# NSG 3600 Peds Exam 3 – GI, GU & Neuro Practice Questions
*Galen College | 2026/2027 Update | 200 Questions with Verified Answers &
Detailed Rationales**
# Section 1: Gastrointestinal Disorders (Questions 1-80)
### Pyloric Stenosis
**1. A 3-week-old infant is brought to the clinic with projectile, non-bilious vomiting immediately
after feedings. The infant appears hungry and eager to feed again after vomiting. The nurse notes
visible peristaltic waves across the upper abdomen. Which assessment finding would the nurse expect
to confirm the suspected diagnosis?**
A) A palpable olive-shaped mass in the right upper quadrant
B) Currant jelly-like stools on rectal examination
C) Bilious vomiting with abdominal distension
D) Blood-streaked emesis and severe irritability
**Answer: A**
*Rationale:* The clinical presentation is classic for hypertrophic pyloric stenosis, which typically
presents between 2 and 8 weeks of age with projectile non-bilious vomiting, visible gastric peristaltic
waves, and a palpable olive-shaped mass in the right upper quadrant . The mass represents the
hypertrophied pyloric muscle. Currant jelly stools are associated with intussusception, and bilious
vomiting suggests a distal obstruction .
**2. A 5-week-old male infant is diagnosed with hypertrophic pyloric stenosis. Which of the following
assessment findings is most consistent with this diagnosis?**
A) Projectile vomiting that occurs immediately after feeding
B) Bilious emesis with abdominal distention
C) Diarrhea and failure to gain weight
D) Currant-jelly stools and severe abdominal pain
**Answer: A**
*Rationale:* Pyloric stenosis presents with projectile, non-bilious vomiting immediately after feedings.
The infant remains hungry (insatiable feeding behavior) due to malnutrition from the vomiting. Bilious
,vomiting suggests an obstruction further down the intestinal tract, and currant-jelly stools are a sign
of intussusception .
**3. A nurse is providing discharge teaching to parents of a 4-week-old infant who underwent a
pyloromyotomy for pyloric stenosis. Which statement indicates the parents require further
teaching?**
A) "We will start feedings 6 hours after surgery as tolerated."
B) "Vomiting during the first 24 hours after surgery is expected."
C) "We should feed the baby 15 mL of Pedialyte every 2 hours."
D) "Vomiting 48 hours after surgery is normal and expected."
**Answer: D**
*Rationale:* Vomiting during the first 24 hours after pyloromyotomy is expected and may be normal.
However, vomiting lasting more than 48 hours postoperatively should be reported to the healthcare
provider as it may indicate complications. Feedings are typically started 6 hours after surgery with
small amounts of Pedialyte or formula as tolerated. The infant will not advance to the next feeding
level until two feedings are tolerated .
**4. Which population is at highest risk for developing hypertrophic pyloric stenosis?**
A) African American females
B) Caucasian first-born males
C) Asian females
D) Hispanic second-born males
**Answer: B**
*Rationale:* Hypertrophic pyloric stenosis is most common in Caucasian, first-born male infants. This
population is at the highest risk for this condition, which requires surgical correction .
**5. A 6-week-old male is diagnosed with pyloric stenosis. The infant has been vomiting and is
dehydrated. What is the priority nursing intervention before surgery?**
A) Prepare the infant for immediate surgery
B) Correct electrolyte imbalances
C) Begin oral feedings
D) Administer preoperative antibiotics
,**Answer: B**
*Rationale:* Before surgery for pyloric stenosis, the infant must be stabilized and electrolyte
imbalances corrected. Dehydration and metabolic alkalosis from vomiting must be addressed before
surgical intervention. If the patient is dehydrated, surgery cannot proceed until fluids and electrolytes
are corrected .
### Intussusception
**6. A 2-year-old child is brought to the emergency department with suspected intussusception.
Which clinical finding would the nurse expect to document?**
A) Intermittent, severe, colicky abdominal pain with the child drawing knees to the chest
B) Continuous, diffuse abdominal pain with rigid guarding
C) Painless rectal bleeding with normal activity between episodes
D) Steady, burning epigastric pain relieved by antacids
**Answer: A**
*Rationale:* Intussusception classically presents with intermittent, severe, colicky abdominal pain
during which the child screams, draws the knees to the chest, and appears pale. Between episodes,
the child may appear comfortable . Currant-jelly stools (blood and mucus) are a late sign .
