Grand Canyon University NSG 434 Final Exam (pdf) | 2026/2027 |
Pediatric Q&A | Pediatric Nursing
1. A nurse is assessing a child's growth and development. According to
Erikson's theory, a 3-year-old child is in which stage of psychosocial
development?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: Initiative vs. Guilt
Rationale: According to Erikson, a 3-year-old child is in the Initiative vs. Guilt
stage (preschool years, ages 3-5). During this stage, children begin to assert
power and control over their environment through play and social
interactions. Autonomy vs. Shame and Doubt is the toddler stage (1-3 years).
---
2. A nurse is assessing a 12-month-old infant's gross motor development.
Which milestone would the nurse expect to observe?
A) Walking independently
B) Standing while holding furniture
C) Sitting without support
D) Rolling over
Correct Answer: Standing while holding furniture
,Rationale: At 12 months, infants typically stand while holding furniture
("cruising") and may take a few steps. Walking independently often occurs
around 12-15 months. Sitting without support is an 8-month milestone, and
rolling over is a 4-6 month milestone.
---
3. Which of the following is a classic sign of moderate dehydration in a child?
A) Capillary refill greater than 4 seconds
B) Sunken eyes and absent tears
C) Irritability and dry mucous membranes
D) Lethargy and weight loss >10%
Correct Answer: Irritability and dry mucous membranes
Rationale: Moderate dehydration (5-10% weight loss in infants, 3-6% in
children) is characterized by irritability, thirst, dry mucous membranes,
slightly increased heart and respiratory rates, and decreased tears. Severe
dehydration presents with lethargy, absent tears, and delayed capillary refill.
---
4. A nurse is caring for an infant with projectile vomiting after feeding and
palpates a small, hard, movable mass in the right upper quadrant. Which
condition is most consistent with these findings?
A) Intussusception
B) Pyloric stenosis
C) Gastroesophageal reflux
D) Hirschsprung disease
,Correct Answer: Pyloric stenosis
Rationale: Pyloric stenosis presents with projectile vomiting and a palpable
"olive-sized" mass in the right upper quadrant, caused by hypertrophy of the
pylorus. This condition typically occurs in infants at 4-6 weeks of age and
requires surgical correction (pyloromyotomy).
---
5. A nurse is assessing a child with suspected intussusception. Which finding
is most characteristic of this condition?
A) Projectile vomiting and an olive-sized mass
B) Crampy abdominal pain with red currant jelly-like stools
C) Ribbon-like, foul-smelling stools and failure to pass meconium
D) Bloody diarrhea with fever
Correct Answer: Crampy abdominal pain with red currant jelly-like stools
Rationale: Intussusception presents with crampy abdominal pain,
inconsolable crying, drawing knees to the chest, and red currant jelly-like
stools. It occurs when the bowel telescopes into itself, causing obstruction
and ischemia. A gas or barium enema is used for diagnosis and treatment.
---
6. A newborn has not passed meconium within 48 hours of birth and is
vomiting bilious contents. Which condition should the nurse suspect?
A) Pyloric stenosis
, B) Hirschsprung disease
C) Intussusception
D) Gastroesophageal reflux
Correct Answer: Hirschsprung disease
Rationale: Hirschsprung disease is characterized by the absence of ganglion
cells in the bowel, leading to loss of peristalsis. Failure to pass meconium
within 24-48 hours of birth is a classic sign in neonates. Other manifestations
include bilious vomiting, constipation, and ribbon-like stools.
---
7. A nurse is assessing a child with ulcerative colitis. Which finding is most
characteristic of this condition?
A) Ribbon-like, foul-smelling stools
B) 10-20 bloody stools per day
C) Projectile vomiting after feeding
D) Red currant jelly-like stools
Correct Answer: 10-20 bloody stools per day
Rationale: Ulcerative colitis is characterized by frequent bloody stools (10-20
per day), abdominal pain, and weight loss. Ribbon-like stools are seen in
Hirschsprung disease, projectile vomiting in pyloric stenosis, and currant jelly
stools in intussusception.
