NSG 3600 Final Exam Actual Exam V2 | NSG 3600 Nursing Practice –
Children’s Health (NSG3600 Final Exam)
1. A 10-month-old infant is admitted with suspected bacterial meningitis. Which clinical
manifestation should the nurse prioritize during the initial assessment?
A. Depressed anterior fontanel
B. High-pitched cry and bulging fontanel
C. Positive Kernig sign
D. Hypothermia and bradycardia
Answer: B
Rationale: In infants, increased intracranial pressure caused by meningitis often manifests
as a high-pitched cry and a bulging fontanel. Unlike older children, infants may not display
classic nuchal rigidity or a positive Kernig sign reliably. Early recognition of these
symptoms is critical to prevent permanent neurological damage or death.
2. A 4-year-old child is brought to the emergency department with a sudden onset of high
fever, drooling, and an agitated state. The child is sitting in a ‘tripod’ position. What is the
nurse’s priority action?
A. Obtain a throat culture immediately
B. Inspect the throat using a tongue blade
C. Place the child in a supine position
D. Prepare for emergency airway management
Answer: D
Rationale: The child is exhibiting classic signs of epiglottitis, which is a medical emergency
due to the risk of total airway obstruction. Attempting to visualize the throat or using a
tongue blade can trigger a laryngospasm and complete airway closure. The nurse must
keep the child calm and prepare for intubation or tracheostomy while keeping emergency
equipment at the bedside.
3. Which developmental milestone should the nurse expect a typically developing 18-month-
old toddler to have achieved?
A. Using a spoon to eat with minimal spilling
B. Building a tower of six to seven blocks
C. Jumping in place with both feet
D. Walking up and down stairs while holding a hand
,Answer: D
Rationale: At 18 months, a toddler should be able to walk up and down stairs with
assistance and walk alone well. Building a tower of six blocks is typically a 24-month
milestone, and jumping in place is expected around 30 months. Identifying these
milestones helps the nurse assess for developmental delays during routine pediatric
screenings.
4. A nurse is caring for a 6-year-old child following a tonsillectomy. Which assessment finding
is the most sensitive indicator of postoperative hemorrhage?
A. Bright red emesis
B. A decrease in blood pressure
C. Frequent swallowing or clearing of the throat
D. Complaints of severe throat pain
Answer: C
Rationale: Frequent swallowing is a classic sign of bleeding in the throat as the child
instinctively swallows the blood. Hypotension is a late sign of shock and does not occur
until a significant amount of blood is lost in pediatric patients. The nurse must monitor for
this subtle sign closely during the first 24 hours and again 7 to 10 days post-op when the
scabs slough off.
5. A 2-month-old infant is diagnosed with Tetralogy of Fallot. During a blood draw, the infant
becomes cyanotic and has rapid, labored respirations. What is the nurse’s immediate
intervention?
A. Administer high-flow oxygen via mask
B. Start an intravenous line for fluid resuscitation
C. Place the infant in a knee-chest position
D. Prepare to administer intramuscular morphine
Answer: C
Rationale: This infant is experiencing a hypercyanotic spell, often called a ‘Tet spell.’
Placing the infant in the knee-chest position increases systemic vascular resistance, which
forces more blood into the pulmonary artery to improve oxygenation. While oxygen and
morphine may be used, the physical repositioning is the first and fastest intervention to
stabilize the child.
6. A school-age child is admitted with a diagnosis of Acute Glomerulonephritis (AGN). Which
clinical finding should the nurse anticipate?
A. Hypotension and polyuria
B. Periorbital edema and tea-colored urine
, C. Massive proteinuria and low cholesterol
D. Increased appetite and weight loss
Answer: B
Rationale: AGN typically follows a streptococcal infection and presents with hematuria,
which gives the urine a smoky or tea-colored appearance. Periorbital edema is common
due to sodium and water retention caused by decreased glomerular filtration. Monitoring
blood pressure and daily weights is essential for these patients as hypertension is a
common complication.
7. The nurse is providing discharge education to the parents of a child newly diagnosed with
Celiac disease. Which food choice indicates that the parents understand the dietary
restrictions?
A. Corn tortillas with grilled chicken
B. Oatmeal with barley
C. Whole wheat crackers
D. Spaghetti made from rye flour
Answer: A
Rationale: Celiac disease requires a lifelong gluten-free diet, which means avoiding wheat,
barley, and rye. Corn, rice, and potatoes are safe alternatives that do not contain gluten. The
nurse must emphasize checking labels for hidden gluten in processed foods to prevent
intestinal damage and malabsorption.
8. A 12-year-old with Type 1 Diabetes Mellitus is found confused and diaphoretic after gym
class. What is the nurse’s first action?
A. Check the blood glucose level
B. Administer 15 grams of rapid-acting carbohydrates
C. Call the provider for a change in insulin dose
D. Provide a snack containing complex protein
Answer: B
Rationale: The child is showing symptoms of hypoglycemia, which can be life-threatening
if it progresses to a seizure or coma. While checking blood glucose is ideal, if the child is
symptomatic and glucose testing is not immediately available, the nurse should treat for
hypoglycemia first. The ‘15-15’ rule involves giving 15g of simple carbs and rechecking in
15 minutes.
