NUR 230 Exam 4 – Galen OB/Peds (2026-
2027) Actual Questions and Correct
Answers | Guarantee Pass
1. A nurse is assessing a child who has just been diagnosed with a brain tumor.
What is the earliest and most critical sign of increased intracranial pressure (ICP)
the nurse should monitor for?
A. Cushing's triad
B. Decorticate posturing
C. A change in level of consciousness
D. Papilledema
Correct Answer: C. A change in level of consciousness
Rationale: A change in level of consciousness (LOC) is often the earliest and most
sensitive indicator of increasing ICP. Subtle changes like confusion or lethargy can
be missed but are critical to detect. Cushing's triad, posturing, and papilledema
are late and more ominous signs of significantly elevated ICP.
2. A child is admitted with a suspected diagnosis of bacterial meningitis. Which
assessment finding is a classic sign of meningeal irritation in this child?
A. Positive Babinski reflex
B. Decorticate posturing
C. Inability to extend the leg when the thigh is flexed at the hip
D. Photophobia
Correct Answer: C. Inability to extend the leg when the thigh is flexed at the hip
Rationale: This describes a positive Kernig sign, which is a classic indicator of
meningeal irritation seen in meningitis. A positive Brudzinski sign is another key
sign. While a positive Babinski can be normal in infants, it is a sign of upper motor
neuron lesion, not specific to meningeal irritation. Decorticate posturing indicates
severe brain injury.
,3. An infant is diagnosed with myelomeningocele. What is the priority nursing
intervention immediately following birth?
A. Start intravenous antibiotics.
B. Position the infant prone.
C. Initiate enteral feedings.
D. Place a dry, sterile gauze over the sac.
Correct Answer: B. Position the infant prone.
Rationale: The primary goal is to protect the exposed spinal sac from trauma and
infection. Positioning the infant prone helps prevent pressure on the sac. The sac
should be kept moist with sterile, non-adherent saline-soaked gauze to prevent it
from drying out and cracking, not dry gauze. Antibiotics may be started later, and
feedings would be initiated after a plan of care is established.
4. A nurse is providing education to the parents of a child newly diagnosed with
Autism Spectrum Disorder. Which characteristic is most consistent with this
diagnosis?
A. Prefers to play with other children
B. Makes strong eye contact
C. Demonstrates a preference for routines
D. Adapts easily to changes in environment
Correct Answer: C. Demonstrates a preference for routines
Rationale: A key characteristic of autism is a strong preference for routines and
sameness, as these children often find comfort in a predictable environment. They
typically have difficulty with social interaction, avoid eye contact, and have trouble
adapting to change.
5. A school-age child is prescribed methylphenidate for ADHD. What is an
essential monitoring parameter that must be assessed at each monthly visit
before the prescription can be refilled?
,A. Blood pressure and weight
B. Visual acuity and hearing
C. Liver function tests
D. Complete blood count
Correct Answer: A. Blood pressure and weight
Rationale: Stimulant medications like methylphenidate can cause side effects such
as decreased appetite leading to weight loss and can also increase blood pressure
and heart rate. Therefore, regular monitoring of weight and blood pressure is
required, often monthly, before a prescription is refilled.
6. A child with hemophilia is brought to the emergency department with a
painful, swollen knee after a fall. Which nursing intervention is most appropriate
to manage this acute joint bleed?
A. Apply a warm compress to the joint.
B. Administer an intramuscular (IM) injection of pain medication.
C. Apply a cold compress to the joint.
D. Elevate the extremity above the heart.
Correct Answer: C. Apply a cold compress to the joint.
Rationale: For a joint bleed in a child with hemophilia, the priority is to manage
pain and swelling. Applying a cold compress (ice pack) is recommended as it helps
to constrict blood vessels and reduce swelling. Warm compresses would worsen
bleeding. IM injections are contraindicated due to the risk of hematoma
formation.
7. A 4-year-old child is diagnosed with Acute Lymphoid Leukemia (ALL). The
parents ask what the most common signs of this condition are. How should the
nurse respond?
A. "He will likely have persistent joint pain and petechiae."
B. "You will notice a significant increase in his appetite."
, C. "He will have a high platelet count and flushed skin."
D. "The first sign is usually a large, painless lump in the abdomen."
Correct Answer: A. "He will likely have persistent joint pain and petechiae."
Rationale: ALL is a cancer of the white blood cells that leads to bone marrow
failure. This results in anemia (fatigue, pallor), neutropenia (infection risk), and
thrombocytopenia (bleeding, petechiae). Joint pain is a cardinal sign of bone
marrow failure, and petechiae are common due to low platelets. Increased
appetite is not a sign; weight loss is more common.
8. The nurse is caring for a child with a Wilms tumor. Which nursing action is
most important to prevent complications?
A. Perform deep palpation of the abdomen to assess the tumor.
B. Ensure the child is on a low-sodium diet.
C. Place a "Do Not Palpate Abdomen" sign over the bed.
D. Encourage frequent ambulation.
Correct Answer: C. Place a "Do Not Palpate Abdomen" sign over the bed.
Rationale: A Wilms tumor is a kidney tumor that is encapsulated. Palpating the
abdomen can cause the tumor to rupture, leading to metastasis and severe
bleeding. It is a critical nursing action to avoid any palpation of the abdomen.
9. An infant's mother reports seeing a "white glow" or "cat's eye reflex" in the
child's eye. The nurse knows this finding is characteristic of which condition?
A. Retinoblastoma
B. Congenital cataracts
C. Strabismus
D. Glaucoma
Correct Answer: A. Retinoblastoma
Rationale: A white pupillary reflex (leukocoria), often described as a "cat's eye
reflex," is a classic and hallmark sign of retinoblastoma, a cancer of the retina. This
finding requires immediate further investigation.
