NURS 629 Exam 4 V2 | NURS 629 Peds |
Actual Q&A with Rationale (NURS629
Exam 4) | Maryville University
1. A 6-year-old child presents with generalized edema, particularly periorbital, and parental
reports of ‘foamy’ urine. Which laboratory and clinical findings are characteristic of Nephrotic
Syndrome? Select all that apply.
A. Hypoalbuminemia
B. Hyperlipidemia
C. Gross hematuria
D. Massive proteinuria (3+ to 4+)
E. Edema
F. Elevated serum creatinine
Correct Answer: A, B, D, E
Nephrotic syndrome is defined by the presence of heavy proteinuria, hypoalbuminemia,
and peripheral edema. Hyperlipidemia occurs as the liver increases protein and lipid
synthesis in response to low oncotic pressure. Gross hematuria is less common and usually
suggests a nephritic process such as post-streptococcal glomerulonephritis.
,2. A 10-year-old presents with a high-pitched ‘barking’ cough and inspiratory stridor that
worsens at night. Which treatment is indicated for moderate to severe symptoms of
Laryngotracheobronchitis (Croup)?
A. Albuterol nebulization
B. Intravenous Ceftriaxone
C. Oral Amoxicillin
D. Nebulized epinephrine and oral dexamethasone
Correct Answer: D
Moderate to severe croup is managed with nebulized racemic epinephrine to provide
rapid airway vasoconstriction. This is followed by a dose of dexamethasone to provide
longer-lasting anti-inflammatory effects on the laryngeal mucosa. Albuterol is ineffective as
the narrowing occurs in the upper airway, not the bronchioles.
3. A mother brings her 12-month-old infant for a well-child checkup. The child’s hemoglobin is
9.2 g/dL. What is the most appropriate first-line intervention for suspected Iron Deficiency
Anemia (IDA)?
A. Immediate referral to hematology
B. Start Vitamin B12 injections
C. Blood transfusion
D. Therapeutic trial of oral iron (3-6 mg/kg/day) and nutritional counseling
, Correct Answer: D
Iron deficiency is the most common cause of microcytic anemia in toddlers, often related
to high cow’s milk intake. A therapeutic trial of iron supplementation followed by a recheck
of the reticulocyte count is standard practice. Nutritional counseling should focus on
limiting milk intake to no more than 16-24 ounces per day.
4. During a physical exam of a 14-year-old male, the nurse practitioner notes a painless, ‘bag
of worms’ sensation in the left scrotum when the patient is standing. What is the most likely
diagnosis?
A. Testicular Torsion
B. Hydrocele
C. Varicocele
D. Epididymitis
Correct Answer: C
A varicocele is a cluster of dilated veins in the spermatic cord, typically occurring on the
left side due to venous anatomy. It is classically described as a ‘bag of worms’ and often
disappears or shrinks when the patient is supine. It is a common cause of reduced sperm
quality and should be monitored for testicular atrophy.
5. Which of the following are clinical manifestations of Type 1 Diabetes Mellitus in a pediatric
patient at the time of diagnosis? Select all that apply.
A. Polydipsia
Actual Q&A with Rationale (NURS629
Exam 4) | Maryville University
1. A 6-year-old child presents with generalized edema, particularly periorbital, and parental
reports of ‘foamy’ urine. Which laboratory and clinical findings are characteristic of Nephrotic
Syndrome? Select all that apply.
A. Hypoalbuminemia
B. Hyperlipidemia
C. Gross hematuria
D. Massive proteinuria (3+ to 4+)
E. Edema
F. Elevated serum creatinine
Correct Answer: A, B, D, E
Nephrotic syndrome is defined by the presence of heavy proteinuria, hypoalbuminemia,
and peripheral edema. Hyperlipidemia occurs as the liver increases protein and lipid
synthesis in response to low oncotic pressure. Gross hematuria is less common and usually
suggests a nephritic process such as post-streptococcal glomerulonephritis.
,2. A 10-year-old presents with a high-pitched ‘barking’ cough and inspiratory stridor that
worsens at night. Which treatment is indicated for moderate to severe symptoms of
Laryngotracheobronchitis (Croup)?
A. Albuterol nebulization
B. Intravenous Ceftriaxone
C. Oral Amoxicillin
D. Nebulized epinephrine and oral dexamethasone
Correct Answer: D
Moderate to severe croup is managed with nebulized racemic epinephrine to provide
rapid airway vasoconstriction. This is followed by a dose of dexamethasone to provide
longer-lasting anti-inflammatory effects on the laryngeal mucosa. Albuterol is ineffective as
the narrowing occurs in the upper airway, not the bronchioles.
3. A mother brings her 12-month-old infant for a well-child checkup. The child’s hemoglobin is
9.2 g/dL. What is the most appropriate first-line intervention for suspected Iron Deficiency
Anemia (IDA)?
A. Immediate referral to hematology
B. Start Vitamin B12 injections
C. Blood transfusion
D. Therapeutic trial of oral iron (3-6 mg/kg/day) and nutritional counseling
, Correct Answer: D
Iron deficiency is the most common cause of microcytic anemia in toddlers, often related
to high cow’s milk intake. A therapeutic trial of iron supplementation followed by a recheck
of the reticulocyte count is standard practice. Nutritional counseling should focus on
limiting milk intake to no more than 16-24 ounces per day.
4. During a physical exam of a 14-year-old male, the nurse practitioner notes a painless, ‘bag
of worms’ sensation in the left scrotum when the patient is standing. What is the most likely
diagnosis?
A. Testicular Torsion
B. Hydrocele
C. Varicocele
D. Epididymitis
Correct Answer: C
A varicocele is a cluster of dilated veins in the spermatic cord, typically occurring on the
left side due to venous anatomy. It is classically described as a ‘bag of worms’ and often
disappears or shrinks when the patient is supine. It is a common cause of reduced sperm
quality and should be monitored for testicular atrophy.
5. Which of the following are clinical manifestations of Type 1 Diabetes Mellitus in a pediatric
patient at the time of diagnosis? Select all that apply.
A. Polydipsia
