NUR 168 Exam 3 | Pediatric Nursing | Independent Study Resource
GALEN NUR 168
Exam 3 Pediatric Nursing Study Guide
Integrated Concepts of Registered Nursing Practice
Pediatric Assessment and Family-Centered Care
Cardiac • Respiratory • Musculoskeletal • Neurologic • Oncology • GI • GU • Integumentary
2026/2027 Updated Study Resource
Structured to the 2026 Galen NUR 168 course description and the publicly indexed Exam 3 blueprint.
Includes high-yield pediatric assessment, clinical-priority tables, red flags, comparison charts, and 75
original practice questions with rationales.
Independent educational material. Not an official Galen exam or answer key. No study resource can guarantee a passing score.
Page 1
, NUR 168 Exam 3 | Pediatric Nursing | Independent Study Resource
How This Guide Is Aligned
Galen College of Nursing's 2026 catalog identifies NUR 168, Integrated Concepts of Registered Nursing Practice, as an 8-
quarter-credit course that supports the transition from practical/vocational nursing to registered nursing practice and
includes care of the child-caring family. A publicly indexed NUR 168 syllabus (Version 13.9, 2024/2025) identifies Exam
3 as a 50-question assessment distributed approximately equally across Units 7, 8, and 9. Current Canvas modules,
instructor announcements, and assigned readings should take precedence if they differ from this public blueprint.
Exam 3 Domain Blueprint Weight Guide Emphasis
Unit 7: Pediatric Overview + Cardiac 16-18 of 50 Growth/development, assessment,
+ Respiratory family-centered care,
pain/play/hospitalization, congenital
and acquired cardiac disorders,
respiratory emergencies and
common pediatric respiratory
disorders.
Unit 8: Musculoskeletal + Neurologic 16-18 of 50 Mobility disorders,
+ Oncology clubfoot/scoliosis/JIA,
hydrocephalus/cerebral
palsy/meningitis/seizures and
increased ICP, pediatric malignancy
principles, treatment complications
and safety.
Unit 9: GI + GU + Integumentary 16-18 of 50 Dehydration and GI emergencies,
common GI conditions,
UTI/nephrotic/glomerular and genital
disorders, skin infection/infestation,
eczema, burns and wound/skin
priorities.
Exam Strategy
Treat Units 7, 8, and 9 as roughly equal. In pediatric priority questions, first identify airway/breathing
threats, shock/dehydration, neurologic deterioration, sepsis/meningitis, cardiac hypoxemia, oncologic
infection/bleeding, and acute abdominal or GU emergencies before routine teaching or comfort measures.
Page 2
, NUR 168 Exam 3 | Pediatric Nursing | Independent Study Resource
Core Learning Outcomes
Perform an age-appropriate pediatric assessment while using family-centered communication and developmental
principles.
Recognize expected growth/development, pain behaviors, hospitalization responses, and safe play/therapeutic
communication approaches.
Differentiate major congenital/acquired cardiac patterns and identify signs of heart failure, hypoxemia, Kawasaki
disease, and rheumatic heart disease.
Prioritize respiratory care for croup, epiglottitis, bronchiolitis/RSV, asthma, pneumonia, and cystic fibrosis.
Recognize musculoskeletal and neurologic red flags, including neurovascular compromise, meningitis, seizures,
increased intracranial pressure, and shunt malfunction.
Apply pediatric oncology safety principles for infection, bleeding, tumor lysis risk, and family-centered supportive
care.
Identify dehydration and acute GI/GU emergencies and prioritize safe care for nephrotic syndrome, post-
streptococcal glomerulonephritis, and UTIs.
Recognize common pediatric skin disorders, infestations, burns, and infection-control needs.
Use clinical judgment to select the most urgent nursing action for a deteriorating child.
Page 3
, NUR 168 Exam 3 | Pediatric Nursing | Independent Study Resource
UNIT 7 - Pediatric Overview, Cardiac & Respiratory
1. Pediatric Assessment: Think Development First
Children are not small adults. Normal findings, communication style, respiratory pattern, coping, and safety needs
change with age. Observe before touching when possible, use the caregiver as a source of baseline information, and
perform the least invasive parts of the exam first when developmentally appropriate.
Assessment Principle High-Yield Application
General appearance Assess tone, interaction, consolability, work of breathing,
color, posture, movement, and response to caregivers
before disturbing the child.
Airway/breathing Look for nasal flaring, grunting, retractions, head
bobbing in infants, stridor, wheeze, cyanosis, altered
speech/cry, and fatigue.
Circulation Assess heart rate, pulses, skin temperature/color,
capillary refill, mental status and urine output;
hypotension can be a late sign of pediatric shock.
Hydration Use mucous membranes, tears, urine output, weight
trend, capillary refill, fontanel in infants, activity level
and intake/output together.
Pain Use an age/development-appropriate tool; self-report is
preferred when the child can reliably report pain.
Family-centered care Include caregivers, respect routines/culture, give honest
simple explanations, offer choices that do not
compromise safety, and support caregiver participation.
2. Growth, Development, Play & Hospitalization
Developmental/Communication
Age Group Helpful Nursing Approach
Focus
Infant Trust, sensory comfort, attachment, Keep caregiver close, use soothing
stranger/separation anxiety later in voice/touch, preserve routines, use
infancy. familiar objects when safe.
Toddler Autonomy, limited language, Offer limited choices, use simple
ritualism, separation anxiety, concrete words, allow safe control,
parallel play. avoid asking yes/no when a
procedure must occur.
Preschooler Initiative, magical thinking, Use play and simple explanations
associative play, fears of body injury. immediately before procedures;
correct misconceptions.
School-age Industry, logical thinking about Explain steps and equipment, let the
concrete events, cooperative play. child participate, protect modesty,
praise mastery.
