NSG 3600 Peds Exam 4: Comprehensive Practice
Test
Galen College of Nursing
Latest 2026 | 100% Correct Q&A with Rationales
1. A school nurse is leading a workshop for teachers on supporting students
with Attention-Deficit/Hyperactivity Disorder (ADHD). Which classroom strategy
is most likely to benefit a child with inattentive-type ADHD?
a. Allowing the child to take tests in a quiet, distraction-reduced area.
b. Seating the child in the back of the classroom to allow for movement.
c. Providing a standing desk for the child to use when feeling fidgety.
d. Implementing a color-coded behavior chart visible to the entire class.
Correct Answer: a. Allowing the child to take tests in a quiet, distraction-
reduced area.
Rationale: Children with inattentive-type ADHD struggle with focus and are easily
distracted by external stimuli. Reducing distractions during tasks requiring
sustained mental effort, like tests, is a key accommodation . Seating near the
front is often recommended. Standing desks help with hyperactivity, not primarily
inattention.
2. The nurse is reinforcing teaching with the parents of a child recently
diagnosed with Autism Spectrum Disorder (ASD). The child engages in hand-
flapping when excited. The parents ask why they do this. What is the nurse's
,best response?
a. "This is a self-stimulatory behavior that helps the child regulate sensory input."
b. "It's a sign of aggression that we need to work on extinguishing immediately."
c. "He is likely trying to get your attention. Ignoring the behavior is best."
d. "This is an early sign of a tic disorder, which is commonly associated with ASD."
Correct Answer: a. "This is a self-stimulatory behavior that helps the child
regulate sensory input."
Rationale: Repetitive movements like hand-flapping, rocking, or spinning are
known as "stimming" (self-stimulatory behavior). These behaviors serve a
purpose for the child, often helping them to self-soothe, focus, or manage
overwhelming sensory input .
3. A newborn with Down syndrome is being assessed. The nurse knows that, in
addition to a cardiac assessment, it is essential to evaluate the infant for which
common gastrointestinal anomaly?
a. Pyloric stenosis
b. Gastroschisis
c. Duodenal atresia
d. Meckel's diverticulum
Correct Answer: c. Duodenal atresia
Rationale: Infants with Down syndrome have a significantly higher risk of certain
gastrointestinal malformations, especially duodenal atresia (obstruction of the
duodenum). This often presents with polyhydramnios in utero and bilious
vomiting shortly after birth .
,4. A 10-month-old infant is brought to the clinic. The nurse observes a "startle"
response when there is a sudden loud noise. The parents report the infant is not
yet rolling over or sitting unsupported. Based on these findings, the nurse
should suspect:
a. Typical infant development.
b. Possible developmental delay.
c. A diagnosis of cerebral palsy.
d. Transient behavioral phenomenon.
Correct Answer: b. Possible developmental delay.
Rationale: The persistence of a primitive reflex like the Moro (startle) reflex
beyond 4-6 months is abnormal and suggests a possible neurological issue.
Combined with the failure to achieve gross motor milestones like rolling and
sitting, this warrants further investigation for developmental delay .
5. The nurse is caring for a 4-year-old child diagnosed with oppositional defiant
disorder (ODD). Which nursing intervention is most appropriate when the child
refuses to comply with a request to clean up toys?
a. Firmly state, "If you don't clean up, you will have a time-out."
b. Give the child two choices: "Would you like to put the blocks away first, or the
cars?"
c. Ignore the noncompliance and clean the toys up yourself to avoid a tantrum.
d. Explain to the child why it's important to be responsible and clean up after play.
Correct Answer: b. Give the child two choices: "Would you like to put the
blocks away first, or the cars?"
Rationale: Providing limited, acceptable choices is a key strategy for managing
, power struggles with children, especially those with ODD. It gives the child a
sense of control while still ensuring the task is completed . Threats can escalate
the behavior, and doing the task for the child reinforces the defiance.
6. A child is brought to the emergency department with multiple bruises in
various stages of healing. The parent gives a vague history and becomes
defensive when asked about the injuries. Which finding would be most
suggestive of physical abuse?
a. Bruises on the shins and elbows.
b. A single bruise on the forehead of a toddler.
c. Bruises in the shape of a handprint on the child's buttocks.
d. A healing abrasion on the chin from a recent fall.
Correct Answer: c. Bruises in the shape of a handprint on the child's
buttocks.
Rationale: Certain injury patterns are highly suggestive of abuse. Bruises that have
a distinct shape of an object (like a hand, belt, or cord) are not consistent with
accidental injury . Bruises over bony prominences are common in active children.
7. A female adolescent is newly diagnosed with bulimia nervosa. Which
assessment finding is most important for the nurse to report to the healthcare
provider immediately?
a. Complaint of fatigue after a long school day.
b. Small, painless calluses on the knuckles.
c. Serum potassium level of 2.8 mEq/L.
d. Expressing feelings of shame about eating habits.
