NSG 3600 Exam 4: Nursing Practice in Children's Health |
2026/2027 Edition | 200 Verified Questions - 180 Questions
with Answers
NSG 3600 Exam 4 Pediatrics 2026-180 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document for NSG 3600 Exam 4 focuses on nursing practice in
children's health, covering growth and development, pediatric assessment, and common acute and
chronic conditions. It includes 200 verified practice questions with correct answers and rationales,
designed to reinforce critical thinking and clinical application. The content is aligned with the latest
pediatric nursing guidelines and evidence-based practices, ensuring students are well-prepared for the
exam and clinical practice. Ideal for nursing students seeking to excel in pediatric nursing.
Key Features:
Growth and Development: Infancy through Adolescence
Pediatric Health Assessment and Vital Signs
Family-Centered Care and Communication
Pediatric Nutrition and Feeding
Immunizations and Health Maintenance
Fluid and Electrolyte Balance in Children
Respiratory Disorders: Asthma, Bronchiolitis, Croup
Cardiovascular Disorders: Congenital Heart Defects, Heart Failure
Neurological Disorders: Seizures, Meningitis, Head Injury
Gastrointestinal Disorders: Gastroenteritis, Appendicitis, Intussusception
Genitourinary Disorders: UTI, Nephrotic Syndrome, Enuresis
Musculoskeletal Disorders: Fractures, Osteomyelitis, Scoliosis
Hematologic Disorders: Sickle Cell Anemia, Hemophilia, Iron Deficiency Anemia
Endocrine Disorders: Diabetes, Growth Hormone Deficiency
Infectious Diseases and Isolation Precautions
Pediatric Emergencies and Poisoning
Child Abuse and Neglect: Recognition and Reporting
Chronic Illness and End-of-Life Care
Updates for 2026:
- Updated to reflect the latest AAP and CDC guidelines for pediatric immunizations and well-child visits.
- Revised to include current evidence-based practices for pediatric asthma management and diabetes care.
- Incorporated new questions on mental health issues in adolescents, including anxiety and depression.
- Enhanced rationales to align with the latest NCLEX-RN test plan and clinical judgment model.
- Added updated content on COVID-19 and its impact on pediatric health and nursing care.
Abstract:
This exam preparation resource for NSG 3600 Exam 4 provides a thorough review of pediatric nursing practice,
emphasizing the unique physiological and psychological needs of children from infancy through adolescence. The
200 practice questions are meticulously crafted to test knowledge across the lifespan, with a focus on growth and
development milestones, family dynamics, and common pediatric disorders. Each question includes a detailed
rationale explaining the correct answer and why distractors are incorrect, promoting deeper understanding and
Page 1
,clinical reasoning. The content is organized by body systems and nursing domains, allowing for systematic study
and self-assessment. Updated for the 2026-2027 academic year, this document integrates the latest evidence-based
guidelines and reflects current pediatric nursing standards. It is an essential tool for nursing students aiming to
achieve a high score on the exam and to deliver competent, compassionate care to pediatric patients.
Keywords:
Pediatric nursing, NSG 3600, Children's health, Exam prep, 200 questions, Growth and development, Nursing
interventions, NCLEX-style
Answer Format:
Each question is presented in NCLEX-style format with four answer options. The correct answer is provided,
followed by a comprehensive rationale explaining the underlying pathophysiology, nursing considerations, and
evidence-based rationale. Distractor explanations are also included to clarify common misconceptions and enhance
learning.
Compliance Checklist:
Aligned with the latest NCLEX-RN test plan and pediatric nursing competencies
References current AAP, CDC, and WHO guidelines
Includes 200 verified questions with correct answers and rationales
Covers all major content areas of NSG 3600 Exam 4
Suitable for self-assessment and exam preparation
Content Area Overview:
Content Area Questions Key Topics Weight
Growth and Development 1-20 Milestones, Piaget, Erikson, play, dental 10%
health
Pediatric Assessment 21-40 Vital signs, physical exam, health history, 10%
pain assessment
Family-Centered Care 41-50 Communication, family dynamics, cultural 5%
considerations
Nutrition and Fluids 51-70 Breastfeeding, formula, nutritional 10%
deficiencies, dehydration
Respiratory Disorders 71-90 Asthma, bronchiolitis, croup, epiglottitis, 10%
foreign body aspiration
Cardiovascular Disorders 91-110 Congenital heart defects, heart failure, 10%
rheumatic fever
Neurological Disorders 111-130 Seizures, meningitis, head injury, increased 10%
ICP
Gastrointestinal Disorders 131-150 Gastroenteritis, appendicitis, 10%
intussusception, cleft lip/palate
Genitourinary Disorders 151-165 UTI, nephrotic syndrome, 7.5%
glomerulonephritis, enuresis
Musculoskeletal Disorders 166-175 Fractures, osteomyelitis, scoliosis, muscular 5%
dystrophy
Hematologic and Endocrine 176-190 Sickle cell anemia, hemophilia, IDA, 7.5%
Disorders diabetes, growth disorders
Infectious Diseases and 191-200 Immunizations, isolation, poisoning, child 5%
Emergencies abuse, emergency care
Page 2
,Q1. In a child with severe dehydration due to gastroenteritis, the nurse is initiating
oral rehydration therapy (ORT). Which finding indicates the need to switch to
intravenous (IV) fluid therapy?
