NSG 3600 Exam 4 Actual Exam V1 | NSG 3600 Nursing Practice –
Children’s Health (NSG3600 Exam 4)
1. A 7-year-old child with Cystic Fibrosis is being educated on the administration of pancreatic
enzymes. Which statement by the parent indicates a correct understanding of the teaching?
A. I will ensure the enzymes are taken with every meal and snack.
B. I will give the enzymes once daily in the morning before breakfast.
C. I will mix the enzymes into a bowl of hot oatmeal for better absorption.
D. I will withhold enzymes if the child is having frequent, fatty stools.
Answer: A
Rationale: Pancreatic enzymes are required to facilitate the digestion of fats and proteins
in children with Cystic Fibrosis. They must be taken consistently with all meals and snacks
to prevent malabsorption and steatorrhea. Mixing enzymes with hot food can denature
them, so they should be administered with cold or room-temperature acidic foods if not
swallowed whole.
2. A nurse is caring for a 10-year-old with Type 1 Diabetes Mellitus who is experiencing
shakiness, sweating, and pallor. What is the priority nursing action?
A. Encourage the child to lie down and rest for 30 minutes.
B. Administer a dose of rapid-acting insulin immediately.
C. Administer 15 grams of simple carbohydrates, such as 4 ounces of orange juice.
D. Call the healthcare provider to request a STAT blood glucose test.
Answer: C
Rationale: Shakiness, sweating, and pallor are classic signs of hypoglycemia in pediatric
patients. The nurse should immediately provide 15g of simple carbohydrates to raise blood
glucose levels quickly. Following treatment, the blood glucose should be rechecked in 15
minutes to determine if additional treatment is necessary.
3. Which clinical manifestation would a nurse expect to find in an infant diagnosed with
Pyloric Stenosis?
A. Currant jelly-like stools containing blood and mucus.
B. Projectile vomiting that occurs shortly after feeding.
C. Abdominal distention and failure to pass meconium.
D. Chronic diarrhea and failure to thrive.
,Answer: B
Rationale: Hypertrophic pyloric stenosis causes an obstruction of the pyloric sphincter,
leading to forceful, non-bile stained projectile vomiting. An olive-shaped mass may also be
palpable in the epigastrium to the right of the umbilicus. Surgical intervention, a
pyloromyotomy, is the definitive treatment for this condition.
4. A 4-year-old is admitted with a Vaso-occlusive crisis due to Sickle Cell Anemia. Which
intervention is the highest priority for the nurse to implement?
A. Initiating intravenous fluid therapy for aggressive hydration.
B. Applying cold compresses to the painful joints.
C. Administering oral antibiotics as a prophylactic measure.
D. Assisting the child with ROM exercises to maintain flexibility.
Answer: A
Rationale: Hydration is critical during a vaso-occlusive crisis to reduce blood viscosity and
promote the flow of red blood cells through the microvasculature. Pain management is also
a priority, but physiologic stabilization via hydration takes precedence to prevent further
tissue ischemia. Cold compresses are contraindicated as they cause vasoconstriction, which
worsens the sickling process.
5. When teaching the parents of an infant with a Pavlik harness for Developmental Dysplasia
of the Hip (DDH), which instruction is most important?
A. Adjust the straps daily to accommodate the infant’s growth.
B. Place the harness directly against the infant’s skin to prevent slipping.
C. Ensure the infant’s legs are kept in an adducted position.
D. Remove the harness only for bathing if permitted by the provider.
Answer: D
Rationale: The Pavlik harness must be worn continuously to maintain the femoral head in
the acetabulum for proper development. Parents should not adjust the straps themselves;
this must be done by a healthcare professional to ensure correct alignment. The harness
should be worn over a thin shirt and socks to protect the skin from irritation and
breakdown.
6. A 12-year-old child is post-operative following a spinal fusion for scoliosis. Which nursing
assessment is critical in the first 24 hours?
