,NSG 434 Exam 2 | Pediatric Nursing Advanced | Grand
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. A 2-year-old child is brought to the emergency department with crampy abdominal pain, inconsolable
crying, drawing knees to the chest, and passing currant jelly-like stools. The nurse suspects which
condition?
A) Appendicitis
B) Intussusception
C) Hirschsprung disease
D) Meckel diverticulum
Correct Answer: Intussusception
Rationale: Intussusception occurs when one bowel segment telescopes into another, causing
obstruction. Classic manifestations include sudden, crampy abdominal pain, drawing knees to chest,
inconsolable crying, and currant jelly stools. Treatment often involves a gas or barium enema to reduce
the telescoping.
2. A nurse is assessing a 4-week-old infant with nonbilious projectile vomiting after feedings. The nurse
palpates an olive-shaped mass in the right upper quadrant. Which condition does the nurse suspect?
A) Celiac disease
B) Pyloric stenosis
C) Biliary atresia
D) Omphalocele
Correct Answer: Pyloric stenosis
Rationale: Pyloric stenosis is characterized by hypertrophy of the pyloric muscle, leading to gastric outlet
obstruction. Classic findings include nonbilious projectile vomiting after feedings and an olive-shaped
mass palpable in the right upper quadrant of the abdomen.
,3. A nurse is providing teaching to the parents of a child with celiac disease. Which food should the
nurse instruct the parents to avoid?
A) Rice
B) Corn
C) Wheat
D) Potatoes
Correct Answer: Wheat
Rationale: Celiac disease is an autoimmune disorder triggered by gluten, a protein found in wheat,
barley, and rye. Avoiding these grains is essential to prevent symptoms such as diarrhea, steatorrhea,
abdominal distention, and failure to thrive.
4. A 6-month-old infant presents with jaundice, pale stools, and dark urine. The nurse suspects biliary
atresia. Which procedure is the definitive treatment for this condition?
A) Kasai procedure
B) Liver transplantation
C) Cholecystectomy
D) Billroth I procedure
Correct Answer: Kasai procedure
Rationale: Biliary atresia is an obstruction of bile flow that leads to jaundice, pale stools, and dark urine.
The Kasai procedure (hepatoportoenterostomy) is the initial surgical treatment to restore bile flow. If
unsuccessful, liver transplantation may be needed.
5. A nurse is assessing a 10-year-old child with ulcerative colitis. Which finding is most consistent with
this condition?
A) Skip lesions on colonoscopy
B) Fistulas and strictures
C) Bloody diarrhea and tenesmus
, D) Transmural inflammation
Correct Answer: Bloody diarrhea and tenesmus
Rationale: Ulcerative colitis is characterized by inflammation of the colon that is continuous, beginning
in the rectum. Classic symptoms include bloody diarrhea, tenesmus, and abdominal pain. Skip lesions,
fistulas, and transmural inflammation are characteristic of Crohn's disease.
6. A nurse is calculating fluid requirements for a child who weighs 22 kg. Using the Holliday-Segar
method, what is the daily maintenance fluid requirement?
A) 1,200 mL
B) 1,500 mL
C) 1,700 mL
D) 1,900 mL
Correct Answer: 1,700 mL
Rationale: The Holliday-Segar method calculates maintenance fluids as: 100 mL/kg for the first 10 kg, 50
mL/kg for the next 10 kg, and 20 mL/kg for each additional kg. For a 22 kg child: 100 × 10 = 1000 mL; 50
× 10 = 500 mL; 20 × 2 = 40 mL; total = 1540 mL (rounded to 1,500 mL). The correct calculation is 1000 +
500 + (20 × 2) = 1,540 mL, which rounds to 1,500 mL. However, if using 20 mL/kg for each additional kg,
the total is 1,540 mL.
7. A 3-year-old child has lost 8% of body weight due to diarrhea. The nurse classifies this as which degree
of dehydration?
