NSG 3600 Exam 2 | NSG 3600 Children’s
Health | Questions & Answers with
Rationales 2026/2027 Update
QUESTION 1
A pediatric nurse is assessing a 4-year-old child with suspected acute asthma
exacerbation. Which physical assessment finding indicates significant lower
airway obstruction?
A) Inspiratory stridor heard over the trachea
B) Expiratory wheezing and prolonged expiratory phase across all lung fields
C) Barking, seal-like cough
D) Asymmetric chest expansion with absent breath sounds on the right side only
Answer: B
Rationale: Asthma causes diffuse lower airway inflammation, bronchospasm, and
mucus plugging, leading to expiratory wheezing and a prolonged expiratory
breathing phase. Inspiratory stridor indicates upper airway obstruction, while a
barking cough is characteristic of croup.
QUESTION 2
A nurse is providing discharge instructions to the parents of a child newly
diagnosed with mild persistent asthma. The child is prescribed an inhaled
corticosteroid (fluticasone) daily. Which instruction is vital to prevent oral
complications?
A) Rinse the child's mouth with water and spit it out after each inhalation dose.
B) Administer the medication immediately after a heavy meal.
C) Mix the inhaler dose with 4 ounces of fruit juice.
D) Limit fluid intake for 2 hours after inhalation.
,Answer: A
Rationale: Inhaled corticosteroids leave drug residue in the oral cavity, which
increases the risk of local fungal infections (oral candidiasis/thrush) and
hoarseness. Rinsing the mouth with water and spitting after use removes the
residual drug.
QUESTION 3
A 2-year-old child is brought to the emergency department with a history of low-
grade fever, hoarseness, and a harsh, barking cough that worsens at night. Which
condition should the nurse suspect?
A) Acute laryngotracheobronchitis (Croup)
B) Acute epiglottitis
C) Foreign body aspiration
D) Cystic fibrosis
Answer: A
Rationale: Acute laryngotracheobronchitis (croup) is a viral inflammation of the
subglottic upper airway characterized by low-grade fever, hoarseness, inspiratory
stridor, and a classic barking, seal-like cough that worsens at night.
QUESTION 4
A nurse is caring for a 3-year-old child with suspected acute epiglottitis. Which
order by the healthcare provider should the nurse question immediately?
A) Inspect the throat with a sterile tongue depressor to obtain a swab
B) Maintain the child in an upright sitting position
C) Administer humidified oxygen as tolerated
D) Prepare equipment for emergency endotracheal intubation
Answer: A
Rationale: Inspecting or swabbing the throat with a tongue depressor in a child
with epiglottitis can trigger acute laryngospasm and complete, fatal airway
,occlusion. Examination should only be performed in a controlled environment
equipped for immediate intubation.
QUESTION 5
A nurse is reviewing the diagnostic evaluation of a 6-month-old infant with
suspected cystic fibrosis. Which laboratory test provides definitive diagnostic
confirmation?
A) Sweat chloride test with a value greater than 60 mEq/L
B) Serum IgE level above normal range
C) Arterial blood gas showing metabolic alkalosis
D) Sputum culture positive for Streptococcus pneumoniae
Answer: A
Rationale: The pilocarpine iontophoresis sweat test (sweat chloride test)
measures sodium and chloride levels in sweat. A sweat chloride concentration
greater than 60 mEq/L on two separate tests confirms the diagnosis of cystic
fibrosis.
QUESTION 6
A nurse is teaching the parents of a school-age child with cystic fibrosis about
pancreatic enzyme replacement therapy. When should these enzyme capsules be
taken?
A) With every meal and all snacks
B) Once daily at bedtime
C) One hour after eating a meal
D) Only when experiencing severe abdominal pain
Answer: A
Rationale: Exocrine pancreatic insufficiency in cystic fibrosis prevents natural
enzyme secretion. Pancreatic enzymes (lipase, protease, amylase) must be taken
with every meal and snack to ensure proper digestion and nutrient absorption.
, QUESTION 7
An infant diagnosed with respiratory syncytial virus (RSV) bronchiolitis is admitted
to the pediatric unit. Which transmission-based precautions must the nurse
implement?
A) Contact precautions
B) Airborne precautions
C) Protective isolation
D) Droplet precautions only
Answer: A
Rationale: RSV is primarily transmitted through direct contact with infected
respiratory secretions or contaminated fomites. Contact precautions (gowns,
gloves, dedicated equipment) are essential to prevent nosocomial spread.
QUESTION 8
A nurse is assessing a child with a history of recurrent pulmonary infections, bulky
foul-smelling greasy stools (steatorrhea), and poor weight gain despite a
voracious appetite. Which genetic disorder aligns with these features?
A) Cystic fibrosis
B) Celiac disease
C) Duchenne muscular dystrophy
D) Sickle cell anemia
Answer: A
Rationale: Cystic fibrosis affects exocrine glands, causing thick mucus buildup in
the respiratory tract (recurrent infections) and obstruction of pancreatic ducts
(exocrine pancreatic insufficiency leading to steatorrhea, malabsorption, and poor
growth).
