NSG 3600 EXAM 3 (GALEN) NEWEST 2026/2027 ACTUAL EXAM
TEST BANK |PEDIATRIC NURSING EXAM 3 REVIEW WITH
COMPLETE 350 REAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALES ALREADY GRADED A+
(BRAND NEW!!)
1. A child with sickle cell disease is admitted with a vaso-occlusive crisis.
Which nursing intervention is the priority?
a. Administer meperidine for pain control
b. Apply ice packs to the painful joints
c. Provide adequate hydration and pain management
d. Place the child in a supine position
Correct Answer - C
Rationale: Hydration and pain management are the priorities for a vaso-
occlusive crisis. Meperidine is generally avoided (risk of seizures); ice
is not used; supine positioning is not specifically indicated.
2. A child with hemophilia A presents with a swollen, painful knee after a fall.
Which intervention should the nurse implement first?
a. Administer factor VIII replacement
b. Apply heat to the joint
c. Administer aspirin for pain
d. Immobilize the joint and elevate it
Correct Answer - A
Rationale: Factor VIII replacement is the specific treatment for hemophilia A
and should be given promptly to stop bleeding. RICE (rest, ice, compression,
elevation) is also used, but factor replacement is the definitive treatment.
Aspirin is contraindicated.
3. A child is diagnosed with immune thrombocytopenic purpura (ITP). Which
finding is most concerning?
a. Platelet count of 50,000/µL
1
, b. Petechiae on the lower extremities
c. Epistaxis that is difficult to control
d. Bruising on the shins
Correct Answer - C
Rationale: Epistaxis that is difficult to control indicates significant
bleeding risk. Severe bleeding (intracranial, GI) is the major concern in
ITP. Platelet count 50,000 is relatively safe; petechiae and bruises are
common.
4. A child with thalassemia major is receiving frequent blood transfusions.
Which complication is associated with chronic transfusion therapy?
a. Iron overload leading to hemosiderosis
b. Hypertension
c. Hyperkalemia
d. Hypocalcemia
Correct Answer - A
Rationale: Each unit of blood contains iron. Chronic transfusions cause iron
overload, leading to hemosiderosis (organ damage: liver, heart, endocrine).
Chelation therapy (deferoxamine) is used.
5. A child with iron deficiency anemia is prescribed oral iron supplements.
Which instruction should the nurse include in parent teaching?
a. "Administer iron with milk to prevent stomach upset."
b. "Iron may cause black, tarry stools; this is normal."
c. "Iron should be given on a full stomach."
d. "Iron can be taken with calcium supplements for better absorption."
Correct Answer - B
Rationale: Iron causes dark/black stools, which is a normal side effect.
Iron should be given on an empty stomach (or with vitamin C) for better
absorption; milk and calcium interfere with absorption.
6. A child is diagnosed with aplastic anemia. Which finding is expected?
a. Pancytopenia (low RBC, WBC, platelets)
2
, b. Elevated WBC and platelet count
c. Polycythemia
d. Elevated ferritin
Correct Answer - A
Rationale: Aplastic anemia is bone marrow failure leading to pancytopenia.
This causes anemia, neutropenia (infection risk), and thrombocytopenia
(bleeding risk).
7. A 3-year-old child is diagnosed with acute lymphoblastic leukemia (ALL).
Which clinical manifestation is most common at diagnosis?
a. Pallor, fatigue, fever, and bone pain
b. Hepatomegaly and jaundice
c. Edema and hypertension
d. Rash and joint swelling
Correct Answer - A
Rationale: ALL presents with signs of bone marrow failure: anemia (pallor,
fatigue), neutropenia (fever, infections), thrombocytopenia (bleeding), and
bone pain due to infiltration of bones.
8. A child with ALL is receiving chemotherapy. Which side effect requires
immediate intervention?
a. Nausea and vomiting
b. Hair loss
c. Fever with neutropenia
d. Mucositis
Correct Answer - C
Rationale: Fever in a neutropenic child indicates possible sepsis and requires
immediate evaluation, cultures, and broad-spectrum antibiotics. Neutropenic
fever is an oncologic emergency.
9. A child is diagnosed with Wilms tumor (nephroblastoma). Which nursing
intervention is a priority?
a. Avoid palpation of the abdomen to prevent tumor rupture
3
, b. Administer chemotherapy only
c. Encourage vigorous physical activity
d. Place the child in a prone position
Correct Answer - A
Rationale: Wilms tumor is an encapsulated renal tumor. Palpation can cause
tumor rupture and spillage of malignant cells. The abdomen should be handled
gently, and a sign "Do not palpate abdomen" is often placed.
10. A child is diagnosed with neuroblastoma. Which finding is characteristic?
a. Abdominal mass, periorbital ecchymosis (raccoon eyes), and bone pain
b. Hepatomegaly and splenomegaly
c. Lymphadenopathy and weight loss
d. Fever and night sweats
Correct Answer - A
Rationale: Neuroblastoma presents with an abdominal or thoracic mass.
Periorbital ecchymosis and proptosis are common due to retro-orbital
metastasis. Bone pain is common from metastases.
11. A child is diagnosed with osteosarcoma. Which finding is expected?
a. Pain and swelling in the long bones (distal femur, proximal tibia)
b. Painful, swollen joints
c. Bone pain that is worse at night and relieved by NSAIDs
d. Fever and night sweats
Correct Answer - A
Rationale: Osteosarcoma typically presents in the metaphysis of long bones
(distal femur, proximal tibia, proximal humerus) with localized pain and
swelling. Pain may be worse at night.
