NUR 203/NUR203 Exam 4 V2 | Pediatric Nursing
Q&A with Rationale | Fortis College
1. A nurse is caring for a child with Cystic Fibrosis. Which of the following instructions
regarding pancreatic enzyme replacement should the nurse provide to the parents?
A. Give enzymes with all meals and snacks.
B. Administer enzymes once daily in the morning.
C. Omit enzymes if the child is having a light snack.
D. Mix the enzymes into hot oatmeal or soup.
Correct Answer: A
Explanation: Pancreatic enzymes are required to assist in the digestion of fats, proteins,
and carbohydrates in children with Cystic Fibrosis. These enzymes must be taken with
every meal and snack to prevent malabsorption and steatorrhea. It is important to note
that enzymes should not be mixed with hot foods as heat can deactivate the enzyme
activity.
2. A 3-year-old child is brought to the emergency department with suspected epiglottitis.
Which nursing action is the highest priority?
A. Ensure emergency airway equipment is readily available at the bedside.
B. Place the child in a supine position for easier breathing.
C. Obtain a throat culture to identify the causative organism.
,D. Start an IV line for immediate antibiotic administration.
Correct Answer: A
Explanation: Epiglottitis is a medical emergency that can lead to rapid and total airway
obstruction. The nurse should never examine the throat or use a tongue blade as this can
trigger a laryngospasm. Having emergency intubation or tracheostomy equipment at the
bedside is the most critical intervention to ensure patient safety.
3. A nurse is assessing a child with Tetralogy of Fallot who suddenly becomes cyanotic and
dyspneic. Which action should the nurse take first?
A. Administer 100% oxygen via face mask.
B. Prepare to administer morphine sulfate intravenously.
C. Place the child in the knee-chest position.
D. Notify the healthcare provider immediately.
Correct Answer: C
Explanation: The knee-chest position increases systemic vascular resistance and
decreases the right-to-left shunt, which helps improve oxygenation during a ‘Tet spell’. This
non-invasive maneuver is the priority action when a child with Tetralogy of Fallot
experiences acute cyanosis. Oxygen and morphine are subsequent interventions used if the
position change does not resolve the episode.
4. Which clinical manifestation is most characteristic of a child with pyloric stenosis?
A. Projectile vomiting after feedings.
, B. Ribbon-like, foul-smelling stools.
C. Currant jelly-like stools.
D. Abdominal pain relieved by a bowel movement.
Correct Answer: A
Explanation: Projectile vomiting is a hallmark sign of hypertrophic pyloric stenosis due to
the gastric outlet obstruction. This usually occurs within the first few weeks of life and is
non-bile stained because the obstruction is proximal to the bile duct. Parents may also
notice a palpable olive-shaped mass in the right upper quadrant of the abdomen.
5. A child is admitted with Acute Glomerulonephritis (AGN). The nurse should expect which of
the following findings in the child’s history?
A. A history of chronic urinary tract infections.
B. A recent history of a streptococcal infection.
C. An allergy to contrast media or iodine.
D. Exposure to lead-based paint in an older home.
Correct Answer: B
Explanation: Acute Glomerulonephritis is often a post-infectious condition that occurs
after a group A beta-hemolytic streptococcal infection of the throat or skin. The immune
complexes deposit in the glomeruli, causing inflammation and damage. Common symptoms
include hematuria, which results in tea-colored or smoky-colored urine.
Q&A with Rationale | Fortis College
1. A nurse is caring for a child with Cystic Fibrosis. Which of the following instructions
regarding pancreatic enzyme replacement should the nurse provide to the parents?
A. Give enzymes with all meals and snacks.
B. Administer enzymes once daily in the morning.
C. Omit enzymes if the child is having a light snack.
D. Mix the enzymes into hot oatmeal or soup.
Correct Answer: A
Explanation: Pancreatic enzymes are required to assist in the digestion of fats, proteins,
and carbohydrates in children with Cystic Fibrosis. These enzymes must be taken with
every meal and snack to prevent malabsorption and steatorrhea. It is important to note
that enzymes should not be mixed with hot foods as heat can deactivate the enzyme
activity.
2. A 3-year-old child is brought to the emergency department with suspected epiglottitis.
Which nursing action is the highest priority?
A. Ensure emergency airway equipment is readily available at the bedside.
B. Place the child in a supine position for easier breathing.
C. Obtain a throat culture to identify the causative organism.
,D. Start an IV line for immediate antibiotic administration.
Correct Answer: A
Explanation: Epiglottitis is a medical emergency that can lead to rapid and total airway
obstruction. The nurse should never examine the throat or use a tongue blade as this can
trigger a laryngospasm. Having emergency intubation or tracheostomy equipment at the
bedside is the most critical intervention to ensure patient safety.
3. A nurse is assessing a child with Tetralogy of Fallot who suddenly becomes cyanotic and
dyspneic. Which action should the nurse take first?
A. Administer 100% oxygen via face mask.
B. Prepare to administer morphine sulfate intravenously.
C. Place the child in the knee-chest position.
D. Notify the healthcare provider immediately.
Correct Answer: C
Explanation: The knee-chest position increases systemic vascular resistance and
decreases the right-to-left shunt, which helps improve oxygenation during a ‘Tet spell’. This
non-invasive maneuver is the priority action when a child with Tetralogy of Fallot
experiences acute cyanosis. Oxygen and morphine are subsequent interventions used if the
position change does not resolve the episode.
4. Which clinical manifestation is most characteristic of a child with pyloric stenosis?
A. Projectile vomiting after feedings.
, B. Ribbon-like, foul-smelling stools.
C. Currant jelly-like stools.
D. Abdominal pain relieved by a bowel movement.
Correct Answer: A
Explanation: Projectile vomiting is a hallmark sign of hypertrophic pyloric stenosis due to
the gastric outlet obstruction. This usually occurs within the first few weeks of life and is
non-bile stained because the obstruction is proximal to the bile duct. Parents may also
notice a palpable olive-shaped mass in the right upper quadrant of the abdomen.
5. A child is admitted with Acute Glomerulonephritis (AGN). The nurse should expect which of
the following findings in the child’s history?
A. A history of chronic urinary tract infections.
B. A recent history of a streptococcal infection.
C. An allergy to contrast media or iodine.
D. Exposure to lead-based paint in an older home.
Correct Answer: B
Explanation: Acute Glomerulonephritis is often a post-infectious condition that occurs
after a group A beta-hemolytic streptococcal infection of the throat or skin. The immune
complexes deposit in the glomeruli, causing inflammation and damage. Common symptoms
include hematuria, which results in tea-colored or smoky-colored urine.
