,NSG 434 Exam 3 | Pediatric Nursing Advanced | Grand
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. A 4-year-old child insists on putting on their own shoes and becomes upset when the parent tries to
help. This behavior is most consistent with which Erikson stage?
A) Trust vs. Mistrust
B) Autonomy vs. Shame/Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: Initiative vs. Guilt
Rationale: Initiative vs. Guilt (ages 3–6) is characterized by children wanting to initiate tasks and feel
capable. They develop a sense of purpose and take pride in their accomplishments. Autonomy vs.
Shame/Doubt (18 months–3 years) focuses on basic self-care like toileting, not complex tasks like
dressing.
2. The nurse expects a 9-month-old infant to demonstrate which fine motor skill?
A) Pincer grasp
B) Building a tower of two cubes
C) Scribbling spontaneously
D) Using a spoon without spilling
Correct Answer: Pincer grasp
Rationale: The pincer grasp (using thumb and forefinger) typically develops around 8–10 months of age.
Building towers of cubes occurs around 12–15 months, scribbling spontaneously around 15–18 months,
and using a spoon without spilling around 18–24 months.
3. Which immunization is contraindicated in a child with a severe egg allergy (anaphylaxis)?
A) MMR
,B) Varicella
C) Inactivated influenza vaccine
D) Hepatitis B
Correct Answer: Inactivated influenza vaccine
Rationale: Some inactivated influenza vaccines are grown in eggs and may contain trace amounts of egg
protein. MMR and Varicella vaccines are safe for egg-allergic children. Hepatitis B does not contain egg
protein. However, some influenza vaccines are now egg-free, so specific product information should be
checked.
4. A 4-year-old is brought to the emergency department with a "froglike" croaking sound on inspiration,
agitation, and drooling. The child insists on sitting upright. What should the nurse do?
A) Lay the child flat and examine the throat
B) Give oral fluids to soothe the throat
C) Notify the physician immediately and be prepared to assist with a tracheostomy or intubation
D) Obtain a throat culture with a tongue depressor
Correct Answer: Notify the physician immediately and be prepared to assist with a tracheostomy or
intubation
Rationale: These are classic signs of acute epiglottitis, a medical emergency. The airway must be secured
quickly. Throat examination with a tongue depressor is contraindicated as it can precipitate complete
airway obstruction. The child should be kept calm and in a position of comfort.
5. A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solution
(ORS). The child's mother calls because he is also occasionally vomiting. What should the nurse
recommend?
A) Stop the ORS and keep the child NPO
B) Give large volumes of ORS every hour
C) Continue giving the child ORS frequently in small amounts
D) Switch to clear soda or juice
, Correct Answer: Continue giving the child ORS frequently in small amounts
Rationale: Frequent, small sips of ORS (e.g., 5–10 mL every 5–10 minutes) are recommended even with
intermittent vomiting to replace fluid and electrolytes safely. Clear sodas and juices have high sugar
content and may worsen diarrhea.
6. What factor predisposes an infant to fluid imbalances?
A) Decreased metabolic rate
B) Immature kidney functioning
C) Larger body fat stores
D) Thicker skin and tissues
Correct Answer: Immature kidney functioning
Rationale: Infants have immature kidney function, which limits their ability to concentrate urine and
conserve water, making them more susceptible to fluid imbalances. They also have a higher metabolic
rate and greater insensible water loss.
7. A nurse is providing support to a family whose infant has just been diagnosed with biliary atresia.
Which statement by the nurse is most appropriate?
A) "The condition resolves spontaneously by age 2."
B) "Phototherapy will cure the disease."
C) "Your baby will need surgery to restore bile flow."
D) "This condition is caused by a virus."
Correct Answer: "Your baby will need surgery to restore bile flow."
Rationale: Biliary atresia is a progressive obstruction of the bile ducts that requires surgical intervention,
typically the Kasai procedure (hepatoportoenterostomy), to restore bile flow. If untreated, it leads to
cirrhosis and liver failure. Phototherapy treats jaundice but does not cure the underlying obstruction.
