NSG 3600 Peds Exam 4 MUST KNOW QUESTIONS
AND ANSWERS
Comprehensive Review Guide
250+ Practice Questions with Correct Answers and
Rationales
1. A school-age child has just been diagnosed with attention deficit hyperactivity disorder (ADHD),
predominantly inattentive presentation. The parent asks the nurse, "What does this diagnosis mean
for my child?" Which response by the nurse is most accurate?
A. "Your child will have difficulty with social interactions and may not make eye contact."
B. "Your child will display excessive running and climbing, as if driven by a motor."
C. "Your child will have significant difficulty sustaining attention and is easily distracted."
D. "Your child will have restrictive and repetitive behaviors, like hand-flapping."
Correct Answer: C
Rationale: The predominantly inattentive presentation of ADHD is characterized by difficulty sustaining
attention, not following through on tasks, and being easily distracted. Hyperactivity-impulsivity (option
B) is the hallmark of the hyperactive-impulsive or combined presentation. Options A and D are core
features of autism spectrum disorder (ASD).
,2. The nurse is developing a plan of care for an 8-year-old with ADHD. Which nursing intervention is
most appropriate to include?
A. Allow the child to choose their own schedule for the day to promote autonomy.
B. Use a reward chart to reinforce positive behaviors like staying seated during meals.
C. Provide a stimulating environment with multiple activities to choose from.
D. Speak to the child in a loud, firm voice to get their attention.
Correct Answer: B
Rationale: Behavioral therapy for ADHD uses positive reinforcement, such as reward charts, to
encourage desired behaviors like task completion and impulse control. Children with ADHD thrive on
structure and clear expectations, not a self-chosen schedule (A). A stimulating environment (C) would be
overstimulating and counterproductive. A calm, clear, and direct voice is recommended, not a loud one
(D).
3. A nurse is providing education to the parents of a newborn diagnosed with Down syndrome
(Trisomy 21). Which information is most important for the nurse to include?
A. Information on support groups like the National Down Syndrome Society for long-term resources.
B. A detailed explanation of the cognitive and intellectual disabilities the child will have.
C. Reassurance that the child will likely not have any major health complications.
D. Instructions on how to position the child to prevent complications from hyperflexibility.
Correct Answer: A
Rationale: When assisting new parents of a child with Down syndrome, it is crucial to be sensitive to
their emotional needs and provide them with information and resources for support. While discussing
potential health issues is necessary, connecting them with support groups (A) is a positive and
,immediate step. Discussing potential intellectual disabilities (B) can be overwhelming and should be
done with care. Children with DS have a high incidence of health problems like heart defects, so option C
is false. While hyperflexibility is a concern, it is not the most important initial teaching point.
4. A 2-year-old child with autism spectrum disorder (ASD) is being admitted to the pediatric unit.
Which room assignment and nursing approach would be most therapeutic for this child?
A. A semi-private room with a friendly, talkative roommate to encourage socialization.
B. A private room near the nurses' station, with a flexible daily routine.
C. A private room away from loud noises, maintaining the child's home routine as much as possible.
D. A semi-private room near the playroom so the child can easily access toys.
Correct Answer: C
Rationale: Children with ASD require a structured and predictable environment to feel comfortable. A
private room away from loud noises minimizes sensory overload. Maintaining the child's home routine is
vital for providing a sense of security and predictability. Options A, B, and D introduce variables
(unfamiliar people, noise, flexible routines) that can cause significant distress for a child with ASD.
5. The nurse is assessing a 4-year-old boy and notes the following: inability to make eye contact, no
spoken language, and repetitive hand-flapping. The mother reports the child had normal development
until 18 months but then lost several acquired skills. The nurse recognizes these findings are most
consistent with:
A. Attention deficit hyperactivity disorder.
B. Child maltreatment.
, C. Down syndrome.
D. Autism spectrum disorder.
Correct Answer: D
Rationale: The clinical manifestations described—impaired social reciprocity (eye contact),
communication issues (no language), and repetitive behaviors (hand-flapping)—are classic for ASD. The
history of regression of previously acquired skills by age 2 is a specific red flag and is characteristic of
autism spectrum disorder.
6. The nurse is caring for a 10-year-old with ADHD who is prescribed methylphenidate (Ritalin). Which
side effect should the nurse teach the parents to monitor for?
A. Increased appetite and weight gain
B. Insomnia and decreased appetite
C. Hypersomnia and lethargy
D. Hypotension and bradycardia
Correct Answer: B
Rationale: Methylphenidate is a central nervous system stimulant. Common side effects include
insomnia, decreased appetite, weight loss, headache, and stomach ache. It can also cause mild increases
in heart rate and blood pressure, not hypotension (D).
7. A child with Down syndrome is being evaluated for associated conditions. The nurse knows that
which condition is most commonly associated with Down syndrome and should be screened for at
birth?
