NSG 3600 Children's Health Exam 3 Actual
2026/2027 – 100% Verified | Detailed Rationales
Pass Guaranteed – A+ Graded
Content Area Overview:
This actual examination reflects the comprehensive pediatric nursing knowledge required for success on
NSG 3600 Children's Health Exam 3. It is designed to evaluate the student's ability to provide holistic,
age-appropriate care for pediatric patients and their families, integrating principles of growth and
development from birth to adolescence. Questions are structured to assess recall of key pediatric
concepts, application of evidence-based nursing interventions, and analysis of complex clinical scenarios
involving gastrointestinal, genitourinary, and neurological systems. This authentic question bank
represents the real exams used in the course and serves as a comprehensive resource for students
demonstrating mastery of pediatric nursing content.
Section 1: Gastrointestinal Disorders (Questions 1–12)
Q1. A 6-month-old infant is brought to the clinic with watery diarrhea for 3 days. The parents report the
infant has had 8–10 loose stools per day and is taking less formula than usual. The infant's anterior
fontanelle is slightly depressed, mucous membranes are dry, and skin turgor is decreased. The nurse
recognizes these findings as consistent with:
A. Mild dehydration
B. Moderate dehydration
C. Severe dehydration
D. Normal infant variation
Rationale: The best answer is B. Moderate dehydration in infants is characterized by sunken fontanelle,
dry mucous membranes, decreased skin turgor, and reduced urine output with maintained
consciousness. Mild dehydration would show only slightly dry mucous membranes without fontanelle
changes, while severe dehydration would present with lethargy, very sunken fontanelle, and signs of
shock. The number of stools and reduced intake support moderate dehydration requiring oral
rehydration therapy or possibly IV fluids.
Correct Answer: B
,Q2. A newborn with a unilateral cleft lip is scheduled for surgical repair at 3 months of age. The nurse's
priority preoperative teaching for the parents should focus on:
A. Introducing solid foods immediately to promote weight gain
B. Specialized feeding techniques using a specialized nipple or squeezable bottle to ensure adequate
nutrition before surgery
C. Delaying all feeding until after surgery
D. Teaching the parents that breastfeeding is impossible with cleft lip
Rationale: The best answer is B. Infants with cleft lip often have difficulty creating suction during
feeding, so specialized feeding techniques using a wide-base nipple, squeezable bottle, or specialized
feeder (like a Haberman feeder) are essential to ensure adequate nutrition and weight gain before
surgery. Breastfeeding may be possible with modifications and support from a lactation consultant.
Adequate nutrition and weight gain are prerequisites for successful surgical repair.
Correct Answer: B
Q3. A 4-month-old male infant is brought to the emergency department with projectile vomiting after
every feeding for the past 2 days. The vomitus is non-bilious and contains undigested formula. On
physical exam, the nurse palpates an olive-shaped mass in the right upper quadrant. These findings are
most consistent with:
A. Gastroesophageal reflux disease
B. Intussusception
C. Hypertrophic pyloric stenosis
D. Hirschsprung's disease
Rationale: The best answer is C. Hypertrophic pyloric stenosis classically presents in male infants (4:1
male-to-female ratio) between 2–8 weeks of age with progressive, projectile, non-bilious vomiting. The
palpable olive-shaped mass in the right upper quadrant is pathognomonic for thickened pyloric muscle.
The non-bilious nature of the vomitus indicates the obstruction is proximal to the ampulla of Vater.
Surgical pyloromyotomy is the definitive treatment, and preoperative correction of dehydration and
electrolyte imbalances (particularly hypochloremic metabolic alkalosis) is critical.
Correct Answer: C
Q4. Following surgical repair of hypertrophic pyloric stenosis, the nurse should prioritize which
intervention?
, A. Initiating full-strength formula feeding immediately
B. Starting with small, frequent feedings of clear liquids and advancing as tolerated per surgeon protocol
C. Keeping the infant NPO for 48 hours postoperatively
D. Administering prokinetic agents to stimulate gastric emptying
Rationale: The best answer is B. Postoperative feeding after pyloromyotomy typically begins with small,
frequent feedings of clear liquids (often glucose water or Pedialyte) and advances to half-strength then
full-strength formula as tolerated. This gradual approach allows the edematous pylorus to heal while
preventing vomiting. Most infants can advance to full feeds within 24 hours. Keeping the infant NPO for
48 hours is excessive, and prokinetic agents are not standard postoperative care for this procedure.
Correct Answer: B
Q5. A 2-year-old child presents with intermittent, severe abdominal pain, drawing the knees to the chest
during episodes. The parent reports currant jelly-like stools. On exam, the nurse palpates a sausage-
shaped mass in the right upper quadrant. These findings are most consistent with:
A. Appendicitis
B. Intussusception
C. Hirschsprung's disease
D. Celiac disease
Rationale: The best answer is B. Intussusception, the telescoping of one portion of intestine into
another, classically presents in children 6–36 months with intermittent, severe, colicky abdominal pain,
vomiting, and currant jelly stools (a mixture of blood, mucus, and sloughed mucosa). The sausage-
shaped mass is the intussuscepted bowel. This is a surgical emergency requiring prompt reduction—
either by air or contrast enema for uncomplicated cases or surgery if perforation or failed reduction
occurs.
Correct Answer: B
Q6. A 10-year-old child is admitted with right lower quadrant pain, rebound tenderness, and a low-grade
fever of 100.8°F. The white blood cell count is 14,500/μL. The nurse anticipates which immediate
intervention?
