PNR 204/PNR204 Exam 4 V2 | Pediatric Nursing
Q&A with Rationale | Fortis College
1. A nurse is providing discharge instructions to the parents of a child with Tetralogy of Fallot.
Which position should the nurse instruct the parents to place the child in during a
hypercyanotic spell?
A. Knee-chest position
B. High Fowler’s position
C. Prone position
D. Supine with legs elevated
Correct Answer: A
Explanation: The knee-chest position increases systemic vascular resistance and
decreases the right-to-left shunt across the ventricular septal defect. This helps to increase
blood flow to the lungs and improve oxygen saturation. Parents should be taught this
immediate intervention to manage ‘tet spells’ at home.
2. A school-age child is admitted with a diagnosis of Acute Glomerulonephritis. Which
assessment finding is most characteristic of this condition?
A. Weight loss and increased appetite
B. Periorbital edema and tea-colored urine
C. Hypotension and bradycardia
,D. Profuse watery diarrhea
Correct Answer: B
Explanation: Acute Glomerulonephritis is often preceded by a streptococcal infection and
results in inflammation of the glomeruli. Periorbital edema occurs due to fluid retention
while the tea-colored urine is caused by hematuria. Monitoring blood pressure and daily
weights are critical nursing interventions for these patients.
3. The nurse is caring for a 10-year-old child with Hemophilia A. Which medication should the
nurse question if ordered for pain management?
A. Acetaminophen
B. Aspirin
C. Morphine
D. Codeine
Correct Answer: B
Explanation: Aspirin should be avoided in children with Hemophilia because it inhibits
platelet aggregation and increases the risk of bleeding. Acetaminophen is the preferred
analgesic for mild to moderate pain in these patients. The nurse must educate the family to
check all over-the-counter labels for salicylate content.
4. A nurse is assessing a child with Pyloric Stenosis. Which finding should the nurse expect to
observe?
A. Ribbon-like stools
, B. Currant jelly-like stools
C. Projectile vomiting after feedings
D. Steatorrhea
Correct Answer: C
Explanation: Pyloric stenosis involves the hypertrophy of the pyloric sphincter, which
obstructs the gastric outlet. This leads to forceful, non-bilious projectile vomiting
immediately after feeding. A palpable olive-shaped mass in the right upper quadrant is also
a classic assessment finding.
5. A child with Cystic Fibrosis is receiving pancrelipase. How should the nurse instruct the
parents to administer this medication?
A. Administer two hours after every meal.
B. Mix the enzymes with hot oatmeal.
C. Give the enzymes with all meals and snacks.
D. Dissolve the capsules in a full glass of milk.
Correct Answer: C
Explanation: Pancreatic enzymes are necessary to facilitate the digestion and absorption
of fats, proteins, and carbohydrates in patients with Cystic Fibrosis. They must be taken
with every meal and snack to ensure nutritional needs are met. If the child cannot swallow
capsules, the beads can be sprinkled on a small amount of acidic food like applesauce.
Q&A with Rationale | Fortis College
1. A nurse is providing discharge instructions to the parents of a child with Tetralogy of Fallot.
Which position should the nurse instruct the parents to place the child in during a
hypercyanotic spell?
A. Knee-chest position
B. High Fowler’s position
C. Prone position
D. Supine with legs elevated
Correct Answer: A
Explanation: The knee-chest position increases systemic vascular resistance and
decreases the right-to-left shunt across the ventricular septal defect. This helps to increase
blood flow to the lungs and improve oxygen saturation. Parents should be taught this
immediate intervention to manage ‘tet spells’ at home.
2. A school-age child is admitted with a diagnosis of Acute Glomerulonephritis. Which
assessment finding is most characteristic of this condition?
A. Weight loss and increased appetite
B. Periorbital edema and tea-colored urine
C. Hypotension and bradycardia
,D. Profuse watery diarrhea
Correct Answer: B
Explanation: Acute Glomerulonephritis is often preceded by a streptococcal infection and
results in inflammation of the glomeruli. Periorbital edema occurs due to fluid retention
while the tea-colored urine is caused by hematuria. Monitoring blood pressure and daily
weights are critical nursing interventions for these patients.
3. The nurse is caring for a 10-year-old child with Hemophilia A. Which medication should the
nurse question if ordered for pain management?
A. Acetaminophen
B. Aspirin
C. Morphine
D. Codeine
Correct Answer: B
Explanation: Aspirin should be avoided in children with Hemophilia because it inhibits
platelet aggregation and increases the risk of bleeding. Acetaminophen is the preferred
analgesic for mild to moderate pain in these patients. The nurse must educate the family to
check all over-the-counter labels for salicylate content.
4. A nurse is assessing a child with Pyloric Stenosis. Which finding should the nurse expect to
observe?
A. Ribbon-like stools
, B. Currant jelly-like stools
C. Projectile vomiting after feedings
D. Steatorrhea
Correct Answer: C
Explanation: Pyloric stenosis involves the hypertrophy of the pyloric sphincter, which
obstructs the gastric outlet. This leads to forceful, non-bilious projectile vomiting
immediately after feeding. A palpable olive-shaped mass in the right upper quadrant is also
a classic assessment finding.
5. A child with Cystic Fibrosis is receiving pancrelipase. How should the nurse instruct the
parents to administer this medication?
A. Administer two hours after every meal.
B. Mix the enzymes with hot oatmeal.
C. Give the enzymes with all meals and snacks.
D. Dissolve the capsules in a full glass of milk.
Correct Answer: C
Explanation: Pancreatic enzymes are necessary to facilitate the digestion and absorption
of fats, proteins, and carbohydrates in patients with Cystic Fibrosis. They must be taken
with every meal and snack to ensure nutritional needs are met. If the child cannot swallow
capsules, the beads can be sprinkled on a small amount of acidic food like applesauce.