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. A 4-year-old child insists on putting on their own shoes and becomes upset when the parent tries to
help. This behavior is most consistent with which Erikson stage?
A) Trust vs. Mistrust
B) Autonomy vs. Shame/Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: Initiative vs. Guilt
Rationale: Initiative vs. Guilt (ages 3–6) is characterized by children wanting to initiate tasks and feel
capable. They develop a sense of purpose and take pride in their accomplishments. Autonomy vs.
Shame/Doubt (18 months–3 years) focuses on basic self-care like toileting, not complex tasks like
dressing.
2. The nurse expects a 9-month-old infant to demonstrate which fine motor skill?
A) Pincer grasp
B) Building a tower of two cubes
C) Scribbling spontaneously
D) Using a spoon without spilling
Correct Answer: Pincer grasp
Rationale: The pincer grasp (using thumb and forefinger) typically develops around 8–10 months of age.
Building towers of cubes occurs around 12–15 months, scribbling spontaneously around 15–18 months,
and using a spoon without spilling around 18–24 months.
3. Which immunization is contraindicated in a child with a severe egg allergy (anaphylaxis)?
A) MMR
,B) Varicella
C) Inactivated influenza vaccine
D) Hepatitis B
Correct Answer: Inactivated influenza vaccine
Rationale: Some inactivated influenza vaccines are grown in eggs and may contain trace amounts of egg
protein. MMR and Varicella vaccines are safe for egg-allergic children. Hepatitis B does not contain egg
protein. However, some influenza vaccines are now egg-free, so specific product information should be
checked.
4. A 4-year-old is brought to the emergency department with a "froglike" croaking sound on inspiration,
agitation, and drooling. The child insists on sitting upright. What should the nurse do?
A) Lay the child flat and examine the throat
B) Give oral fluids to soothe the throat
C) Notify the physician immediately and be prepared to assist with a tracheostomy or intubation
D) Obtain a throat culture with a tongue depressor
Correct Answer: Notify the physician immediately and be prepared to assist with a tracheostomy or
intubation
Rationale: These are classic signs of acute epiglottitis, a medical emergency. The airway must be secured
quickly. Throat examination with a tongue depressor is contraindicated as it can precipitate complete
airway obstruction. The child should be kept calm and in a position of comfort.
5. A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solution
(ORS). The child's mother calls because he is also occasionally vomiting. What should the nurse
recommend?
A) Stop the ORS and keep the child NPO
B) Give large volumes of ORS every hour
C) Continue giving the child ORS frequently in small amounts
D) Switch to clear soda or juice
, Correct Answer: Continue giving the child ORS frequently in small amounts
Rationale: Frequent, small sips of ORS (e.g., 5–10 mL every 5–10 minutes) are recommended even with
intermittent vomiting to replace fluid and electrolytes safely. Clear sodas and juices have high sugar
content and may worsen diarrhea.
6. What factor predisposes an infant to fluid imbalances?
A) Decreased metabolic rate
B) Immature kidney functioning
C) Larger body fat stores
D) Thicker skin and tissues
Correct Answer: Immature kidney functioning
Rationale: Infants have immature kidney function, which limits their ability to concentrate urine and
conserve water, making them more susceptible to fluid imbalances. They also have a higher metabolic
rate and greater insensible water loss.
7. A nurse is providing support to a family whose infant has just been diagnosed with biliary atresia.
Which statement by the nurse is most appropriate?
A) "The condition resolves spontaneously by age 2."
B) "Phototherapy will cure the disease."
C) "Your baby will need surgery to restore bile flow."
D) "This condition is caused by a virus."
Correct Answer: "Your baby will need surgery to restore bile flow."
Rationale: Biliary atresia is a progressive obstruction of the bile ducts that requires surgical intervention,
typically the Kasai procedure (hepatoportoenterostomy), to restore bile flow. If untreated, it leads to
cirrhosis and liver failure. Phototherapy treats jaundice but does not cure the underlying obstruction.
