NSG 3600 Peds Exam 3: Pre & Post Quiz Questions
Units 5-7 GI, GU, Neuro | 100% Correct Answers
(2026/2027 Edition)
SECTION 1: Gastrointestinal (GI) System Disorders
Question 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
Correct Answer: A. A palpable olive-shaped mass in the right upper quadrant
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 or epigastrium. The mass represents the hypertrophied pyloric muscle.
Currant jelly stools are associated with intussusception. Bilious vomiting with
abdominal distension suggests a distal intestinal obstruction such as malrotation with
volvulus. Blood-streaked emesis and severe irritability are more consistent with GERD
complications or esophagitis.
Question 2.
,The nurse is caring for a 6-month-old infant diagnosed with moderate dehydration
secondary to acute gastroenteritis. The infant weighs 8 kg and has dry mucous
membranes, decreased skin turgor, and a sunken anterior fontanelle. The provider
orders oral rehydration therapy (ORT). Which nursing action is the priority?
A. Offer the ORT solution using a teaspoon or syringe every 1-2 minutes
B. Dilute the ORT solution with equal parts water to improve palatability
C. Withhold all oral intake for 4 hours to rest the gastrointestinal tract
D. Substitute the infant's usual formula for the ORT solution to maintain nutrition
Correct Answer: A. Offer the ORT solution using a teaspoon or syringe every 1-2 minutes
Rationale: For infants with moderate dehydration, ORT should be administered
frequently in small volumes (5-10 mL) using a teaspoon or syringe every 1-2 minutes to
prevent vomiting and promote absorption. Diluting ORT solution alters the
glucose-to-sodium ratio, reducing its effectiveness. Withholding oral intake contradicts
evidence-based guidelines for gastroenteritis management. Substituting formula for
ORT solution does not provide the correct electrolyte composition needed for
rehydration.
Question 3.
A 4-year-old child with celiac disease is being discharged after a recent exacerbation.
The nurse is providing dietary teaching to the parents. Which statement by the parent
indicates a correct understanding of the child's nutritional management?
A. "My child can have small amounts of wheat bread if no symptoms are present."
B. "I will need to read all food labels carefully to avoid gluten-containing products."
C. "Oats are naturally gluten-free, so my child can eat oatmeal every day."
D. "Rice and corn are not safe for my child because they contain hidden gluten."
Correct Answer: B. "I will need to read all food labels carefully to avoid gluten-containing
products."
,Rationale: Celiac disease requires strict lifelong adherence to a gluten-free diet,
necessitating careful label reading to identify hidden sources of gluten in processed
foods, medications, and cosmetics. Even small amounts of gluten can trigger an
autoimmune response and intestinal damage. Oats are often cross-contaminated with
gluten during processing unless certified gluten-free. Rice and corn are naturally
gluten-free and safe for children with celiac disease.
Question 4.
The nurse is assessing a 2-year-old 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
Correct Answer: A. Intermittent, severe, colicky abdominal pain with the child drawing
knees to the chest
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 normal or lethargic. Continuous
diffuse pain with rigid guarding suggests peritonitis or appendiceal rupture. Painless
rectal bleeding with normal activity is more characteristic of Meckel's diverticulum.
Steady epigastric pain relieved by antacids suggests peptic ulcer disease or GERD.
Question 5.
A school-age child with Crohn's disease is receiving infliximab infusions. The nurse is
monitoring for signs of an infusion reaction. Which assessment finding requires
immediate intervention?
A. Mild headache and fatigue 24 hours after the infusion
, B. Flushing, urticaria, and dyspnea during the infusion
C. Slight joint stiffness in the knees 48 hours post-infusion
D. Decreased appetite and mild nausea the evening of the infusion
Correct Answer: B. Flushing, urticaria, and dyspnea during the infusion
Rationale: Flushing, urticaria, and dyspnea during infliximab infusion indicate an acute
hypersensitivity or anaphylactoid reaction requiring immediate discontinuation of the
infusion, airway assessment, and emergency intervention per protocol. Mild headache,
fatigue, joint stiffness, decreased appetite, and mild nausea are common, expected side
effects that do not require immediate emergency intervention but should be
documented and monitored.
Question 6.
The nurse is caring for a neonate with biliary atresia who is scheduled for a Kasai
portoenterostomy. The parents ask about the purpose of the surgery. Which explanation
by the nurse is most accurate?
A. "The surgery will create a new drainage pathway for bile to flow from the liver into the
intestine."
B. "The procedure removes the blocked bile ducts and replaces them with a donor duct."
C. "The surgeon will place a stent in the common bile duct to keep it open permanently."
D. "This is a temporary procedure to buy time until the baby is old enough for a liver
transplant."
Correct Answer: A. "The surgery will create a new drainage pathway for bile to flow from
the liver into the intestine."
Rationale: The Kasai portoenterostomy involves excising the obliterated extrahepatic
bile ducts and creating a Roux-en-Y anastomosis between a loop of jejunum and the
porta hepatis to establish bile drainage. It does not involve donor ducts, permanent
stents, or serve merely as a bridge to transplant, though liver transplant may ultimately
be needed if bile drainage is not achieved.
