NSG 3600 Exam 2 – Pediatric Nursing Complete
Practice Questions - Galen College (2026)
QUESTIONS 1–50: Cardiac Defects & Cardiovascular Disorders
QUESTION 1
A 2-year-old child is in congestive heart failure with a congenital heart
defect. Which assessment finding indicates a toxic digoxin level?
A) Tachycardia and hypertension
B) Bradycardia, nausea, and vomiting
C) Polyuria and polydipsia
D) Hyperglycemia and glycosuria
Correct Answer: B) Bradycardia, nausea, and vomiting
Rationale: Bradycardia and vomiting are classic signs of digoxin toxicity.
Other signs include nausea, visual disturbances, and cardiac arrhythmias .
QUESTION 2
A 3-year-old is being discharged with heart failure. The parents want to
know how much physical activity to allow. What is the nurse's best
response?
A) "Limit activity to 15 minutes per day"
B) "Allow him to regulate his activity"
C) "Encourage 30 minutes of daily exercise"
D) "Keep him on strict bed rest"
Correct Answer: B) "Allow him to regulate his activity"
,Rationale: Children with heart failure should be allowed to self-regulate their
activity. They will naturally stop when they become fatigued. Over-restriction
can lead to deconditioning .
QUESTION 3
A newborn is diagnosed with an atrial septal defect (ASD). The nurse knows
this means blood is shunting from the:
A) Right atrium to left atrium
B) Left atrium to right atrium
C) Right ventricle to left ventricle
D) Aorta to pulmonary artery
Correct Answer: B) Left atrium to right atrium
Rationale: ASD is an acyanotic defect with left-to-right shunting because the
left atrium has higher pressure than the right atrium. This increases
pulmonary blood flow .
QUESTION 4
A nurse is preparing a child for a cardiac catheterization via the femoral
artery. Which action should the nurse take post-procedure?
A) Encourage early ambulation
B) Check dorsalis pedis pulses in the affected extremity
C) Apply heat to the insertion site
D) Keep the child in a high-Fowler's position
Correct Answer: B) Check dorsalis pedis pulses in the affected extremity
,Rationale: The priority is to assess for arterial obstruction or hematoma at the
insertion site. Diminished or absent pulses distal to the site are critical
findings requiring immediate reporting. The child should remain on bed rest
with the affected leg straight .
QUESTION 5
A child is brought in with left-sided heart failure. Which symptom would
the nurse question?
A) Tachypnea
B) Pulmonary congestion
C) Hepatomegaly
D) Crackles
Correct Answer: C) Hepatomegaly
Rationale: Hepatomegaly is a sign of right-sided heart failure (backs up to the
rest of the body). Left-sided heart failure backs up to the lungs, causing
pulmonary congestion, tachypnea, and crackles [citation:8,10].
QUESTION 6
A child presents with a barking cough, low-grade fever, and inspiratory
stridor. The nurse suspects:
A) Epiglottitis
B) Laryngotracheobronchitis (Croup)
C) Bacterial tracheitis
D) Bronchiolitis
Correct Answer: B) Laryngotracheobronchitis (Croup)
, Rationale: Croup (laryngotracheobronchitis) is characterized by a "barking"
cough, inspiratory stridor, and varying degrees of respiratory distress,
typically in children aged 3-36 months [citation:10,11].
QUESTION 7
A toddler presents with drooling, difficulty swallowing, difficulty speaking,
and accessory muscle use that started suddenly after nap time. Which order
would the nurse question?
A) Obtain a throat culture and strep test
B) Prepare for intubation
C) Administer racemic epinephrine
D) Place the child in a position of comfort
Correct Answer: A) Obtain a throat culture and strep test
Rationale: These symptoms suggest epiglottitis, a life-threatening emergency.
The nurse should NOT attempt to visualize the throat or obtain a throat
culture as this can cause complete airway obstruction. The child should be
kept comfortable and prepared for possible intubation .
QUESTION 8
A newborn is coughing and choking each time they are fed. What should
the nurse do first?