A. Checking neurovascular status of the lower extremities.
B. Monitoring the surgical site for signs of keloid formation.
C. Assessing for the presence of a positive Brudzinski sign.
, D. Evaluating the child’s ability to perform deep squats.
Answer: A
Rationale: Following spinal surgery, there is a risk of nerve damage or spinal cord
compression. Frequent neurovascular checks, including sensation, movement, and pulses
in the lower extremities, are essential to detect early complications. The patient should also
be log-rolled to maintain spinal alignment and prevent injury to the fusion site.
7. A nurse is preparing to administer Digoxin to an infant with Congenital Heart Disease.
Which action should the nurse take first?
A. Mix the medication with formula to ensure the infant drinks it all.
B. Assess the infant’s blood pressure in all four extremities.
C. Check the infant’s apical pulse for one full minute.
D. Review the infant’s recent serum calcium levels.
Answer: C
Rationale: Before administering Digoxin, the nurse must assess the apical pulse for 60
seconds. In infants, the dose is generally withheld if the heart rate is less than 90-110 beats
per minute, depending on facility policy. Digoxin toxicity can manifest as bradycardia or
vomiting, making accurate heart rate assessment vital.
8. A toddler is diagnosed with Nephrotic Syndrome. Which of the following clinical findings
should the nurse expect? (Select all that apply)
A. Gross hematuria and hypertension.
B. Massive proteinuria, hypoalbuminemia, and edema.
C. Polyuria, polydipsia, and weight loss.
D. Elevated serum creatinine and ketones in the urine.
Answer: B
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability to
proteins, resulting in massive proteinuria and subsequent hypoalbuminemia. This leads to
a shift in fluid from the intravascular space to the interstitial space, causing generalized
edema. In contrast, hematuria and hypertension are more commonly associated with Acute
Glomerulonephritis.
9. A child is admitted with Kawasaki Disease. The nurse should be prepared to administer
which combination of medications?
A. Intravenous Immunoglobulin (IVIG) and high-dose Aspirin.
B. Antibiotics and Acetaminophen.
Children’s Health (NSG3600 Exam 4)
1. A 7-year-old child with Cystic Fibrosis is being educated on the administration of pancreatic
enzymes. Which statement by the parent indicates a correct understanding of the teaching?
A. I will ensure the enzymes are taken with every meal and snack.
B. I will give the enzymes once daily in the morning before breakfast.
C. I will mix the enzymes into a bowl of hot oatmeal for better absorption.
D. I will withhold enzymes if the child is having frequent, fatty stools.
Answer: A
Rationale: Pancreatic enzymes are required to facilitate the digestion of fats and proteins
in children with Cystic Fibrosis. They must be taken consistently with all meals and snacks
to prevent malabsorption and steatorrhea. Mixing enzymes with hot food can denature
them, so they should be administered with cold or room-temperature acidic foods if not
swallowed whole.
2. A nurse is caring for a 10-year-old with Type 1 Diabetes Mellitus who is experiencing
shakiness, sweating, and pallor. What is the priority nursing action?
A. Encourage the child to lie down and rest for 30 minutes.
B. Administer a dose of rapid-acting insulin immediately.
C. Administer 15 grams of simple carbohydrates, such as 4 ounces of orange juice.
D. Call the healthcare provider to request a STAT blood glucose test.
Answer: C
Rationale: Shakiness, sweating, and pallor are classic signs of hypoglycemia in pediatric
patients. The nurse should immediately provide 15g of simple carbohydrates to raise blood
glucose levels quickly. Following treatment, the blood glucose should be rechecked in 15
minutes to determine if additional treatment is necessary.
3. Which clinical manifestation would a nurse expect to find in an infant diagnosed with
Pyloric Stenosis?