QUESTION 9
Health | Questions & Answers with
Rationales 2026/2027 Update
QUESTION 1
A pediatric nurse is assessing a 4-year-old child with suspected acute asthma
exacerbation. Which physical assessment finding indicates significant lower
airway obstruction?
A) Inspiratory stridor heard over the trachea
B) Expiratory wheezing and prolonged expiratory phase across all lung fields
C) Barking, seal-like cough
D) Asymmetric chest expansion with absent breath sounds on the right side only
Answer: B
Rationale: Asthma causes diffuse lower airway inflammation, bronchospasm, and
mucus plugging, leading to expiratory wheezing and a prolonged expiratory
breathing phase. Inspiratory stridor indicates upper airway obstruction, while a
barking cough is characteristic of croup.
QUESTION 2
A nurse is providing discharge instructions to the parents of a child newly
diagnosed with mild persistent asthma. The child is prescribed an inhaled
corticosteroid (fluticasone) daily. Which instruction is vital to prevent oral
complications?
A) Rinse the child's mouth with water and spit it out after each inhalation dose.
B) Administer the medication immediately after a heavy meal.
C) Mix the inhaler dose with 4 ounces of fruit juice.
D) Limit fluid intake for 2 hours after inhalation.
,Answer: A
Rationale: Inhaled corticosteroids leave drug residue in the oral cavity, which
increases the risk of local fungal infections (oral candidiasis/thrush) and
hoarseness. Rinsing the mouth with water and spitting after use removes the
residual drug.
QUESTION 3
A 2-year-old child is brought to the emergency department with a history of low-
grade fever, hoarseness, and a harsh, barking cough that worsens at night. Which
condition should the nurse suspect?
A) Acute laryngotracheobronchitis (Croup)
B) Acute epiglottitis
C) Foreign body aspiration
D) Cystic fibrosis
Answer: A
Rationale: Acute laryngotracheobronchitis (croup) is a viral inflammation of the
subglottic upper airway characterized by low-grade fever, hoarseness, inspiratory
stridor, and a classic barking, seal-like cough that worsens at night.
QUESTION 4
A nurse is caring for a 3-year-old child with suspected acute epiglottitis. Which
order by the healthcare provider should the nurse question immediately?
A) Inspect the throat with a sterile tongue depressor to obtain a swab
B) Maintain the child in an upright sitting position
C) Administer humidified oxygen as tolerated
D) Prepare equipment for emergency endotracheal intubation
Answer: A
Rationale: Inspecting or swabbing the throat with a tongue depressor in a child
with epiglottitis can trigger acute laryngospasm and complete, fatal airway
,occlusion. Examination should only be performed in a controlled environment
equipped for immediate intubation.
QUESTION 5
A nurse is reviewing the diagnostic evaluation of a 6-month-old infant with
suspected cystic fibrosis. Which laboratory test provides definitive diagnostic
confirmation?
A) Sweat chloride test with a value greater than 60 mEq/L
B) Serum IgE level above normal range
C) Arterial blood gas showing metabolic alkalosis
D) Sputum culture positive for Streptococcus pneumoniae
Answer: A
Rationale: The pilocarpine iontophoresis sweat test (sweat chloride test)
measures sodium and chloride levels in sweat. A sweat chloride concentration
greater than 60 mEq/L on two separate tests confirms the diagnosis of cystic
fibrosis.
QUESTION 6
A nurse is teaching the parents of a school-age child with cystic fibrosis about
pancreatic enzyme replacement therapy. When should these enzyme capsules be
taken?
A) With every meal and all snacks
B) Once daily at bedtime
C) One hour after eating a meal
D) Only when experiencing severe abdominal pain
Answer: A
Rationale: Exocrine pancreatic insufficiency in cystic fibrosis prevents natural
enzyme secretion. Pancreatic enzymes (lipase, protease, amylase) must be taken
with every meal and snack to ensure proper digestion and nutrient absorption.
, QUESTION 7
An infant diagnosed with respiratory syncytial virus (RSV) bronchiolitis is admitted
to the pediatric unit. Which transmission-based precautions must the nurse
implement?
A) Contact precautions
B) Airborne precautions
C) Protective isolation
D) Droplet precautions only
Answer: A
Rationale: RSV is primarily transmitted through direct contact with infected
respiratory secretions or contaminated fomites. Contact precautions (gowns,
gloves, dedicated equipment) are essential to prevent nosocomial spread.
QUESTION 8
A nurse is assessing a child with a history of recurrent pulmonary infections, bulky
foul-smelling greasy stools (steatorrhea), and poor weight gain despite a
voracious appetite. Which genetic disorder aligns with these features?
A) Cystic fibrosis
B) Celiac disease
C) Duchenne muscular dystrophy
D) Sickle cell anemia
Answer: A
Rationale: Cystic fibrosis affects exocrine glands, causing thick mucus buildup in
the respiratory tract (recurrent infections) and obstruction of pancreatic ducts
(exocrine pancreatic insufficiency leading to steatorrhea, malabsorption, and poor
growth).
QUESTION 9
