1
NSG 3600 Exam 2 | Exam 2 NSG 3600 Questions
and Answers 2025/2026 Update - Galen
Exam 2 Focus Areas: Pediatric Cardiac Disorders, Respiratory Disorders,
Gastrointestinal Conditions, Infectious Diseases, Growth & Development
Milestones, Pediatric Emergencies, and Medication Safety.
SECTION 1: CONGENITAL HEART DEFECTS & PEDIATRIC CARDIAC (Questions 1–
35)
1. The nurse is performing the cardiac screening on a newborn before discharge.
Which assessment finding would be suggestive of a Coarctation of the Aorta?
A. Higher BP in left arm than right arm
B. Higher BP in right arm than right leg
C. Lower BP in both arms compared to legs
D. Equal BP in all four extremities
:Answer: B. Higher BP in right arm than right leg.
Rationale: Coarctation of the aorta is a narrowing that impedes blood flow to the
lower extremities. This creates higher blood pressure in the upper extremities
(proximal to the narrowing) compared to the lower extremities.
2. The nurse is getting vital signs on a 36-hour-old infant and notes bounding
peripheral pulses and a BP of 96/25. The nurse suspects:
A. Tetralogy of Fallot
B. Patent Ductus Arteriosus
C. Ventricular Septal Defect
D. Coarctation of the Aorta
:Answer: B. Patent Ductus Arteriosus.
Rationale: PDA presents with a wide pulse pressure (difference between systolic
and diastolic) and bounding pulses due to the continuous run-off of blood from the
pg. 1
,2
aorta into the pulmonary artery. A classic loud, continuous "machinery-like"
murmur is heard.
3. Which is NOT a component of Tetralogy of Fallot?
A. Pulmonary stenosis
B. Ventricular septal defect
C. Hypertrophic Left Ventricle
D. Overriding aorta
:Answer: C. Hypertrophic Left Ventricle.
Rationale: Tetralogy of Fallot consists of four defects: Pulmonary stenosis,
Ventricular septal defect (VSD), Overriding aorta, and Right ventricular
hypertrophy (not left ventricular hypertrophy).
4. A 3-month-old has Digoxin scheduled at 2000. The nurse assesses the infant
and notes an apical HR of 112, RR 42, BP 96/60. What should the nurse do next?
A. Administer the medication as ordered
B. Withhold the medication and notify the provider
C. Double check the digoxin dose with another nurse
D. Administer half the prescribed dose
:Answer: C. Double check the digoxin dose with another nurse.
*Rationale: Digoxin is a high-alert medication requiring an independent double-
check by two nurses before administration. The infant's HR of 112 is above the
hold parameter (usually <90–100 bpm for infants).*
5. An infant is admitted with a known congenital heart defect. The infant has
begun having increased PVCs. At home, this baby takes labetalol, furosemide,
iron, and a multivitamin. Which order would the nurse expect to receive?
A. Increase furosemide dose
B. Electrolyte lab levels
C. Discontinue labetalol
D. Start digoxin therapy
pg. 2
,3
:Answer: B. Electrolyte lab levels.
Rationale: The infant is on furosemide (potassium-wasting diuretic) and has
developed PVCs, which can be caused by electrolyte imbalances such as
hypokalemia. Checking electrolyte levels is the priority to identify and correct the
underlying cause.
6. The nurse is educating parents about their baby's upcoming echocardiogram.
Which statement by the parents indicates a need for further teaching?
A. "The test uses sound waves to look at the heart."
B. "My baby cannot have a bottle for 4 hours before the test."
C. "The procedure is not painful."
D. "We will be able to stay with our baby during the test."
:Answer: B. "My baby cannot have a bottle for 4 hours before the test."
Rationale: An echocardiogram does not require NPO status. The baby can eat
normally before the test. This is a non-invasive ultrasound that does not require
sedation or fasting in most cases.
7. For which congenital heart defect would the nurse expect low oxygen
saturations?
A. Ventricular Septal Defect
B. Patent Ductus Arteriosus
C. Transposition of the Great Vessels
D. Coarctation of the Aorta
:Answer: C. Transposition of the Great Vessels.
