NUR 203/NUR203 Exam 2 V2 | Pediatric Nursing
Q&A with Rationale | Fortis College
1. A 2-year-old child is admitted to the pediatric unit with a diagnosis of
Laryngotracheobronchitis (Croup). Which clinical manifestation should the nurse prioritize for
immediate reporting?
A. Barking cough especially at night
B. Inspiratory stridor and suprasternal retractions
C. Oral temperature of 100.2” F (37.9” C)
D. Decreased appetite and mild irritability
Correct Answer: B
Explanation: Inspiratory stridor and suprasternal retractions are signs of significant upper
airway obstruction and impending respiratory distress. While a barking cough is
characteristic of croup, it is the respiratory effort and stridor that indicate a need for
immediate intervention such as nebulized epinephrine. The nurse must monitor for
worsening airway patency to prevent full respiratory arrest.
2. The nurse is preparing to care for a child suspected of having Acute Epiglottitis. Which
action is strictly contraindicated during the physical assessment?
A. Monitoring pulse oximetry levels
B. Assessing the child’s respiratory rate
,C. Visualizing the throat with a tongue blade
D. Auscultating the lung fields for breath sounds
Correct Answer: C
Explanation: Visualizing the throat with a tongue blade or performing a throat culture can
trigger a sudden laryngospasm in a child with epiglottitis. This can lead to a complete and
fatal airway obstruction within seconds. Assessment of epiglottitis should be limited to
observation and should only be performed by a provider capable of emergency intubation
or tracheostomy.
3. A school-age child with Cystic Fibrosis (CF) is being educated on the use of pancreatic
enzymes. When should the nurse instruct the child to take these enzymes?
A. Immediately upon waking in the morning
B. Only after fatty meals to prevent diarrhea
C. Once daily at bedtime with a glass of water
D. With every meal and every snack
Correct Answer: D
Explanation: Pancreatic enzymes are required for the digestion and absorption of fats and
proteins in patients with Cystic Fibrosis. Because the pancreatic ducts are blocked by thick
mucus, these enzymes must be taken with all meals and snacks to facilitate nutrient uptake.
Failure to adhere to this regimen leads to steatorrhea and malnutrition in the pediatric
patient.
,4. An infant is diagnosed with Tetralogy of Fallot and experiences a ‘Tet spell’ during crying.
What is the nurse’s immediate priority action?
A. Administer a dose of Digoxin immediately
B. Provide 100% oxygen via a simple face mask
C. Prepare for emergency endotracheal intubation
D. Place the infant in the knee-chest position
Correct Answer: D
Explanation: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunting of blood through the ventricular septal defect. This
maneuver increases pulmonary blood flow and improves oxygenation during a
hypercyanotic spell. Although oxygen is beneficial, positioning is the first-line mechanical
intervention to stabilize the infant’s hemodynamics.
5. The nurse is caring for a 10-year-old child diagnosed with Nephrotic Syndrome. Which
clinical finding should the nurse anticipate?
A. Increased urinary output and fever
B. Gross hematuria and hypertension
C. Hypolipidemia and weight loss
D. Massive proteinuria and generalized edema
Correct Answer: D
, Explanation: Nephrotic syndrome is characterized by increased glomerular permeability
to protein, leading to massive proteinuria. This results in hypoalbuminemia, which lowers
osmotic pressure and causes fluid to shift into the interstitial spaces, manifesting as
generalized edema. Management focuses on reducing protein loss and controlling fluid
retention through corticosteroids and diuretics.
6. A child is hospitalized with Acute Post-Streptococcal Glomerulonephritis (APSGN). Which
laboratory result most likely confirms this diagnosis?
A. Elevated Blood Urea Nitrogen (BUN) and Creatinine
B. Positive Antistreptolysin O (ASO) titer
C. Low serum cholesterol and triglycerides
D. Negative throat culture for Group A Strep
Correct Answer: B
Explanation: An elevated Antistreptolysin O (ASO) titer indicates a recent infection with
Group A beta-hemolytic streptococcus, which is the precursor to APSGN. APSGN typically
appears 1 to 2 weeks after a strep throat infection or 3 to 6 weeks after a skin infection.
While BUN and Creatinine may be elevated, the ASO titer specifically links the current renal
symptoms to the prior streptococcal infection.
7. An 8-year-old child with Type 1 Diabetes Mellitus (T1DM) is planning to play soccer this
afternoon. What instruction should the nurse provide to the parents?
