nurse is reviewing the lab results of an infant with hypertrophic pyloric stenosis. Which finding
is most expected?
A) Hypochloremic metabolic alkalosis
B) Hyperkalemia
C) Metabolic acidosis
D) Hypernatremia
Correct Answer: Hypochloremic metabolic alkalosis
Rationale: Loss of gastric hydrochloric acid from vomiting leads to hypochloremia, hypokalemia, and
metabolic alkalosis. This classic electrolyte pattern distinguishes pyloric stenosis from other causes of
vomiting.
3. A 9‑month‑old infant is admitted with episodic screaming, drawing up of the legs, and passage of
“red currant jelly” stools. The nurse anticipates which diagnostic test?
,A) Upper GI series
B) Barium or air enema
C) Abdominal ultrasound
D) CT scan of the abdomen
Correct Answer: Barium or air enema
Rationale: Intussusception is confirmed and often reduced by barium or air enema. This procedure is
both diagnostic and therapeutic. Ultrasound may be used initially, but enema is definitive for
reduction.
4. A child with intussusception develops a fever of 100.5°F (38.1°C) and increasing abdominal
tenderness. What is the priority nursing action?
A) Prepare for discharge with oral antibiotics
B) Notify the provider immediately; these signs may indicate perforation
C) Apply a heating pad to the abdomen
D) Offer clear liquids and reassess in 1 hour
Correct Answer: Notify the provider immediately; these signs may indicate perforation
Rationale: Fever, worsening pain, and tenderness suggest bowel perforation and peritonitis, a surgical
emergency. The provider must be notified immediately for possible surgical intervention.
5. A newborn has not passed meconium within 48 hours of birth. The nurse suspects which condition?
A) Celiac disease
B) Intussusception
C) Hirschsprung disease
D) Pyloric stenosis
Correct Answer: Hirschsprung disease
, Rationale: Failure to pass meconium within the first 48 hours is a hallmark of Hirschsprung disease,
caused by the absence of ganglion cells in the distal colon, leading to functional obstruction.
6. Which statement by the parent of an infant with Hirschsprung disease indicates a need for further
teaching?
A) “I will watch for signs of enterocolitis like fever and explosive diarrhea.”
B) “My child will need surgery to remove the affected part of the colon.”
C) “Once the colostomy is closed, my child will not need any more follow‑up.”
D) “I should report any abdominal distension to the provider.”
Correct Answer: “Once the colostomy is closed, my child will not need any more follow‑up.”
Rationale: Children with Hirschsprung disease require long‑term follow‑up to monitor for
complications such as enterocolitis, strictures, or bowel dysfunction. Stating no further follow‑up is
needed indicates misunderstanding.
7. The nurse is teaching parents of a newborn with a cleft lip about feeding. Which statement by the
parents indicates correct understanding?
A) “We will use a regular nipple and bottle.”
B) “We should feed the baby in a supine position.”
C) “We will use a Haberman feeder and keep the baby upright during feedings.”
D) “Breastfeeding is impossible for our baby.”
Correct Answer: “We will use a Haberman feeder and keep the baby upright during feedings.”
Rationale: A Haberman feeder (or other specialized nipple) allows the infant to feed without creating
suction, and an upright position reduces the risk of aspiration. Breastfeeding may be possible with
modifications and support.
8. An infant returns from surgical repair of a cleft lip. Which postoperative order should the nurse
implement?
