NR 328 PEDIATRIC NURSING FINAL
EXAM PRACTICE QUESTIONS 2027
1. A 6-week-old infant is brought to the clinic for projectile vomiting after feedings. The
mother describes the infant as always hungry. Upon assessment, the nurse palpates an olive-
shaped mass in the right upper quadrant. Which condition is most likely?
A. Intussusception
B. Gastroesophageal reflux
C. Hirschsprung’s disease
D. Hypertrophic pyloric stenosis
Answer: D
Conceptual Explanation: Hypertrophic pyloric stenosis is characterized by projectile non-
bilious vomiting, constant hunger, and a palpable olive-shaped mass in the epigastrium to
the right of the umbilicus.
2. A child with Tetralogy of Fallot becomes acutely cyanotic and hyperpneic while crying.
Which action should the nurse take first?
A. Administer 100% oxygen via face mask
B. Place the child in a knee-chest position
,C. Prepare for immediate intravenous fluid bolus
D. Administer morphine sulfate intramuscularly
Answer: B
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which helps reduce the right-to-left shunt and improves oxygenation during a
hypercyanotic (‘tet’) spell.
3. Which clinical manifestation is a hallmark sign of Hirschsprung’s disease in a newborn?
A. Projectile vomiting
B. Current jelly-like stools
C. Failure to pass meconium within the first 24 to 48 hours
D. Severe perianal itching
Answer: C
Conceptual Explanation: Hirschsprung’s disease is a congenital aganglionic megacolon.
Failure to pass meconium in the first 48 hours of life is a key diagnostic sign.
4. A nurse is caring for a 4-year-old child with suspected epiglottitis. Which nursing
intervention is contraindicated?
A. Visualizing the throat with a tongue depressor
B. Allowing the child to remain in a tripod position
C. Monitoring oxygen saturation
, D. Providing humidified oxygen
Answer: A
Conceptual Explanation: Visualizing the throat with a tongue depressor can trigger a
laryngospasm, leading to complete airway obstruction in a child with epiglottitis.
5. A school-age child is admitted with a diagnosis of acute glomerulonephritis. What history
finding is most significant?
A. A recent urinary tract infection
B. A family history of polycystic kidney disease
C. A recent streptococcal throat infection
D. Frequent episodes of dehydration
Answer: C
Conceptual Explanation: Acute post-streptococcal glomerulonephritis is an immune-
complex disease that typically follows a Group A beta-hemolytic streptococcal infection of
the throat or skin.
6. A nurse is assessing a child with nephrotic syndrome. Which finding should the nurse
expect?
A. Gross hematuria and hypertension
B. Massive proteinuria and generalized edema
C. Decreased cholesterol and increased albumin levels
EXAM PRACTICE QUESTIONS 2027
1. A 6-week-old infant is brought to the clinic for projectile vomiting after feedings. The
mother describes the infant as always hungry. Upon assessment, the nurse palpates an olive-
shaped mass in the right upper quadrant. Which condition is most likely?
A. Intussusception
B. Gastroesophageal reflux
C. Hirschsprung’s disease
D. Hypertrophic pyloric stenosis
Answer: D
Conceptual Explanation: Hypertrophic pyloric stenosis is characterized by projectile non-
bilious vomiting, constant hunger, and a palpable olive-shaped mass in the epigastrium to
the right of the umbilicus.
2. A child with Tetralogy of Fallot becomes acutely cyanotic and hyperpneic while crying.
Which action should the nurse take first?
A. Administer 100% oxygen via face mask
B. Place the child in a knee-chest position
,C. Prepare for immediate intravenous fluid bolus
D. Administer morphine sulfate intramuscularly
Answer: B
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which helps reduce the right-to-left shunt and improves oxygenation during a
hypercyanotic (‘tet’) spell.
3. Which clinical manifestation is a hallmark sign of Hirschsprung’s disease in a newborn?
A. Projectile vomiting
B. Current jelly-like stools
C. Failure to pass meconium within the first 24 to 48 hours
D. Severe perianal itching
Answer: C
Conceptual Explanation: Hirschsprung’s disease is a congenital aganglionic megacolon.
Failure to pass meconium in the first 48 hours of life is a key diagnostic sign.
4. A nurse is caring for a 4-year-old child with suspected epiglottitis. Which nursing
intervention is contraindicated?
A. Visualizing the throat with a tongue depressor
B. Allowing the child to remain in a tripod position
C. Monitoring oxygen saturation
, D. Providing humidified oxygen
Answer: A
Conceptual Explanation: Visualizing the throat with a tongue depressor can trigger a
laryngospasm, leading to complete airway obstruction in a child with epiglottitis.
5. A school-age child is admitted with a diagnosis of acute glomerulonephritis. What history
finding is most significant?
A. A recent urinary tract infection
B. A family history of polycystic kidney disease
C. A recent streptococcal throat infection
D. Frequent episodes of dehydration
Answer: C
Conceptual Explanation: Acute post-streptococcal glomerulonephritis is an immune-
complex disease that typically follows a Group A beta-hemolytic streptococcal infection of
the throat or skin.
6. A nurse is assessing a child with nephrotic syndrome. Which finding should the nurse
expect?
A. Gross hematuria and hypertension
B. Massive proteinuria and generalized edema
C. Decreased cholesterol and increased albumin levels