A. The child's heart rate is 120 beats per minute and respiratory rate is 30 breaths per
minute.
B. The child is unable to tolerate oral fluids due to persistent vomiting.
C. The child's urine output is 1 mL/kg/hr over the past 4 hours.
D. The child's capillary refill time is 3 seconds.
Correct Answer: B. The child is unable to tolerate oral fluids due to persistent
vomiting.
Rationale: Persistent vomiting that prevents retention of oral fluids is a clear indication
for IV therapy because ORT cannot be effective if the child cannot keep fluids down.
Tachycardia and tachypnea may be signs of moderate dehydration but are not absolute
contraindications to ORT. Urine output of 1 mL/kg/hr is low but not an immediate
indication for IV if ORT can be given. Capillary refill of 3 seconds is consistent with
moderate dehydration and may improve with ORT.
Why Wrong:
A - Tachycardia and tachypnea are common in dehydration but do not necessarily
preclude the use of ORT.
C - Low urine output is concerning but can be addressed with successful ORT; it is
not an immediate indication for IV therapy.
D - Capillary refill of 3 seconds indicates moderate dehydration but is not an absolute
criterion for IV therapy if ORT is tolerated.
Reference: Hockenberry, M.J., & Wilson, D. (2023). Wong's Nursing Care of Infants and
Children, 11th ed., Ch. 28.
Q2. A pediatric client is receiving IV fluids at a rate of 80 mL/hr. The nurse notes that
the client's urine output has been 0.8 mL/kg/hr over the past 6 hours. Which action is
most appropriate?
A. Continue the current IV rate and reassess in 4 hours.
B. Notify the provider and prepare to administer a fluid bolus.
C. Decrease the IV rate to 60 mL/hr to prevent fluid overload.
D. Obtain a urine specific gravity to further assess hydration status.
Correct Answer: B. Notify the provider and prepare to administer a fluid bolus.
Rationale: A urine output of 0.8 mL/kg/hr is below the normal threshold of 1-2 mL/kg/hr
and indicates inadequate renal perfusion, which may signal worsening dehydration or
hypovolemia. The nurse should notify the provider and anticipate a fluid bolus to restore
circulating volume. Continuing at the same rate may lead to further deterioration.
Decreasing the rate would worsen the problem. Urine specific gravity is a useful adjunct
but the priority is to improve perfusion.
Page 3
, Why Wrong:
A - Continuing at the same rate does not address the inadequate urine output and may
delay necessary intervention.
C - Decreasing the IV rate would further compromise perfusion and worsen the low
urine output.
D - While urine specific gravity is a valid assessment, it does not take precedence over
immediate intervention for low urine output.
Reference: Hockenberry, M.J., & Wilson, D. (2023). Wong's Nursing Care of Infants and
Children, 11th ed., Ch. 28.
Q3. Which assessment finding is most indicative of increased intracranial pressure
(ICP) in a child with a head injury?
A. Sunset eyes (setting sun sign)
B. Bulging anterior fontanel
C. Bradycardia and widened pulse pressure
D. Irritability and high-pitched cry
Correct Answer: C. Bradycardia and widened pulse pressure
Rationale: Cushing's triad (bradycardia, hypertension with widened pulse pressure, and
irregular respirations) is a late and ominous sign of increased ICP that indicates
brainstem compression. Sunset eyes and bulging fontanel are signs of increased ICP in
infants, but they are not as specific for a child with a head injury. Irritability and
high-pitched cry are early signs but not as definitive as Cushing's triad.
Why Wrong:
A - Sunset eyes are a sign of increased ICP in infants but are not the most indicative
finding in a child with head injury.
B - Bulging anterior fontanel is an infant sign and may not be present in older
children.
D - Irritability and high-pitched cry are early signs but less specific than Cushing's
triad.
Reference: Hockenberry, M.J., & Wilson, D. (2023). Wong's Nursing Care of Infants and
Children, 11th ed., Ch. 30.
Q4. A child with asthma is prescribed montelukast. Which instruction should the
nurse include in the teaching plan?
A. Take the medication at the first sign of wheezing.
B. Administer the medication in the evening for optimal effect.
C. Chew the tablet thoroughly before swallowing.
D. Use this medication to relieve acute bronchospasm.
Correct Answer: B. Administer the medication in the evening for optimal effect.