Rationale: Transposition of the great vessels is a cyanotic heart defect where the
aorta arises from the right ventricle and the pulmonary artery from the left
ventricle, creating two parallel circuits. Deoxygenated blood circulates
systemically, causing severe cyanosis and low oxygen saturations.
8. Which statement made by a 12-year-old about their upcoming cardiac
catheterization requires follow-up teaching?
pg. 3
, 4
A. "I will need to lie flat for several hours after the procedure."
B. "They will insert a thin tube through a blood vessel."
C. "I will need to stay home from school for at least 1 week after the procedure."
D. "I might feel a warm sensation when they inject the dye."
:Answer: C. "I will need to stay home from school for at least 1 week after the
procedure."
Rationale: Most children can return to normal activities, including school, within
24–48 hours after an uncomplicated cardiac catheterization. Prolonged school
absence is not typically required.
9. A child with Kawasaki disease is admitted to the unit. The nurse should
prepare to:
A. Give high-dose aspirin as ordered
B. Start IV antibiotics immediately
C. Place the child in contact isolation
D. Administer routine childhood vaccinations
:Answer: A. Give high-dose aspirin as ordered.
Rationale: Kawasaki disease is treated with high-dose aspirin (anti-inflammatory
doses) during the acute phase and IVIG (intravenous immunoglobulin). Aspirin is
typically contraindicated in children due to Reye's syndrome risk, but it is
specifically indicated for Kawasaki disease to reduce inflammation and prevent
coronary artery aneurysms.
10. The nurse is preparing a dose of aspirin for a 4-year-old with Kawasaki
disease. The parents are concerned because they were told never to give their
child aspirin. The best response from the nurse would be:
A. "This is a different kind of aspirin that is safe for children."
B. "Typically aspirin is not given to children, but with Kawasaki disease, aspirin
therapy is necessary to protect the heart."
C. "You can refuse the medication if you want."
D. "The dose is so small it won't cause any harm."
pg. 4
NSG 3600 Exam 2 | Exam 2 NSG 3600 Questions
and Answers 2025/2026 Update - Galen
Exam 2 Focus Areas: Pediatric Cardiac Disorders, Respiratory Disorders,
Gastrointestinal Conditions, Infectious Diseases, Growth & Development
Milestones, Pediatric Emergencies, and Medication Safety.
SECTION 1: CONGENITAL HEART DEFECTS & PEDIATRIC CARDIAC (Questions 1–
35)
1. The nurse is performing the cardiac screening on a newborn before discharge.
Which assessment finding would be suggestive of a Coarctation of the Aorta?
A. Higher BP in left arm than right arm
B. Higher BP in right arm than right leg
C. Lower BP in both arms compared to legs
D. Equal BP in all four extremities
:Answer: B. Higher BP in right arm than right leg.
Rationale: Coarctation of the aorta is a narrowing that impedes blood flow to the
lower extremities. This creates higher blood pressure in the upper extremities
(proximal to the narrowing) compared to the lower extremities.
2. The nurse is getting vital signs on a 36-hour-old infant and notes bounding
peripheral pulses and a BP of 96/25. The nurse suspects:
A. Tetralogy of Fallot
B. Patent Ductus Arteriosus
C. Ventricular Septal Defect
D. Coarctation of the Aorta
:Answer: B. Patent Ductus Arteriosus.
Rationale: PDA presents with a wide pulse pressure (difference between systolic
and diastolic) and bounding pulses due to the continuous run-off of blood from the
pg. 1
,2
aorta into the pulmonary artery. A classic loud, continuous "machinery-like"
murmur is heard.
3. Which is NOT a component of Tetralogy of Fallot?
A. Pulmonary stenosis
B. Ventricular septal defect
C. Hypertrophic Left Ventricle
D. Overriding aorta
:Answer: C. Hypertrophic Left Ventricle.
Rationale: Tetralogy of Fallot consists of four defects: Pulmonary stenosis,
Ventricular septal defect (VSD), Overriding aorta, and Right ventricular
hypertrophy (not left ventricular hypertrophy).