A) Mild dehydration
B) Moderate dehydration
C) Severe dehydration
D) No dehydration
Correct Answer: Moderate dehydration
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. A 2-year-old child is brought to the emergency department with crampy abdominal pain, inconsolable
crying, drawing knees to the chest, and passing currant jelly-like stools. The nurse suspects which
condition?
A) Appendicitis
B) Intussusception
C) Hirschsprung disease
D) Meckel diverticulum
Correct Answer: Intussusception
Rationale: Intussusception occurs when one bowel segment telescopes into another, causing
obstruction. Classic manifestations include sudden, crampy abdominal pain, drawing knees to chest,
inconsolable crying, and currant jelly stools. Treatment often involves a gas or barium enema to reduce
the telescoping.
2. A nurse is assessing a 4-week-old infant with nonbilious projectile vomiting after feedings. The nurse
palpates an olive-shaped mass in the right upper quadrant. Which condition does the nurse suspect?
A) Celiac disease
B) Pyloric stenosis
C) Biliary atresia
D) Omphalocele
Correct Answer: Pyloric stenosis
Rationale: Pyloric stenosis is characterized by hypertrophy of the pyloric muscle, leading to gastric outlet
obstruction. Classic findings include nonbilious projectile vomiting after feedings and an olive-shaped
mass palpable in the right upper quadrant of the abdomen.
,3. A nurse is providing teaching to the parents of a child with celiac disease. Which food should the
nurse instruct the parents to avoid?
A) Rice
B) Corn
C) Wheat
D) Potatoes
Correct Answer: Wheat
Rationale: Celiac disease is an autoimmune disorder triggered by gluten, a protein found in wheat,
barley, and rye. Avoiding these grains is essential to prevent symptoms such as diarrhea, steatorrhea,
abdominal distention, and failure to thrive.
4. A 6-month-old infant presents with jaundice, pale stools, and dark urine. The nurse suspects biliary
atresia. Which procedure is the definitive treatment for this condition?
A) Kasai procedure
B) Liver transplantation
C) Cholecystectomy
D) Billroth I procedure
Correct Answer: Kasai procedure
Rationale: Biliary atresia is an obstruction of bile flow that leads to jaundice, pale stools, and dark urine.
The Kasai procedure (hepatoportoenterostomy) is the initial surgical treatment to restore bile flow. If
unsuccessful, liver transplantation may be needed.
5. A nurse is assessing a 10-year-old child with ulcerative colitis. Which finding is most consistent with
this condition?
A) Skip lesions on colonoscopy
B) Fistulas and strictures
C) Bloody diarrhea and tenesmus
, D) Transmural inflammation
Correct Answer: Bloody diarrhea and tenesmus
Rationale: Ulcerative colitis is characterized by inflammation of the colon that is continuous, beginning
in the rectum. Classic symptoms include bloody diarrhea, tenesmus, and abdominal pain. Skip lesions,
fistulas, and transmural inflammation are characteristic of Crohn's disease.
6. A nurse is calculating fluid requirements for a child who weighs 22 kg. Using the Holliday-Segar
method, what is the daily maintenance fluid requirement?
A) 1,200 mL
B) 1,500 mL
C) 1,700 mL
D) 1,900 mL
Correct Answer: 1,700 mL
Rationale: The Holliday-Segar method calculates maintenance fluids as: 100 mL/kg for the first 10 kg, 50
mL/kg for the next 10 kg, and 20 mL/kg for each additional kg. For a 22 kg child: 100 × 10 = 1000 mL; 50
× 10 = 500 mL; 20 × 2 = 40 mL; total = 1540 mL (rounded to 1,500 mL). The correct calculation is 1000 +
500 + (20 × 2) = 1,540 mL, which rounds to 1,500 mL. However, if using 20 mL/kg for each additional kg,
the total is 1,540 mL.
7. A 3-year-old child has lost 8% of body weight due to diarrhea. The nurse classifies this as which degree
of dehydration?
A) Mild dehydration
B) Moderate dehydration
C) Severe dehydration
D) No dehydration
Correct Answer: Moderate dehydration
