,NSG 3600 Exam 4 | Pediatric Nursing |
Galen College | 26/27|Guaranteed Pass
1. A nurse is evaluating a 4-year-old child with attention deficit hyperactivity disorder (ADHD). Which
characteristic is most consistent with this diagnosis?
A) The child exhibits repetitive motor movements and restricted interests
B) The child demonstrates inattention, impulsivity, and hyperactivity
C) The child has an intense, persistent fear of social situations
D) The child shows a consistent pattern of defiant and argumentative behavior
Correct Answer: The child demonstrates inattention, impulsivity, and hyperactivity
Rationale: ADHD is characterized by a persistent pattern of inattention, impulsivity, and hyperactivity
that interferes with functioning or development. Repetitive movements and restricted interests are
characteristic of autism spectrum disorder, intense social fear is characteristic of social anxiety
disorder, and defiant behavior is characteristic of oppositional defiant disorder.
2. A nurse is developing a care plan for a child with ADHD. The healthcare provider prescribes a
psychostimulant. Which medication class is most commonly used as first-line pharmacologic therapy
for this condition?
A) Selective serotonin reuptake inhibitors
B) Central nervous system stimulants
C) Atypical antipsychotics
D) Tricyclic antidepressants
Correct Answer: Central nervous system stimulants
Rationale: Psychostimulants such as methylphenidate, dextroamphetamine, and lisdexamfetamine
are the first-line pharmacologic therapy for ADHD. These medications are dose-titrated based on
symptom resolution, not the child's weight, and require regular monitoring for side effects including
growth parameters, blood pressure, and sleep quality.
,3. A nurse is assessing a child with newly diagnosed ADHD. Which diagnostic approach is essential for
confirming this condition?
A) A single blood test to measure neurotransmitter levels
B) A multidisciplinary evaluation including medical history, physical exam, and psychological testing
C) An electroencephalogram to detect abnormal brain wave patterns
D) A brief questionnaire completed only by the child's teacher
Correct Answer: A multidisciplinary evaluation including medical history, physical exam, and
psychological testing
Rationale: Diagnosis of ADHD requires a comprehensive multidisciplinary evaluation, including
medical and developmental histories, physical exam, vision and hearing assessment, detailed
neurologic evaluation, psychological testing, behavioral checklists, and adaptive scales. This approach
rules out other psychiatric disorders and medical problems.
4. A nurse is providing behavioral interventions for a child with ADHD. Which environmental
modification is most appropriate to help the child succeed?
A) Allowing the child to choose all daily activities independently
B) Establishing structured routines and minimizing distractions
C) Removing all rules to reduce frustration
D) Changing the daily schedule frequently to prevent boredom
Correct Answer: Establishing structured routines and minimizing distractions
Rationale: Environmental modifications for ADHD include establishing structured routines, minimizing
distractions, and teaching organizational skills. These strategies help the child focus and succeed.
Complete freedom and removing rules are not therapeutic, and frequent schedule changes can
increase anxiety and disorganization.
5. A nurse is caring for a 5-year-old child with sickle cell disease. The child is receiving morphine
sulfate for pain control and intravenous fluids. The nurse assesses O2 saturation of 92%, respiratory
rate of 13 breaths per minute, heart rate of 100 beats per minute, and the child is difficult to arouse.
Which action should the nurse take first?
, A) Apply supplemental oxygen via nasal cannula
B) Administer naloxone to reverse the effects of morphine
C) Increase the rate of intravenous fluids
D) Notify the healthcare provider for a STAT hemoglobin level
Correct Answer: Administer naloxone to reverse the effects of morphine
Rationale: The child's presentation—difficulty arousing with a respiratory rate of 13—is concerning for
opioid-induced respiratory depression from morphine. Naloxone is the priority antidote to reverse
morphine effects and prevent respiratory arrest. While oxygen is important, it does not address the
underlying cause of decreased consciousness.
6. After administering naloxone to a child with suspected morphine overdose, which action should the
nurse take next?
A) Discontinue all pain medications and document the event
B) Apply oxygen, monitor vital signs, and consider further assessment and treatments
C) Place the child in a prone position to improve ventilation
D) Administer a bolus of intravenous fluids and prepare for discharge
Correct Answer: Apply oxygen, monitor vital signs, and consider further assessment and treatments
Rationale: After administering naloxone, the nurse's next priority is to apply oxygen, monitor vital
signs, and consider further assessment and treatments. The prone position is inappropriate and could
compromise the airway. Discontinuing all pain medications is not appropriate without further
evaluation.
7. A nurse is providing discharge teaching to the parents of a child who had surgical resection of a
neuroblastoma 4 days ago. Which statement by the parents indicates that teaching has been
effective?
A) "We will keep our child isolated from all social contact for at least 2 weeks."
B) "We will begin slowly reintroducing our child into social interaction."
