NSG 3600 Pediatrics Exam 2 – Complete Review Questions & Answers | Galen College of Nursing | Updated 2026–2027.

Complete Galen College of Nursing NSG 3600 (NSG3600) Pediatrics – Exam 4 Review featuring organized questions and answers for focused exam preparation. Designed to help review key pediatric nursing concepts, reinforce important Exam 4 material, and support efficient study. Latest updated for 2026–2027. Below are **all 75 questions with multiple-choice options only** from the uploaded **NSG 3600: Pediatrics — Exam 2** PDF. Correct answers and explanations have been removed. 1. **Why should feedings generally be stopped when an infant’s respiratory rate is greater than 60 breaths/min according to the Exam 2 notes?** A. The infant becomes hyperglycemic B. The infant has difficulty coordinating sucking, swallowing, and breathing C. The infant develops bradycardia D. Gastric emptying stops completely 2. **Persistent expiratory grunting in an infant should be interpreted as:** A. A normal finding after feeding B. A sign that requires prompt attention C. A manifestation of teething D. Expected abdominal breathing 3. **Which respiratory characteristic contributes to frequent otitis media in toddlers?** A. Long vertical Eustachian tubes B. Fully developed frontal sinuses C. Short, horizontal Eustachian tubes D. Large tracheal diameter 4. **Esophageal atresia is considered an emergency primarily because the infant:** A. Cannot safely be fed B. Will always have diarrhea C. Is unable to produce saliva D. Develops hypertension 5. **Which finding is strongly associated with esophageal atresia?** A. Strawberry tongue B. Frothing and bubbling at the mouth or nose C. Sandpaper rash D. Clubbing of the fingers 6. **Which maternal history is associated with esophageal atresia in the uploaded notes?** A. Oligohydramnios B. Diabetes only C. Polyhydramnios D. Hypertension 7. **A newborn has excessive secretions, cyanosis, choking with feeding, and an inability to pass an NG tube. What is the priority action?** A. Begin thickened oral feedings B. Place the infant NPO C. Place the infant flat D. Give pancreatic enzymes 8. **Which position is recommended preoperatively for an infant with esophageal atresia?** A. Flat supine B. Trendelenburg C. HOB elevated about 30–45 degrees with the head turned sideways D. Prone with the head below the stomach 9. **Cystic fibrosis is described in the notes as which type of disorder?** A. X-linked dominant B. Acquired autoimmune C. Autosomal recessive D. Viral 10. **Which diagnostic test is especially associated with cystic fibrosis?** A. Monospot test B. Quantitative sweat chloride test C. Rapid strep test D. PT/PTT 11. **Which newborn finding is identified as a classic gastrointestinal manifestation of cystic fibrosis?** A. Failure to pass meconium during the first 24–48 hours B. Frequent watery stools C. Bloody diarrhea D. Projectile vomiting 12. **Steatorrhea in a child with cystic fibrosis refers to:** A. Blood in the stool B. Hard, dry stools C. Fatty stools that may float D. Mucus-only stools 13. **A child with cystic fibrosis should receive pancreatic enzymes:** A. Once every morning B. Only with high-fat meals C. At bedtime only D. With every meal and snack 14. **Which vitamins are especially at risk for deficiency in cystic fibrosis?** A. B1, B6, B12, C B. A, D, E, K C. C and B12 only D. B2 and folate 15. **When should chest physiotherapy be scheduled for a child with cystic fibrosis?** A. Immediately after a large meal B. During the meal C. Before meals D. Only at bedtime 16. **Why should chest physiotherapy generally not be performed immediately after meals?** A. It may cause vomiting B. It causes hypoglycemia C. It raises intracranial pressure D. It causes hypertension 17. **Which diet is emphasized for a child with cystic fibrosis in the uploaded notes?** A. Low-calorie, low-fat diet B. High-calorie/high-nutrient diet C. Clear-liquid diet D. Sodium-free diet 18. **Acute streptococcal pharyngitis is caused by:** A. Group A beta-hemolytic streptococcus B. Haemophilus influenzae type B C. RSV D. Epstein-Barr virus 19. **Which finding is characteristic of group A streptococcal pharyngitis?** A. Koplik spots B. Petechiae on the palate and a fine sandpaper-like rash C. Vesicular lesions D. Inspiratory whoop 20. **What medication is identified as the drug of choice for streptococcal pharyngitis?** A. Acyclovir B. Oseltamivir C. Penicillin D. Albuterol 21. **If a child with streptococcal pharyngitis is allergic to penicillin, the study guide identifies which alternative?** A. Erythromycin B. Digoxin C. Indomethacin D. Furosemide 22. **Following tonsillectomy, which position best facilitates drainage of secretions?** A. Supine B. Side-lying C. Trendelenburg D. High Fowler's only 23. **Which finding after a tonsillectomy is particularly concerning for bleeding?** A. Sleeping B. Mild throat discomfort C. Persistent swallowing D. Refusal of ice cream 24. **Which food or drink should be avoided after tonsillectomy because it can make assessment for bleeding difficult?