NSG 3600 Exam 4 Actual Exam V2 | NSG 3600 Nursing Practice –
Children’s Health (NSG3600 Exam 4)
1. A 10-year-old with asthma presents to the emergency department with wheezing and
intercostal retractions. Which medication should the nurse prioritize for administration?
A. Salmeterol (long-acting bronchodilator)
B. Montelukast (leukotriene modifier)
C. Fluticasone (inhaled corticosteroid)
D. Albuterol (short-acting bronchodilator)
Answer: D
Rationale: In an acute asthma exacerbation, the priority is to provide rapid relief of
bronchospasm using a short-acting beta-2 agonist like Albuterol. Long-acting
bronchodilators and inhaled corticosteroids are for maintenance therapy and do not
provide immediate relief. Effective nursing care involves assessing respiratory status
immediately after administration to evaluate treatment efficacy.
2. A nurse is teaching the parents of a child with Type 1 Diabetes about management during
exercise. Which instruction is most accurate?
A. Consume a complex carbohydrate snack before exercise.
B. Avoid exercise if the blood glucose is above 150 mg/dL.
C. Administer extra insulin before playing sports.
D. Restrict fluid intake during physical activity.
Answer: A
Rationale: Exercise increases glucose uptake by the muscles and can lead to hypoglycemia
in children with Type 1 Diabetes. Providing a carbohydrate snack before activity helps
maintain stable blood glucose levels. Parents should also monitor for delayed
hypoglycemia that can occur several hours after exercise ends.
3. The nurse is caring for a 4-year-old child diagnosed with Cystic Fibrosis (CF). Which
intervention is essential for managing the child’s nutritional needs?
A. Provide a low-fat, low-protein diet.
B. Administer pancreatic enzymes with every meal and snack.
C. Limit fluid intake to prevent pulmonary congestion.
D. Administer enzymes once daily in the morning.
,Answer: B
Rationale: Pancreatic insufficiency in CF leads to malabsorption of fats and proteins,
requiring enzyme replacement therapy with all food intake. These enzymes facilitate the
digestion and absorption of nutrients necessary for growth. Without these enzymes, the
child may experience steatorrhea and failure to thrive.
4. A 2-year-old child is hospitalized for a minor procedure. According to Erikson’s stages,
which nursing action best supports the child’s developmental needs?
A. Provide detailed explanations of the procedure’s pathophysiology.
B. Encourage the child to perform tasks independently when possible.
C. Restrict parental visits to promote self-reliance.
D. Focus exclusively on physical comfort and feeding.
Answer: B
Rationale: Toddlers are in the ‘Autonomy vs. Shame and Doubt’ stage where they strive for
independence and control. Nursing care should provide choices and encourage self-care
activities to foster a sense of autonomy. Restricting parents would be detrimental as it
would cause separation anxiety, a major stressor at this age.
5. A child is admitted for observation following a generalized tonic-clonic seizure. Which
safety precaution is the nurse’s highest priority?
A. Keep a padded tongue blade at the bedside.
B. Ensure suction equipment and oxygen are available at the bedside.
C. Maintain the child in a supine position during a seizure.
D. Restrict the child to bed rest with all four side rails up.
Answer: B
Rationale: Airway management and safety are the primary concerns for patients with
seizure disorders. Having suction and oxygen ready allows for immediate intervention if
the airway is compromised. Padded tongue blades should never be used as they can cause
oral trauma or airway obstruction.
6. A 6-year-old child is 4 hours post-tonsillectomy. Which assessment finding requires
immediate notification of the surgeon?
A. Refusal to drink citrus juices.
B. Presence of dried dark brown blood on the tongue.
C. A report of a sore throat rated 4/10.
D. Frequent swallowing and clearing of the throat.
, Answer: D
Rationale: Frequent swallowing is a classic sign of active bleeding from the surgical site in
post-tonsillectomy patients. Early detection of hemorrhage is critical as it can lead to
hypovolemia and airway compromise. Dark brown blood is usually ‘old’ and expected,
whereas active bright red bleeding is a crisis.
7. The nurse is assessing a 12-month-old infant for dehydration. Which finding is the most
reliable indicator of moderate dehydration?
A. Sunken fontanels and decreased urine output.
B. Moist mucous membranes.
C. Brisk capillary refill of 1-2 seconds.
D. Increased tearing when the infant cries.
Answer: A
Rationale: Sunken fontanels, dry mucous membranes, and decreased urinary output are
key signs of moderate dehydration in infants. In pediatric patients, monitoring the number
of wet diapers is a practical way for parents and nurses to gauge hydration status. Tearing
and brisk capillary refill are indicators of adequate hydration.
8. An infant with Tetralogy of Fallot becomes cyanotic and agitated during a blood draw.
What is the nurse’s first action?
A. Place the infant in the knee-chest position.
B. Call the rapid response team.
C. Administer a dose of Digoxin.
D. Initiate bag-valve-mask ventilation.
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which reduces
the right-to-left shunt in Tetralogy of Fallot ‘Tet’ spells. This position helps improve
oxygenation by forcing more blood into the lungs. Nursing interventions during a Tet spell
also include providing a calm environment and administering oxygen if necessary.
9. A 12-year-old child is hospitalized with a Sickle Cell Vaso-occlusive crisis. What is the
priority nursing intervention?
