NSG 3600 Exam 4 Pediatrics Review
questions and correct answers with
Rationales/ Galen NSG 3600 Nursing
Practice in Children’s Health Exam 4
Latest Prep Guide
Section I: Gastrointestinal Disorders (Questions 1-10)
1. In caring for an infant diagnosed with pyloric stenosis, the nurse would
anticipate which intervention?
A) Medicate the infant with analgesics
B) Change the infant's diet to one that is lactose-free
C) Assist in doing a barium enema procedure on the infant
D) Prepare the infant for surgery
Correct Answer: D) Prepare the infant for surgery
Rationale: Pyloric stenosis is characterized by thickening of the pyloric muscle, causing
gastric outlet obstruction. The definitive treatment is surgical correction via a
pyloromyotomy. The condition is not painful, so analgesics would not be needed until
after surgical repair. The condition is unrelated to lactose intolerance, and a barium
enema is used to diagnose intussusception, not pyloric stenosis.
2. A mother is alarmed because her 6-week-old boy has begun vomiting almost
immediately after every feeding. In the past week, the vomiting has grown more
,forceful, with the vomit projecting several feet from his mouth. He is always
hungry again just after vomiting. At the physician's office, the nurse holds the
child and offers him a bottle. While he drinks, the nurse notes an olive-size lump in
his right abdomen. Which condition should the nurse suspect?
A) Peptic ulcer disease
B) Gastroesophageal reflux
C) Pyloric stenosis
D) Appendicitis
Correct Answer: C) Pyloric stenosis
Rationale: With pyloric stenosis, infants typically begin projectile vomiting almost
immediately after feeding at 4-6 weeks of age. Infants are usually hungry immediately
after vomiting because they are not nauseated. A definitive diagnosis can be made by
palpating an "olive-size" lump in the right abdomen during feeding. Peptic ulcer disease
presents with hematemesis or melena, GER involves small-volume non-forceful
regurgitation, and appendicitis typically begins with anorexia and diffuse pain.
3. A nurse taking a health history of a newborn notes a maternal history of
polyhydramnios. What GI condition might this history precipitate?
A) Cleft palate
B) Pyloric stenosis
C) Esophageal atresia (EA)
D) Hernia
Correct Answer: C) Esophageal atresia (EA)
Rationale: A maternal history of polyhydramnios is present in approximately one-third
of cases of esophageal atresia (EA) and in some cases of tracheoesophageal fistula (TEF).
The excess amniotic fluid results from the fetus's inability to swallow and absorb
amniotic fluid due to the esophageal obstruction.
4. A toddler requires an enema. After explaining the procedure to the parent and
preparing the supplies, what action will the nurse take?
, A) Place the toddler on the left side
B) Place the toddler on the abdomen
C) Place the toddler on the right side
D) Place the toddler on the back
Correct Answer: B) Place the toddler on the abdomen
Rationale: The best position for administering an enema to an infant or toddler is on
the abdomen with the knees bent (knee-chest position). This allows for proper flow and
comfort. For an older child or adolescent, the nurse places the child on the left side with
the right leg flexed toward the chest.
5. The nurse is caring for a 4-year-old child 36 hours post-op following removal of
a Wilms tumor. Which finding requires immediate follow-up by the nurse?
A) Mild pain at the surgical site
B) Absent bowel sounds in all four quadrants
C) Pink-tinged urine in the Foley catheter
D) A heart rate of 110 beats per minute
Correct Answer: B) Absent bowel sounds in all four quadrants
Rationale: Absent bowel sounds 36 hours after abdominal surgery may indicate ileus or
bowel obstruction, which are serious complications requiring immediate assessment and
intervention. Mild pain is expected postoperatively, pink-tinged urine is common after
kidney surgery, and a heart rate of 110 bpm is within the expected range for a 4-year-
old.
6. A child had neuroblastoma surgery. Which statement by the parents requires
nursing intervention?
A) "We will watch for signs of infection at the incision site."
B) "Our child needs to wear a helmet to protect the incision."
C) "We will give pain medication as prescribed."