** A. Clear water B. Ice chips C. Apple juice D. Red or brown fluids 25. **Parents should be told that the tonsillectomy scab is especially likely to dislodge around:** A. Days 1–2 B. Days 3–4 C. Days 8–12 D. Weeks 4–6 26. **Which radiographic finding is associated with croup?** A. Thumb sign B. Steeple sign C. Boot-shaped heart D. Ground-glass appearance 27. **Which cough is characteristic of croup?** A. Productive wet cough B. Inspiratory whoop C. Seal-bark cough D. Bloody cough 28. **Inspiratory stridor in a child with croup may lead to an order for:** A. Digoxin B. Racemic epinephrine C. Indomethacin D. Penicillin 29. **Which intervention is emphasized for a child with croup?** A. Keep the child calm B. Encourage continuous crying to open the airway C. Place the child completely flat D. Perform repeated throat examinations 30. **Which radiographic sign is associated with acute epiglottitis?** A. Steeple sign B. Thumb sign C. Sail sign D. Halo sign 31. **The organism emphasized as a major cause of acute epiglottitis is:** A. Epstein-Barr virus B. Group A strep C. Haemophilus influenzae type B D. Bordetella pertussis 32. **Which action should be avoided in a child suspected of having acute epiglottitis?** A. Preparing emergency airway equipment B. Keeping the child calm C. Monitoring breathing D. Examining the throat unnecessarily 33. **Which vaccine is emphasized as a means of preventing epiglottitis caused by the organism highlighted in the notes?** A. MMR B. Hib C. HPV D. Hepatitis A 34. **Which finding is characteristic of otitis media?** A. Bulging, red, immobile tympanic membrane B. Strawberry tongue C. Steeple sign D. Koplik spots 35. **Which parent teaching helps decrease the risk of otitis media?** A. Prop the bottle during sleep B. Feed the child flat C. Hold the child upright during feedings and avoid bottle propping D. Use cotton swabs routinely 36. **Which symptom is most characteristic of pertussis?** A. Inspiratory whoop following paroxysmal coughing B. Sandpaper rash C. Enlarged parotid glands D. Strawberry tongue 37. **Which vaccine provides protection against pertussis in childhood?** A. IPV B. MMR C. DTaP D. Varicella 38. **Which medication is identified in the study material as a treatment for influenza when given early?** A. Oseltamivir B. Captopril C. Digoxin D. Indomethacin 39. **Which assessment finding is particularly emphasized in RSV/bronchiolitis?** A. Strawberry tongue B. Intercostal retractions and audible wheezing C. Enlarged liver only D. Bounding upper-extremity pulses 40. **Which medication is identified as the quick-relief drug for pediatric asthma?** A. Penicillin B. Furosemide C. Albuterol D. Aspirin 41. **Which chamber receives systemic venous blood from the superior and inferior vena cava?** A. Left atrium B. Right atrium C. Left ventricle D. Right ventricle 42. **Which vessel is unique because it carries deoxygenated blood away from the heart?** A. Pulmonary artery B. Pulmonary vein C. Aorta D. Coronary artery 43. **Which vessels return oxygenated blood from the lungs to the left atrium?** A. Vena cavae B. Pulmonary arteries C. Pulmonary veins D. Coronary sinus 44. **Cardiac output is calculated using which formula?** A. CO = BP × HR B. CO = SV × HR C. CO = preload ÷ afterload D. CO = HR ÷ SV 45. **Preload is best described as:** A. The resistance against which the heart ejects blood B. The electrical impulse from the SA node C. The amount of blood returning to and filling the heart before contraction D. The oxygen content of arterial blood 46. **Afterload refers to:** A. Pressure the ventricle must overcome to eject blood B. Blood returning to the heart before contraction C. Number of heartbeats per minute D. Amount of oxygen carried by hemoglobin 47. **In fetal circulation, the foramen ovale allows blood to flow directly from the:** A. Right atrium to left atrium B. Left ventricle to right ventricle C. Pulmonary artery to aorta D. Umbilical artery to vena cava 48. **The ductus arteriosus connects the:** A. Right atrium and left atrium B. Pulmonary artery and aorta C. Umbilical vein and liver D. Left ventricle and pulmonary vein 49. **Which statement distinguishes cyanotic from acyanotic congenital heart defects in the notes?** A. Cyanotic defects involve right-to-left shunting; acyanotic defects commonly involve left-to-right shunting B. Both always involve right-to-left shunting C. Acyanotic defects cause immediate clubbing at birth D. Cyanotic defects never affect oxygen saturation 50. **Which finding is identified as an important hallmark of cardiac dysfunction in an infant?** A. Increased appetite B. Poor feeding and poor growth C. Excessive weight gain from muscle growth D. Decreased need for sleep 51. **Which finding is associated with left-sided heart failure?** A. Pulmonary congestion with tachypnea and dyspnea B. Only peripheral edema C. Increased appetite D. Strong lower-extremity pulses 52. **Which finding is associated with systemic venous congestion/right-sided heart failure?