NSG 3600 Exam 2 – Pediatric Nursing Complete
Practice Test Bank 2 VERSIONS
Instructions
• Correct Answers are in Bold Italics
• Rationales are in Italic
• Based on Galen College of Nursing NSG 3600 Exam 2 curriculum
• Covers pediatric cardiac, respiratory, infectious diseases, and growth
& development
1. A child with unrepaired left-to-right shunt develops clubbing of the fingers. This finding
suggests progression to which condition?
A. Eisenmenger syndrome
B. Superior vena cava syndrome
C. Cardiac tamponade
D. Pulmonary hypertension crisis
Correct Answer: A. Eisenmenger syndrome.
Rationale: Clubbing develops from chronic tissue hypoxia. Its progression in a child with an
unrepaired left-to-right shunt suggests reversal to right-to-left shunting, known as Eisenmenger
syndrome. This represents advanced pulmonary vascular disease that may no longer be
surgically correctable .
,2. A nurse is caring for an infant with heart failure. Which feeding strategy best supports
adequate nutrition while minimizing cardiac workload?
A. Offer large volumes every 4 hours to maximize intake
B. Use a nipple with a large hole to reduce sucking effort
C. Provide frequent, small feedings with rest periods
D. Supplement with high-sodium formula to promote fluid retention
Correct Answer: C. Provide frequent, small feedings with rest periods.
Rationale: Small, frequent feedings with rest periods reduce energy expenditure, prevent fatigue,
and improve overall intake in infants with increased metabolic demands. Large volumes and
large-hole nipples increase aspiration risk .
3. A child with rheumatic fever has Sydenham chorea. Which nursing intervention is most
appropriate?
A. Restrain limbs to prevent injury from involuntary movements
B. Provide a quiet environment and assist with activities of daily living
C. Administer sedatives around the clock to control movements
D. Encourage vigorous physical therapy to strengthen muscles
Correct Answer: B. Provide a quiet environment and assist with activities of daily living.
Rationale: A calm environment reduces stimulation that can exacerbate choreiform movements.
Assistance with ADLs supports safety and dignity during this self-limited condition. Restraints
increase agitation and injury risk .
4. Which statement by a new graduate nurse indicates understanding of digoxin toxicity
signs in infants?
,A. "I will report a heart rate above 160 bpm."
B. "Vomiting and poor feeding can be early signs of toxicity."
C. "A rash on the chest is a common side effect to monitor."
D. "Increased urine output means the dose is working well."
*Correct Answer: B. "Vomiting and poor feeding can be early signs of toxicity." *
Rationale: Gastrointestinal symptoms (vomiting, poor feeding, nausea) are often early, non-
specific signs of digoxin toxicity in infants. Bradycardia, not tachycardia, is a concerning sign .
5. A nurse is preparing enoxaparin for a pediatric patient. Which action is a priority before
administration?
A. Assess the injection site for bruising
B. Verify the child's weight in kilograms
C. Check the child's heart rate
D. Assess for bleeding after administration
Correct Answer: B. Verify the child's weight in kilograms.
Rationale: Enoxaparin is weight-based in pediatrics; inaccurate weight leads to under- or over-
dosing with risk of thrombosis or bleeding. Verify weight before each dose .
6. Which finding in a child with a pacemaker requires immediate evaluation?
A. Heart rate of 90 bpm while sleeping
B. Complaint of "fluttering" in the chest
C. Small scar at the generator site 6 months post-implant
D. Ability to participate in age-appropriate activities
Correct Answer: B. Complaint of "fluttering" in the chest.
, Rationale: Palpitations or "fluttering" may indicate pacemaker malfunction, arrhythmia, or lead
issue—requires prompt ECG and device interrogation. A paced rate of 90 bpm during sleep may
be appropriate depending on programmed settings .
7. A nurse is assessing a newborn immediately after birth. The nurse notes excessive
drooling and copious secretions pooling in the mouth. What is the nurse's immediate
priority?
A. Position the infant supine and suction the oropharynx
B. Recognize this as a medical emergency and prepare for immediate intervention
C. Feed the infant slowly to help clear the secretions
D. Place the infant in Trendelenburg position to facilitate drainage
Correct Answer: B. Recognize this as a medical emergency and prepare for immediate
intervention.
Rationale: Excessive drooling and secretions in a newborn are classic signs of esophageal
atresia, a medical emergency requiring immediate intervention to prevent aspiration and
respiratory compromise. Supine positioning increases aspiration risk; feeding will cause
aspiration .
8. A nurse is preparing a newborn with esophageal atresia for surgery. Which preoperative
positioning is most appropriate?
A. Supine with head of bed flat
B. Prone with head turned to the side
C. Supine with head elevated 30-40 degrees and turned sideways
D. Lateral recumbent with dependent lung down
Correct Answer: C. Supine with head elevated 30-40 degrees and turned sideways.