A. Currant jelly-like stools containing blood and mucus.
B. Projectile vomiting that occurs shortly after feeding.
C. Abdominal distention and failure to pass meconium.
D. Chronic diarrhea and failure to thrive.
,Answer: B
Rationale: Hypertrophic pyloric stenosis causes an obstruction of the pyloric sphincter,
leading to forceful, non-bile stained projectile vomiting. An olive-shaped mass may also be
palpable in the epigastrium to the right of the umbilicus. Surgical intervention, a
pyloromyotomy, is the definitive treatment for this condition.
4. A 4-year-old is admitted with a Vaso-occlusive crisis due to Sickle Cell Anemia. Which
intervention is the highest priority for the nurse to implement?
A. Initiating intravenous fluid therapy for aggressive hydration.
B. Applying cold compresses to the painful joints.
C. Administering oral antibiotics as a prophylactic measure.
D. Assisting the child with ROM exercises to maintain flexibility.
Answer: A
Rationale: Hydration is critical during a vaso-occlusive crisis to reduce blood viscosity and
promote the flow of red blood cells through the microvasculature. Pain management is also
a priority, but physiologic stabilization via hydration takes precedence to prevent further
tissue ischemia. Cold compresses are contraindicated as they cause vasoconstriction, which
worsens the sickling process.
5. When teaching the parents of an infant with a Pavlik harness for Developmental Dysplasia
of the Hip (DDH), which instruction is most important?
A. Adjust the straps daily to accommodate the infant’s growth.
B. Place the harness directly against the infant’s skin to prevent slipping.
C. Ensure the infant’s legs are kept in an adducted position.
D. Remove the harness only for bathing if permitted by the provider.
Answer: D
Rationale: The Pavlik harness must be worn continuously to maintain the femoral head in
the acetabulum for proper development. Parents should not adjust the straps themselves;
this must be done by a healthcare professional to ensure correct alignment. The harness
should be worn over a thin shirt and socks to protect the skin from irritation and
breakdown.
6. A 12-year-old child is post-operative following a spinal fusion for scoliosis. Which nursing
assessment is critical in the first 24 hours?
A. Checking neurovascular status of the lower extremities.
B. Monitoring the surgical site for signs of keloid formation.
C. Assessing for the presence of a positive Brudzinski sign.
, D. Evaluating the child’s ability to perform deep squats.
Answer: A
Rationale: Following spinal surgery, there is a risk of nerve damage or spinal cord
compression. Frequent neurovascular checks, including sensation, movement, and pulses
in the lower extremities, are essential to detect early complications. The patient should also
be log-rolled to maintain spinal alignment and prevent injury to the fusion site.
7. A nurse is preparing to administer Digoxin to an infant with Congenital Heart Disease.
Which action should the nurse take first?
A. Mix the medication with formula to ensure the infant drinks it all.
B. Assess the infant’s blood pressure in all four extremities.
C. Check the infant’s apical pulse for one full minute.
D. Review the infant’s recent serum calcium levels.
Answer: C
Rationale: Before administering Digoxin, the nurse must assess the apical pulse for 60
seconds. In infants, the dose is generally withheld if the heart rate is less than 90-110 beats
per minute, depending on facility policy. Digoxin toxicity can manifest as bradycardia or
vomiting, making accurate heart rate assessment vital.
8. A toddler is diagnosed with Nephrotic Syndrome. Which of the following clinical findings
should the nurse expect? (Select all that apply)
A. Gross hematuria and hypertension.
B. Massive proteinuria, hypoalbuminemia, and edema.
C. Polyuria, polydipsia, and weight loss.
D. Elevated serum creatinine and ketones in the urine.
Answer: B
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability to
proteins, resulting in massive proteinuria and subsequent hypoalbuminemia. This leads to
a shift in fluid from the intravascular space to the interstitial space, causing generalized
edema. In contrast, hematuria and hypertension are more commonly associated with Acute
Glomerulonephritis.
9. A child is admitted with Kawasaki Disease. The nurse should be prepared to administer
which combination of medications?
A. Intravenous Immunoglobulin (IVIG) and high-dose Aspirin.
B. Antibiotics and Acetaminophen.