2027) Actual Questions and Correct
Answers | Guarantee Pass
1. A nurse is assessing a child who has just been diagnosed with a brain tumor.
What is the earliest and most critical sign of increased intracranial pressure (ICP)
the nurse should monitor for?
A. Cushing's triad
B. Decorticate posturing
C. A change in level of consciousness
D. Papilledema
Correct Answer: C. A change in level of consciousness
Rationale: A change in level of consciousness (LOC) is often the earliest and most
sensitive indicator of increasing ICP. Subtle changes like confusion or lethargy can
be missed but are critical to detect. Cushing's triad, posturing, and papilledema
are late and more ominous signs of significantly elevated ICP.
2. A child is admitted with a suspected diagnosis of bacterial meningitis. Which
assessment finding is a classic sign of meningeal irritation in this child?
A. Positive Babinski reflex
B. Decorticate posturing
C. Inability to extend the leg when the thigh is flexed at the hip
D. Photophobia
Correct Answer: C. Inability to extend the leg when the thigh is flexed at the hip
Rationale: This describes a positive Kernig sign, which is a classic indicator of
meningeal irritation seen in meningitis. A positive Brudzinski sign is another key
sign. While a positive Babinski can be normal in infants, it is a sign of upper motor
neuron lesion, not specific to meningeal irritation. Decorticate posturing indicates
severe brain injury.
,3. An infant is diagnosed with myelomeningocele. What is the priority nursing
intervention immediately following birth?
A. Start intravenous antibiotics.
B. Position the infant prone.
C. Initiate enteral feedings.
D. Place a dry, sterile gauze over the sac.
Correct Answer: B. Position the infant prone.
Rationale: The primary goal is to protect the exposed spinal sac from trauma and
infection. Positioning the infant prone helps prevent pressure on the sac. The sac
should be kept moist with sterile, non-adherent saline-soaked gauze to prevent it
from drying out and cracking, not dry gauze. Antibiotics may be started later, and
feedings would be initiated after a plan of care is established.
4. A nurse is providing education to the parents of a child newly diagnosed with
Autism Spectrum Disorder. Which characteristic is most consistent with this
diagnosis?
A. Prefers to play with other children
B. Makes strong eye contact
C. Demonstrates a preference for routines
D. Adapts easily to changes in environment
Correct Answer: C. Demonstrates a preference for routines
Rationale: A key characteristic of autism is a strong preference for routines and
sameness, as these children often find comfort in a predictable environment. They
typically have difficulty with social interaction, avoid eye contact, and have trouble
adapting to change.
5. A school-age child is prescribed methylphenidate for ADHD. What is an
essential monitoring parameter that must be assessed at each monthly visit
before the prescription can be refilled?
,A. Blood pressure and weight
B. Visual acuity and hearing
C. Liver function tests
D. Complete blood count
Correct Answer: A. Blood pressure and weight
Rationale: Stimulant medications like methylphenidate can cause side effects such
as decreased appetite leading to weight loss and can also increase blood pressure
and heart rate. Therefore, regular monitoring of weight and blood pressure is
required, often monthly, before a prescription is refilled.
6. A child with hemophilia is brought to the emergency department with a
painful, swollen knee after a fall. Which nursing intervention is most appropriate
to manage this acute joint bleed?
A. Apply a warm compress to the joint.
B. Administer an intramuscular (IM) injection of pain medication.
C. Apply a cold compress to the joint.
D. Elevate the extremity above the heart.
Correct Answer: C. Apply a cold compress to the joint.
Rationale: For a joint bleed in a child with hemophilia, the priority is to manage
pain and swelling. Applying a cold compress (ice pack) is recommended as it helps
to constrict blood vessels and reduce swelling. Warm compresses would worsen
bleeding. IM injections are contraindicated due to the risk of hematoma
formation.
7. A 4-year-old child is diagnosed with Acute Lymphoid Leukemia (ALL). The
parents ask what the most common signs of this condition are. How should the
nurse respond?
A. "He will likely have persistent joint pain and petechiae."
B. "You will notice a significant increase in his appetite."
, C. "He will have a high platelet count and flushed skin."
D. "The first sign is usually a large, painless lump in the abdomen."
Correct Answer: A. "He will likely have persistent joint pain and petechiae."
Rationale: ALL is a cancer of the white blood cells that leads to bone marrow
failure. This results in anemia (fatigue, pallor), neutropenia (infection risk), and
thrombocytopenia (bleeding, petechiae). Joint pain is a cardinal sign of bone
marrow failure, and petechiae are common due to low platelets. Increased
appetite is not a sign; weight loss is more common.
8. The nurse is caring for a child with a Wilms tumor. Which nursing action is
most important to prevent complications?
A. Perform deep palpation of the abdomen to assess the tumor.
B. Ensure the child is on a low-sodium diet.
C. Place a "Do Not Palpate Abdomen" sign over the bed.
D. Encourage frequent ambulation.
Correct Answer: C. Place a "Do Not Palpate Abdomen" sign over the bed.
Rationale: A Wilms tumor is a kidney tumor that is encapsulated. Palpating the
abdomen can cause the tumor to rupture, leading to metastasis and severe
bleeding. It is a critical nursing action to avoid any palpation of the abdomen.
9. An infant's mother reports seeing a "white glow" or "cat's eye reflex" in the
child's eye. The nurse knows this finding is characteristic of which condition?
A. Retinoblastoma
B. Congenital cataracts
C. Strabismus
D. Glaucoma
Correct Answer: A. Retinoblastoma
Rationale: A white pupillary reflex (leukocoria), often described as a "cat's eye
reflex," is a classic and hallmark sign of retinoblastoma, a cancer of the retina. This
finding requires immediate further investigation.