12. A child is diagnosed with Ewing sarcoma. Which finding is characteristic?
a. Pain and swelling in the diaphysis of long bones, often with fever
b. "Onion-skin" appearance on X-ray
c. Pain that worsens at night
d. All of the above
4
TEST BANK |PEDIATRIC NURSING EXAM 3 REVIEW WITH
COMPLETE 350 REAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALES ALREADY GRADED A+
(BRAND NEW!!)
1. A child with sickle cell disease is admitted with a vaso-occlusive crisis.
Which nursing intervention is the priority?
a. Administer meperidine for pain control
b. Apply ice packs to the painful joints
c. Provide adequate hydration and pain management
d. Place the child in a supine position
Correct Answer - C
Rationale: Hydration and pain management are the priorities for a vaso-
occlusive crisis. Meperidine is generally avoided (risk of seizures); ice
is not used; supine positioning is not specifically indicated.
2. A child with hemophilia A presents with a swollen, painful knee after a fall.
Which intervention should the nurse implement first?
a. Administer factor VIII replacement
b. Apply heat to the joint
c. Administer aspirin for pain
d. Immobilize the joint and elevate it
Correct Answer - A
Rationale: Factor VIII replacement is the specific treatment for hemophilia A
and should be given promptly to stop bleeding. RICE (rest, ice, compression,
elevation) is also used, but factor replacement is the definitive treatment.
Aspirin is contraindicated.
3. A child is diagnosed with immune thrombocytopenic purpura (ITP). Which
finding is most concerning?
a. Platelet count of 50,000/µL
1
, b. Petechiae on the lower extremities
c. Epistaxis that is difficult to control
d. Bruising on the shins
Correct Answer - C
Rationale: Epistaxis that is difficult to control indicates significant
bleeding risk. Severe bleeding (intracranial, GI) is the major concern in
ITP. Platelet count 50,000 is relatively safe; petechiae and bruises are
common.
4. A child with thalassemia major is receiving frequent blood transfusions.
Which complication is associated with chronic transfusion therapy?
a. Iron overload leading to hemosiderosis
b. Hypertension
c. Hyperkalemia
d. Hypocalcemia
Correct Answer - A
Rationale: Each unit of blood contains iron. Chronic transfusions cause iron
overload, leading to hemosiderosis (organ damage: liver, heart, endocrine).
Chelation therapy (deferoxamine) is used.
5. A child with iron deficiency anemia is prescribed oral iron supplements.
Which instruction should the nurse include in parent teaching?
a. "Administer iron with milk to prevent stomach upset."
b. "Iron may cause black, tarry stools; this is normal."
c. "Iron should be given on a full stomach."
d. "Iron can be taken with calcium supplements for better absorption."
Correct Answer - B
Rationale: Iron causes dark/black stools, which is a normal side effect.
Iron should be given on an empty stomach (or with vitamin C) for better
absorption; milk and calcium interfere with absorption.
6. A child is diagnosed with aplastic anemia. Which finding is expected?
a. Pancytopenia (low RBC, WBC, platelets)
2
, b. Elevated WBC and platelet count
c. Polycythemia
d. Elevated ferritin
Correct Answer - A
Rationale: Aplastic anemia is bone marrow failure leading to pancytopenia.
This causes anemia, neutropenia (infection risk), and thrombocytopenia
(bleeding risk).
7. A 3-year-old child is diagnosed with acute lymphoblastic leukemia (ALL).
Which clinical manifestation is most common at diagnosis?
a. Pallor, fatigue, fever, and bone pain
b. Hepatomegaly and jaundice
c. Edema and hypertension
d. Rash and joint swelling
Correct Answer - A
Rationale: ALL presents with signs of bone marrow failure: anemia (pallor,
fatigue), neutropenia (fever, infections), thrombocytopenia (bleeding), and
bone pain due to infiltration of bones.
8. A child with ALL is receiving chemotherapy. Which side effect requires
immediate intervention?
a. Nausea and vomiting
b. Hair loss
c. Fever with neutropenia
d. Mucositis
Correct Answer - C
Rationale: Fever in a neutropenic child indicates possible sepsis and requires
immediate evaluation, cultures, and broad-spectrum antibiotics. Neutropenic
fever is an oncologic emergency.
9. A child is diagnosed with Wilms tumor (nephroblastoma). Which nursing
intervention is a priority?
a. Avoid palpation of the abdomen to prevent tumor rupture
3
, b. Administer chemotherapy only
c. Encourage vigorous physical activity
d. Place the child in a prone position
Correct Answer - A
Rationale: Wilms tumor is an encapsulated renal tumor. Palpation can cause
tumor rupture and spillage of malignant cells. The abdomen should be handled
gently, and a sign "Do not palpate abdomen" is often placed.
10. A child is diagnosed with neuroblastoma. Which finding is characteristic?
a. Abdominal mass, periorbital ecchymosis (raccoon eyes), and bone pain
b. Hepatomegaly and splenomegaly
c. Lymphadenopathy and weight loss
d. Fever and night sweats
Correct Answer - A
Rationale: Neuroblastoma presents with an abdominal or thoracic mass.
Periorbital ecchymosis and proptosis are common due to retro-orbital
metastasis. Bone pain is common from metastases.
11. A child is diagnosed with osteosarcoma. Which finding is expected?
a. Pain and swelling in the long bones (distal femur, proximal tibia)
b. Painful, swollen joints
c. Bone pain that is worse at night and relieved by NSAIDs
d. Fever and night sweats
Correct Answer - A
Rationale: Osteosarcoma typically presents in the metaphysis of long bones
(distal femur, proximal tibia, proximal humerus) with localized pain and
swelling. Pain may be worse at night.
12. A child is diagnosed with Ewing sarcoma. Which finding is characteristic?
a. Pain and swelling in the diaphysis of long bones, often with fever
b. "Onion-skin" appearance on X-ray
c. Pain that worsens at night
d. All of the above
4