A) Offer a smaller feeding
B) Place the infant in an upright position
C) Make the infant NPO
D) Assess the infant's gag reflex
Practice Questions - Galen College (2026)
QUESTIONS 1–50: Cardiac Defects & Cardiovascular Disorders
QUESTION 1
A 2-year-old child is in congestive heart failure with a congenital heart
defect. Which assessment finding indicates a toxic digoxin level?
A) Tachycardia and hypertension
B) Bradycardia, nausea, and vomiting
C) Polyuria and polydipsia
D) Hyperglycemia and glycosuria
Correct Answer: B) Bradycardia, nausea, and vomiting
Rationale: Bradycardia and vomiting are classic signs of digoxin toxicity.
Other signs include nausea, visual disturbances, and cardiac arrhythmias .
QUESTION 2
A 3-year-old is being discharged with heart failure. The parents want to
know how much physical activity to allow. What is the nurse's best
response?
A) "Limit activity to 15 minutes per day"
B) "Allow him to regulate his activity"
C) "Encourage 30 minutes of daily exercise"
D) "Keep him on strict bed rest"
Correct Answer: B) "Allow him to regulate his activity"
,Rationale: Children with heart failure should be allowed to self-regulate their
activity. They will naturally stop when they become fatigued. Over-restriction
can lead to deconditioning .
QUESTION 3
A newborn is diagnosed with an atrial septal defect (ASD). The nurse knows
this means blood is shunting from the:
A) Right atrium to left atrium
B) Left atrium to right atrium
C) Right ventricle to left ventricle
D) Aorta to pulmonary artery
Correct Answer: B) Left atrium to right atrium
Rationale: ASD is an acyanotic defect with left-to-right shunting because the
left atrium has higher pressure than the right atrium. This increases
pulmonary blood flow .
QUESTION 4
A nurse is preparing a child for a cardiac catheterization via the femoral
artery. Which action should the nurse take post-procedure?
A) Encourage early ambulation
B) Check dorsalis pedis pulses in the affected extremity
C) Apply heat to the insertion site
D) Keep the child in a high-Fowler's position
Correct Answer: B) Check dorsalis pedis pulses in the affected extremity
,Rationale: The priority is to assess for arterial obstruction or hematoma at the
insertion site. Diminished or absent pulses distal to the site are critical
findings requiring immediate reporting. The child should remain on bed rest
with the affected leg straight .
QUESTION 5
A child is brought in with left-sided heart failure. Which symptom would
the nurse question?
A) Tachypnea
B) Pulmonary congestion
C) Hepatomegaly
D) Crackles
Correct Answer: C) Hepatomegaly
Rationale: Hepatomegaly is a sign of right-sided heart failure (backs up to the
rest of the body). Left-sided heart failure backs up to the lungs, causing
pulmonary congestion, tachypnea, and crackles [citation:8,10].
QUESTION 6
A child presents with a barking cough, low-grade fever, and inspiratory
stridor. The nurse suspects:
A) Epiglottitis
B) Laryngotracheobronchitis (Croup)
C) Bacterial tracheitis
D) Bronchiolitis
Correct Answer: B) Laryngotracheobronchitis (Croup)
, Rationale: Croup (laryngotracheobronchitis) is characterized by a "barking"
cough, inspiratory stridor, and varying degrees of respiratory distress,
typically in children aged 3-36 months [citation:10,11].
QUESTION 7
A toddler presents with drooling, difficulty swallowing, difficulty speaking,
and accessory muscle use that started suddenly after nap time. Which order
would the nurse question?
A) Obtain a throat culture and strep test
B) Prepare for intubation
C) Administer racemic epinephrine
D) Place the child in a position of comfort
Correct Answer: A) Obtain a throat culture and strep test
Rationale: These symptoms suggest epiglottitis, a life-threatening emergency.
The nurse should NOT attempt to visualize the throat or obtain a throat
culture as this can cause complete airway obstruction. The child should be
kept comfortable and prepared for possible intubation .
QUESTION 8
A newborn is coughing and choking each time they are fed. What should
the nurse do first?
A) Offer a smaller feeding
B) Place the infant in an upright position
C) Make the infant NPO
D) Assess the infant's gag reflex
