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NSG 3600 Exam 2
Nursing Practice: Children's Health (Galen College of Nursing)
Comprehensive Study Guide and Practice Questions (2026)
Welcome to your NSG 3600 Exam 2 Study Guide! As your pediatric nursing educator, I
have crafted this comprehensive review to help you master the critical concepts of
children's health. This guide reflects the 2026 Galen College of Nursing curriculum and
is designed to test your clinical judgment, prioritization skills, and pathophysiological
understanding.
Remember, in pediatrics, airway is always priority, and family-centered care is the
foundation of everything we do. Take a deep breath, review the rationales carefully,
and let's get to work!
PART A: RESPIRATORY DISORDERS DRILL (Questions 1–10)
1. A 3-year-old is brought to the emergency department with sudden onset of fever, drooling,
and stridor. The child is sitting upright leaning forward on their hands. What is the priority
nursing intervention?
A. Lay the child supine to prepare for an abdominal assessment.
B. Examine the oropharynx using a tongue blade to visualize the epiglottis.
C. Keep the child in a sitting position, do not examine the throat, and prepare for intubation.
D. Administer racemic epinephrine via nebulizer immediately.
Answer: C.
Rationale: This child is exhibiting classic signs of epiglottitis—a medical emergency. The tripod
position maximizes airway patency. You must NEVER place the child supine or use a tongue
blade, as this can trigger complete airway obstruction. Preparation for intubation is the
priority. Racemic epinephrine is for croup, not epiglottitis.
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2. Which anatomical difference in infants increases their risk for acute otitis media (AOM)
compared to older children?
A. Longer and more angled Eustachian tubes
B. Shorter, wider, and more horizontal Eustachian tubes
C. Presence of the gag reflex until 6 months of age
D. Obligate mouth breathing until 12 months of age
Answer: B.
Rationale: Infants have Eustachian tubes that are shorter, wider, and more horizontal,
allowing nasopharyngeal secretions to pool and enter the middle ear easily. Infants are
obligate nose breathers, not mouth breathers.
3. A 6-month-old infant is diagnosed with bronchiolitis due to RSV. The provider orders
palivizumab (Synagis). The nurse understands that this medication is:
A. A cure for RSV once the infant is infected.
B. A monthly prophylactic injection given to high-risk infants during RSV season.
C. An antiviral oral suspension used for 5 days.
D. A broad-spectrum antibiotic to prevent secondary pneumonia.
Answer: B.
Rationale: Palivizumab (Synagis) is a monoclonal antibody administered monthly via
intramuscular injection to high-risk infants (e.g., premature, congenital heart disease) during
RSV season to prevent severe RSV infection. It is not a treatment.
4. A nurse is educating the parents of a child newly diagnosed with asthma. Which medication
should the nurse identify as a "controller" medication used for long-term prevention of
asthma symptoms?
A. Albuterol
B. Montelukast
C. Inhaled corticosteroids (ICS) like fluticasone
, 3
D. Oral prednisone
Answer: C.
Rationale: Inhaled corticosteroids (ICS) are the cornerstone of long-term controller therapy
due to their anti-inflammatory properties. Albuterol is a SABA used for quick relief.
Montelukast is a leukotriene modifier (adjunct), and prednisolone is for acute exacerbations.
5. A child with cystic fibrosis (CF) has pancreatic insufficiency. The nurse expects to administer
which medication with meals and snacks?
A. Dornase alfa (Pulmozyme)
B. Pancreatic enzymes (e.g., pancrelipase)
C. Fat-soluble vitamins only
D. Proton pump inhibitors (PPIs)
Answer: B.
Rationale: In CF, thick mucus blocks pancreatic enzymes from reaching the intestines, leading
to malabsorption and steatorrhea. Pancreatic enzymes must be given with all meals and
snacks to aid digestion and promote weight gain.
6. Which assessment finding is the hallmark sign of croup (laryngotracheobronchitis)?
A. Drooling and difficulty swallowing
B. A "barking" cough and inspiratory stridor
C. Expiratory wheezing and prolonged expiration
D. High fever and toxic appearance
Answer: B.
Rationale: Croup is characterized by a barking cough (often sounding like a seal) and
inspiratory stridor, typically worsening at night. Drooling and toxic appearance are signs of
epiglottitis. Wheezing indicates lower airway disease like asthma.
