NR 328 PEDIATRIC NURSING
COMPREHENSIVE EXAM STUDY GUIDE
2026
1. A 4-month-old infant with Tetralogy of Fallot experiences a ‘tet spell’ during a blood draw.
Which action should the nurse take first?
A. Place the infant in a knee-chest position.
B. Administer 100% oxygen via face mask.
C. Prepare to administer morphine sulfate intravenously.
D. Notify the healthcare provider immediately.
Answer: A
Conceptual Explanation: The knee-chest position is the priority intervention because it
increases systemic vascular resistance, which reduces the right-to-left shunt and improves
pulmonary blood flow.
2. A child is admitted with a diagnosis of Kawasaki Disease. Which medication regimen should
the nurse anticipate to prevent coronary artery aneurysms?
A. Acyclovir and ibuprofen.
B. Corticosteroids and low-dose heparin.
,C. High-dose aspirin and Intravenous Immunoglobulin (IVIG).
D. Warfarin and diphenhydramine.
Answer: C
Conceptual Explanation: High-dose aspirin and IVIG are the standard treatments for
Kawasaki Disease to reduce inflammation and prevent the development of coronary artery
abnormalities.
3. The nurse is providing discharge teaching to the parents of a child with Cystic Fibrosis.
When should the parents be instructed to administer pancreatic enzymes?
A. Immediately following every meal and snack.
B. Once daily in the morning on an empty stomach.
C. Thirty minutes before every meal and snack.
D. With or just before every meal and snack.
Answer: D
Conceptual Explanation: Pancreatic enzymes must be taken with all meals and snacks to
ensure they are present in the duodenum when food arrives to facilitate digestion and
absorption.
4. An infant is suspected of having Pyloric Stenosis. Which clinical finding should the nurse
expect to observe?
A. Currant jelly-like stools containing blood and mucus.
, B. Projectile vomiting followed by immediate hunger.
C. Abdominal distension and failure to pass meconium.
D. Bile-stained emesis and diarrhea.
Answer: B
Conceptual Explanation: Hypertrophic pyloric stenosis typically manifests as non-bilious
projectile vomiting in an infant who remains hungry despite vomiting.
5. A 5-year-old is hospitalized with Nephrotic Syndrome. Which assessment finding is most
characteristic of this condition?
A. Gross hematuria and hypertension.
B. Severe proteinuria and generalized edema.
C. Increased urinary output and weight loss.
D. Elevated serum albumin and low cholesterol.
Answer: B
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, hyperlipidemia, and significant edema (anasarca).
6. A child with Sickle Cell Anemia is admitted in a vaso-occlusive crisis. Which nursing
intervention is the highest priority?
A. Administration of cold compresses to painful joints.
B. Intravenous hydration and pain management.
COMPREHENSIVE EXAM STUDY GUIDE
2026
1. A 4-month-old infant with Tetralogy of Fallot experiences a ‘tet spell’ during a blood draw.
Which action should the nurse take first?
A. Place the infant in a knee-chest position.
B. Administer 100% oxygen via face mask.
C. Prepare to administer morphine sulfate intravenously.
D. Notify the healthcare provider immediately.
Answer: A
Conceptual Explanation: The knee-chest position is the priority intervention because it
increases systemic vascular resistance, which reduces the right-to-left shunt and improves
pulmonary blood flow.
2. A child is admitted with a diagnosis of Kawasaki Disease. Which medication regimen should
the nurse anticipate to prevent coronary artery aneurysms?
A. Acyclovir and ibuprofen.
B. Corticosteroids and low-dose heparin.
,C. High-dose aspirin and Intravenous Immunoglobulin (IVIG).
D. Warfarin and diphenhydramine.
Answer: C
Conceptual Explanation: High-dose aspirin and IVIG are the standard treatments for
Kawasaki Disease to reduce inflammation and prevent the development of coronary artery
abnormalities.
3. The nurse is providing discharge teaching to the parents of a child with Cystic Fibrosis.
When should the parents be instructed to administer pancreatic enzymes?
A. Immediately following every meal and snack.
B. Once daily in the morning on an empty stomach.
C. Thirty minutes before every meal and snack.
D. With or just before every meal and snack.
Answer: D
Conceptual Explanation: Pancreatic enzymes must be taken with all meals and snacks to
ensure they are present in the duodenum when food arrives to facilitate digestion and
absorption.
4. An infant is suspected of having Pyloric Stenosis. Which clinical finding should the nurse
expect to observe?
A. Currant jelly-like stools containing blood and mucus.
, B. Projectile vomiting followed by immediate hunger.
C. Abdominal distension and failure to pass meconium.
D. Bile-stained emesis and diarrhea.
Answer: B
Conceptual Explanation: Hypertrophic pyloric stenosis typically manifests as non-bilious
projectile vomiting in an infant who remains hungry despite vomiting.
5. A 5-year-old is hospitalized with Nephrotic Syndrome. Which assessment finding is most
characteristic of this condition?
A. Gross hematuria and hypertension.
B. Severe proteinuria and generalized edema.
C. Increased urinary output and weight loss.
D. Elevated serum albumin and low cholesterol.
Answer: B
Conceptual Explanation: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, hyperlipidemia, and significant edema (anasarca).
6. A child with Sickle Cell Anemia is admitted in a vaso-occlusive crisis. Which nursing
intervention is the highest priority?
A. Administration of cold compresses to painful joints.
B. Intravenous hydration and pain management.
