NSG3600 Exam 4 V1 | NSG 3600 Nursing
Practice – Children’s Health Exam Q&A |
Galen College of Nursing
1. A 6-year-old child is brought to the emergency department with suspected hypovolemic
shock. What is the initial recommended fluid bolus volume for this patient?
A. 10 mL/kg of 0.45% normal saline
B. 30 mL/kg of albumin
C. 5 mL/kg of 5% Dextrose in water
D. 20 mL/kg of Lactated Ringer’s or Normal Saline
Answer: D
Rationale: The standard initial fluid resuscitation for a pediatric patient in hypovolemic
shock is a 20 mL/kg bolus of an isotonic crystalloid, such as Normal Saline or Lactated
Ringer’s, to restore circulating volume quickly. This intervention is critical for maintaining
organ perfusion. Repeated boluses may be necessary based on the child’s clinical response
and vital signs.
2. When assessing a child with a suspected Wilms tumor, which nursing action is strictly
contraindicated?
A. Measuring the child’s blood pressure
B. Palpating the abdomen to determine tumor size
,C. Obtaining a urine sample for analysis
D. Auscultating bowel sounds in all four quadrants
Answer: B
Rationale: Palpating the abdomen of a child with a Wilms tumor is contraindicated
because manipulation can cause the protective capsule of the tumor to rupture, potentially
leading to the seeding of cancer cells throughout the abdominal cavity. This protocol is vital
for preventing metastasis. Nursing care focuses on gentle handling and clear labeling of the
bedside to prevent accidental palpation by other staff.
3. A nurse is caring for a child who has just been diagnosed with Acute Lymphocytic Leukemia
(ALL). Which lab value should the nurse prioritize?
A. Serum Creatinine
B. Absolute Neutrophil Count (ANC)
C. Aspartate Aminotransferase (AST)
D. Partial Thromboplastin Time (PTT)
Answer: B
Rationale: The Absolute Neutrophil Count is a critical indicator of the child’s ability to fight
infection, which is often compromised in leukemia due to the overproduction of immature
white blood cells. Monitoring ANC helps determine if the child requires neutropenic
precautions. Low ANC levels significantly increase the risk of life-threatening sepsis during
chemotherapy.
, 4. An infant is brought to the PICU with symptoms of increased intracranial pressure (ICP).
Which sign would the nurse expect to observe?
A. Sunken fontanels
B. Hypotension and tachycardia
C. Increased appetite and sucking reflex
D. High-pitched, shrill cry
Answer: D
Rationale: In infants, a high-pitched, shrill cry is a classic clinical manifestation of
increased intracranial pressure. Other signs include bulging fontanels, irritability, and
sunsetting eyes. Unlike adults, infants have open sutures that allow for some expansion, but
neurological distress remains a primary concern.
5. A child is admitted with severe dehydration. Which clinical finding best supports this
diagnosis?
A. Weight loss of 10% or more
B. Capillary refill time of 2 seconds
C. Moist mucous membranes
D. Urine output of 1.5 mL/kg/hr
Answer: A
Practice – Children’s Health Exam Q&A |
Galen College of Nursing
1. A 6-year-old child is brought to the emergency department with suspected hypovolemic
shock. What is the initial recommended fluid bolus volume for this patient?
A. 10 mL/kg of 0.45% normal saline
B. 30 mL/kg of albumin
C. 5 mL/kg of 5% Dextrose in water
D. 20 mL/kg of Lactated Ringer’s or Normal Saline
Answer: D
Rationale: The standard initial fluid resuscitation for a pediatric patient in hypovolemic
shock is a 20 mL/kg bolus of an isotonic crystalloid, such as Normal Saline or Lactated
Ringer’s, to restore circulating volume quickly. This intervention is critical for maintaining
organ perfusion. Repeated boluses may be necessary based on the child’s clinical response
and vital signs.
2. When assessing a child with a suspected Wilms tumor, which nursing action is strictly
contraindicated?
A. Measuring the child’s blood pressure
B. Palpating the abdomen to determine tumor size
,C. Obtaining a urine sample for analysis
D. Auscultating bowel sounds in all four quadrants
Answer: B
Rationale: Palpating the abdomen of a child with a Wilms tumor is contraindicated
because manipulation can cause the protective capsule of the tumor to rupture, potentially
leading to the seeding of cancer cells throughout the abdominal cavity. This protocol is vital
for preventing metastasis. Nursing care focuses on gentle handling and clear labeling of the
bedside to prevent accidental palpation by other staff.
3. A nurse is caring for a child who has just been diagnosed with Acute Lymphocytic Leukemia
(ALL). Which lab value should the nurse prioritize?
A. Serum Creatinine
B. Absolute Neutrophil Count (ANC)
C. Aspartate Aminotransferase (AST)
D. Partial Thromboplastin Time (PTT)
Answer: B
Rationale: The Absolute Neutrophil Count is a critical indicator of the child’s ability to fight
infection, which is often compromised in leukemia due to the overproduction of immature
white blood cells. Monitoring ANC helps determine if the child requires neutropenic
precautions. Low ANC levels significantly increase the risk of life-threatening sepsis during
chemotherapy.
, 4. An infant is brought to the PICU with symptoms of increased intracranial pressure (ICP).
Which sign would the nurse expect to observe?
A. Sunken fontanels
B. Hypotension and tachycardia
C. Increased appetite and sucking reflex
D. High-pitched, shrill cry
Answer: D
Rationale: In infants, a high-pitched, shrill cry is a classic clinical manifestation of
increased intracranial pressure. Other signs include bulging fontanels, irritability, and
sunsetting eyes. Unlike adults, infants have open sutures that allow for some expansion, but
neurological distress remains a primary concern.
5. A child is admitted with severe dehydration. Which clinical finding best supports this
diagnosis?
A. Weight loss of 10% or more
B. Capillary refill time of 2 seconds
C. Moist mucous membranes
D. Urine output of 1.5 mL/kg/hr
Answer: A
