NSG 434 Exam 2 – Nursing Care of Children – (2026)
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GASTROINTESTINAL DISORDERS
1. What are the "3 C's" of Tracheoesophageal Fistulas (TEF)?
• A) Coughing, Choking, Cyanosis
• B) Constipation, Crying, Colic
• C) Cyanosis, Clubbing, Coughing
• D) Choking, Colic, Constipation
Answer: A – Coughing, Choking, Cyanosis
Rationale: The 3 C's are the classic signs when an infant with TEF is fed. Food
enters the fistula and trachea, causing immediate respiratory distress
characterized by coughing, choking, and cyanosis .
2. A child diagnosed with Biliary Atresia is scheduled for which surgical
procedure?
• A) Dacron Patch
• B) Kasai Procedure
• C) Nissen Fundoplication
• D) Hypospadias Repair
Answer: B – Kasai Procedure
Rationale: The Kasai procedure (hepatoportoenterostomy) attaches a segment of
the liver to the small intestine to improve bile drainage. It is not a cure but
improves prognosis; most patients eventually require a liver transplant. A Dacron
patch treats ventricular septal defects, Nissen fundoplication treats GERD, and
hypospadias repair corrects a urethral defect .
,3. An infant has been diagnosed with Hirschsprung disease. The mother asks
what to expect the baby's stools to look like. How will the nurse respond?
• A) Ribbon-like stool
• B) Steatorrhea (fatty stool)
• C) Red currant jelly-like stool
• D) Chalky white stool
Answer: A – Ribbon-like stool
Rationale: Hirschsprung disease involves a lack of ganglion cells in the bowel,
leading to a narrow, aganglionic segment. Stools passing through this area
become thin and ribbon-like. Steatorrhea is seen with celiac disease, red currant
jelly stool is classic for intussusception, and chalky white stool is seen with biliary
atresia .
4. What is a major complication that can result from Malrotation?
• A) Intussusception of the bowel
• B) Infection from bowel sticking out of the cavity
• C) Short bowel syndrome
• D) Decreased blood flow to the body
Answer: D – Decreased blood flow to the body
Rationale: Malrotation can lead to volvulus, where the intestine twists around the
superior mesenteric artery and compromises blood supply. This is a surgical
emergency requiring immediate intervention .
5. What does the stool look like with intussusception?
• A) Ribbon-like stool
• B) Steatorrhea (fatty stool)
, • C) Red currant jelly-like stool
• D) Chalky white stool
Answer: C – Red currant jelly-like stool
Rationale: This classic finding is due to intestinal bleeding and the mixing of blood
with mucus from the bowel. The stool contains blood and mucus, giving it a
characteristic appearance .
6. What indicates that intussusception has resolved?
• A) Passage of normal stool
• B) Decreased abdominal pain
• C) Vomiting stops
• D) Fever resolves
Answer: A – Passage of normal stool
Rationale: A normal bowel movement after treatment (often with an air or
barium enema) is the best indicator that the intestine has been successfully
reduced and is functioning properly.
7. What electrolyte imbalance can excessive vomiting in pyloric stenosis cause?
• A) Metabolic acidosis
• B) Metabolic alkalosis
• C) Respiratory acidosis
• D) Respiratory alkalosis
Answer: B – Metabolic alkalosis
Rationale: Pyloric stenosis causes projectile vomiting, leading to loss of gastric
acid (HCl). This results in metabolic alkalosis due to the loss of hydrogen and
chloride ions.
, 8. Which statement is true about GER in infants?
• A) Peak incidence is at 12 months of age
• B) 85% of infants outgrow it by 12 months
• C) It is more common in females
• D) It always requires surgical intervention
Answer: B – 85% of infants outgrow it by 12 months
Rationale: Gastroesophageal reflux (GER) is often a maturational process. Peak
incidence is at 4 months of age, and approximately 85% of infants outgrow it by
12 months .
9. What is the definitive diagnostic test for Hirschsprung disease?
• A) Abdominal X-ray
• B) Rectal biopsy
• C) Stool culture
• D) CBC
Answer: B – Rectal biopsy
Rationale: A rectal biopsy to detect the absence of ganglion cells is the definitive
diagnosis for Hirschsprung disease .
10. A neonate with Hirschsprung disease would most likely present with which
symptom?