**7. The nurse is caring for an infant with intussusception. Which assessment finding is characteristic
of this condition?**
A) Projectile vomiting after feedings
B) A palpable sausage-shaped mass in the right upper quadrant
C) Ribbon-like stools
D) An olive-shaped mass in the epigastric area
**Answer: B**
*Rationale:* Intussusception involves one portion of the intestine telescoping into another, causing
obstruction. A sausage-shaped mass is often palpable in the right upper quadrant. Currant-jelly stools
and intermittent colicky pain are also classic findings .
**8. A child with suspected intussusception is scheduled for a barium enema. The nurse understands
that this procedure is performed for which purpose?**
A) Confirm the diagnosis
, B) Reduce the invaginated bowel segment
C) Prepare for surgical resection
D) Determine the extent of necrosis
**Answer: B**
*Rationale:* A barium enema is both diagnostic and therapeutic for intussusception. The hydrostatic
pressure from the barium or air enema can often reduce the invaginated bowel segment, eliminating
the need for surgical intervention. If the bowel does not reduce, surgery becomes necessary .
**9. A child with intussusception is waiting to have surgery. The patient passes a normal stool. What
should the nurse do?**
A) Obtain an abdominal ultrasound
B) Perform a test to check for blood in the stool
C) Notify the doctor immediately
D) Document the color only
**Answer: C**
*Rationale:* If a child with intussusception passes a normal stool, it may indicate spontaneous
reduction of the intussusception. The healthcare provider should be notified immediately for further
evaluation and to determine if surgery is still needed .
**10. Which finding in a child with intussusception would cause the nurse to notify the healthcare
provider immediately?**
A) The infant passes a currant-jelly stool
B) The infant has intermittent colicky pain
C) The infant's abdomen is rigid and the infant is lethargic
D) The infant has a sausage-shaped mass in the right upper quadrant
**Answer: C**
*Rationale:* A rigid abdomen and lethargy in an infant with intussusception indicate possible
perforation or peritonitis. The infant may also show signs of shock (tachycardia, hypotension). This is
a medical emergency requiring immediate notification of the healthcare provider .
### Hirschsprung Disease
*Galen College | 2026/2027 Update | 200 Questions with Verified Answers &
Detailed Rationales**
# Section 1: Gastrointestinal Disorders (Questions 1-80)
### Pyloric Stenosis
**1. A 3-week-old infant is brought to the clinic with projectile, non-bilious vomiting immediately
after feedings. The infant appears hungry and eager to feed again after vomiting. The nurse notes
visible peristaltic waves across the upper abdomen. Which assessment finding would the nurse expect
to confirm the suspected diagnosis?**
A) A palpable olive-shaped mass in the right upper quadrant
B) Currant jelly-like stools on rectal examination
C) Bilious vomiting with abdominal distension
D) Blood-streaked emesis and severe irritability
**Answer: A**
*Rationale:* The clinical presentation is classic for hypertrophic pyloric stenosis, which typically
presents between 2 and 8 weeks of age with projectile non-bilious vomiting, visible gastric peristaltic
waves, and a palpable olive-shaped mass in the right upper quadrant . The mass represents the
hypertrophied pyloric muscle. Currant jelly stools are associated with intussusception, and bilious
vomiting suggests a distal obstruction .
**2. A 5-week-old male infant is diagnosed with hypertrophic pyloric stenosis. Which of the following
assessment findings is most consistent with this diagnosis?**
A) Projectile vomiting that occurs immediately after feeding
B) Bilious emesis with abdominal distention
C) Diarrhea and failure to gain weight
D) Currant-jelly stools and severe abdominal pain
**Answer: A**
*Rationale:* Pyloric stenosis presents with projectile, non-bilious vomiting immediately after feedings.
The infant remains hungry (insatiable feeding behavior) due to malnutrition from the vomiting. Bilious
,vomiting suggests an obstruction further down the intestinal tract, and currant-jelly stools are a sign
of intussusception .
**3. A nurse is providing discharge teaching to parents of a 4-week-old infant who underwent a
pyloromyotomy for pyloric stenosis. Which statement indicates the parents require further
teaching?**
A) "We will start feedings 6 hours after surgery as tolerated."
B) "Vomiting during the first 24 hours after surgery is expected."
