NUR 203 /NUR203 Exam 3 Pediatric Nursing
2026/2027/2028 Testing Cycle | Newly Released
50 Questions With Answers & Expert Rationales
Guaranteed Pass | Graded A+ | Fortis College
Endocrine, Gastrointestinal, & Renal Alterations
Q1: A nurse is assessing a school-age child with diabetes insipidus. Which clinical finding
should the nurse expect?
A. Weight gain
B. High urine specific gravity
C. Low serum osmolality
D. Intense polydipsia and polyuria
Correct Answer: D
Rationale: Correct because diabetes insipidus is characterized by a deficiency of antidiuretic
hormone or renal resistance to ADH, resulting in massive polyuria and compensatory intense
polydipsia as the body attempts to prevent dehydration. Weight gain is inconsistent with DI and
is more characteristic of fluid-retentive states such as SIADH. The nurse monitors daily weights,
intake and output, and urine specific gravity to assess treatment response and hydration status.
Q2: A school-age child is admitted with acute glomerulonephritis following a streptococcal
throat infection. Which assessment triad is most characteristic of this condition?
A. Massive proteinuria, anasarca, and hypoalbuminemia
B. Gross hematuria, periorbital edema, and severe hypertension
C. Frothy urine, normal blood pressure, and hyperlipidemia
D. Oliguria, hypokalemia, and jugular venous distension
Correct Answer: B
,Rationale: Correct because acute glomerulonephritis classically presents with gross hematuria
producing smoky or cola-colored urine, periorbital edema that is most prominent in the morning,
and severe hypertension resulting from fluid retention and renin release. Massive proteinuria
with anasarca and hypoalbuminemia characterizes nephrotic syndrome rather than AGN. The
nurse monitors blood pressure closely and prepares to administer antihypertensives if values
become dangerously elevated.
Q3: A nurse is teaching parents of a 4-month-old with gastroesophageal reflux about feeding
interventions. Which strategies should the nurse include? Select all that apply.
A. Thicken formula with infant rice cereal as prescribed
B. Hold the infant upright for 30 minutes after each feeding
C. Place the infant in a car seat immediately after feeding
D. Burp the infant frequently throughout the feeding
E. Position the infant prone for sleep after feedings
Correct Answer: A, B, D
Rationale: Correct because thickening formula with rice cereal reduces the volume of refluxate,
holding the infant upright for 30 minutes after feeding uses gravity to keep gastric contents in the
stomach, and frequent burping decreases gastric distension that exacerbates reflux. Placing the
infant in a car seat immediately after feeding increases intra-abdominal pressure from slouching
and worsens reflux, while prone positioning for sleep is contraindicated due to the increased risk
of sudden infant death syndrome. The nurse emphasizes these evidence-based feeding
modifications to reduce aspiration risk and promote adequate nutrition.
Q4: A 3-week-old infant is brought to the clinic with jaundice that has progressively worsened
since birth. Which finding is the hallmark clinical manifestation of biliary atresia?
A. Clay-colored stools and dark tea-colored urine
B. Bright green watery stools
C. Projectile non-bilious vomiting
D. Palpable olive-shaped abdominal mass
Correct Answer: A
Rationale: Correct because biliary atresia causes progressive obstruction of the extrahepatic bile
ducts, resulting in the inability to excrete bile into the intestinal tract, which manifests as acholic
clay-colored stools and dark tea-colored urine from conjugated bilirubin excreted renally. Bright
green stools are not characteristic of biliary atresia, projectile vomiting suggests pyloric stenosis,
and an olive-shaped mass is pathognomonic for hypertrophic pyloric stenosis. The nurse
, recognizes this clinical picture to facilitate urgent referral for diagnostic evaluation and potential
Kasai procedure.
Q5: A nurse is caring for a child with nephrotic syndrome. Which urinary characteristic should
the nurse document?
A. Tea-colored urine with visible blood
B. Clear and dilute urine with low specific gravity
C. Frothy, foamy urine indicating massive proteinuria
D. Dark concentrated urine with high specific gravity
Correct Answer: C
Rationale: Correct because nephrotic syndrome is defined by massive proteinuria exceeding 3.5
grams per day, which produces frothy or foamy urine as albumin alters surface tension in the
toilet water. Tea-colored hematuria is characteristic of acute glomerulonephritis, while clear
dilute urine suggests diabetes insipidus and dark concentrated urine is seen in dehydrated states
or SIADH. The nurse monitors urine characteristics and performs dipstick analysis to quantify
protein loss and evaluate response to corticosteroid therapy.
Q6: A nurse is assessing a newborn in the nursery. Which finding is the primary indicator of
Hirschsprung disease?
A. Projectile vomiting immediately after feedings
B. Passage of meconium within 6 hours of birth
C. Visible peristaltic waves across the abdomen
D. Failure to pass meconium within 24 to 48 hours of life
Correct Answer: D
Rationale: Correct because Hirschsprung disease involves the absence of parasympathetic
ganglion cells in the distal colon, causing functional obstruction and the inability to propagate
peristalsis, which manifests as failure to pass meconium within the first 24 to 48 hours of life.
Projectile vomiting after feedings is characteristic of hypertrophic pyloric stenosis, early
meconium passage is normal, and visible peristaltic waves may occur in Hirschsprung but are
not the primary neonatal indicator. The nurse reports this delayed meconium passage
immediately to initiate diagnostic workup including rectal biopsy.
