,NSG 3600 Exam 4 | Children's Health (2026/2027)
PDF | Nursing | Galen
1. A nurse is caring for a 5-year-old with sickle cell disease who is difficult to
arouse after receiving morphine. Oxygen saturation is 92%, respiratory rate 13,
heart rate 100. What is the priority action?
A) Administer naloxone to reverse opioid effects
B) Apply oxygen and monitor vital signs
C) Increase the intravenous fluid rate
D) Notify the provider and request hemoglobin
Correct Answer: A) Administer naloxone to reverse opioid effects
Rationale: The child’s decreased arousal and low respiratory rate suggest
opioid-induced respiratory depression. Naloxone is the priority antidote to
reverse morphine and prevent respiratory arrest. Oxygen alone does not
reverse the opioid effect. Increasing fluids and notifying the provider are
secondary.
2. A parent of a child with cystic fibrosis asks about pancreatic enzyme
replacement. Which instruction should the nurse include?
A) Give enzymes 1 hour after meals
B) Give enzymes with every meal and snack
C) Skip enzymes for small snacks
D) Crush capsules and mix with warm milk
Correct Answer: B) Give enzymes with every meal and snack
,Rationale: Pancreatic enzymes are needed to digest fats and proteins and must
be given with all food intake to be effective. Skipping doses or giving after meals
reduces effectiveness. Crushing or mixing with warm milk may alter the
medication.
3. A 2-year-old is admitted with suspected epiglottitis. Which nursing action is
the priority?
A) Obtain a throat culture
B) Inspect the oropharynx
C) Prepare for immediate endotracheal intubation
D) Start an IV line for antibiotics
Correct Answer: C) Prepare for immediate endotracheal intubation
Rationale: Epiglottitis is a medical emergency with rapid airway obstruction.
Airway management is the priority. Throat inspection or cultures can trigger
laryngospasm and are contraindicated. IV antibiotics are important but after
airway stabilization.
4. An infant with Tetralogy of Fallot has a hypercyanotic spell. Which action
should the nurse take first?
A) Administer 100% oxygen
B) Begin CPR
C) Prepare IV morphine
D) Place the infant in knee-chest position
, Correct Answer: D) Place the infant in knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance,
reducing right-to-left shunt and improving oxygenation during a Tet spell.
Oxygen and morphine may be used but the knee-chest position is the
immediate priority.
5. Which clinical manifestation is characteristic of pyloric stenosis in a 4-week-
old infant?
A) Projectile vomiting followed by hunger
B) Bile-stained emesis
C) Currant jelly-like stools
D) Abdominal distension and failure to pass meconium
Correct Answer: A) Projectile vomiting followed by hunger
Rationale: Pyloric stenosis causes non-bilious projectile vomiting due to pyloric
narrowing. The infant remains hungry after vomiting. Currant jelly stools are
intussusception, bile-stained emesis is obstruction, and failure to pass
meconium is Hirschsprung disease.
6. A nurse is teaching parents of a child with type 1 diabetes about
hypoglycemia. Which sign should be included?
A) Increased thirst and urination
B) Sweating, shakiness, and irritability
C) Abdominal pain and nausea
D) Fruity breath odor
PDF | Nursing | Galen
1. A nurse is caring for a 5-year-old with sickle cell disease who is difficult to
arouse after receiving morphine. Oxygen saturation is 92%, respiratory rate 13,
heart rate 100. What is the priority action?
A) Administer naloxone to reverse opioid effects
B) Apply oxygen and monitor vital signs
C) Increase the intravenous fluid rate
D) Notify the provider and request hemoglobin
Correct Answer: A) Administer naloxone to reverse opioid effects
Rationale: The child’s decreased arousal and low respiratory rate suggest
opioid-induced respiratory depression. Naloxone is the priority antidote to
reverse morphine and prevent respiratory arrest. Oxygen alone does not
reverse the opioid effect. Increasing fluids and notifying the provider are
secondary.
2. A parent of a child with cystic fibrosis asks about pancreatic enzyme
replacement. Which instruction should the nurse include?
A) Give enzymes 1 hour after meals
B) Give enzymes with every meal and snack
C) Skip enzymes for small snacks
D) Crush capsules and mix with warm milk
Correct Answer: B) Give enzymes with every meal and snack
,Rationale: Pancreatic enzymes are needed to digest fats and proteins and must
be given with all food intake to be effective. Skipping doses or giving after meals
reduces effectiveness. Crushing or mixing with warm milk may alter the
medication.
3. A 2-year-old is admitted with suspected epiglottitis. Which nursing action is
the priority?
A) Obtain a throat culture
B) Inspect the oropharynx
C) Prepare for immediate endotracheal intubation
D) Start an IV line for antibiotics
Correct Answer: C) Prepare for immediate endotracheal intubation
Rationale: Epiglottitis is a medical emergency with rapid airway obstruction.
Airway management is the priority. Throat inspection or cultures can trigger
laryngospasm and are contraindicated. IV antibiotics are important but after
airway stabilization.
4. An infant with Tetralogy of Fallot has a hypercyanotic spell. Which action
should the nurse take first?
A) Administer 100% oxygen
B) Begin CPR
C) Prepare IV morphine
D) Place the infant in knee-chest position
, Correct Answer: D) Place the infant in knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance,
reducing right-to-left shunt and improving oxygenation during a Tet spell.
Oxygen and morphine may be used but the knee-chest position is the
immediate priority.
5. Which clinical manifestation is characteristic of pyloric stenosis in a 4-week-
old infant?
A) Projectile vomiting followed by hunger
B) Bile-stained emesis
C) Currant jelly-like stools
D) Abdominal distension and failure to pass meconium
Correct Answer: A) Projectile vomiting followed by hunger
Rationale: Pyloric stenosis causes non-bilious projectile vomiting due to pyloric
narrowing. The infant remains hungry after vomiting. Currant jelly stools are
intussusception, bile-stained emesis is obstruction, and failure to pass
meconium is Hirschsprung disease.
6. A nurse is teaching parents of a child with type 1 diabetes about
hypoglycemia. Which sign should be included?
A) Increased thirst and urination
B) Sweating, shakiness, and irritability
C) Abdominal pain and nausea
D) Fruity breath odor