Test
Galen College of Nursing
Latest 2026 | 100% Correct Q&A with Rationales
1. A school nurse is leading a workshop for teachers on supporting students
with Attention-Deficit/Hyperactivity Disorder (ADHD). Which classroom strategy
is most likely to benefit a child with inattentive-type ADHD?
a. Allowing the child to take tests in a quiet, distraction-reduced area.
b. Seating the child in the back of the classroom to allow for movement.
c. Providing a standing desk for the child to use when feeling fidgety.
d. Implementing a color-coded behavior chart visible to the entire class.
Correct Answer: a. Allowing the child to take tests in a quiet, distraction-
reduced area.
Rationale: Children with inattentive-type ADHD struggle with focus and are easily
distracted by external stimuli. Reducing distractions during tasks requiring
sustained mental effort, like tests, is a key accommodation . Seating near the
front is often recommended. Standing desks help with hyperactivity, not primarily
inattention.
2. The nurse is reinforcing teaching with the parents of a child recently
diagnosed with Autism Spectrum Disorder (ASD). The child engages in hand-
flapping when excited. The parents ask why they do this. What is the nurse's
,best response?
a. "This is a self-stimulatory behavior that helps the child regulate sensory input."
b. "It's a sign of aggression that we need to work on extinguishing immediately."
c. "He is likely trying to get your attention. Ignoring the behavior is best."
d. "This is an early sign of a tic disorder, which is commonly associated with ASD."
Correct Answer: a. "This is a self-stimulatory behavior that helps the child
regulate sensory input."
Rationale: Repetitive movements like hand-flapping, rocking, or spinning are
known as "stimming" (self-stimulatory behavior). These behaviors serve a
purpose for the child, often helping them to self-soothe, focus, or manage
overwhelming sensory input .
3. A newborn with Down syndrome is being assessed. The nurse knows that, in
addition to a cardiac assessment, it is essential to evaluate the infant for which
common gastrointestinal anomaly?
a. Pyloric stenosis
b. Gastroschisis
c. Duodenal atresia
d. Meckel's diverticulum
Correct Answer: c. Duodenal atresia
Rationale: Infants with Down syndrome have a significantly higher risk of certain
gastrointestinal malformations, especially duodenal atresia (obstruction of the
duodenum). This often presents with polyhydramnios in utero and bilious
vomiting shortly after birth .
,4. A 10-month-old infant is brought to the clinic. The nurse observes a "startle"
response when there is a sudden loud noise. The parents report the infant is not
yet rolling over or sitting unsupported. Based on these findings, the nurse
should suspect:
a. Typical infant development.
b. Possible developmental delay.
c. A diagnosis of cerebral palsy.
d. Transient behavioral phenomenon.
Correct Answer: b. Possible developmental delay.
Rationale: The persistence of a primitive reflex like the Moro (startle) reflex
beyond 4-6 months is abnormal and suggests a possible neurological issue.
Combined with the failure to achieve gross motor milestones like rolling and
sitting, this warrants further investigation for developmental delay .
5. The nurse is caring for a 4-year-old child diagnosed with oppositional defiant
disorder (ODD). Which nursing intervention is most appropriate when the child
refuses to comply with a request to clean up toys?
a. Firmly state, "If you don't clean up, you will have a time-out."
b. Give the child two choices: "Would you like to put the blocks away first, or the
cars?"
c. Ignore the noncompliance and clean the toys up yourself to avoid a tantrum.
d. Explain to the child why it's important to be responsible and clean up after play.
Correct Answer: b. Give the child two choices: "Would you like to put the
blocks away first, or the cars?"
Rationale: Providing limited, acceptable choices is a key strategy for managing
, power struggles with children, especially those with ODD. It gives the child a
sense of control while still ensuring the task is completed . Threats can escalate
the behavior, and doing the task for the child reinforces the defiance.
6. A child is brought to the emergency department with multiple bruises in
various stages of healing. The parent gives a vague history and becomes
defensive when asked about the injuries. Which finding would be most
suggestive of physical abuse?
a. Bruises on the shins and elbows.
b. A single bruise on the forehead of a toddler.
c. Bruises in the shape of a handprint on the child's buttocks.
d. A healing abrasion on the chin from a recent fall.
Correct Answer: c. Bruises in the shape of a handprint on the child's
buttocks.
Rationale: Certain injury patterns are highly suggestive of abuse. Bruises that have
a distinct shape of an object (like a hand, belt, or cord) are not consistent with
accidental injury . Bruises over bony prominences are common in active children.
7. A female adolescent is newly diagnosed with bulimia nervosa. Which
assessment finding is most important for the nurse to report to the healthcare
provider immediately?
a. Complaint of fatigue after a long school day.
b. Small, painless calluses on the knuckles.
c. Serum potassium level of 2.8 mEq/L.
d. Expressing feelings of shame about eating habits.