Page 4
GALEN NUR 168
Exam 3 Pediatric Nursing Study Guide
Integrated Concepts of Registered Nursing Practice
Pediatric Assessment and Family-Centered Care
Cardiac • Respiratory • Musculoskeletal • Neurologic • Oncology • GI • GU • Integumentary
2026/2027 Updated Study Resource
Structured to the 2026 Galen NUR 168 course description and the publicly indexed Exam 3 blueprint.
Includes high-yield pediatric assessment, clinical-priority tables, red flags, comparison charts, and 75
original practice questions with rationales.
Independent educational material. Not an official Galen exam or answer key. No study resource can guarantee a passing score.
Page 1
, NUR 168 Exam 3 | Pediatric Nursing | Independent Study Resource
How This Guide Is Aligned
Galen College of Nursing's 2026 catalog identifies NUR 168, Integrated Concepts of Registered Nursing Practice, as an 8-
quarter-credit course that supports the transition from practical/vocational nursing to registered nursing practice and
includes care of the child-caring family. A publicly indexed NUR 168 syllabus (Version 13.9, 2024/2025) identifies Exam
3 as a 50-question assessment distributed approximately equally across Units 7, 8, and 9. Current Canvas modules,
instructor announcements, and assigned readings should take precedence if they differ from this public blueprint.
Exam 3 Domain Blueprint Weight Guide Emphasis
Unit 7: Pediatric Overview + Cardiac 16-18 of 50 Growth/development, assessment,
+ Respiratory family-centered care,
pain/play/hospitalization, congenital
and acquired cardiac disorders,
respiratory emergencies and
common pediatric respiratory
disorders.
Unit 8: Musculoskeletal + Neurologic 16-18 of 50 Mobility disorders,
+ Oncology clubfoot/scoliosis/JIA,
hydrocephalus/cerebral
palsy/meningitis/seizures and
increased ICP, pediatric malignancy
principles, treatment complications
and safety.
Unit 9: GI + GU + Integumentary 16-18 of 50 Dehydration and GI emergencies,
common GI conditions,
UTI/nephrotic/glomerular and genital
disorders, skin infection/infestation,
eczema, burns and wound/skin
priorities.
Exam Strategy
Treat Units 7, 8, and 9 as roughly equal. In pediatric priority questions, first identify airway/breathing
threats, shock/dehydration, neurologic deterioration, sepsis/meningitis, cardiac hypoxemia, oncologic
infection/bleeding, and acute abdominal or GU emergencies before routine teaching or comfort measures.
Page 2
, NUR 168 Exam 3 | Pediatric Nursing | Independent Study Resource
Core Learning Outcomes
Perform an age-appropriate pediatric assessment while using family-centered communication and developmental
principles.
Recognize expected growth/development, pain behaviors, hospitalization responses, and safe play/therapeutic
communication approaches.
Differentiate major congenital/acquired cardiac patterns and identify signs of heart failure, hypoxemia, Kawasaki
disease, and rheumatic heart disease.
Prioritize respiratory care for croup, epiglottitis, bronchiolitis/RSV, asthma, pneumonia, and cystic fibrosis.
Recognize musculoskeletal and neurologic red flags, including neurovascular compromise, meningitis, seizures,
increased intracranial pressure, and shunt malfunction.
Apply pediatric oncology safety principles for infection, bleeding, tumor lysis risk, and family-centered supportive
care.
Identify dehydration and acute GI/GU emergencies and prioritize safe care for nephrotic syndrome, post-
streptococcal glomerulonephritis, and UTIs.
Recognize common pediatric skin disorders, infestations, burns, and infection-control needs.
Use clinical judgment to select the most urgent nursing action for a deteriorating child.
Page 3
, NUR 168 Exam 3 | Pediatric Nursing | Independent Study Resource
UNIT 7 - Pediatric Overview, Cardiac & Respiratory
1. Pediatric Assessment: Think Development First
Children are not small adults. Normal findings, communication style, respiratory pattern, coping, and safety needs
change with age. Observe before touching when possible, use the caregiver as a source of baseline information, and
perform the least invasive parts of the exam first when developmentally appropriate.
Assessment Principle High-Yield Application
General appearance Assess tone, interaction, consolability, work of breathing,
color, posture, movement, and response to caregivers
before disturbing the child.
Airway/breathing Look for nasal flaring, grunting, retractions, head
bobbing in infants, stridor, wheeze, cyanosis, altered
speech/cry, and fatigue.
Circulation Assess heart rate, pulses, skin temperature/color,
capillary refill, mental status and urine output;
hypotension can be a late sign of pediatric shock.
Hydration Use mucous membranes, tears, urine output, weight
trend, capillary refill, fontanel in infants, activity level
and intake/output together.
Pain Use an age/development-appropriate tool; self-report is
preferred when the child can reliably report pain.
Family-centered care Include caregivers, respect routines/culture, give honest
simple explanations, offer choices that do not
compromise safety, and support caregiver participation.
2. Growth, Development, Play & Hospitalization
Developmental/Communication
Age Group Helpful Nursing Approach
Focus
Infant Trust, sensory comfort, attachment, Keep caregiver close, use soothing
stranger/separation anxiety later in voice/touch, preserve routines, use
infancy. familiar objects when safe.
Toddler Autonomy, limited language, Offer limited choices, use simple
ritualism, separation anxiety, concrete words, allow safe control,
parallel play. avoid asking yes/no when a
procedure must occur.
Preschooler Initiative, magical thinking, Use play and simple explanations
associative play, fears of body injury. immediately before procedures;
correct misconceptions.
School-age Industry, logical thinking about Explain steps and equipment, let the
concrete events, cooperative play. child participate, protect modesty,
praise mastery.
Page 4