A. Administration of oral antibiotics and discharge home
B. NPO status, IV fluids, pain management, and surgical consultation for probable appendicitis
C. Barium enema to rule out intussusception
D. Initiation of a clear liquid diet and observation
2026/2027 – 100% Verified | Detailed Rationales
Pass Guaranteed – A+ Graded
Content Area Overview:
This actual examination reflects the comprehensive pediatric nursing knowledge required for success on
NSG 3600 Children's Health Exam 3. It is designed to evaluate the student's ability to provide holistic,
age-appropriate care for pediatric patients and their families, integrating principles of growth and
development from birth to adolescence. Questions are structured to assess recall of key pediatric
concepts, application of evidence-based nursing interventions, and analysis of complex clinical scenarios
involving gastrointestinal, genitourinary, and neurological systems. This authentic question bank
represents the real exams used in the course and serves as a comprehensive resource for students
demonstrating mastery of pediatric nursing content.
Section 1: Gastrointestinal Disorders (Questions 1–12)
Q1. A 6-month-old infant is brought to the clinic with watery diarrhea for 3 days. The parents report the
infant has had 8–10 loose stools per day and is taking less formula than usual. The infant's anterior
fontanelle is slightly depressed, mucous membranes are dry, and skin turgor is decreased. The nurse
recognizes these findings as consistent with:
A. Mild dehydration
B. Moderate dehydration
C. Severe dehydration
D. Normal infant variation
Rationale: The best answer is B. Moderate dehydration in infants is characterized by sunken fontanelle,
dry mucous membranes, decreased skin turgor, and reduced urine output with maintained
consciousness. Mild dehydration would show only slightly dry mucous membranes without fontanelle
changes, while severe dehydration would present with lethargy, very sunken fontanelle, and signs of
shock. The number of stools and reduced intake support moderate dehydration requiring oral
rehydration therapy or possibly IV fluids.
Correct Answer: B
,Q2. A newborn with a unilateral cleft lip is scheduled for surgical repair at 3 months of age. The nurse's
priority preoperative teaching for the parents should focus on:
A. Introducing solid foods immediately to promote weight gain
B. Specialized feeding techniques using a specialized nipple or squeezable bottle to ensure adequate
nutrition before surgery
C. Delaying all feeding until after surgery
D. Teaching the parents that breastfeeding is impossible with cleft lip
Rationale: The best answer is B. Infants with cleft lip often have difficulty creating suction during
feeding, so specialized feeding techniques using a wide-base nipple, squeezable bottle, or specialized
feeder (like a Haberman feeder) are essential to ensure adequate nutrition and weight gain before
surgery. Breastfeeding may be possible with modifications and support from a lactation consultant.
Adequate nutrition and weight gain are prerequisites for successful surgical repair.
Correct Answer: B
Q3. A 4-month-old male infant is brought to the emergency department with projectile vomiting after
every feeding for the past 2 days. The vomitus is non-bilious and contains undigested formula. On
physical exam, the nurse palpates an olive-shaped mass in the right upper quadrant. These findings are
most consistent with:
A. Gastroesophageal reflux disease
B. Intussusception
C. Hypertrophic pyloric stenosis
D. Hirschsprung's disease
Rationale: The best answer is C. Hypertrophic pyloric stenosis classically presents in male infants (4:1
male-to-female ratio) between 2–8 weeks of age with progressive, projectile, non-bilious vomiting. The
palpable olive-shaped mass in the right upper quadrant is pathognomonic for thickened pyloric muscle.
The non-bilious nature of the vomitus indicates the obstruction is proximal to the ampulla of Vater.
Surgical pyloromyotomy is the definitive treatment, and preoperative correction of dehydration and
electrolyte imbalances (particularly hypochloremic metabolic alkalosis) is critical.
Correct Answer: C
Q4. Following surgical repair of hypertrophic pyloric stenosis, the nurse should prioritize which
intervention?
, A. Initiating full-strength formula feeding immediately
B. Starting with small, frequent feedings of clear liquids and advancing as tolerated per surgeon protocol
C. Keeping the infant NPO for 48 hours postoperatively
D. Administering prokinetic agents to stimulate gastric emptying
Rationale: The best answer is B. Postoperative feeding after pyloromyotomy typically begins with small,
frequent feedings of clear liquids (often glucose water or Pedialyte) and advances to half-strength then
full-strength formula as tolerated. This gradual approach allows the edematous pylorus to heal while
preventing vomiting. Most infants can advance to full feeds within 24 hours. Keeping the infant NPO for
48 hours is excessive, and prokinetic agents are not standard postoperative care for this procedure.
Correct Answer: B
Q5. A 2-year-old child presents with intermittent, severe abdominal pain, drawing the knees to the chest
during episodes. The parent reports currant jelly-like stools. On exam, the nurse palpates a sausage-
shaped mass in the right upper quadrant. These findings are most consistent with:
A. Appendicitis
B. Intussusception
C. Hirschsprung's disease
D. Celiac disease
Rationale: The best answer is B. Intussusception, the telescoping of one portion of intestine into
another, classically presents in children 6–36 months with intermittent, severe, colicky abdominal pain,
vomiting, and currant jelly stools (a mixture of blood, mucus, and sloughed mucosa). The sausage-
shaped mass is the intussuscepted bowel. This is a surgical emergency requiring prompt reduction—
either by air or contrast enema for uncomplicated cases or surgery if perforation or failed reduction
occurs.
Correct Answer: B
Q6. A 10-year-old child is admitted with right lower quadrant pain, rebound tenderness, and a low-grade
fever of 100.8°F. The white blood cell count is 14,500/μL. The nurse anticipates which immediate
intervention?
A. Administration of oral antibiotics and discharge home
B. NPO status, IV fluids, pain management, and surgical consultation for probable appendicitis
C. Barium enema to rule out intussusception
D. Initiation of a clear liquid diet and observation