Page 4
2026/2027 Edition | 200 Verified Questions - 180 Questions
with Answers
NSG 3600 Exam 4 Pediatrics 2026-180 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document for NSG 3600 Exam 4 focuses on nursing practice in
children's health, covering growth and development, pediatric assessment, and common acute and
chronic conditions. It includes 200 verified practice questions with correct answers and rationales,
designed to reinforce critical thinking and clinical application. The content is aligned with the latest
pediatric nursing guidelines and evidence-based practices, ensuring students are well-prepared for the
exam and clinical practice. Ideal for nursing students seeking to excel in pediatric nursing.
Key Features:
Growth and Development: Infancy through Adolescence
Pediatric Health Assessment and Vital Signs
Family-Centered Care and Communication
Pediatric Nutrition and Feeding
Immunizations and Health Maintenance
Fluid and Electrolyte Balance in Children
Respiratory Disorders: Asthma, Bronchiolitis, Croup
Cardiovascular Disorders: Congenital Heart Defects, Heart Failure
Neurological Disorders: Seizures, Meningitis, Head Injury
Gastrointestinal Disorders: Gastroenteritis, Appendicitis, Intussusception
Genitourinary Disorders: UTI, Nephrotic Syndrome, Enuresis
Musculoskeletal Disorders: Fractures, Osteomyelitis, Scoliosis
Hematologic Disorders: Sickle Cell Anemia, Hemophilia, Iron Deficiency Anemia
Endocrine Disorders: Diabetes, Growth Hormone Deficiency
Infectious Diseases and Isolation Precautions
Pediatric Emergencies and Poisoning
Child Abuse and Neglect: Recognition and Reporting
Chronic Illness and End-of-Life Care
Updates for 2026:
- Updated to reflect the latest AAP and CDC guidelines for pediatric immunizations and well-child visits.
- Revised to include current evidence-based practices for pediatric asthma management and diabetes care.
- Incorporated new questions on mental health issues in adolescents, including anxiety and depression.
- Enhanced rationales to align with the latest NCLEX-RN test plan and clinical judgment model.
- Added updated content on COVID-19 and its impact on pediatric health and nursing care.
Abstract:
This exam preparation resource for NSG 3600 Exam 4 provides a thorough review of pediatric nursing practice,
emphasizing the unique physiological and psychological needs of children from infancy through adolescence. The
200 practice questions are meticulously crafted to test knowledge across the lifespan, with a focus on growth and
development milestones, family dynamics, and common pediatric disorders. Each question includes a detailed
rationale explaining the correct answer and why distractors are incorrect, promoting deeper understanding and
Page 1
,clinical reasoning. The content is organized by body systems and nursing domains, allowing for systematic study
and self-assessment. Updated for the 2026-2027 academic year, this document integrates the latest evidence-based
guidelines and reflects current pediatric nursing standards. It is an essential tool for nursing students aiming to
achieve a high score on the exam and to deliver competent, compassionate care to pediatric patients.
Keywords:
Pediatric nursing, NSG 3600, Children's health, Exam prep, 200 questions, Growth and development, Nursing
interventions, NCLEX-style
Answer Format:
Each question is presented in NCLEX-style format with four answer options. The correct answer is provided,
followed by a comprehensive rationale explaining the underlying pathophysiology, nursing considerations, and
evidence-based rationale. Distractor explanations are also included to clarify common misconceptions and enhance
learning.
Compliance Checklist:
Aligned with the latest NCLEX-RN test plan and pediatric nursing competencies
References current AAP, CDC, and WHO guidelines
Includes 200 verified questions with correct answers and rationales
Covers all major content areas of NSG 3600 Exam 4
Suitable for self-assessment and exam preparation
Content Area Overview:
Content Area Questions Key Topics Weight
Growth and Development 1-20 Milestones, Piaget, Erikson, play, dental 10%
health
Pediatric Assessment 21-40 Vital signs, physical exam, health history, 10%
pain assessment
Family-Centered Care 41-50 Communication, family dynamics, cultural 5%
considerations
Nutrition and Fluids 51-70 Breastfeeding, formula, nutritional 10%
deficiencies, dehydration
Respiratory Disorders 71-90 Asthma, bronchiolitis, croup, epiglottitis, 10%
foreign body aspiration
Cardiovascular Disorders 91-110 Congenital heart defects, heart failure, 10%
rheumatic fever
Neurological Disorders 111-130 Seizures, meningitis, head injury, increased 10%
ICP
Gastrointestinal Disorders 131-150 Gastroenteritis, appendicitis, 10%
intussusception, cleft lip/palate
Genitourinary Disorders 151-165 UTI, nephrotic syndrome, 7.5%
glomerulonephritis, enuresis
Musculoskeletal Disorders 166-175 Fractures, osteomyelitis, scoliosis, muscular 5%
dystrophy
Hematologic and Endocrine 176-190 Sickle cell anemia, hemophilia, IDA, 7.5%
Disorders diabetes, growth disorders
Infectious Diseases and 191-200 Immunizations, isolation, poisoning, child 5%
Emergencies abuse, emergency care
Page 2
,Q1. In a child with severe dehydration due to gastroenteritis, the nurse is initiating
oral rehydration therapy (ORT). Which finding indicates the need to switch to
intravenous (IV) fluid therapy?
