NURS 629 Exam 3 V2 | NURS 629 Peds |
Actual Q&A with Rationale (NURS629
Exam 3) | Maryville University
1. A 3-year-old presents to the clinic with a high fever, muffled voice, and is sitting in a
‘tripod’ position. What is the most critical contraindication in the management of this
patient?
A. Administering humidified oxygen
B. Ordering a lateral neck radiograph
C. Starting an intravenous line for fluids
D. Using a tongue blade to visualize the posterior pharynx
Correct Answer: D
The patient exhibits classic signs of epiglottitis, which is a medical emergency. Inserting a
tongue blade or any object into the throat can trigger a laryngospasm and complete airway
obstruction. The practitioner must keep the child calm and prepare for an emergency
airway in a controlled environment like the operating room.
2. Which of the following is considered the most common cyanotic congenital heart defect?
A. Atrial Septal Defect
B. Patent Ductus Arteriosus
C. Tetralogy of Fallot
,D. Ventricular Septal Defect
Correct Answer: C
Tetralogy of Fallot is characterized by four distinct cardiac defects and is the most
frequent cause of cyanosis in children beyond the neonatal period. While Ventricular Septal
Defect is the most common overall heart defect, it is primarily acyanotic. Early surgical
repair is usually required to manage the pulmonary stenosis and overriding aorta
associated with this condition.
3. (SATA) A practitioner is evaluating a 4-year-old for suspected Kawasaki Disease. Which
clinical manifestations must be present for a diagnosis, in addition to a high fever for at least
five days?
A. Bilateral conjunctival injection without exudate
B. Changes in oral mucous membranes, such as ‘strawberry tongue’
C. Polymorphous rash
D. Vesicular lesions on the hands and feet
E. Cervical lymphadenopathy (usually unilateral)
F. Changes in the extremities, such as edema or erythema of the palms and soles
Correct Answer: A, B, C, E, F
Kawasaki Disease requires a fever of 5 days or more plus at least four out of five specific
clinical criteria. These criteria include conjunctival injection, oral changes, extremity
, changes, rash, and cervical lymphadenopathy. Vesicular lesions are not typical of Kawasaki
and suggest a different viral etiology like Hand-Foot-and-Mouth disease.
4. A 6-week-old male infant presents with a history of forceful, non-bilious vomiting after
every feeding. Upon palpation of the abdomen, an olive-shaped mass is noted in the right
upper quadrant. What is the most likely diagnosis?
A. Gastroesophageal Reflux Disease
B. Intussusception
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung Disease
Correct Answer: C
The clinical triad of projectile non-bilious vomiting, an olive-shaped mass, and visible
peristaltic waves is pathognomonic for pyloric stenosis. This condition typically presents
between 3 to 6 weeks of age and requires surgical intervention via pyloromyotomy.
Diagnostic confirmation is usually achieved through an abdominal ultrasound showing
thickening of the pyloric muscle.
5. A child is diagnosed with Hirschsprung Disease. Which clinical finding is characteristic of
this condition?
A. Currant jelly stools
B. Right lower quadrant pain
C. Projectile vomiting
Actual Q&A with Rationale (NURS629
Exam 3) | Maryville University
1. A 3-year-old presents to the clinic with a high fever, muffled voice, and is sitting in a
‘tripod’ position. What is the most critical contraindication in the management of this
patient?
A. Administering humidified oxygen
B. Ordering a lateral neck radiograph
C. Starting an intravenous line for fluids
D. Using a tongue blade to visualize the posterior pharynx
Correct Answer: D
The patient exhibits classic signs of epiglottitis, which is a medical emergency. Inserting a
tongue blade or any object into the throat can trigger a laryngospasm and complete airway
obstruction. The practitioner must keep the child calm and prepare for an emergency
airway in a controlled environment like the operating room.
2. Which of the following is considered the most common cyanotic congenital heart defect?
A. Atrial Septal Defect
B. Patent Ductus Arteriosus
C. Tetralogy of Fallot
,D. Ventricular Septal Defect
Correct Answer: C
Tetralogy of Fallot is characterized by four distinct cardiac defects and is the most
frequent cause of cyanosis in children beyond the neonatal period. While Ventricular Septal
Defect is the most common overall heart defect, it is primarily acyanotic. Early surgical
repair is usually required to manage the pulmonary stenosis and overriding aorta
associated with this condition.
3. (SATA) A practitioner is evaluating a 4-year-old for suspected Kawasaki Disease. Which
clinical manifestations must be present for a diagnosis, in addition to a high fever for at least
five days?
A. Bilateral conjunctival injection without exudate
B. Changes in oral mucous membranes, such as ‘strawberry tongue’
C. Polymorphous rash
D. Vesicular lesions on the hands and feet
E. Cervical lymphadenopathy (usually unilateral)
F. Changes in the extremities, such as edema or erythema of the palms and soles
Correct Answer: A, B, C, E, F
Kawasaki Disease requires a fever of 5 days or more plus at least four out of five specific
clinical criteria. These criteria include conjunctival injection, oral changes, extremity
, changes, rash, and cervical lymphadenopathy. Vesicular lesions are not typical of Kawasaki
and suggest a different viral etiology like Hand-Foot-and-Mouth disease.
4. A 6-week-old male infant presents with a history of forceful, non-bilious vomiting after
every feeding. Upon palpation of the abdomen, an olive-shaped mass is noted in the right
upper quadrant. What is the most likely diagnosis?
A. Gastroesophageal Reflux Disease
B. Intussusception
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung Disease
Correct Answer: C
The clinical triad of projectile non-bilious vomiting, an olive-shaped mass, and visible
peristaltic waves is pathognomonic for pyloric stenosis. This condition typically presents
between 3 to 6 weeks of age and requires surgical intervention via pyloromyotomy.
Diagnostic confirmation is usually achieved through an abdominal ultrasound showing
thickening of the pyloric muscle.
5. A child is diagnosed with Hirschsprung Disease. Which clinical finding is characteristic of
this condition?
A. Currant jelly stools
B. Right lower quadrant pain
C. Projectile vomiting