D) "We will begin slowly reintroducing our child into social interaction."
questions and correct answers with
Rationales/ Galen NSG 3600 Nursing
Practice in Children’s Health Exam 4
Latest Prep Guide
Section I: Gastrointestinal Disorders (Questions 1-10)
1. In caring for an infant diagnosed with pyloric stenosis, the nurse would
anticipate which intervention?
A) Medicate the infant with analgesics
B) Change the infant's diet to one that is lactose-free
C) Assist in doing a barium enema procedure on the infant
D) Prepare the infant for surgery
Correct Answer: D) Prepare the infant for surgery
Rationale: Pyloric stenosis is characterized by thickening of the pyloric muscle, causing
gastric outlet obstruction. The definitive treatment is surgical correction via a
pyloromyotomy. The condition is not painful, so analgesics would not be needed until
after surgical repair. The condition is unrelated to lactose intolerance, and a barium
enema is used to diagnose intussusception, not pyloric stenosis.
2. A mother is alarmed because her 6-week-old boy has begun vomiting almost
immediately after every feeding. In the past week, the vomiting has grown more
,forceful, with the vomit projecting several feet from his mouth. He is always
hungry again just after vomiting. At the physician's office, the nurse holds the
child and offers him a bottle. While he drinks, the nurse notes an olive-size lump in
his right abdomen. Which condition should the nurse suspect?
A) Peptic ulcer disease
B) Gastroesophageal reflux
C) Pyloric stenosis
D) Appendicitis
Correct Answer: C) Pyloric stenosis
Rationale: With pyloric stenosis, infants typically begin projectile vomiting almost
immediately after feeding at 4-6 weeks of age. Infants are usually hungry immediately
after vomiting because they are not nauseated. A definitive diagnosis can be made by
palpating an "olive-size" lump in the right abdomen during feeding. Peptic ulcer disease
presents with hematemesis or melena, GER involves small-volume non-forceful
regurgitation, and appendicitis typically begins with anorexia and diffuse pain.
3. A nurse taking a health history of a newborn notes a maternal history of
polyhydramnios. What GI condition might this history precipitate?
A) Cleft palate
B) Pyloric stenosis
C) Esophageal atresia (EA)
D) Hernia
Correct Answer: C) Esophageal atresia (EA)
Rationale: A maternal history of polyhydramnios is present in approximately one-third
of cases of esophageal atresia (EA) and in some cases of tracheoesophageal fistula (TEF).
The excess amniotic fluid results from the fetus's inability to swallow and absorb
amniotic fluid due to the esophageal obstruction.
4. A toddler requires an enema. After explaining the procedure to the parent and
preparing the supplies, what action will the nurse take?
, A) Place the toddler on the left side
B) Place the toddler on the abdomen
C) Place the toddler on the right side
D) Place the toddler on the back
Correct Answer: B) Place the toddler on the abdomen
Rationale: The best position for administering an enema to an infant or toddler is on
the abdomen with the knees bent (knee-chest position). This allows for proper flow and
comfort. For an older child or adolescent, the nurse places the child on the left side with
the right leg flexed toward the chest.
5. The nurse is caring for a 4-year-old child 36 hours post-op following removal of
a Wilms tumor. Which finding requires immediate follow-up by the nurse?
A) Mild pain at the surgical site
B) Absent bowel sounds in all four quadrants
C) Pink-tinged urine in the Foley catheter
D) A heart rate of 110 beats per minute
Correct Answer: B) Absent bowel sounds in all four quadrants
Rationale: Absent bowel sounds 36 hours after abdominal surgery may indicate ileus or
bowel obstruction, which are serious complications requiring immediate assessment and
intervention. Mild pain is expected postoperatively, pink-tinged urine is common after
kidney surgery, and a heart rate of 110 bpm is within the expected range for a 4-year-
old.
6. A child had neuroblastoma surgery. Which statement by the parents requires
nursing intervention?
A) "We will watch for signs of infection at the incision site."
B) "Our child needs to wear a helmet to protect the incision."
C) "We will give pain medication as prescribed."
D) "We will begin slowly reintroducing our child into social interaction."