A. The child's heart rate is 120 beats per minute and respiratory rate is 30 breaths per
minute.
B. The child is unable to tolerate oral fluids due to persistent vomiting.
C. The child's urine output is 1 mL/kg/hr over the past 4 hours.
D. The child's capillary refill time is 3 seconds.
Correct Answer: B. The child is unable to tolerate oral fluids due to persistent
vomiting.
Rationale: Persistent vomiting that prevents retention of oral fluids is a clear indication
for IV therapy because ORT cannot be effective if the child cannot keep fluids down.
Tachycardia and tachypnea may be signs of moderate dehydration but are not absolute
contraindications to ORT. Urine output of 1 mL/kg/hr is low but not an immediate
indication for IV if ORT can be given. Capillary refill of 3 seconds is consistent with
moderate dehydration and may improve with ORT.
Why Wrong:
A - Tachycardia and tachypnea are common in dehydration but do not necessarily
preclude the use of ORT.
C - Low urine output is concerning but can be addressed with successful ORT; it is
not an immediate indication for IV therapy.
D - Capillary refill of 3 seconds indicates moderate dehydration but is not an absolute
criterion for IV therapy if ORT is tolerated.
Reference: Hockenberry, M.J., & Wilson, D. (2023). Wong's Nursing Care of Infants and
Children, 11th ed., Ch. 28.
Q2. A pediatric client is receiving IV fluids at a rate of 80 mL/hr. The nurse notes that
the client's urine output has been 0.8 mL/kg/hr over the past 6 hours. Which action is
most appropriate?
A. Continue the current IV rate and reassess in 4 hours.
B. Notify the provider and prepare to administer a fluid bolus.
C. Decrease the IV rate to 60 mL/hr to prevent fluid overload.
D. Obtain a urine specific gravity to further assess hydration status.
Correct Answer: B. Notify the provider and prepare to administer a fluid bolus.
Rationale: A urine output of 0.8 mL/kg/hr is below the normal threshold of 1-2 mL/kg/hr
and indicates inadequate renal perfusion, which may signal worsening dehydration or
hypovolemia. The nurse should notify the provider and anticipate a fluid bolus to restore
circulating volume. Continuing at the same rate may lead to further deterioration.
Decreasing the rate would worsen the problem. Urine specific gravity is a useful adjunct
but the priority is to improve perfusion.
Page 3
, Why Wrong:
A - Continuing at the same rate does not address the inadequate urine output and may
delay necessary intervention.
C - Decreasing the IV rate would further compromise perfusion and worsen the low
urine output.
D - While urine specific gravity is a valid assessment, it does not take precedence over
immediate intervention for low urine output.
Reference: Hockenberry, M.J., & Wilson, D. (2023). Wong's Nursing Care of Infants and
Children, 11th ed., Ch. 28.
Q3. Which assessment finding is most indicative of increased intracranial pressure
(ICP) in a child with a head injury?
A. Sunset eyes (setting sun sign)
B. Bulging anterior fontanel
C. Bradycardia and widened pulse pressure
D. Irritability and high-pitched cry
Correct Answer: C. Bradycardia and widened pulse pressure
Rationale: Cushing's triad (bradycardia, hypertension with widened pulse pressure, and
irregular respirations) is a late and ominous sign of increased ICP that indicates
brainstem compression. Sunset eyes and bulging fontanel are signs of increased ICP in
infants, but they are not as specific for a child with a head injury. Irritability and
high-pitched cry are early signs but not as definitive as Cushing's triad.
Why Wrong:
A - Sunset eyes are a sign of increased ICP in infants but are not the most indicative
finding in a child with head injury.
B - Bulging anterior fontanel is an infant sign and may not be present in older
children.
D - Irritability and high-pitched cry are early signs but less specific than Cushing's
triad.
Reference: Hockenberry, M.J., & Wilson, D. (2023). Wong's Nursing Care of Infants and
Children, 11th ed., Ch. 30.
Q4. A child with asthma is prescribed montelukast. Which instruction should the
nurse include in the teaching plan?
A. Take the medication at the first sign of wheezing.
B. Administer the medication in the evening for optimal effect.
C. Chew the tablet thoroughly before swallowing.
D. Use this medication to relieve acute bronchospasm.
Correct Answer: B. Administer the medication in the evening for optimal effect.
Page 4
