,Galen NSG 3600 Exam 4 – Children's Health
(2026) Actual Q&A PDF
1. The nurse is teaching a parent about ADHD. Which neurotransmitter imbalance is associated with
this disorder?
A) Serotonin and acetylcholine
B) Dopamine and norepinephrine
C) GABA and glutamate
D) Histamine and melatonin
Correct Answer: Dopamine and norepinephrine
Rationale: ADHD is linked to imbalances in dopamine and norepinephrine, which affect attention,
impulse control, and executive function. Stimulant medications increase the availability of these
neurotransmitters.
2. A school‑age child with ADHD is prescribed methylphenidate. The parent asks how the dose is
determined. The nurse responds that dosing is based on:
A) The child’s weight
B) The child’s age
C) Resolution of symptoms, not weight
D) A standard dose for all children
Correct Answer: Resolution of symptoms, not weight
Rationale: Psychostimulants for ADHD are titrated based on clinical response—reduction of core
symptoms—rather than weight. The lowest effective dose is used. Weight is monitored for growth,
not dosing.
3. Which behavior is most characteristic of a child with autism spectrum disorder?
,A) Excessive eye contact and sharing of interests
B) Hand flapping and insistence on sameness
C) Hallucinations and delusions
D) Grandiose sense of self‑importance
Correct Answer: Hand flapping and insistence on sameness
Rationale: Core features of ASD include restricted, repetitive patterns of behavior, such as
stereotyped movements (hand flapping) and inflexible adherence to routines. Social communication
deficits are also present.
4. A child with Down syndrome has a single palmar crease, hypotonia, and a protruding tongue. The
nurse recognizes these as:
A) Signs of Fragile X syndrome
B) Classic physical characteristics of Trisomy 21
C) Indicators of hypothyroidism only
D) Side effects of growth hormone therapy
Correct Answer: Classic physical characteristics of Trisomy 21
Rationale: The single palmar crease (simian crease), hypotonia, flat nasal bridge, and protruding
tongue are characteristic features of Down syndrome. These findings, along with associated
conditions, guide health screening.
5. A parent of a child newly diagnosed with ADHD asks about non‑medication treatments. The nurse
explains that a three‑pronged approach includes pharmacologic therapy, behavioral therapy, and:
A) Strict dietary elimination
B) Environmental manipulation
C) Daily blood tests
D) Complete social isolation
, Correct Answer: Environmental manipulation
Rationale: ADHD management involves medication, behavioral therapy, and modifying the child’s
environment (structure, routine, reduced distractions) to support success. Dietary elimination and
isolation are not evidence‑based.
6. A child with autism spectrum disorder becomes distressed when the daily routine is changed.
Which nursing intervention is most appropriate?
A) Insist the child adapt to the new schedule immediately
B) Use a visual schedule and prepare the child in advance for changes
C) Place the child in time‑out until calm
D) Avoid all activities to prevent distress
Correct Answer: Use a visual schedule and prepare the child in advance for changes
Rationale: Predictability reduces anxiety in children with ASD. Visual schedules and advance warning
help the child anticipate transitions. Forcing adaptation or using punishment increases distress.
7. A child with Type 1 diabetes is ill with vomiting and fever. The parent asks if insulin should be given.
The nurse’s best response is:
A) “Skip the insulin until your child can eat.”
B) “Never withhold insulin; check blood glucose and ketones frequently, and call the provider if
needed.”
C) “Give half the usual dose only.”
D) “Switch to oral medication during the illness.”
Correct Answer: “Never withhold insulin; check blood glucose and ketones frequently, and call the
provider if needed.”
Rationale: During illness, insulin must be continued to prevent DKA. Blood glucose and ketones are
monitored frequently, and fluids are encouraged. The provider is contacted if the child cannot retain
fluids or has high ketones.
(2026) Actual Q&A PDF
1. The nurse is teaching a parent about ADHD. Which neurotransmitter imbalance is associated with
this disorder?
A) Serotonin and acetylcholine
B) Dopamine and norepinephrine
C) GABA and glutamate
D) Histamine and melatonin
Correct Answer: Dopamine and norepinephrine
Rationale: ADHD is linked to imbalances in dopamine and norepinephrine, which affect attention,
impulse control, and executive function. Stimulant medications increase the availability of these
neurotransmitters.
2. A school‑age child with ADHD is prescribed methylphenidate. The parent asks how the dose is
determined. The nurse responds that dosing is based on:
A) The child’s weight
B) The child’s age
C) Resolution of symptoms, not weight
D) A standard dose for all children
Correct Answer: Resolution of symptoms, not weight
Rationale: Psychostimulants for ADHD are titrated based on clinical response—reduction of core
symptoms—rather than weight. The lowest effective dose is used. Weight is monitored for growth,
not dosing.
3. Which behavior is most characteristic of a child with autism spectrum disorder?
,A) Excessive eye contact and sharing of interests
B) Hand flapping and insistence on sameness
C) Hallucinations and delusions
D) Grandiose sense of self‑importance
Correct Answer: Hand flapping and insistence on sameness
Rationale: Core features of ASD include restricted, repetitive patterns of behavior, such as
stereotyped movements (hand flapping) and inflexible adherence to routines. Social communication
deficits are also present.
4. A child with Down syndrome has a single palmar crease, hypotonia, and a protruding tongue. The
nurse recognizes these as:
A) Signs of Fragile X syndrome
B) Classic physical characteristics of Trisomy 21
C) Indicators of hypothyroidism only
D) Side effects of growth hormone therapy
Correct Answer: Classic physical characteristics of Trisomy 21
Rationale: The single palmar crease (simian crease), hypotonia, flat nasal bridge, and protruding
tongue are characteristic features of Down syndrome. These findings, along with associated
conditions, guide health screening.
5. A parent of a child newly diagnosed with ADHD asks about non‑medication treatments. The nurse
explains that a three‑pronged approach includes pharmacologic therapy, behavioral therapy, and:
A) Strict dietary elimination
B) Environmental manipulation
C) Daily blood tests
D) Complete social isolation
, Correct Answer: Environmental manipulation
Rationale: ADHD management involves medication, behavioral therapy, and modifying the child’s
environment (structure, routine, reduced distractions) to support success. Dietary elimination and
isolation are not evidence‑based.
6. A child with autism spectrum disorder becomes distressed when the daily routine is changed.
Which nursing intervention is most appropriate?
A) Insist the child adapt to the new schedule immediately
B) Use a visual schedule and prepare the child in advance for changes
C) Place the child in time‑out until calm
D) Avoid all activities to prevent distress
Correct Answer: Use a visual schedule and prepare the child in advance for changes
Rationale: Predictability reduces anxiety in children with ASD. Visual schedules and advance warning
help the child anticipate transitions. Forcing adaptation or using punishment increases distress.
7. A child with Type 1 diabetes is ill with vomiting and fever. The parent asks if insulin should be given.
The nurse’s best response is:
A) “Skip the insulin until your child can eat.”
B) “Never withhold insulin; check blood glucose and ketones frequently, and call the provider if
needed.”
C) “Give half the usual dose only.”
D) “Switch to oral medication during the illness.”
Correct Answer: “Never withhold insulin; check blood glucose and ketones frequently, and call the
provider if needed.”
Rationale: During illness, insulin must be continued to prevent DKA. Blood glucose and ketones are
monitored frequently, and fluids are encouraged. The provider is contacted if the child cannot retain
fluids or has high ketones.
