NUR 3270 PEDIATRICS AND CHILD
HEALTH COMPREHENSIVE EXAM
QUESTIONS WITH VERIFIED ANSWERS
AND DETAILED EXPLANATIONS
1. A 2-year-old child is admitted with a diagnosis of Tetralogy of Fallot. During a blood draw,
the child begins to cry and becomes severely cyanotic with rapid breathing. Which action
should the nurse take first?
A. Administer high-flow oxygen via a non-rebreather mask.
B. Place the child in a knee-chest position.
C. Prepare for immediate administration of morphine sulfate.
D. Call for the rapid response team.
Answer: B
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which helps reduce the right-to-left shunt and improves oxygenation during a
hypercyanotic (‘tet’) spell.
2. The nurse is providing discharge teaching to the parents of a child newly diagnosed with
Cystic Fibrosis. Which instruction regarding pancreatic enzyme replacement is correct?
A. Administer enzymes two hours after every meal.
,B. Give enzymes with all meals and snacks.
C. Crush the enzyme beads to ensure better absorption.
D. Omit enzymes if the child is having a fatty meal.
Answer: B
Conceptual Explanation: Pancreatic enzymes must be taken with all meals and snacks to
facilitate the digestion and absorption of fats, proteins, and carbohydrates in children with
CF.
3. A 4-week-old infant is brought to the clinic for projectile vomiting after feedings. The nurse
notes an olive-shaped mass in the right upper quadrant. Which condition does the nurse
suspect?
A. Intussusception
B. Gastroesophageal Reflux
C. Hirschsprung Disease
D. Pyloric Stenosis
Answer: D
Conceptual Explanation: Hypertrophic pyloric stenosis is characterized by non-bilious
projectile vomiting and a palpable olive-shaped mass in the epigastrium to the right of the
umbilicus.
, 4. A 5-year-old child presents to the Emergency Department with a high fever, drooling, and a
muffled voice. The child is sitting in a ‘tripod’ position. What is the nurse’s priority action?
A. Keep the child calm and avoid invasive procedures.
B. Examine the throat using a tongue blade to check for edema.
C. Obtain a throat culture to identify the causative organism.
D. Place the child in a supine position for easier breathing.
Answer: A
Conceptual Explanation: These are signs of epiglottitis. The priority is to maintain a
patent airway by keeping the child calm and avoiding any throat examination, which could
trigger a laryngospasm.
5. When caring for a child diagnosed with Wilms Tumor, which nursing intervention is critical
during the pre-operative period?
A. Measure the abdominal girth every 4 hours.
B. Perform deep abdominal palpation to monitor tumor size.
C. Place the child in a prone position for comfort.
D. Avoid any palpation of the abdomen.
Answer: D
HEALTH COMPREHENSIVE EXAM
QUESTIONS WITH VERIFIED ANSWERS
AND DETAILED EXPLANATIONS
1. A 2-year-old child is admitted with a diagnosis of Tetralogy of Fallot. During a blood draw,
the child begins to cry and becomes severely cyanotic with rapid breathing. Which action
should the nurse take first?
A. Administer high-flow oxygen via a non-rebreather mask.
B. Place the child in a knee-chest position.
C. Prepare for immediate administration of morphine sulfate.
D. Call for the rapid response team.
Answer: B
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which helps reduce the right-to-left shunt and improves oxygenation during a
hypercyanotic (‘tet’) spell.
2. The nurse is providing discharge teaching to the parents of a child newly diagnosed with
Cystic Fibrosis. Which instruction regarding pancreatic enzyme replacement is correct?
A. Administer enzymes two hours after every meal.
,B. Give enzymes with all meals and snacks.
C. Crush the enzyme beads to ensure better absorption.
D. Omit enzymes if the child is having a fatty meal.
Answer: B
Conceptual Explanation: Pancreatic enzymes must be taken with all meals and snacks to
facilitate the digestion and absorption of fats, proteins, and carbohydrates in children with
CF.
3. A 4-week-old infant is brought to the clinic for projectile vomiting after feedings. The nurse
notes an olive-shaped mass in the right upper quadrant. Which condition does the nurse
suspect?
A. Intussusception
B. Gastroesophageal Reflux
C. Hirschsprung Disease
D. Pyloric Stenosis
Answer: D
Conceptual Explanation: Hypertrophic pyloric stenosis is characterized by non-bilious
projectile vomiting and a palpable olive-shaped mass in the epigastrium to the right of the
umbilicus.
, 4. A 5-year-old child presents to the Emergency Department with a high fever, drooling, and a
muffled voice. The child is sitting in a ‘tripod’ position. What is the nurse’s priority action?
A. Keep the child calm and avoid invasive procedures.
B. Examine the throat using a tongue blade to check for edema.
C. Obtain a throat culture to identify the causative organism.
D. Place the child in a supine position for easier breathing.
Answer: A
Conceptual Explanation: These are signs of epiglottitis. The priority is to maintain a
patent airway by keeping the child calm and avoiding any throat examination, which could
trigger a laryngospasm.
5. When caring for a child diagnosed with Wilms Tumor, which nursing intervention is critical
during the pre-operative period?
A. Measure the abdominal girth every 4 hours.
B. Perform deep abdominal palpation to monitor tumor size.
C. Place the child in a prone position for comfort.
D. Avoid any palpation of the abdomen.
Answer: D
