NURS 4581 PEDIATRIC NURSING FINAL
EXAM COMPREHENSIVE STUDY GUIDE
1. A 2-year-old child is admitted with suspected Epiglottitis. Which nursing action is the
highest priority?
A. Obtain a throat culture to identify the causative organism.
B. Place the child in a supine position to facilitate breathing.
C. Apply a warm mist humidifier to the bedside.
D. Prepare for immediate endotracheal intubation or tracheostomy.
Answer: D
Conceptual Explanation: Epiglottitis is a medical emergency that can lead to sudden
airway obstruction. Examination of the throat or obtaining a culture can trigger a
laryngospasm. Airway management is the absolute priority.
2. Which developmental milestone is most characteristic of a 4-year-old child according to
Piaget’s stages of cognitive development?
A. Understanding the concept of conservation of mass.
B. Demonstrating egocentric thinking and animism.
,C. Exhibiting object permanence during play.
D. Developing the ability to use abstract reasoning.
Answer: B
Conceptual Explanation: A 4-year-old is in the Preoperational stage (2-7 years),
characterized by egocentrism (seeing the world from only their perspective) and animism
(giving lifelike qualities to inanimate objects).
3. A neonate is diagnosed with Tetralogy of Fallot. Which four defects are associated with this
condition?
A. ASD, VSD, Pulmonary Stenosis, Left Ventricular Hypertrophy
B. Coarctation of Aorta, VSD, ASD, PDA
C. VSD, Overriding Aorta, Pulmonary Stenosis, Right Ventricular Hypertrophy
D. Tricuspid Atresia, VSD, Pulmonary Atresia, Overriding Aorta
Answer: C
Conceptual Explanation: Tetralogy of Fallot consists of four defects: Ventricular Septal
Defect (VSD), Pulmonary Stenosis, Overriding Aorta, and Right Ventricular Hypertrophy.
4. What is the primary pathophysiology behind Cystic Fibrosis?
A. Autoimmune destruction of the alveolar basement membrane.
B. Chronic inflammation of the bronchial tubes due to allergens.
C. Defective chloride ion transport leading to thick, tenacious mucus.
, D. Excessive production of surfactant in the neonatal period.
Answer: C
Conceptual Explanation: Cystic Fibrosis is caused by a mutation in the CFTR protein,
which disrupts the transport of chloride and water, resulting in thick secretions that
obstruct various organs, primarily the lungs and pancreas.
5. An infant presents with projectile vomiting and a palpable olive-shaped mass in the
epigastrium. What is the most likely diagnosis?
A. Intussusception
B. Hirschsprung Disease
C. Pyloric Stenosis
D. Gastroesophageal Reflux
Answer: C
Conceptual Explanation: Hypertrophic Pyloric Stenosis typically presents in infants aged
2-8 weeks with non-bilious projectile vomiting and a characteristic olive-shaped mass in
the upper abdomen.
6. A 10-year-old child with Sickle Cell Anemia is admitted for a Vaso-occlusive Crisis. Which
intervention should the nurse implement first?
A. Administering IV fluids and oral hydration.
B. Applying cold compresses to the painful joints.
EXAM COMPREHENSIVE STUDY GUIDE
1. A 2-year-old child is admitted with suspected Epiglottitis. Which nursing action is the
highest priority?
A. Obtain a throat culture to identify the causative organism.
B. Place the child in a supine position to facilitate breathing.
C. Apply a warm mist humidifier to the bedside.
D. Prepare for immediate endotracheal intubation or tracheostomy.
Answer: D
Conceptual Explanation: Epiglottitis is a medical emergency that can lead to sudden
airway obstruction. Examination of the throat or obtaining a culture can trigger a
laryngospasm. Airway management is the absolute priority.
2. Which developmental milestone is most characteristic of a 4-year-old child according to
Piaget’s stages of cognitive development?
A. Understanding the concept of conservation of mass.
B. Demonstrating egocentric thinking and animism.
,C. Exhibiting object permanence during play.
D. Developing the ability to use abstract reasoning.
Answer: B
Conceptual Explanation: A 4-year-old is in the Preoperational stage (2-7 years),
characterized by egocentrism (seeing the world from only their perspective) and animism
(giving lifelike qualities to inanimate objects).
3. A neonate is diagnosed with Tetralogy of Fallot. Which four defects are associated with this
condition?
A. ASD, VSD, Pulmonary Stenosis, Left Ventricular Hypertrophy
B. Coarctation of Aorta, VSD, ASD, PDA
C. VSD, Overriding Aorta, Pulmonary Stenosis, Right Ventricular Hypertrophy
D. Tricuspid Atresia, VSD, Pulmonary Atresia, Overriding Aorta
Answer: C
Conceptual Explanation: Tetralogy of Fallot consists of four defects: Ventricular Septal
Defect (VSD), Pulmonary Stenosis, Overriding Aorta, and Right Ventricular Hypertrophy.
4. What is the primary pathophysiology behind Cystic Fibrosis?
A. Autoimmune destruction of the alveolar basement membrane.
B. Chronic inflammation of the bronchial tubes due to allergens.
C. Defective chloride ion transport leading to thick, tenacious mucus.
, D. Excessive production of surfactant in the neonatal period.
Answer: C
Conceptual Explanation: Cystic Fibrosis is caused by a mutation in the CFTR protein,
which disrupts the transport of chloride and water, resulting in thick secretions that
obstruct various organs, primarily the lungs and pancreas.
5. An infant presents with projectile vomiting and a palpable olive-shaped mass in the
epigastrium. What is the most likely diagnosis?
A. Intussusception
B. Hirschsprung Disease
C. Pyloric Stenosis
D. Gastroesophageal Reflux
Answer: C
Conceptual Explanation: Hypertrophic Pyloric Stenosis typically presents in infants aged
2-8 weeks with non-bilious projectile vomiting and a characteristic olive-shaped mass in
the upper abdomen.
6. A 10-year-old child with Sickle Cell Anemia is admitted for a Vaso-occlusive Crisis. Which
intervention should the nurse implement first?
A. Administering IV fluids and oral hydration.
B. Applying cold compresses to the painful joints.