9. Which assessment finding in a 3-week-old infant is most suggestive of Pyloric Stenosis?
A. Currant jelly-like stools
Children’s Health (NSG3600 Final Exam)
1. A 10-month-old infant is admitted with suspected bacterial meningitis. Which clinical
manifestation should the nurse prioritize during the initial assessment?
A. Depressed anterior fontanel
B. High-pitched cry and bulging fontanel
C. Positive Kernig sign
D. Hypothermia and bradycardia
Answer: B
Rationale: In infants, increased intracranial pressure caused by meningitis often manifests
as a high-pitched cry and a bulging fontanel. Unlike older children, infants may not display
classic nuchal rigidity or a positive Kernig sign reliably. Early recognition of these
symptoms is critical to prevent permanent neurological damage or death.
2. A 4-year-old child is brought to the emergency department with a sudden onset of high
fever, drooling, and an agitated state. The child is sitting in a ‘tripod’ position. What is the
nurse’s priority action?
A. Obtain a throat culture immediately
B. Inspect the throat using a tongue blade
C. Place the child in a supine position
D. Prepare for emergency airway management
Answer: D
Rationale: The child is exhibiting classic signs of epiglottitis, which is a medical emergency
due to the risk of total airway obstruction. Attempting to visualize the throat or using a
tongue blade can trigger a laryngospasm and complete airway closure. The nurse must
keep the child calm and prepare for intubation or tracheostomy while keeping emergency
equipment at the bedside.
3. Which developmental milestone should the nurse expect a typically developing 18-month-
old toddler to have achieved?
A. Using a spoon to eat with minimal spilling
B. Building a tower of six to seven blocks
C. Jumping in place with both feet
D. Walking up and down stairs while holding a hand
,Answer: D
Rationale: At 18 months, a toddler should be able to walk up and down stairs with
assistance and walk alone well. Building a tower of six blocks is typically a 24-month
milestone, and jumping in place is expected around 30 months. Identifying these
milestones helps the nurse assess for developmental delays during routine pediatric
screenings.
4. A nurse is caring for a 6-year-old child following a tonsillectomy. Which assessment finding
is the most sensitive indicator of postoperative hemorrhage?
A. Bright red emesis
B. A decrease in blood pressure
C. Frequent swallowing or clearing of the throat
D. Complaints of severe throat pain
Answer: C
Rationale: Frequent swallowing is a classic sign of bleeding in the throat as the child
instinctively swallows the blood. Hypotension is a late sign of shock and does not occur
until a significant amount of blood is lost in pediatric patients. The nurse must monitor for
this subtle sign closely during the first 24 hours and again 7 to 10 days post-op when the
scabs slough off.
5. A 2-month-old infant is diagnosed with Tetralogy of Fallot. During a blood draw, the infant
becomes cyanotic and has rapid, labored respirations. What is the nurse’s immediate
intervention?
A. Administer high-flow oxygen via mask
B. Start an intravenous line for fluid resuscitation
C. Place the infant in a knee-chest position
D. Prepare to administer intramuscular morphine
Answer: C
Rationale: This infant is experiencing a hypercyanotic spell, often called a ‘Tet spell.’
Placing the infant in the knee-chest position increases systemic vascular resistance, which
forces more blood into the pulmonary artery to improve oxygenation. While oxygen and
morphine may be used, the physical repositioning is the first and fastest intervention to
stabilize the child.
6. A school-age child is admitted with a diagnosis of Acute Glomerulonephritis (AGN). Which
clinical finding should the nurse anticipate?
A. Hypotension and polyuria
B. Periorbital edema and tea-colored urine
, C. Massive proteinuria and low cholesterol
D. Increased appetite and weight loss
Answer: B
Rationale: AGN typically follows a streptococcal infection and presents with hematuria,
which gives the urine a smoky or tea-colored appearance. Periorbital edema is common
due to sodium and water retention caused by decreased glomerular filtration. Monitoring
blood pressure and daily weights is essential for these patients as hypertension is a
common complication.
7. The nurse is providing discharge education to the parents of a child newly diagnosed with
Celiac disease. Which food choice indicates that the parents understand the dietary
restrictions?
A. Corn tortillas with grilled chicken
B. Oatmeal with barley
C. Whole wheat crackers
D. Spaghetti made from rye flour
Answer: A
Rationale: Celiac disease requires a lifelong gluten-free diet, which means avoiding wheat,
barley, and rye. Corn, rice, and potatoes are safe alternatives that do not contain gluten. The
nurse must emphasize checking labels for hidden gluten in processed foods to prevent
intestinal damage and malabsorption.
8. A 12-year-old with Type 1 Diabetes Mellitus is found confused and diaphoretic after gym
class. What is the nurse’s first action?
A. Check the blood glucose level
B. Administer 15 grams of rapid-acting carbohydrates
C. Call the provider for a change in insulin dose
D. Provide a snack containing complex protein
Answer: B
Rationale: The child is showing symptoms of hypoglycemia, which can be life-threatening
if it progresses to a seizure or coma. While checking blood glucose is ideal, if the child is
symptomatic and glucose testing is not immediately available, the nurse should treat for
hypoglycemia first. The ‘15-15’ rule involves giving 15g of simple carbs and rechecking in
15 minutes.
9. Which assessment finding in a 3-week-old infant is most suggestive of Pyloric Stenosis?
A. Currant jelly-like stools