A. Decrease the insulin dose by half before the game
Q&A with Rationale | Fortis College
1. A 2-year-old child is admitted to the pediatric unit with a diagnosis of
Laryngotracheobronchitis (Croup). Which clinical manifestation should the nurse prioritize for
immediate reporting?
A. Barking cough especially at night
B. Inspiratory stridor and suprasternal retractions
C. Oral temperature of 100.2” F (37.9” C)
D. Decreased appetite and mild irritability
Correct Answer: B
Explanation: Inspiratory stridor and suprasternal retractions are signs of significant upper
airway obstruction and impending respiratory distress. While a barking cough is
characteristic of croup, it is the respiratory effort and stridor that indicate a need for
immediate intervention such as nebulized epinephrine. The nurse must monitor for
worsening airway patency to prevent full respiratory arrest.
2. The nurse is preparing to care for a child suspected of having Acute Epiglottitis. Which
action is strictly contraindicated during the physical assessment?
A. Monitoring pulse oximetry levels
B. Assessing the child’s respiratory rate
,C. Visualizing the throat with a tongue blade
D. Auscultating the lung fields for breath sounds
Correct Answer: C
Explanation: Visualizing the throat with a tongue blade or performing a throat culture can
trigger a sudden laryngospasm in a child with epiglottitis. This can lead to a complete and
fatal airway obstruction within seconds. Assessment of epiglottitis should be limited to
observation and should only be performed by a provider capable of emergency intubation
or tracheostomy.
3. A school-age child with Cystic Fibrosis (CF) is being educated on the use of pancreatic
enzymes. When should the nurse instruct the child to take these enzymes?
A. Immediately upon waking in the morning
B. Only after fatty meals to prevent diarrhea
C. Once daily at bedtime with a glass of water
D. With every meal and every snack
Correct Answer: D
Explanation: Pancreatic enzymes are required for the digestion and absorption of fats and
proteins in patients with Cystic Fibrosis. Because the pancreatic ducts are blocked by thick
mucus, these enzymes must be taken with all meals and snacks to facilitate nutrient uptake.
Failure to adhere to this regimen leads to steatorrhea and malnutrition in the pediatric
patient.
,4. An infant is diagnosed with Tetralogy of Fallot and experiences a ‘Tet spell’ during crying.
What is the nurse’s immediate priority action?
A. Administer a dose of Digoxin immediately
B. Provide 100% oxygen via a simple face mask
C. Prepare for emergency endotracheal intubation
D. Place the infant in the knee-chest position
Correct Answer: D
Explanation: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunting of blood through the ventricular septal defect. This
maneuver increases pulmonary blood flow and improves oxygenation during a
hypercyanotic spell. Although oxygen is beneficial, positioning is the first-line mechanical
intervention to stabilize the infant’s hemodynamics.
5. The nurse is caring for a 10-year-old child diagnosed with Nephrotic Syndrome. Which
clinical finding should the nurse anticipate?
A. Increased urinary output and fever
B. Gross hematuria and hypertension
C. Hypolipidemia and weight loss
D. Massive proteinuria and generalized edema
Correct Answer: D
, Explanation: Nephrotic syndrome is characterized by increased glomerular permeability
to protein, leading to massive proteinuria. This results in hypoalbuminemia, which lowers
osmotic pressure and causes fluid to shift into the interstitial spaces, manifesting as
generalized edema. Management focuses on reducing protein loss and controlling fluid
retention through corticosteroids and diuretics.
6. A child is hospitalized with Acute Post-Streptococcal Glomerulonephritis (APSGN). Which
laboratory result most likely confirms this diagnosis?
A. Elevated Blood Urea Nitrogen (BUN) and Creatinine
B. Positive Antistreptolysin O (ASO) titer
C. Low serum cholesterol and triglycerides
D. Negative throat culture for Group A Strep
Correct Answer: B
Explanation: An elevated Antistreptolysin O (ASO) titer indicates a recent infection with
Group A beta-hemolytic streptococcus, which is the precursor to APSGN. APSGN typically
appears 1 to 2 weeks after a strep throat infection or 3 to 6 weeks after a skin infection.
While BUN and Creatinine may be elevated, the ASO titer specifically links the current renal
symptoms to the prior streptococcal infection.
7. An 8-year-old child with Type 1 Diabetes Mellitus (T1DM) is planning to play soccer this
afternoon. What instruction should the nurse provide to the parents?
A. Decrease the insulin dose by half before the game
