Multiple Choice Situational Questions:

1. A 6-month-old infant is brought to the ER with excessive crying, abdominal distention, and passing gas. The mother reports the baby cries for more than 3 hours daily for the past 3 weeks. What is the likely diagnosis? a) Gastroenteritis
   b) Colic
   c) Intussusception
   d) Appendicitis

2. A nurse is caring for a child who was recently diagnosed with Hirschsprung's disease. Which symptom is most likely related to this condition? a) Frequent loose stools
   b) Failure to pass meconium within the first 48 hours of life
   c) Polyuria
   d) Hematuria

3. A 2-year-old presents with repeated regurgitation and abdominal pain after meals. The nurse suspects gastroesophageal reflux (GER). What treatment would most likely be recommended? a) Surgical intervention
   b) Positioning the child upright after feeding
   c) Providing high-calorie formula
   d) Increasing the volume of each feed

4. A child is admitted with a diagnosis of failure to thrive. The child’s weight is below the 3rd percentile, and developmental milestones are delayed. Which nursing intervention should be prioritized? a) Restrict fluids
   b) Provide vitamin supplements
   c) Monitor daily caloric intake
   d) Limit physical activity

5. A 5-year-old with intussusception presents with abdominal pain and “currant jelly” stools. What is the most appropriate initial treatment? a) Immediate surgery
   b) Barium enema
   c) Nasogastric tube placement
   d) Laparoscopy

6. A 3-year-old child with type 1 diabetes presents with symptoms of excessive thirst, frequent urination, and weight loss. What is the likely cause of these symptoms? a) Hypoglycemia
   b) Hyperglycemia
   c) Diabetic ketoacidosis
   d) Insulin overdose

7. Which dietary recommendation is appropriate for a child with obesity? a) High-fat diet to promote growth
   b) Frequent, high-calorie snacks
   c) Increased intake of fruits and vegetables
   d) Limit all physical activities

8. A 2-week-old infant is diagnosed with cleft lip and palate. The parents ask about feeding options. Which feeding strategy is most appropriate? a) Breastfeeding without modification
   b) Use of a Haberman feeder or special bottle
   c) Delaying feeding until after surgery
   d) Switching to solid foods early

9. A child presents with recurrent urinary tract infections (UTIs). The child is diagnosed with vesicoureteral reflux. What complication should the nurse monitor for? a) Polyuria
   b) Hematuria
   c) Chronic kidney disease
   d) Edema

10. An infant with Hirschsprung’s disease has a distended abdomen and vomiting. What immediate intervention is required? a) Oral hydration
    b) Enema
    c) Immediate surgical consultation
    d) Administering probiotics

11. A 4-year-old child with intussusception is scheduled for surgery after unsuccessful hydrostatic reduction. What is the nurse’s primary postoperative concern? a) Risk of infection
    b) Fluid volume overload
    c) Electrolyte imbalance
    d) Pain management

12. A nurse is teaching parents about managing an infant with colic. Which of the following is a recommended approach? a) Avoid swaddling the infant
    b) Gently massage the infant's abdomen
    c) Feed the infant less frequently
    d) Restrict the infant’s movement

13. A 10-year-old diagnosed with type 2 diabetes mellitus asks about lifestyle changes. Which advice is most appropriate? a) Increase simple carbohydrate intake
    b) Encourage regular exercise
    c) Avoid all physical activity
    d) Focus on rapid weight loss

14. A child diagnosed with cleft palate is at increased risk for which of the following? a) Hearing loss
    b) Polyuria
    c) Visual impairment
    d) Asthma

15. A child with failure to thrive is admitted for nutritional rehabilitation. Which laboratory test is most helpful to assess nutritional deficiencies? a) Blood glucose levels
    b) Serum albumin
    c) Urinalysis
    d) Electrocardiogram (ECG)

16. A 6-month-old infant with colic cries uncontrollably, especially in the evening. What advice should the nurse offer to the parents? a) Limit the baby’s feedings to prevent overstimulation
    b) Swaddle the infant and use white noise to calm them
    c) Increase the baby’s formula intake
    d) Allow the baby to cry until they settle on their own

17. A newborn with an imperforate anus is scheduled for surgery. Which preoperative intervention is essential? a) Administering oral fluids
    b) Colostomy preparation
    c) Monitoring for jaundice
    d) Encouraging the baby to pass stool

18. Which nursing diagnosis is most appropriate for a child with diabetes mellitus experiencing frequent episodes of hyperglycemia? a) Risk for infection
    b) Risk for impaired urinary elimination
    c) Risk for fluid volume deficit
    d) Impaired physical mobility

19. A nurse is preparing a child for cleft palate repair. What preoperative instruction is critical for the parents? a) Feed the child solid food the night before surgery
    b) Avoid using special feeding bottles
    c) Use elbow restraints to prevent the child from touching the surgical site
    d) Restrict all fluid intake before the procedure

20. A 2-year-old with Hirschsprung’s disease is receiving bowel irrigation before surgery. Which outcome indicates the irrigation is successful? a) Increased abdominal distension
    b) Passage of normal stool
    c) Resolution of vomiting
    d) Presence of blood in the stool

Situational Identification Questions:

1. A newborn is brought in with a distended abdomen, vomiting, and has not passed stool in the first 48 hours of life. What is the most likely diagnosis?

2. A 3-month-old infant presents with excessive crying for several hours, especially at night, and draws their legs up to their abdomen. What condition should be suspected?

3. A child presents with a swollen abdomen, bilious vomiting, and “currant jelly” stools. What is the probable diagnosis?

4. A 5-year-old child is diagnosed with failure to thrive and presents with irritability, delayed motor development, and frequent crying. What underlying factor should be considered?

5. A 6-month-old infant with diabetes mellitus is showing signs of polyuria, polydipsia, and polyphagia. What is the most likely cause of these symptoms?

6. A newborn presents with an imperforate anus and passes stool through the vaginal opening. What congenital condition is this associated with?

7. A child with diabetes mellitus is admitted for excessive thirst, frequent urination, and weight loss. What complication is most likely?

8. A 2-year-old is brought to the ER with signs of severe abdominal pain and a sausage-shaped mass in the right hypochondrium. What is the likely condition?

9. A 4-year-old with cleft lip is preparing for surgical repair. What critical postoperative instruction should the nurse provide to the parents?

10. A child is diagnosed with type 1 diabetes and presents with irritability, fatigue, and frequent urination. What diagnostic test result would confirm the diagnosis?

Answer Key:

Multiple Choice:

1. b

2. b

3. b

4. c

5. b

6. b

7. c

8. b

9. c

10. c

11. d

12. b

13. b

14. a

15. b

16. b

17. b

18. a

19. c

20. b

Situational Identification:

1. Hirschsprung’s disease

2. Colic

3. Intussusception

4. Malnutrition or feeding issues

5. Hyperglycemia

6. Persistent cloaca

7. Diabetic ketoacidosis

8. Intussusception

9. Avoid prone positioning and apply elbow restraints

10. Fasting blood glucose above 126 mg/dL