AND VERIFIED ANSWERS- Galen]
OVERVIEW:
NUR 254 ACTUAL EXAM 3 covers pediatric topics including celiac gluten-free
oatmeal spaghetti avoidance, intussusception currant-jelly brown stool resolution,
enuresis bedtime voiding, glomerulonephritis periorbital edema hypertension,
nephrotic hypoalbuminemia, GERD lansoprazole short-term, TEF coughing
cyanosis drooling, Hirschsprung enterocolitis infection monitoring, UTI cotton
underwear hygiene, cleft lip spoon avoidance, diarrhea ORS, otitis breastfeeding
prevention, Tet spell knee-chest oxygen, HF feeding oxygen, asthma peak flow
triggers, rheumatic carditis activity restriction, digoxin bradycardia
Correct answer highlighted in bold Green + rationales.
1. The nurse is teaching the mother of a child who has celiac disease about appropriate food
choices. Which foods from the box below identified by the mother indicate a need for further
teaching?
Box: 1. Chicken breast. 2. Oatmeal. 3. Instant soup. 4. Bananas. 5. Apple slices. 6. Spaghetti. 7.
Sugar-free cherry pie.
A. 2, 3, 6, 7.
B. 2, 4, 6, 7.
C. 3, 4, 6, 7.
D. 1, 2, 3, 7.
Rationale: Celiac disease requires lifelong gluten-free diet. Gluten is in wheat, barley, rye, and
contaminated oats. Oatmeal, instant soup (contains gluten additives), spaghetti (wheat), and
cherry pie (crust contains wheat) must be avoided. Chicken, bananas, apple slices are gluten-
free.
2. The nurse is caring for a child with probable intussusception. Which of the following is the
most appropriate nursing action when the child has a normal, brown stool?
A. Notify the primary health care provider (PHCP).
B. Auscultate for bowel sounds.
C. Take vital signs, including blood pressure (BP).
D. Measure the child's abdominal girth.
Rationale: Passage of a normal brown stool indicates reduction of intussusception, which is an
important finding to report immediately to the PHCP. Currant-jelly stools are expected in
intussusception; brown stool suggests resolution.
, 3. The nurse is assessing a child who is suspected of having celiac disease. Which of the
following findings should the nurse expect the parents to report?
A. Black and tarry stools.
B. Excessive hunger.
C. Chronic constipation.
D. Steatorrhea.
Rationale: Celiac disease causes malabsorption, leading to steatorrhea (foul-smelling, fatty,
bulky stools), chronic diarrhea, abdominal distention, and failure to thrive due to villous
atrophy from gluten.
4. The nurse has attended a continuing education conference on enuresis. Which of the
following statements by the nurse indicates a correct understanding of the conference?
A. One intervention for nocturnal enuresis is using the restroom before going to bed.
B. Children who have phenylketonuria (PKU) typically demonstrate enuresis by age 3 years.
C. Children who suffer from enuresis have inappropriate defecation at least twice a week for
at least 3 months.
D. The medication most frequently prescribed to treat enuresis is haloperidol.
Rationale: Nocturnal enuresis interventions include limiting fluids before bed, voiding before
sleep, enuresis alarm, and desmopressin. It is more common in boys. PKU and encopresis
definitions are different.
5. The nurse is assessing a child who is suspected of having acute glomerulonephritis. Which of
the following is an expected finding?
A. Hypokalemia.
B. Periorbital edema.
C. Hypotension.
D. Enuresis.
Rationale: Acute glomerulonephritis presents with periorbital edema, hypertension,
hematuria, oliguria, and proteinuria following streptococcal infection.
6. The nurse is caring for a child who was admitted to the pediatric unit with nephrotic
syndrome. Which of the following laboratory results should the nurse expect to see?
A. Low albumin.
B. Low specific gravity.
C. Gross hematuria.
D. Thrombocytopenia.
Rationale: Nephrotic syndrome shows low albumin (hypoalbuminemia), high cholesterol, high
proteinuria, and high specific gravity due to protein loss. Edema and weight gain are key signs.