2026/2027/2028 Testing Cycle | Newly Released
50 Questions With Answers & Expert Rationales
Guaranteed Pass | Graded A+ | Fortis College
Endocrine, Gastrointestinal, & Renal Alterations
Q1: A nurse is assessing a school-age child with diabetes insipidus. Which clinical finding
should the nurse expect?
A. Weight gain
B. High urine specific gravity
C. Low serum osmolality
D. Intense polydipsia and polyuria
Correct Answer: D
Rationale: Correct because diabetes insipidus is characterized by a deficiency of antidiuretic
hormone or renal resistance to ADH, resulting in massive polyuria and compensatory intense
polydipsia as the body attempts to prevent dehydration. Weight gain is inconsistent with DI and
is more characteristic of fluid-retentive states such as SIADH. The nurse monitors daily weights,
intake and output, and urine specific gravity to assess treatment response and hydration status.
Q2: A school-age child is admitted with acute glomerulonephritis following a streptococcal
throat infection. Which assessment triad is most characteristic of this condition?
A. Massive proteinuria, anasarca, and hypoalbuminemia
B. Gross hematuria, periorbital edema, and severe hypertension
C. Frothy urine, normal blood pressure, and hyperlipidemia
D. Oliguria, hypokalemia, and jugular venous distension
Correct Answer: B
,Rationale: Correct because acute glomerulonephritis classically presents with gross hematuria
producing smoky or cola-colored urine, periorbital edema that is most prominent in the morning,
and severe hypertension resulting from fluid retention and renin release. Massive proteinuria
with anasarca and hypoalbuminemia characterizes nephrotic syndrome rather than AGN. The
nurse monitors blood pressure closely and prepares to administer antihypertensives if values
become dangerously elevated.
Q3: A nurse is teaching parents of a 4-month-old with gastroesophageal reflux about feeding
interventions. Which strategies should the nurse include? Select all that apply.
A. Thicken formula with infant rice cereal as prescribed
B. Hold the infant upright for 30 minutes after each feeding
C. Place the infant in a car seat immediately after feeding
D. Burp the infant frequently throughout the feeding
E. Position the infant prone for sleep after feedings
Correct Answer: A, B, D
Rationale: Correct because thickening formula with rice cereal reduces the volume of refluxate,
holding the infant upright for 30 minutes after feeding uses gravity to keep gastric contents in the
stomach, and frequent burping decreases gastric distension that exacerbates reflux. Placing the
infant in a car seat immediately after feeding increases intra-abdominal pressure from slouching
and worsens reflux, while prone positioning for sleep is contraindicated due to the increased risk
of sudden infant death syndrome. The nurse emphasizes these evidence-based feeding
modifications to reduce aspiration risk and promote adequate nutrition.
Q4: A 3-week-old infant is brought to the clinic with jaundice that has progressively worsened
since birth. Which finding is the hallmark clinical manifestation of biliary atresia?
A. Clay-colored stools and dark tea-colored urine
B. Bright green watery stools
C. Projectile non-bilious vomiting
D. Palpable olive-shaped abdominal mass
Correct Answer: A
Rationale: Correct because biliary atresia causes progressive obstruction of the extrahepatic bile
ducts, resulting in the inability to excrete bile into the intestinal tract, which manifests as acholic
clay-colored stools and dark tea-colored urine from conjugated bilirubin excreted renally. Bright
green stools are not characteristic of biliary atresia, projectile vomiting suggests pyloric stenosis,
and an olive-shaped mass is pathognomonic for hypertrophic pyloric stenosis. The nurse
, recognizes this clinical picture to facilitate urgent referral for diagnostic evaluation and potential
Kasai procedure.
Q5: A nurse is caring for a child with nephrotic syndrome. Which urinary characteristic should
the nurse document?
A. Tea-colored urine with visible blood
B. Clear and dilute urine with low specific gravity
C. Frothy, foamy urine indicating massive proteinuria
D. Dark concentrated urine with high specific gravity
Correct Answer: C
Rationale: Correct because nephrotic syndrome is defined by massive proteinuria exceeding 3.5
grams per day, which produces frothy or foamy urine as albumin alters surface tension in the
toilet water. Tea-colored hematuria is characteristic of acute glomerulonephritis, while clear
dilute urine suggests diabetes insipidus and dark concentrated urine is seen in dehydrated states
or SIADH. The nurse monitors urine characteristics and performs dipstick analysis to quantify
protein loss and evaluate response to corticosteroid therapy.
Q6: A nurse is assessing a newborn in the nursery. Which finding is the primary indicator of
Hirschsprung disease?
A. Projectile vomiting immediately after feedings
B. Passage of meconium within 6 hours of birth
C. Visible peristaltic waves across the abdomen
D. Failure to pass meconium within 24 to 48 hours of life
Correct Answer: D
Rationale: Correct because Hirschsprung disease involves the absence of parasympathetic
ganglion cells in the distal colon, causing functional obstruction and the inability to propagate
peristalsis, which manifests as failure to pass meconium within the first 24 to 48 hours of life.
Projectile vomiting after feedings is characteristic of hypertrophic pyloric stenosis, early
meconium passage is normal, and visible peristaltic waves may occur in Hirschsprung but are
not the primary neonatal indicator. The nurse reports this delayed meconium passage
immediately to initiate diagnostic workup including rectal biopsy.
