NURS 629 Exam 3 V3 | NURS 629 Peds |
Actual Q&A with Rationale (NURS629
Exam 3) | Maryville University
1. A 5-year-old child presents with periorbital edema, dark-colored urine, and hypertension
following a recent streptococcal throat infection. Which clinical features are consistent with
Acute Post-Streptococcal Glomerulonephritis (APSGN)? (Select All That Apply)
A. Gross hematuria
B. Edema
C. Massive proteinuria (>3.5g/day)
D. Hypertension
E. Reduced serum C3 complement levels
F. Hypocholesterolemia
Correct Answer: A, B, D, E
Acute post-streptococcal glomerulonephritis typically presents with a classic triad of
hematuria, edema, and hypertension. Laboratory findings often reveal a significant drop in
C3 complement levels during the acute phase of the illness. Unlike nephrotic syndrome,
proteinuria in APSGN is usually mild to moderate rather than massive.
,2. When assessing a 4-week-old infant suspected of having hypertrophic pyloric stenosis,
which physical examination finding is most pathognomonic?
A. Sausage-shaped mass in the right upper quadrant
B. Olive-shaped mass in the epigastrium
C. Palpable fecal mass in the left lower quadrant
D. Distended abdomen with visible bowel loops
Correct Answer: B
The presence of an olive-shaped mass in the epigastrium or right upper quadrant is a
classic finding of pyloric stenosis. This occurs due to the hypertrophy of the pyloric
sphincter muscle which becomes palpable. Diagnosis is often confirmed via ultrasound
showing increased pyloric muscle thickness.
3. A child is diagnosed with Hirschsprung disease. Which of the following is the primary
pathophysiological defect in this condition?
A. Mechanical obstruction due to fecal impaction
B. Telescoping of one segment of the intestine into another
C. Inflammation and ulceration of the colon
D. Absence of ganglion cells in the distal bowel
Correct Answer: D
, Hirschsprung disease, or congenital aganglionic megacolon, is characterized by the
absence of intramural ganglion cells in the submucosal and myenteric plexuses. This
absence prevents normal peristalsis in the affected segment, leading to functional
obstruction. The definitive diagnosis is usually made via a rectal suction biopsy showing
the lack of these cells.
4. What is the gold standard for diagnosing Vesicoureteral Reflux (VUR) in a pediatric patient?
A. Renal ultrasound
B. Computed tomography (CT) urogram
C. Intravenous pyelogram (IVP)
D. Voiding cystourethrogram (VCUG)
Correct Answer: D
A voiding cystourethrogram is the definitive imaging modality used to diagnose and grade
vesicoureteral reflux. It involves catheterizing the bladder and injecting contrast to
visualize any retrograde flow into the ureters during micturition. While ultrasound is often
the first screen, it cannot rule out reflux.
5. Which of the following clinical findings would the Nurse Practitioner expect to see in a child
with Intussusception?
A. Painless rectal bleeding
B. Currant jelly-like stools
C. Projectile non-bilious vomiting
Actual Q&A with Rationale (NURS629
Exam 3) | Maryville University
1. A 5-year-old child presents with periorbital edema, dark-colored urine, and hypertension
following a recent streptococcal throat infection. Which clinical features are consistent with
Acute Post-Streptococcal Glomerulonephritis (APSGN)? (Select All That Apply)
A. Gross hematuria
B. Edema
C. Massive proteinuria (>3.5g/day)
D. Hypertension
E. Reduced serum C3 complement levels
F. Hypocholesterolemia
Correct Answer: A, B, D, E
Acute post-streptococcal glomerulonephritis typically presents with a classic triad of
hematuria, edema, and hypertension. Laboratory findings often reveal a significant drop in
C3 complement levels during the acute phase of the illness. Unlike nephrotic syndrome,
proteinuria in APSGN is usually mild to moderate rather than massive.
,2. When assessing a 4-week-old infant suspected of having hypertrophic pyloric stenosis,
which physical examination finding is most pathognomonic?
A. Sausage-shaped mass in the right upper quadrant
B. Olive-shaped mass in the epigastrium
C. Palpable fecal mass in the left lower quadrant
D. Distended abdomen with visible bowel loops
Correct Answer: B
The presence of an olive-shaped mass in the epigastrium or right upper quadrant is a
classic finding of pyloric stenosis. This occurs due to the hypertrophy of the pyloric
sphincter muscle which becomes palpable. Diagnosis is often confirmed via ultrasound
showing increased pyloric muscle thickness.
3. A child is diagnosed with Hirschsprung disease. Which of the following is the primary
pathophysiological defect in this condition?
A. Mechanical obstruction due to fecal impaction
B. Telescoping of one segment of the intestine into another
C. Inflammation and ulceration of the colon
D. Absence of ganglion cells in the distal bowel
Correct Answer: D
, Hirschsprung disease, or congenital aganglionic megacolon, is characterized by the
absence of intramural ganglion cells in the submucosal and myenteric plexuses. This
absence prevents normal peristalsis in the affected segment, leading to functional
obstruction. The definitive diagnosis is usually made via a rectal suction biopsy showing
the lack of these cells.
4. What is the gold standard for diagnosing Vesicoureteral Reflux (VUR) in a pediatric patient?
A. Renal ultrasound
B. Computed tomography (CT) urogram
C. Intravenous pyelogram (IVP)
D. Voiding cystourethrogram (VCUG)
Correct Answer: D
A voiding cystourethrogram is the definitive imaging modality used to diagnose and grade
vesicoureteral reflux. It involves catheterizing the bladder and injecting contrast to
visualize any retrograde flow into the ureters during micturition. While ultrasound is often
the first screen, it cannot rule out reflux.
5. Which of the following clinical findings would the Nurse Practitioner expect to see in a child
with Intussusception?
A. Painless rectal bleeding
B. Currant jelly-like stools
C. Projectile non-bilious vomiting
