NR328/NR 328 Exam 3 V3 | Pediatric Nursing Q&A
with Rationale | Chamberlain University
1. A nurse is caring for a child with Cystic Fibrosis. Which instruction regarding the
administration of pancreatic enzymes should the nurse include in the teaching?
A. Administer enzymes with every meal and snack.
B. Give the enzymes only when the child has a fatty stool.
C. Administer the enzymes once daily in the morning.
D. Mix the enzymes into hot oatmeal to improve absorption.
Correct Answer: A
Explanation: Pancreatic enzymes are essential for children with Cystic Fibrosis to properly
digest fats, proteins, and carbohydrates. These enzymes must be taken with every meal and
snack to ensure adequate nutrient absorption throughout the day. The nurse should also
advise that the enzymes should not be mixed with hot foods, as heat can deactivate them.
2. A toddler with Tetralogy of Fallot becomes acutely cyanotic and agitated while crying.
What is the priority nursing action?
A. Administer high-flow oxygen via a non-rebreather mask.
B. Place the child in a knee-chest position.
C. Prepare for immediate endotracheal intubation.
D. Obtain a full set of vital signs including blood pressure.
,Correct Answer: B
Explanation: The child is experiencing a hypercyanotic episode, also known as a ‘Tet spell.’
Placing the child in a knee-chest position increases systemic vascular resistance, which
helps reduce the right-to-left shunt. This intervention is the first priority to improve
oxygenation before other treatments like oxygen or morphine are administered.
3. A nurse is assessing a child suspected of having Acute Epiglottitis. Which action is
contraindicated?
A. Allowing the child to sit in a tripod position.
B. Assessing the throat with a tongue depressor.
C. Administering humidified oxygen.
D. Preparing for lateral neck X-rays.
Correct Answer: B
Explanation: Visualizing the throat with a tongue blade or swab can cause immediate
laryngospasm and complete airway obstruction in a child with epiglottitis. The priority is
to maintain a patent airway and keep the child as calm as possible. The child should be
allowed to remain in a position of comfort, usually the tripod position, until an airway is
secured.
4. A school-aged child is admitted with Nephrotic Syndrome. Which clinical finding should the
nurse expect to observe?
A. Gross hematuria and hypertension.
, B. Massive proteinuria and generalized edema.
C. Severe hypotension and dehydration.
D. Weight loss and increased urinary output.
Correct Answer: B
Explanation: Nephrotic Syndrome is characterized by increased glomerular permeability
to protein, leading to massive proteinuria. This loss of protein causes a decrease in colloidal
osmotic pressure, resulting in generalized edema (anasarca). In contrast, hematuria and
hypertension are more commonly associated with Acute Glomerulonephritis.
5. Which physical assessment finding is most indicative of Bacterial Meningitis in an
adolescent?
A. Positive Kernig sign.
B. Hyperactive bowel sounds.
C. Negative Brudzinski sign.
D. Increased appetite and lethargy.
Correct Answer: A
Explanation: A positive Kernig sign, which is pain or resistance when extending the leg
with the hip flexed, indicates meningeal irritation. Another classic sign is the Brudzinski
sign, where neck flexion causes involuntary flexion of the hips and knees. These findings,
along with nuchal rigidity and high fever, are critical markers for meningitis.
with Rationale | Chamberlain University
1. A nurse is caring for a child with Cystic Fibrosis. Which instruction regarding the
administration of pancreatic enzymes should the nurse include in the teaching?
A. Administer enzymes with every meal and snack.
B. Give the enzymes only when the child has a fatty stool.
C. Administer the enzymes once daily in the morning.
D. Mix the enzymes into hot oatmeal to improve absorption.
Correct Answer: A
Explanation: Pancreatic enzymes are essential for children with Cystic Fibrosis to properly
digest fats, proteins, and carbohydrates. These enzymes must be taken with every meal and
snack to ensure adequate nutrient absorption throughout the day. The nurse should also
advise that the enzymes should not be mixed with hot foods, as heat can deactivate them.
2. A toddler with Tetralogy of Fallot becomes acutely cyanotic and agitated while crying.
What is the priority nursing action?
A. Administer high-flow oxygen via a non-rebreather mask.
B. Place the child in a knee-chest position.
C. Prepare for immediate endotracheal intubation.
D. Obtain a full set of vital signs including blood pressure.
,Correct Answer: B
Explanation: The child is experiencing a hypercyanotic episode, also known as a ‘Tet spell.’
Placing the child in a knee-chest position increases systemic vascular resistance, which
helps reduce the right-to-left shunt. This intervention is the first priority to improve
oxygenation before other treatments like oxygen or morphine are administered.
3. A nurse is assessing a child suspected of having Acute Epiglottitis. Which action is
contraindicated?
A. Allowing the child to sit in a tripod position.
B. Assessing the throat with a tongue depressor.
C. Administering humidified oxygen.
D. Preparing for lateral neck X-rays.
Correct Answer: B
Explanation: Visualizing the throat with a tongue blade or swab can cause immediate
laryngospasm and complete airway obstruction in a child with epiglottitis. The priority is
to maintain a patent airway and keep the child as calm as possible. The child should be
allowed to remain in a position of comfort, usually the tripod position, until an airway is
secured.
4. A school-aged child is admitted with Nephrotic Syndrome. Which clinical finding should the
nurse expect to observe?
A. Gross hematuria and hypertension.
, B. Massive proteinuria and generalized edema.
C. Severe hypotension and dehydration.
D. Weight loss and increased urinary output.
Correct Answer: B
Explanation: Nephrotic Syndrome is characterized by increased glomerular permeability
to protein, leading to massive proteinuria. This loss of protein causes a decrease in colloidal
osmotic pressure, resulting in generalized edema (anasarca). In contrast, hematuria and
hypertension are more commonly associated with Acute Glomerulonephritis.
5. Which physical assessment finding is most indicative of Bacterial Meningitis in an
adolescent?
A. Positive Kernig sign.
B. Hyperactive bowel sounds.
C. Negative Brudzinski sign.
D. Increased appetite and lethargy.
Correct Answer: A
Explanation: A positive Kernig sign, which is pain or resistance when extending the leg
with the hip flexed, indicates meningeal irritation. Another classic sign is the Brudzinski
sign, where neck flexion causes involuntary flexion of the hips and knees. These findings,
along with nuchal rigidity and high fever, are critical markers for meningitis.
