NUR 334 EXAM 3: PEDIATRIC NURSING
AND COMPLEX CARE QUESTIONS AND
DETAILED ANSWERS 2026/2027
1. A 4-year-old child is admitted to the emergency department with a high fever, severe sore
throat, and drooling. The child is sitting in a tripod position. Which action should the nurse
take first?
A. Examine the throat using a tongue blade
B. Obtain a throat culture for Streptococcus
C. Administer nebulized racemic epinephrine
D. Prepare for immediate endotracheal intubation
Answer: D
Conceptual Explanation: These symptoms are classic for epiglottitis, a medical
emergency. The priority is maintaining the airway. Examining the throat can trigger a
complete airway obstruction.
2. A child with Tetralogy of Fallot becomes acutely cyanotic and hyperpneic during a blood
draw. Which intervention is the priority?
A. Place the child in the knee-chest position
B. Administer 100% oxygen via non-rebreather mask
,C. Administer intravenous morphine sulfate
D. Prepare for immediate surgical repair
Answer: A
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which reduces the right-to-left shunt and improves pulmonary blood flow during a ‘tet
spell’.
3. A nurse is caring for an infant with pyloric stenosis. Which acid-base imbalance is the infant
most at risk for developing?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: C
Conceptual Explanation: Persistent vomiting in pyloric stenosis leads to the loss of
hydrochloric acid and potassium, resulting in metabolic alkalosis.
4. The nurse is providing discharge teaching to the parents of a child newly diagnosed with
Cystic Fibrosis. Which statement by the parents indicates a need for further teaching
regarding pancreatic enzymes?
A. If my child skips a meal, I should still give the enzymes.
, B. I can open the capsules and sprinkle them on applesauce.
C. I will give the enzymes with all meals and snacks.
D. The dosage will be adjusted based on the number of stools per day.
Answer: A
Conceptual Explanation: Pancreatic enzymes must be taken with food to be effective; they
should not be taken if the child is not eating.
5. Which clinical manifestation is a hallmark sign of Hirschsprung disease in a newborn?
A. Failure to pass meconium within the first 24 to 48 hours
B. Projectile vomiting immediately after feeding
C. Currant jelly-like stools containing blood and mucus
D. Palpable olive-shaped mass in the right upper quadrant
Answer: A
Conceptual Explanation: Hirschsprung disease is characterized by the absence of
ganglion cells in the distal colon, leading to an inability to pass meconium.
6. A child is admitted with Nephrotic Syndrome. Which clinical finding should the nurse
expect to observe?
A. Massive proteinuria and generalized edema
B. Gross hematuria and hypertension
AND COMPLEX CARE QUESTIONS AND
DETAILED ANSWERS 2026/2027
1. A 4-year-old child is admitted to the emergency department with a high fever, severe sore
throat, and drooling. The child is sitting in a tripod position. Which action should the nurse
take first?
A. Examine the throat using a tongue blade
B. Obtain a throat culture for Streptococcus
C. Administer nebulized racemic epinephrine
D. Prepare for immediate endotracheal intubation
Answer: D
Conceptual Explanation: These symptoms are classic for epiglottitis, a medical
emergency. The priority is maintaining the airway. Examining the throat can trigger a
complete airway obstruction.
2. A child with Tetralogy of Fallot becomes acutely cyanotic and hyperpneic during a blood
draw. Which intervention is the priority?
A. Place the child in the knee-chest position
B. Administer 100% oxygen via non-rebreather mask
,C. Administer intravenous morphine sulfate
D. Prepare for immediate surgical repair
Answer: A
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which reduces the right-to-left shunt and improves pulmonary blood flow during a ‘tet
spell’.
3. A nurse is caring for an infant with pyloric stenosis. Which acid-base imbalance is the infant
most at risk for developing?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: C
Conceptual Explanation: Persistent vomiting in pyloric stenosis leads to the loss of
hydrochloric acid and potassium, resulting in metabolic alkalosis.
4. The nurse is providing discharge teaching to the parents of a child newly diagnosed with
Cystic Fibrosis. Which statement by the parents indicates a need for further teaching
regarding pancreatic enzymes?
A. If my child skips a meal, I should still give the enzymes.
, B. I can open the capsules and sprinkle them on applesauce.
C. I will give the enzymes with all meals and snacks.
D. The dosage will be adjusted based on the number of stools per day.
Answer: A
Conceptual Explanation: Pancreatic enzymes must be taken with food to be effective; they
should not be taken if the child is not eating.
5. Which clinical manifestation is a hallmark sign of Hirschsprung disease in a newborn?
A. Failure to pass meconium within the first 24 to 48 hours
B. Projectile vomiting immediately after feeding
C. Currant jelly-like stools containing blood and mucus
D. Palpable olive-shaped mass in the right upper quadrant
Answer: A
Conceptual Explanation: Hirschsprung disease is characterized by the absence of
ganglion cells in the distal colon, leading to an inability to pass meconium.
6. A child is admitted with Nephrotic Syndrome. Which clinical finding should the nurse
expect to observe?
A. Massive proteinuria and generalized edema
B. Gross hematuria and hypertension