---
Pediatric Q&A | Pediatric Nursing
1. A nurse is assessing a child's growth and development. According to
Erikson's theory, a 3-year-old child is in which stage of psychosocial
development?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Correct Answer: Initiative vs. Guilt
Rationale: According to Erikson, a 3-year-old child is in the Initiative vs. Guilt
stage (preschool years, ages 3-5). During this stage, children begin to assert
power and control over their environment through play and social
interactions. Autonomy vs. Shame and Doubt is the toddler stage (1-3 years).
---
2. A nurse is assessing a 12-month-old infant's gross motor development.
Which milestone would the nurse expect to observe?
A) Walking independently
B) Standing while holding furniture
C) Sitting without support
D) Rolling over
Correct Answer: Standing while holding furniture
,Rationale: At 12 months, infants typically stand while holding furniture
("cruising") and may take a few steps. Walking independently often occurs
around 12-15 months. Sitting without support is an 8-month milestone, and
rolling over is a 4-6 month milestone.
---
3. Which of the following is a classic sign of moderate dehydration in a child?
A) Capillary refill greater than 4 seconds
B) Sunken eyes and absent tears
C) Irritability and dry mucous membranes
D) Lethargy and weight loss >10%
Correct Answer: Irritability and dry mucous membranes
Rationale: Moderate dehydration (5-10% weight loss in infants, 3-6% in
children) is characterized by irritability, thirst, dry mucous membranes,
slightly increased heart and respiratory rates, and decreased tears. Severe
dehydration presents with lethargy, absent tears, and delayed capillary refill.
---
4. A nurse is caring for an infant with projectile vomiting after feeding and
palpates a small, hard, movable mass in the right upper quadrant. Which
condition is most consistent with these findings?
A) Intussusception
B) Pyloric stenosis
C) Gastroesophageal reflux
D) Hirschsprung disease
,Correct Answer: Pyloric stenosis
Rationale: Pyloric stenosis presents with projectile vomiting and a palpable
"olive-sized" mass in the right upper quadrant, caused by hypertrophy of the
pylorus. This condition typically occurs in infants at 4-6 weeks of age and
requires surgical correction (pyloromyotomy).
---
5. A nurse is assessing a child with suspected intussusception. Which finding
is most characteristic of this condition?
A) Projectile vomiting and an olive-sized mass
B) Crampy abdominal pain with red currant jelly-like stools
C) Ribbon-like, foul-smelling stools and failure to pass meconium
D) Bloody diarrhea with fever
Correct Answer: Crampy abdominal pain with red currant jelly-like stools
Rationale: Intussusception presents with crampy abdominal pain,
inconsolable crying, drawing knees to the chest, and red currant jelly-like
stools. It occurs when the bowel telescopes into itself, causing obstruction
and ischemia. A gas or barium enema is used for diagnosis and treatment.
---
6. A newborn has not passed meconium within 48 hours of birth and is
vomiting bilious contents. Which condition should the nurse suspect?
A) Pyloric stenosis
, B) Hirschsprung disease
C) Intussusception
D) Gastroesophageal reflux
Correct Answer: Hirschsprung disease
Rationale: Hirschsprung disease is characterized by the absence of ganglion
cells in the bowel, leading to loss of peristalsis. Failure to pass meconium
within 24-48 hours of birth is a classic sign in neonates. Other manifestations
include bilious vomiting, constipation, and ribbon-like stools.
---
7. A nurse is assessing a child with ulcerative colitis. Which finding is most
characteristic of this condition?
A) Ribbon-like, foul-smelling stools
B) 10-20 bloody stools per day
C) Projectile vomiting after feeding
D) Red currant jelly-like stools
Correct Answer: 10-20 bloody stools per day
Rationale: Ulcerative colitis is characterized by frequent bloody stools (10-20
per day), abdominal pain, and weight loss. Ribbon-like stools are seen in
Hirschsprung disease, projectile vomiting in pyloric stenosis, and currant jelly
stools in intussusception.
---