4. A 3-month-old has Digoxin scheduled at 2000. The nurse assesses the infant
and notes an apical HR of 112, RR 42, BP 96/60. What should the nurse do next?
A. Administer the medication as ordered
B. Withhold the medication and notify the provider
C. Double check the digoxin dose with another nurse
D. Administer half the prescribed dose
:Answer: C. Double check the digoxin dose with another nurse.
*Rationale: Digoxin is a high-alert medication requiring an independent double-
check by two nurses before administration. The infant's HR of 112 is above the
hold parameter (usually <90–100 bpm for infants).*
5. An infant is admitted with a known congenital heart defect. The infant has
begun having increased PVCs. At home, this baby takes labetalol, furosemide,
iron, and a multivitamin. Which order would the nurse expect to receive?
A. Increase furosemide dose
B. Electrolyte lab levels
C. Discontinue labetalol
D. Start digoxin therapy
pg. 2
,3
:Answer: B. Electrolyte lab levels.
Rationale: The infant is on furosemide (potassium-wasting diuretic) and has
developed PVCs, which can be caused by electrolyte imbalances such as
hypokalemia. Checking electrolyte levels is the priority to identify and correct the
underlying cause.
6. The nurse is educating parents about their baby's upcoming echocardiogram.
Which statement by the parents indicates a need for further teaching?
A. "The test uses sound waves to look at the heart."
B. "My baby cannot have a bottle for 4 hours before the test."
C. "The procedure is not painful."
D. "We will be able to stay with our baby during the test."
:Answer: B. "My baby cannot have a bottle for 4 hours before the test."
Rationale: An echocardiogram does not require NPO status. The baby can eat
normally before the test. This is a non-invasive ultrasound that does not require
sedation or fasting in most cases.
7. For which congenital heart defect would the nurse expect low oxygen
saturations?
A. Ventricular Septal Defect
B. Patent Ductus Arteriosus
C. Transposition of the Great Vessels
D. Coarctation of the Aorta
:Answer: C. Transposition of the Great Vessels.
Rationale: Transposition of the great vessels is a cyanotic heart defect where the
aorta arises from the right ventricle and the pulmonary artery from the left
ventricle, creating two parallel circuits. Deoxygenated blood circulates
systemically, causing severe cyanosis and low oxygen saturations.
8. Which statement made by a 12-year-old about their upcoming cardiac
catheterization requires follow-up teaching?
pg. 3
, 4
A. "I will need to lie flat for several hours after the procedure."
B. "They will insert a thin tube through a blood vessel."
C. "I will need to stay home from school for at least 1 week after the procedure."
D. "I might feel a warm sensation when they inject the dye."
:Answer: C. "I will need to stay home from school for at least 1 week after the
procedure."
Rationale: Most children can return to normal activities, including school, within
24–48 hours after an uncomplicated cardiac catheterization. Prolonged school
absence is not typically required.
9. A child with Kawasaki disease is admitted to the unit. The nurse should
prepare to:
A. Give high-dose aspirin as ordered
B. Start IV antibiotics immediately
C. Place the child in contact isolation
D. Administer routine childhood vaccinations
:Answer: A. Give high-dose aspirin as ordered.
Rationale: Kawasaki disease is treated with high-dose aspirin (anti-inflammatory
doses) during the acute phase and IVIG (intravenous immunoglobulin). Aspirin is
typically contraindicated in children due to Reye's syndrome risk, but it is
specifically indicated for Kawasaki disease to reduce inflammation and prevent
coronary artery aneurysms.
10. The nurse is preparing a dose of aspirin for a 4-year-old with Kawasaki
disease. The parents are concerned because they were told never to give their
child aspirin. The best response from the nurse would be:
A. "This is a different kind of aspirin that is safe for children."
B. "Typically aspirin is not given to children, but with Kawasaki disease, aspirin
therapy is necessary to protect the heart."
C. "You can refuse the medication if you want."
D. "The dose is so small it won't cause any harm."
pg. 4