Units 5-7 GI, GU, Neuro | 100% Correct Answers
(2026/2027 Edition)
SECTION 1: Gastrointestinal (GI) System Disorders
Question 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
Correct Answer: A. A palpable olive-shaped mass in the right upper quadrant
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 or epigastrium. The mass represents the hypertrophied pyloric muscle.
Currant jelly stools are associated with intussusception. Bilious vomiting with
abdominal distension suggests a distal intestinal obstruction such as malrotation with
volvulus. Blood-streaked emesis and severe irritability are more consistent with GERD
complications or esophagitis.
Question 2.
,The nurse is caring for a 6-month-old infant diagnosed with moderate dehydration
secondary to acute gastroenteritis. The infant weighs 8 kg and has dry mucous
membranes, decreased skin turgor, and a sunken anterior fontanelle. The provider
orders oral rehydration therapy (ORT). Which nursing action is the priority?
A. Offer the ORT solution using a teaspoon or syringe every 1-2 minutes
B. Dilute the ORT solution with equal parts water to improve palatability
C. Withhold all oral intake for 4 hours to rest the gastrointestinal tract
D. Substitute the infant's usual formula for the ORT solution to maintain nutrition
Correct Answer: A. Offer the ORT solution using a teaspoon or syringe every 1-2 minutes
Rationale: For infants with moderate dehydration, ORT should be administered
frequently in small volumes (5-10 mL) using a teaspoon or syringe every 1-2 minutes to
prevent vomiting and promote absorption. Diluting ORT solution alters the
glucose-to-sodium ratio, reducing its effectiveness. Withholding oral intake contradicts
evidence-based guidelines for gastroenteritis management. Substituting formula for
ORT solution does not provide the correct electrolyte composition needed for
rehydration.
Question 3.
A 4-year-old child with celiac disease is being discharged after a recent exacerbation.
The nurse is providing dietary teaching to the parents. Which statement by the parent
indicates a correct understanding of the child's nutritional management?
A. "My child can have small amounts of wheat bread if no symptoms are present."
B. "I will need to read all food labels carefully to avoid gluten-containing products."
C. "Oats are naturally gluten-free, so my child can eat oatmeal every day."
D. "Rice and corn are not safe for my child because they contain hidden gluten."
Correct Answer: B. "I will need to read all food labels carefully to avoid gluten-containing
products."
,Rationale: Celiac disease requires strict lifelong adherence to a gluten-free diet,
necessitating careful label reading to identify hidden sources of gluten in processed
foods, medications, and cosmetics. Even small amounts of gluten can trigger an
autoimmune response and intestinal damage. Oats are often cross-contaminated with
gluten during processing unless certified gluten-free. Rice and corn are naturally
gluten-free and safe for children with celiac disease.
Question 4.
The nurse is assessing a 2-year-old 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
Correct Answer: A. Intermittent, severe, colicky abdominal pain with the child drawing
knees to the chest
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 normal or lethargic. Continuous
diffuse pain with rigid guarding suggests peritonitis or appendiceal rupture. Painless
rectal bleeding with normal activity is more characteristic of Meckel's diverticulum.
Steady epigastric pain relieved by antacids suggests peptic ulcer disease or GERD.
Question 5.
A school-age child with Crohn's disease is receiving infliximab infusions. The nurse is
monitoring for signs of an infusion reaction. Which assessment finding requires
immediate intervention?
A. Mild headache and fatigue 24 hours after the infusion
, B. Flushing, urticaria, and dyspnea during the infusion
C. Slight joint stiffness in the knees 48 hours post-infusion
D. Decreased appetite and mild nausea the evening of the infusion
Correct Answer: B. Flushing, urticaria, and dyspnea during the infusion
Rationale: Flushing, urticaria, and dyspnea during infliximab infusion indicate an acute
hypersensitivity or anaphylactoid reaction requiring immediate discontinuation of the
infusion, airway assessment, and emergency intervention per protocol. Mild headache,
fatigue, joint stiffness, decreased appetite, and mild nausea are common, expected side
effects that do not require immediate emergency intervention but should be
documented and monitored.
Question 6.
The nurse is caring for a neonate with biliary atresia who is scheduled for a Kasai
portoenterostomy. The parents ask about the purpose of the surgery. Which explanation
by the nurse is most accurate?
A. "The surgery will create a new drainage pathway for bile to flow from the liver into the
intestine."
B. "The procedure removes the blocked bile ducts and replaces them with a donor duct."
C. "The surgeon will place a stent in the common bile duct to keep it open permanently."
D. "This is a temporary procedure to buy time until the baby is old enough for a liver
transplant."
Correct Answer: A. "The surgery will create a new drainage pathway for bile to flow from
the liver into the intestine."
Rationale: The Kasai portoenterostomy involves excising the obliterated extrahepatic
bile ducts and creating a Roux-en-Y anastomosis between a loop of jejunum and the
porta hepatis to establish bile drainage. It does not involve donor ducts, permanent
stents, or serve merely as a bridge to transplant, though liver transplant may ultimately
be needed if bile drainage is not achieved.