C) "We should feed the baby 15 mL of Pedialyte every 2 hours."
D) "Vomiting 48 hours after surgery is normal and expected."
**Answer: D**
*Rationale:* Vomiting during the first 24 hours after pyloromyotomy is expected and may be normal.
However, vomiting lasting more than 48 hours postoperatively should be reported to the healthcare
provider as it may indicate complications. Feedings are typically started 6 hours after surgery with
small amounts of Pedialyte or formula as tolerated. The infant will not advance to the next feeding
level until two feedings are tolerated .
**4. Which population is at highest risk for developing hypertrophic pyloric stenosis?**
A) African American females
B) Caucasian first-born males
C) Asian females
D) Hispanic second-born males
**Answer: B**
*Rationale:* Hypertrophic pyloric stenosis is most common in Caucasian, first-born male infants. This
population is at the highest risk for this condition, which requires surgical correction .
**5. A 6-week-old male is diagnosed with pyloric stenosis. The infant has been vomiting and is
dehydrated. What is the priority nursing intervention before surgery?**
A) Prepare the infant for immediate surgery
B) Correct electrolyte imbalances
C) Begin oral feedings
D) Administer preoperative antibiotics
,**Answer: B**
*Rationale:* Before surgery for pyloric stenosis, the infant must be stabilized and electrolyte
imbalances corrected. Dehydration and metabolic alkalosis from vomiting must be addressed before
surgical intervention. If the patient is dehydrated, surgery cannot proceed until fluids and electrolytes
are corrected .
### Intussusception
**6. A 2-year-old child is brought to the emergency department with suspected intussusception.
Which clinical finding would the nurse expect to document?**
A) Intermittent, severe, colicky abdominal pain with the child drawing knees to the chest
B) Continuous, diffuse abdominal pain with rigid guarding
C) Painless rectal bleeding with normal activity between episodes
D) Steady, burning epigastric pain relieved by antacids
**Answer: A**
*Rationale:* Intussusception classically presents with intermittent, severe, colicky abdominal pain
during which the child screams, draws the knees to the chest, and appears pale. Between episodes,
the child may appear comfortable . Currant-jelly stools (blood and mucus) are a late sign .
**7. The nurse is caring for an infant with intussusception. Which assessment finding is characteristic
of this condition?**
A) Projectile vomiting after feedings
B) A palpable sausage-shaped mass in the right upper quadrant
C) Ribbon-like stools
D) An olive-shaped mass in the epigastric area
**Answer: B**
*Rationale:* Intussusception involves one portion of the intestine telescoping into another, causing
obstruction. A sausage-shaped mass is often palpable in the right upper quadrant. Currant-jelly stools
and intermittent colicky pain are also classic findings .
**8. A child with suspected intussusception is scheduled for a barium enema. The nurse understands
that this procedure is performed for which purpose?**
A) Confirm the diagnosis
, B) Reduce the invaginated bowel segment
C) Prepare for surgical resection
D) Determine the extent of necrosis
**Answer: B**
*Rationale:* A barium enema is both diagnostic and therapeutic for intussusception. The hydrostatic
pressure from the barium or air enema can often reduce the invaginated bowel segment, eliminating
the need for surgical intervention. If the bowel does not reduce, surgery becomes necessary .
**9. A child with intussusception is waiting to have surgery. The patient passes a normal stool. What
should the nurse do?**
A) Obtain an abdominal ultrasound
B) Perform a test to check for blood in the stool
C) Notify the doctor immediately
D) Document the color only
**Answer: C**
*Rationale:* If a child with intussusception passes a normal stool, it may indicate spontaneous
reduction of the intussusception. The healthcare provider should be notified immediately for further
evaluation and to determine if surgery is still needed .
**10. Which finding in a child with intussusception would cause the nurse to notify the healthcare
provider immediately?**
A) The infant passes a currant-jelly stool
B) The infant has intermittent colicky pain
C) The infant's abdomen is rigid and the infant is lethargic
D) The infant has a sausage-shaped mass in the right upper quadrant
**Answer: C**
*Rationale:* A rigid abdomen and lethargy in an infant with intussusception indicate possible
perforation or peritonitis. The infant may also show signs of shock (tachycardia, hypotension). This is
a medical emergency requiring immediate notification of the healthcare provider .
### Hirschsprung Disease