• A) Frequent diarrhea
• B) Failure to pass meconium within 24-48 hours
• C) Excessive weight gain
• D) Hyperactive bowel sounds
Actual Questions & Answers (GCU) 100% Guarantee
Pass
GASTROINTESTINAL DISORDERS
1. What are the "3 C's" of Tracheoesophageal Fistulas (TEF)?
• A) Coughing, Choking, Cyanosis
• B) Constipation, Crying, Colic
• C) Cyanosis, Clubbing, Coughing
• D) Choking, Colic, Constipation
Answer: A – Coughing, Choking, Cyanosis
Rationale: The 3 C's are the classic signs when an infant with TEF is fed. Food
enters the fistula and trachea, causing immediate respiratory distress
characterized by coughing, choking, and cyanosis .
2. A child diagnosed with Biliary Atresia is scheduled for which surgical
procedure?
• A) Dacron Patch
• B) Kasai Procedure
• C) Nissen Fundoplication
• D) Hypospadias Repair
Answer: B – Kasai Procedure
Rationale: The Kasai procedure (hepatoportoenterostomy) attaches a segment of
the liver to the small intestine to improve bile drainage. It is not a cure but
improves prognosis; most patients eventually require a liver transplant. A Dacron
patch treats ventricular septal defects, Nissen fundoplication treats GERD, and
hypospadias repair corrects a urethral defect .
,3. An infant has been diagnosed with Hirschsprung disease. The mother asks
what to expect the baby's stools to look like. How will the nurse respond?
• A) Ribbon-like stool
• B) Steatorrhea (fatty stool)
• C) Red currant jelly-like stool
• D) Chalky white stool
Answer: A – Ribbon-like stool
Rationale: Hirschsprung disease involves a lack of ganglion cells in the bowel,
leading to a narrow, aganglionic segment. Stools passing through this area
become thin and ribbon-like. Steatorrhea is seen with celiac disease, red currant
jelly stool is classic for intussusception, and chalky white stool is seen with biliary
atresia .
4. What is a major complication that can result from Malrotation?
• A) Intussusception of the bowel
• B) Infection from bowel sticking out of the cavity
• C) Short bowel syndrome
• D) Decreased blood flow to the body
Answer: D – Decreased blood flow to the body
Rationale: Malrotation can lead to volvulus, where the intestine twists around the
superior mesenteric artery and compromises blood supply. This is a surgical
emergency requiring immediate intervention .
5. What does the stool look like with intussusception?
• A) Ribbon-like stool
• B) Steatorrhea (fatty stool)
, • C) Red currant jelly-like stool
• D) Chalky white stool
Answer: C – Red currant jelly-like stool
Rationale: This classic finding is due to intestinal bleeding and the mixing of blood
with mucus from the bowel. The stool contains blood and mucus, giving it a
characteristic appearance .
6. What indicates that intussusception has resolved?
• A) Passage of normal stool
• B) Decreased abdominal pain
• C) Vomiting stops
• D) Fever resolves
Answer: A – Passage of normal stool
Rationale: A normal bowel movement after treatment (often with an air or
barium enema) is the best indicator that the intestine has been successfully
reduced and is functioning properly.
7. What electrolyte imbalance can excessive vomiting in pyloric stenosis cause?
• A) Metabolic acidosis
• B) Metabolic alkalosis
• C) Respiratory acidosis
• D) Respiratory alkalosis
Answer: B – Metabolic alkalosis
Rationale: Pyloric stenosis causes projectile vomiting, leading to loss of gastric
acid (HCl). This results in metabolic alkalosis due to the loss of hydrogen and
chloride ions.
, 8. Which statement is true about GER in infants?
• A) Peak incidence is at 12 months of age
• B) 85% of infants outgrow it by 12 months
• C) It is more common in females
• D) It always requires surgical intervention
Answer: B – 85% of infants outgrow it by 12 months
Rationale: Gastroesophageal reflux (GER) is often a maturational process. Peak
incidence is at 4 months of age, and approximately 85% of infants outgrow it by
12 months .
9. What is the definitive diagnostic test for Hirschsprung disease?
• A) Abdominal X-ray
• B) Rectal biopsy
• C) Stool culture
• D) CBC
Answer: B – Rectal biopsy
Rationale: A rectal biopsy to detect the absence of ganglion cells is the definitive
diagnosis for Hirschsprung disease .
10. A neonate with Hirschsprung disease would most likely present with which
symptom?
• A) Frequent diarrhea
• B) Failure to pass meconium within 24-48 hours
• C) Excessive weight gain
• D) Hyperactive bowel sounds
