Guide Galen College of Nursing | Latest 2026/2027 Update |
Comprehensive Q&A Review
Introduction
This study guide provides a comprehensive review for NUR 254 Exam 4: Maternal and
Pediatrics at Galen College of Nursing. Exam 4 focuses primarily on pediatric hematologic
and immunologic disorders, with integration of maternal-newborn concepts .
Key Topics Covered:
Hematologic Disorders (Anemias, Sickle Cell, Hemophilia)
Pediatric Cancers (Leukemia, Wilms' Tumor, Neuroblastoma, Osteosarcoma)
Neurologic & Musculoskeletal Conditions
Pediatric Infections & Skin Disorders
Maternal-Newborn Review
,Section 1: Hematologic Disorders
Anemia – General Concepts
Q1. What are the clinical manifestations of anemia in children?
Answer:
Pallor – most common finding
Fatigue – due to decreased oxygen delivery
Tachycardia – heart attempting to compensate
Murmurs – due to increased viscosity and turbulence
Growth retardation – due to fatigue impacting milestone achievement
Mottling, decreased cap refill, cool extremities
Rationale: Anemia causes increased cardiac workload. Cluster care and small frequent
feedings are recommended to conserve energy .
Q2. What are normal pediatric hemoglobin (Hgb) and hematocrit (Hct) values?
Age Group Hemoglobin Hematocrit
1-6 years 9.5-14 g/dL 30-40%
6-18 years 10-15.5 g/dL 32-44%
Q3. What is the general management for anemia in children?
, Answer:
Treat underlying cause (nutritional intervention, transfusions after hemorrhage)
Supportive care: IV fluids, rest, decrease O₂ demands, supplemental oxygen PRN
Iron-rich foods and supplements as indicated
Blood transfusions when necessary
Iron Deficiency Anemia
Q4. What is the most common type of anemia in the U.S.?
Answer:
Iron deficiency anemia – primarily due to nutritional deficiency .
Q5. Which children are at highest risk for iron deficiency anemia?
Answer:
Children 12-36 months are at highest risk. Also at risk: "milk babies" (excessive cow's milk
intake without adequate iron sources) .
Rationale: Cow's milk is not recommended before 12 months because it is low in iron and
can cause occult GI bleeding. Even after 12 months, intake should be limited .
Q6. What are the causes of iron deficiency anemia?
Answer:
Inadequate dietary iron supply (nutritional deficiency)
Excessive cow's milk intake ("milk babies")
GI blood loss from cow's milk intolerance