Practice Test Bank 2 VERSIONS
Instructions
• Correct Answers are in Bold Italics
• Rationales are in Italic
• Based on Galen College of Nursing NSG 3600 Exam 2 curriculum
• Covers pediatric cardiac, respiratory, infectious diseases, and growth
& development
1. A child with unrepaired left-to-right shunt develops clubbing of the fingers. This finding
suggests progression to which condition?
A. Eisenmenger syndrome
B. Superior vena cava syndrome
C. Cardiac tamponade
D. Pulmonary hypertension crisis
Correct Answer: A. Eisenmenger syndrome.
Rationale: Clubbing develops from chronic tissue hypoxia. Its progression in a child with an
unrepaired left-to-right shunt suggests reversal to right-to-left shunting, known as Eisenmenger
syndrome. This represents advanced pulmonary vascular disease that may no longer be
surgically correctable .
,2. A nurse is caring for an infant with heart failure. Which feeding strategy best supports
adequate nutrition while minimizing cardiac workload?
A. Offer large volumes every 4 hours to maximize intake
B. Use a nipple with a large hole to reduce sucking effort
C. Provide frequent, small feedings with rest periods
D. Supplement with high-sodium formula to promote fluid retention
Correct Answer: C. Provide frequent, small feedings with rest periods.
Rationale: Small, frequent feedings with rest periods reduce energy expenditure, prevent fatigue,
and improve overall intake in infants with increased metabolic demands. Large volumes and
large-hole nipples increase aspiration risk .
3. A child with rheumatic fever has Sydenham chorea. Which nursing intervention is most
appropriate?
A. Restrain limbs to prevent injury from involuntary movements
B. Provide a quiet environment and assist with activities of daily living
C. Administer sedatives around the clock to control movements
D. Encourage vigorous physical therapy to strengthen muscles
Correct Answer: B. Provide a quiet environment and assist with activities of daily living.
Rationale: A calm environment reduces stimulation that can exacerbate choreiform movements.
Assistance with ADLs supports safety and dignity during this self-limited condition. Restraints
increase agitation and injury risk .
4. Which statement by a new graduate nurse indicates understanding of digoxin toxicity
signs in infants?
,A. "I will report a heart rate above 160 bpm."
B. "Vomiting and poor feeding can be early signs of toxicity."
C. "A rash on the chest is a common side effect to monitor."
D. "Increased urine output means the dose is working well."
*Correct Answer: B. "Vomiting and poor feeding can be early signs of toxicity." *
Rationale: Gastrointestinal symptoms (vomiting, poor feeding, nausea) are often early, non-
specific signs of digoxin toxicity in infants. Bradycardia, not tachycardia, is a concerning sign .
5. A nurse is preparing enoxaparin for a pediatric patient. Which action is a priority before
administration?
A. Assess the injection site for bruising
B. Verify the child's weight in kilograms
C. Check the child's heart rate
D. Assess for bleeding after administration
Correct Answer: B. Verify the child's weight in kilograms.
Rationale: Enoxaparin is weight-based in pediatrics; inaccurate weight leads to under- or over-
dosing with risk of thrombosis or bleeding. Verify weight before each dose .
6. Which finding in a child with a pacemaker requires immediate evaluation?
A. Heart rate of 90 bpm while sleeping
B. Complaint of "fluttering" in the chest
C. Small scar at the generator site 6 months post-implant
D. Ability to participate in age-appropriate activities
Correct Answer: B. Complaint of "fluttering" in the chest.
, Rationale: Palpitations or "fluttering" may indicate pacemaker malfunction, arrhythmia, or lead
issue—requires prompt ECG and device interrogation. A paced rate of 90 bpm during sleep may
be appropriate depending on programmed settings .
7. A nurse is assessing a newborn immediately after birth. The nurse notes excessive
drooling and copious secretions pooling in the mouth. What is the nurse's immediate
priority?
A. Position the infant supine and suction the oropharynx
B. Recognize this as a medical emergency and prepare for immediate intervention
C. Feed the infant slowly to help clear the secretions
D. Place the infant in Trendelenburg position to facilitate drainage
Correct Answer: B. Recognize this as a medical emergency and prepare for immediate
intervention.
Rationale: Excessive drooling and secretions in a newborn are classic signs of esophageal
atresia, a medical emergency requiring immediate intervention to prevent aspiration and
respiratory compromise. Supine positioning increases aspiration risk; feeding will cause
aspiration .
8. A nurse is preparing a newborn with esophageal atresia for surgery. Which preoperative
positioning is most appropriate?
A. Supine with head of bed flat
B. Prone with head turned to the side
C. Supine with head elevated 30-40 degrees and turned sideways
D. Lateral recumbent with dependent lung down
Correct Answer: C. Supine with head elevated 30-40 degrees and turned sideways.