A. Encourage a low-fluid diet to prevent edema.
B. Administer intravenous fluids and oxygen.
C. Apply cold compresses to painful joints.
D. Administer Meperidine for pain management.
Children’s Health (NSG3600 Exam 4)
1. A 10-year-old with asthma presents to the emergency department with wheezing and
intercostal retractions. Which medication should the nurse prioritize for administration?
A. Salmeterol (long-acting bronchodilator)
B. Montelukast (leukotriene modifier)
C. Fluticasone (inhaled corticosteroid)
D. Albuterol (short-acting bronchodilator)
Answer: D
Rationale: In an acute asthma exacerbation, the priority is to provide rapid relief of
bronchospasm using a short-acting beta-2 agonist like Albuterol. Long-acting
bronchodilators and inhaled corticosteroids are for maintenance therapy and do not
provide immediate relief. Effective nursing care involves assessing respiratory status
immediately after administration to evaluate treatment efficacy.
2. A nurse is teaching the parents of a child with Type 1 Diabetes about management during
exercise. Which instruction is most accurate?
A. Consume a complex carbohydrate snack before exercise.
B. Avoid exercise if the blood glucose is above 150 mg/dL.
C. Administer extra insulin before playing sports.
D. Restrict fluid intake during physical activity.
Answer: A
Rationale: Exercise increases glucose uptake by the muscles and can lead to hypoglycemia
in children with Type 1 Diabetes. Providing a carbohydrate snack before activity helps
maintain stable blood glucose levels. Parents should also monitor for delayed
hypoglycemia that can occur several hours after exercise ends.
3. The nurse is caring for a 4-year-old child diagnosed with Cystic Fibrosis (CF). Which
intervention is essential for managing the child’s nutritional needs?
A. Provide a low-fat, low-protein diet.
B. Administer pancreatic enzymes with every meal and snack.
C. Limit fluid intake to prevent pulmonary congestion.
D. Administer enzymes once daily in the morning.
,Answer: B
Rationale: Pancreatic insufficiency in CF leads to malabsorption of fats and proteins,
requiring enzyme replacement therapy with all food intake. These enzymes facilitate the
digestion and absorption of nutrients necessary for growth. Without these enzymes, the
child may experience steatorrhea and failure to thrive.
4. A 2-year-old child is hospitalized for a minor procedure. According to Erikson’s stages,
which nursing action best supports the child’s developmental needs?
A. Provide detailed explanations of the procedure’s pathophysiology.
B. Encourage the child to perform tasks independently when possible.
C. Restrict parental visits to promote self-reliance.
D. Focus exclusively on physical comfort and feeding.
Answer: B
Rationale: Toddlers are in the ‘Autonomy vs. Shame and Doubt’ stage where they strive for
independence and control. Nursing care should provide choices and encourage self-care
activities to foster a sense of autonomy. Restricting parents would be detrimental as it
would cause separation anxiety, a major stressor at this age.
5. A child is admitted for observation following a generalized tonic-clonic seizure. Which
safety precaution is the nurse’s highest priority?
A. Keep a padded tongue blade at the bedside.
B. Ensure suction equipment and oxygen are available at the bedside.
C. Maintain the child in a supine position during a seizure.
D. Restrict the child to bed rest with all four side rails up.
Answer: B
Rationale: Airway management and safety are the primary concerns for patients with
seizure disorders. Having suction and oxygen ready allows for immediate intervention if
the airway is compromised. Padded tongue blades should never be used as they can cause
oral trauma or airway obstruction.
6. A 6-year-old child is 4 hours post-tonsillectomy. Which assessment finding requires
immediate notification of the surgeon?
A. Refusal to drink citrus juices.
B. Presence of dried dark brown blood on the tongue.
C. A report of a sore throat rated 4/10.
D. Frequent swallowing and clearing of the throat.
, Answer: D
Rationale: Frequent swallowing is a classic sign of active bleeding from the surgical site in
post-tonsillectomy patients. Early detection of hemorrhage is critical as it can lead to
hypovolemia and airway compromise. Dark brown blood is usually ‘old’ and expected,
whereas active bright red bleeding is a crisis.
7. The nurse is assessing a 12-month-old infant for dehydration. Which finding is the most
reliable indicator of moderate dehydration?
A. Sunken fontanels and decreased urine output.
B. Moist mucous membranes.
C. Brisk capillary refill of 1-2 seconds.
D. Increased tearing when the infant cries.
Answer: A
Rationale: Sunken fontanels, dry mucous membranes, and decreased urinary output are
key signs of moderate dehydration in infants. In pediatric patients, monitoring the number
of wet diapers is a practical way for parents and nurses to gauge hydration status. Tearing
and brisk capillary refill are indicators of adequate hydration.
8. An infant with Tetralogy of Fallot becomes cyanotic and agitated during a blood draw.
What is the nurse’s first action?
A. Place the infant in the knee-chest position.
B. Call the rapid response team.
C. Administer a dose of Digoxin.
D. Initiate bag-valve-mask ventilation.
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which reduces
the right-to-left shunt in Tetralogy of Fallot ‘Tet’ spells. This position helps improve
oxygenation by forcing more blood into the lungs. Nursing interventions during a Tet spell
also include providing a calm environment and administering oxygen if necessary.
9. A 12-year-old child is hospitalized with a Sickle Cell Vaso-occlusive crisis. What is the
priority nursing intervention?
A. Encourage a low-fluid diet to prevent edema.
B. Administer intravenous fluids and oxygen.
C. Apply cold compresses to painful joints.
D. Administer Meperidine for pain management.