C) "We will allow our child to resume all normal activities immediately."
Galen College | 26/27|Guaranteed Pass
1. A nurse is evaluating a 4-year-old child with attention deficit hyperactivity disorder (ADHD). Which
characteristic is most consistent with this diagnosis?
A) The child exhibits repetitive motor movements and restricted interests
B) The child demonstrates inattention, impulsivity, and hyperactivity
C) The child has an intense, persistent fear of social situations
D) The child shows a consistent pattern of defiant and argumentative behavior
Correct Answer: The child demonstrates inattention, impulsivity, and hyperactivity
Rationale: ADHD is characterized by a persistent pattern of inattention, impulsivity, and hyperactivity
that interferes with functioning or development. Repetitive movements and restricted interests are
characteristic of autism spectrum disorder, intense social fear is characteristic of social anxiety
disorder, and defiant behavior is characteristic of oppositional defiant disorder.
2. A nurse is developing a care plan for a child with ADHD. The healthcare provider prescribes a
psychostimulant. Which medication class is most commonly used as first-line pharmacologic therapy
for this condition?
A) Selective serotonin reuptake inhibitors
B) Central nervous system stimulants
C) Atypical antipsychotics
D) Tricyclic antidepressants
Correct Answer: Central nervous system stimulants
Rationale: Psychostimulants such as methylphenidate, dextroamphetamine, and lisdexamfetamine
are the first-line pharmacologic therapy for ADHD. These medications are dose-titrated based on
symptom resolution, not the child's weight, and require regular monitoring for side effects including
growth parameters, blood pressure, and sleep quality.
,3. A nurse is assessing a child with newly diagnosed ADHD. Which diagnostic approach is essential for
confirming this condition?
A) A single blood test to measure neurotransmitter levels
B) A multidisciplinary evaluation including medical history, physical exam, and psychological testing
C) An electroencephalogram to detect abnormal brain wave patterns
D) A brief questionnaire completed only by the child's teacher
Correct Answer: A multidisciplinary evaluation including medical history, physical exam, and
psychological testing
Rationale: Diagnosis of ADHD requires a comprehensive multidisciplinary evaluation, including
medical and developmental histories, physical exam, vision and hearing assessment, detailed
neurologic evaluation, psychological testing, behavioral checklists, and adaptive scales. This approach
rules out other psychiatric disorders and medical problems.
4. A nurse is providing behavioral interventions for a child with ADHD. Which environmental
modification is most appropriate to help the child succeed?
A) Allowing the child to choose all daily activities independently
B) Establishing structured routines and minimizing distractions
C) Removing all rules to reduce frustration
D) Changing the daily schedule frequently to prevent boredom
Correct Answer: Establishing structured routines and minimizing distractions
Rationale: Environmental modifications for ADHD include establishing structured routines, minimizing
distractions, and teaching organizational skills. These strategies help the child focus and succeed.
Complete freedom and removing rules are not therapeutic, and frequent schedule changes can
increase anxiety and disorganization.
5. A nurse is caring for a 5-year-old child with sickle cell disease. The child is receiving morphine
sulfate for pain control and intravenous fluids. The nurse assesses O2 saturation of 92%, respiratory
rate of 13 breaths per minute, heart rate of 100 beats per minute, and the child is difficult to arouse.
Which action should the nurse take first?
, A) Apply supplemental oxygen via nasal cannula
B) Administer naloxone to reverse the effects of morphine
C) Increase the rate of intravenous fluids
D) Notify the healthcare provider for a STAT hemoglobin level
Correct Answer: Administer naloxone to reverse the effects of morphine
Rationale: The child's presentation—difficulty arousing with a respiratory rate of 13—is concerning for
opioid-induced respiratory depression from morphine. Naloxone is the priority antidote to reverse
morphine effects and prevent respiratory arrest. While oxygen is important, it does not address the
underlying cause of decreased consciousness.
6. After administering naloxone to a child with suspected morphine overdose, which action should the
nurse take next?
A) Discontinue all pain medications and document the event
B) Apply oxygen, monitor vital signs, and consider further assessment and treatments
C) Place the child in a prone position to improve ventilation
D) Administer a bolus of intravenous fluids and prepare for discharge
Correct Answer: Apply oxygen, monitor vital signs, and consider further assessment and treatments
Rationale: After administering naloxone, the nurse's next priority is to apply oxygen, monitor vital
signs, and consider further assessment and treatments. The prone position is inappropriate and could
compromise the airway. Discontinuing all pain medications is not appropriate without further
evaluation.
7. A nurse is providing discharge teaching to the parents of a child who had surgical resection of a
neuroblastoma 4 days ago. Which statement by the parents indicates that teaching has been
effective?
A) "We will keep our child isolated from all social contact for at least 2 weeks."
B) "We will begin slowly reintroducing our child into social interaction."
C) "We will allow our child to resume all normal activities immediately."