** A. Only dry cough B. Hepatomegaly, peripheral edema, weight gain, and neck-vein distention C. Decreased liver size D. Weight loss without edema 53. **When feeding an infant with congestive heart failure, which intervention decreases energy expenditure?** A. Keep the infant completely flat B. Use low-calorie formula C. Elevate the HOB and use an enlarged nipple with high-calorie formula D. Force the infant to finish one large feeding 54. **Before administering digoxin to an infant, the nurse should:** A. Measure the apical pulse for a full minute B. Check the respiratory rate for 10 seconds C. Give furosemide first D. Restrict potassium 55. **The study guide instructs the nurse to hold digoxin in an infant when the pulse is below approximately:** A. 160 beats/min B. 130 beats/min C. 90–100 beats/min D. 120 beats/min 56. **Which finding is emphasized as an important sign of digoxin toxicity?** A. Increased appetite B. Vomiting C. Hypertension D. Polyuria 57. **What therapeutic digoxin level is listed in the study guide?** A. 0.8–2 ng/mL B. 3–5 ng/mL C. 5–10 ng/mL D. 0.1–0.4 ng/mL 58. **Furosemide helps treat CHF primarily by:** A. Increasing afterload B. Decreasing preload through diuresis C. Increasing fluid retention D. Closing a VSD 59. **Which dietary teaching is important for a child receiving furosemide?** A. Avoid potassium-containing foods B. Increase foods containing potassium C. Avoid all fruits D. Use a sodium supplement 60. **Captopril is used in cardiac disease primarily to:** A. Increase afterload B. Decrease afterload through vasodilation C. Increase preload D. Close the ductus arteriosus 61. **Before a cardiac catheterization, which nursing action is appropriate?** A. Encourage a full breakfast B. Assess for contrast/dye allergy and renal function and maintain NPO status as ordered C. Place the child prone D. Give an NSAID immediately before the procedure 62. **Following cardiac catheterization through the femoral site, which assessment has high priority?** A. Hair color B. Distal pulses, capillary refill, temperature, color, and bleeding at the site C. Visual acuity only D. Hearing assessment 63. **Which intervention helps the body eliminate contrast dye following cardiac catheterization?** A. Restrict all fluids B. Increase fluid intake as appropriate C. Give additional sodium D. Keep the child NPO for 24 hours 64. **Which congenital heart defect is identified in the notes as the most common?** A. Tetralogy of Fallot B. Coarctation of the aorta C. Ventricular septal defect D. Transposition of the great arteries 65. **Which murmur is associated with a VSD in the uploaded notes?** A. Machine-like murmur B. Harsh murmur with a thrill at the lower left sternal border C. Diastolic murmur over the carotids D. No murmur under any circumstances 66. **Which murmur is characteristic of patent ductus arteriosus?** A. Machine-like murmur B. Inspiratory murmur C. Friction rub only D. Venous hum 67. **Which medication may be used to promote closure of a PDA according to the uploaded study guide?** A. Prostaglandin B. Digoxin C. Indomethacin D. Morphine 68. **Which combination correctly lists the four defects in Tetralogy of Fallot?** A. ASD, mitral stenosis, aortic stenosis, PDA B. VSD, overriding aorta, right ventricular hypertrophy, pulmonary stenosis/atresia C. VSD, left ventricular hypertrophy, PDA, coarctation D. ASD, overriding pulmonary artery, mitral regurgitation, right atrial hypertrophy 69. **A child with Tetralogy of Fallot develops a cyanotic “Tet spell” after crying. What intervention is emphasized first in the study guide?** A. Place the child flat B. Put the child in knee-chest position C. Encourage running D. Administer a large feeding 70. **Which additional intervention is listed for a Tet spell when IV access is available?** A. Penicillin B. Indomethacin C. Morphine D. Furosemide only 71. **Which assessment pattern is characteristic of coarctation of the aorta?** A. Weak upper-extremity pulses and bounding femoral pulses B. Equal hypertension in all four extremities C. Upper-extremity hypertension with weak lower-extremity pulses D. Stronger lower-extremity perfusion than upper-extremity perfusion 72. **Which treatment may be used for coarctation of the aorta?** A. Balloon angioplasty or surgical repair B. Pancreatic enzymes C. Tonsillectomy D. Chest physiotherapy 73. **Which cluster of findings is most characteristic of the acute “red phase” of Kawasaki disease?** A. Persistent high fever, red/swollen hands and feet, strawberry tongue, cracked lips, conjunctival redness, and rash B. Inspiratory whoop and facial petechiae C. Steatorrhea and meconium ileus D. Weak femoral pulses with hypertension in the arms 74. **Which medications are particularly emphasized in the treatment of Kawasaki disease?** A. Penicillin and erythromycin B. IV immunoglobulin and aspirin C. Digoxin and albuterol D. Indomethacin and morphine 75. **A child develops migratory joint inflammation, carditis, erythema marginatum and subcutaneous nodules several weeks after group A streptococcal pharyngitis. Which condition should the nurse suspect?** A. Kawasaki disease B. Tetralogy of Fallot C. Rheumatic fever D. Cystic fibrosis