NSG 3600 Peds Exam 4 Practice Questions & Study
Guide| WITH VERRIFIED CORRECT ANSWERS
2026 LATEST TEST WITH MUST KNOW QUESTIONS
AND CORRECT ANSWERS
1. A school nurse is assessing a child who has difficulty sustaining attention, is easily distracted, and
often blurts out Correct Answers in class. These behaviors are present in both the classroom and
on the playground. This clinical picture is most consistent with:
A. Autism Spectrum Disorder
B. Oppositional Defiant Disorder
C. Attention Deficit Hyperactivity Disorder
D. An anxiety disorder
Correct Answer: C
Rationale: ADHD is characterized by inattention, hyperactivity, and impulsivity that must be present in
at least two settings (e.g., school and home). The description of symptoms across multiple environments
is key to the diagnosis .
2. A nurse is providing education to the parents of a child newly diagnosed with ADHD. The nurse
explains that the three-pronged approach to management includes pharmacologic therapy,
behavioral therapy, and:
A. A strict adherence to a gluten-free diet
B. Environmental manipulation
C. Monthly blood tests to monitor drug levels
D. Limiting all social interactions to reduce stimuli
Correct Answer: B
Rationale: Therapeutic management for ADHD is a three-pronged approach: 1) pharmacologic therapy
(stimulants or non-stimulants), 2) behavioral therapy (parenting skills, rewards), and 3) environmental
manipulation (modifying the environment to help the child succeed) .
, 3. When discussing pharmacologic therapy for a child with ADHD, the nurse should instruct the family
that the dosage of stimulant medications is primarily based on:
A. The child's weight in kilograms
B. The child's age in years
C. The resolution of symptoms and presence of side effects
D. The serum blood levels of the medication
Correct Answer: C
Rationale: The dosage for stimulant medications is titrated based on the child's therapeutic response
(resolution of symptoms) and the emergence of side effects, not strictly on the child's weight .
4. The nurse is assessing a newborn and notes a single palmar crease (simian crease), a flat nasal
bridge, a protruding tongue, and hypotonia. These findings are most suggestive of:
A. Fetal alcohol syndrome
B. Down syndrome (Trisomy 21)
C. Cerebral palsy
D. Autism spectrum disorder
Correct Answer: B
Rationale: These are classic physical features of Down syndrome, which is caused by an extra copy of
chromosome 21. Common findings include hypotonia, a single palmar crease, a flat facial profile, and a
protruding tongue .
5. A nurse is caring for an infant with Down syndrome. The nurse should be aware that this infant is at
a significantly higher risk for which comorbid condition?
A. Congenital heart defects (e.g., VSD)
B. Type 1 diabetes
C. Neuroblastoma
D. Cystic fibrosis
Correct Answer: A
Rationale: Infants with Down syndrome have a high incidence of congenital heart defects, most
commonly ventricular septal defects (VSDs) .
6. The parents of a 2-year-old newly diagnosed with autism spectrum disorder (ASD) ask the nurse
about the cause. Which response by the nurse is most accurate and therapeutic?
Guide| WITH VERRIFIED CORRECT ANSWERS
2026 LATEST TEST WITH MUST KNOW QUESTIONS
AND CORRECT ANSWERS
1. A school nurse is assessing a child who has difficulty sustaining attention, is easily distracted, and
often blurts out Correct Answers in class. These behaviors are present in both the classroom and
on the playground. This clinical picture is most consistent with:
A. Autism Spectrum Disorder
B. Oppositional Defiant Disorder
C. Attention Deficit Hyperactivity Disorder
D. An anxiety disorder
Correct Answer: C
Rationale: ADHD is characterized by inattention, hyperactivity, and impulsivity that must be present in
at least two settings (e.g., school and home). The description of symptoms across multiple environments
is key to the diagnosis .
2. A nurse is providing education to the parents of a child newly diagnosed with ADHD. The nurse
explains that the three-pronged approach to management includes pharmacologic therapy,
behavioral therapy, and:
A. A strict adherence to a gluten-free diet
B. Environmental manipulation
C. Monthly blood tests to monitor drug levels
D. Limiting all social interactions to reduce stimuli
Correct Answer: B
Rationale: Therapeutic management for ADHD is a three-pronged approach: 1) pharmacologic therapy
(stimulants or non-stimulants), 2) behavioral therapy (parenting skills, rewards), and 3) environmental
manipulation (modifying the environment to help the child succeed) .
, 3. When discussing pharmacologic therapy for a child with ADHD, the nurse should instruct the family
that the dosage of stimulant medications is primarily based on:
A. The child's weight in kilograms
B. The child's age in years
C. The resolution of symptoms and presence of side effects
D. The serum blood levels of the medication
Correct Answer: C
Rationale: The dosage for stimulant medications is titrated based on the child's therapeutic response
(resolution of symptoms) and the emergence of side effects, not strictly on the child's weight .
4. The nurse is assessing a newborn and notes a single palmar crease (simian crease), a flat nasal
bridge, a protruding tongue, and hypotonia. These findings are most suggestive of:
A. Fetal alcohol syndrome
B. Down syndrome (Trisomy 21)
C. Cerebral palsy
D. Autism spectrum disorder
Correct Answer: B
Rationale: These are classic physical features of Down syndrome, which is caused by an extra copy of
chromosome 21. Common findings include hypotonia, a single palmar crease, a flat facial profile, and a
protruding tongue .
5. A nurse is caring for an infant with Down syndrome. The nurse should be aware that this infant is at
a significantly higher risk for which comorbid condition?
A. Congenital heart defects (e.g., VSD)
B. Type 1 diabetes
C. Neuroblastoma
D. Cystic fibrosis
Correct Answer: A
Rationale: Infants with Down syndrome have a high incidence of congenital heart defects, most
commonly ventricular septal defects (VSDs) .
6. The parents of a 2-year-old newly diagnosed with autism spectrum disorder (ASD) ask the nurse
about the cause. Which response by the nurse is most accurate and therapeutic?