NSG 3600 Exam 2
Nursing Practice: Children's Health (Galen College of Nursing)
Comprehensive Study Guide and Practice Questions (2026)
Welcome to your NSG 3600 Exam 2 Study Guide! As your pediatric nursing educator, I
have crafted this comprehensive review to help you master the critical concepts of
children's health. This guide reflects the 2026 Galen College of Nursing curriculum and
is designed to test your clinical judgment, prioritization skills, and pathophysiological
understanding.
Remember, in pediatrics, airway is always priority, and family-centered care is the
foundation of everything we do. Take a deep breath, review the rationales carefully,
and let's get to work!
PART A: RESPIRATORY DISORDERS DRILL (Questions 1–10)
1. A 3-year-old is brought to the emergency department with sudden onset of fever, drooling,
and stridor. The child is sitting upright leaning forward on their hands. What is the priority
nursing intervention?
A. Lay the child supine to prepare for an abdominal assessment.
B. Examine the oropharynx using a tongue blade to visualize the epiglottis.
C. Keep the child in a sitting position, do not examine the throat, and prepare for intubation.
D. Administer racemic epinephrine via nebulizer immediately.
Answer: C.
Rationale: This child is exhibiting classic signs of epiglottitis—a medical emergency. The tripod
position maximizes airway patency. You must NEVER place the child supine or use a tongue
blade, as this can trigger complete airway obstruction. Preparation for intubation is the
priority. Racemic epinephrine is for croup, not epiglottitis.
,2
2. Which anatomical difference in infants increases their risk for acute otitis media (AOM)
compared to older children?
A. Longer and more angled Eustachian tubes
B. Shorter, wider, and more horizontal Eustachian tubes
C. Presence of the gag reflex until 6 months of age
D. Obligate mouth breathing until 12 months of age
Answer: B.
Rationale: Infants have Eustachian tubes that are shorter, wider, and more horizontal,
allowing nasopharyngeal secretions to pool and enter the middle ear easily. Infants are
obligate nose breathers, not mouth breathers.
3. A 6-month-old infant is diagnosed with bronchiolitis due to RSV. The provider orders
palivizumab (Synagis). The nurse understands that this medication is:
A. A cure for RSV once the infant is infected.
B. A monthly prophylactic injection given to high-risk infants during RSV season.
C. An antiviral oral suspension used for 5 days.
D. A broad-spectrum antibiotic to prevent secondary pneumonia.
Answer: B.
Rationale: Palivizumab (Synagis) is a monoclonal antibody administered monthly via
intramuscular injection to high-risk infants (e.g., premature, congenital heart disease) during
RSV season to prevent severe RSV infection. It is not a treatment.
4. A nurse is educating the parents of a child newly diagnosed with asthma. Which medication
should the nurse identify as a "controller" medication used for long-term prevention of
asthma symptoms?
A. Albuterol
B. Montelukast
C. Inhaled corticosteroids (ICS) like fluticasone
, 3
D. Oral prednisone
Answer: C.
Rationale: Inhaled corticosteroids (ICS) are the cornerstone of long-term controller therapy
due to their anti-inflammatory properties. Albuterol is a SABA used for quick relief.
Montelukast is a leukotriene modifier (adjunct), and prednisolone is for acute exacerbations.
5. A child with cystic fibrosis (CF) has pancreatic insufficiency. The nurse expects to administer
which medication with meals and snacks?
A. Dornase alfa (Pulmozyme)
B. Pancreatic enzymes (e.g., pancrelipase)
C. Fat-soluble vitamins only
D. Proton pump inhibitors (PPIs)
Answer: B.
Rationale: In CF, thick mucus blocks pancreatic enzymes from reaching the intestines, leading
to malabsorption and steatorrhea. Pancreatic enzymes must be given with all meals and
snacks to aid digestion and promote weight gain.
6. Which assessment finding is the hallmark sign of croup (laryngotracheobronchitis)?
A. Drooling and difficulty swallowing
B. A "barking" cough and inspiratory stridor
C. Expiratory wheezing and prolonged expiration
D. High fever and toxic appearance
Answer: B.
Rationale: Croup is characterized by a barking cough (often sounding like a seal) and
inspiratory stridor, typically worsening at night. Drooling and toxic appearance are signs of
epiglottitis. Wheezing indicates lower airway disease like asthma.