AND ANSWERS
Comprehensive Review Guide
250+ Practice Questions with Correct Answers and
Rationales
1. A school-age child has just been diagnosed with attention deficit hyperactivity disorder (ADHD),
predominantly inattentive presentation. The parent asks the nurse, "What does this diagnosis mean
for my child?" Which response by the nurse is most accurate?
A. "Your child will have difficulty with social interactions and may not make eye contact."
B. "Your child will display excessive running and climbing, as if driven by a motor."
C. "Your child will have significant difficulty sustaining attention and is easily distracted."
D. "Your child will have restrictive and repetitive behaviors, like hand-flapping."
Correct Answer: C
Rationale: The predominantly inattentive presentation of ADHD is characterized by difficulty sustaining
attention, not following through on tasks, and being easily distracted. Hyperactivity-impulsivity (option
B) is the hallmark of the hyperactive-impulsive or combined presentation. Options A and D are core
features of autism spectrum disorder (ASD).
,2. The nurse is developing a plan of care for an 8-year-old with ADHD. Which nursing intervention is
most appropriate to include?
A. Allow the child to choose their own schedule for the day to promote autonomy.
B. Use a reward chart to reinforce positive behaviors like staying seated during meals.
C. Provide a stimulating environment with multiple activities to choose from.
D. Speak to the child in a loud, firm voice to get their attention.
Correct Answer: B
Rationale: Behavioral therapy for ADHD uses positive reinforcement, such as reward charts, to
encourage desired behaviors like task completion and impulse control. Children with ADHD thrive on
structure and clear expectations, not a self-chosen schedule (A). A stimulating environment (C) would be
overstimulating and counterproductive. A calm, clear, and direct voice is recommended, not a loud one
(D).
3. A nurse is providing education to the parents of a newborn diagnosed with Down syndrome
(Trisomy 21). Which information is most important for the nurse to include?
A. Information on support groups like the National Down Syndrome Society for long-term resources.
B. A detailed explanation of the cognitive and intellectual disabilities the child will have.
C. Reassurance that the child will likely not have any major health complications.
D. Instructions on how to position the child to prevent complications from hyperflexibility.
Correct Answer: A
Rationale: When assisting new parents of a child with Down syndrome, it is crucial to be sensitive to
their emotional needs and provide them with information and resources for support. While discussing
potential health issues is necessary, connecting them with support groups (A) is a positive and
,immediate step. Discussing potential intellectual disabilities (B) can be overwhelming and should be
done with care. Children with DS have a high incidence of health problems like heart defects, so option C
is false. While hyperflexibility is a concern, it is not the most important initial teaching point.
4. A 2-year-old child with autism spectrum disorder (ASD) is being admitted to the pediatric unit.
Which room assignment and nursing approach would be most therapeutic for this child?
A. A semi-private room with a friendly, talkative roommate to encourage socialization.
B. A private room near the nurses' station, with a flexible daily routine.
C. A private room away from loud noises, maintaining the child's home routine as much as possible.
D. A semi-private room near the playroom so the child can easily access toys.
Correct Answer: C
Rationale: Children with ASD require a structured and predictable environment to feel comfortable. A
private room away from loud noises minimizes sensory overload. Maintaining the child's home routine is
vital for providing a sense of security and predictability. Options A, B, and D introduce variables
(unfamiliar people, noise, flexible routines) that can cause significant distress for a child with ASD.
5. The nurse is assessing a 4-year-old boy and notes the following: inability to make eye contact, no
spoken language, and repetitive hand-flapping. The mother reports the child had normal development
until 18 months but then lost several acquired skills. The nurse recognizes these findings are most
consistent with:
A. Attention deficit hyperactivity disorder.
B. Child maltreatment.
, C. Down syndrome.
D. Autism spectrum disorder.
Correct Answer: D
Rationale: The clinical manifestations described—impaired social reciprocity (eye contact),
communication issues (no language), and repetitive behaviors (hand-flapping)—are classic for ASD. The
history of regression of previously acquired skills by age 2 is a specific red flag and is characteristic of
autism spectrum disorder.
6. The nurse is caring for a 10-year-old with ADHD who is prescribed methylphenidate (Ritalin). Which
side effect should the nurse teach the parents to monitor for?
A. Increased appetite and weight gain
B. Insomnia and decreased appetite
C. Hypersomnia and lethargy
D. Hypotension and bradycardia
Correct Answer: B
Rationale: Methylphenidate is a central nervous system stimulant. Common side effects include
insomnia, decreased appetite, weight loss, headache, and stomach ache. It can also cause mild increases
in heart rate and blood pressure, not hypotension (D).
7. A child with Down syndrome is being evaluated for associated conditions. The nurse knows that
which condition is most commonly associated with Down syndrome and should be screened for at
birth?
