NSG 3600 Final Exam Actual Exam V1 | NSG 3600 Nursing Practice –
Children’s Health (NSG3600 Final Exam)
1. A nurse is assessing a 6-month-old infant during a well-baby visit. According to Erikson’s
stages of psychosocial development, which task should the infant be mastering?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Industry vs. Inferiority
D. Trust vs. Mistrust
Answer: D
Rationale: This exam comprehensively evaluates the student’s ability to integrate
developmental theories with clinical practice. Erikson identifies the infancy stage (birth to
1 year) as Trust vs. Mistrust, where the infant learns to rely on caregivers for basic needs.
Failure to meet these needs results in a sense of mistrust and anxiety regarding the world.
2. A 2-year-old child is admitted with a suspected case of epiglottitis. Which nursing action is
the highest priority?
A. Obtain a throat culture to identify the causative organism.
B. Assess the child’s throat using a tongue depressor.
C. Ensure emergency intubation equipment is at the bedside.
D. Place the child in a supine position to facilitate breathing.
Answer: C
Rationale: Epiglottitis is a medical emergency that can lead to rapid airway obstruction.
The nurse should never examine the throat with a tongue depressor as it can trigger a
laryngospasm. Airway maintenance is the absolute priority, so intubation or tracheostomy
equipment must be immediately available.
3. A 4-year-old is hospitalized for a surgical procedure. Which tool is most appropriate for the
nurse to use when assessing this child’s pain level?
A. The Wong-Baker FACES scale
B. The FLACC scale
C. The Numeric Rating Scale (0-10)
D. Visual Analog Scale
Answer: A
,Rationale: The Wong-Baker FACES scale is designed for children as young as 3 years old
because they can point to a face that represents their pain level. The FLACC scale is
behavior-based and usually used for non-verbal infants or children. Numeric scales are
usually reserved for children older than 8 who understand numerical values.
4. The nurse is providing discharge education to the parents of a child with Tetralogy of Fallot.
Which position should the nurse instruct the parents to use if the child experiences a ‘Tet
spell’?
A. High Fowler’s position
B. Prone position
C. Knee-chest position
D. Trendelenburg position
Answer: C
Rationale: A ‘Tet spell’ or hypercyanotic spell involves a sudden decrease in pulmonary
blood flow. The knee-chest position increases systemic vascular resistance, which helps
shunt blood back into the pulmonary artery. This is a critical evidence-based intervention
to improve oxygenation during acute cyanosis.
5. A school-age child is admitted with a vaso-occlusive sickle cell crisis. Which of the following
provider orders should the nurse implement first?
A. Administer 0.9% Normal Saline at 150 mL/hr.
B. Administer Meperidine (Demerol) 2mg/kg IV for pain.
C. Apply cold compresses to the affected joints.
D. Administer oxygen via nasal cannula at 2L/min.
Answer: A
Rationale: Hydration is the priority in a sickle cell crisis to reduce blood viscosity and
prevent further sickling/infarction. While oxygen and pain management are important,
hydration directly addresses the underlying cause of the occlusion. Meperidine is
contraindicated in pediatric sickle cell patients due to the risk of seizures.
6. Which of the following findings would the nurse expect to assess in a 10-month-old infant
with Intussusception?
A. Ribbon-like, foul-smelling stools
B. Projectile vomiting after feedings
C. Pain localized in the lower left quadrant
D. Currant jelly-like stools containing blood and mucus
, Answer: D
Rationale: Intussusception is the telescoping of one part of the intestine into another,
leading to ischemia. The ‘currant jelly’ stool is a hallmark sign caused by the leakage of
blood and mucus into the intestinal lumen. Ribbon-like stools are associated with
Hirschsprung’s disease, and projectile vomiting is a sign of pyloric stenosis.
7. A nurse is teaching the parents of a toddler with Cystic Fibrosis (CF) about nutritional
management. Which instruction is most important?
A. Restricting salt intake during summer months.
B. Providing a low-fat, low-protein diet.
C. Administering pancreatic enzymes with all meals and snacks.
D. Feeding the child immediately before chest physiotherapy.
Answer: C
Rationale: In CF, thick mucus blocks the pancreatic ducts, preventing digestive enzymes
from reaching the duodenum. Pancreatic enzymes must be taken with all food to ensure the
absorption of nutrients and fat-soluble vitamins. CF patients actually require high-calorie,
high-protein, and high-fat diets with liberal salt intake.
8. A 7-year-old child with Glomerulonephritis is being monitored for complications. Which
finding should the nurse report to the provider immediately?
A. Brown ‘tea-colored’ urine
B. Periorbital edema
C. Mild proteinuria
D. Blood pressure of 145/95 mmHg
Answer: D
Rationale: Acute Glomerulonephritis can lead to severe hypertension and encephalopathy.
A blood pressure of 145/95 is significantly elevated for a 7-year-old and requires
immediate intervention to prevent seizures or cardiac strain. Tea-colored urine and
periorbital edema are expected findings of the disease process.
9. The nurse is assessing a child with suspected Nephrotic Syndrome. Which of the following
clinical manifestations are characteristic of this disorder? (Select all that apply: 1. Proteinuria,
2. Hypoalbuminemia, 3. Gross hematuria, 4. Edema)
A. 1, 2, and 4
B. 2, 3, and 4
C. 1, 2, and 3
Children’s Health (NSG3600 Final Exam)
1. A nurse is assessing a 6-month-old infant during a well-baby visit. According to Erikson’s
stages of psychosocial development, which task should the infant be mastering?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Industry vs. Inferiority
D. Trust vs. Mistrust
Answer: D
Rationale: This exam comprehensively evaluates the student’s ability to integrate
developmental theories with clinical practice. Erikson identifies the infancy stage (birth to
1 year) as Trust vs. Mistrust, where the infant learns to rely on caregivers for basic needs.
Failure to meet these needs results in a sense of mistrust and anxiety regarding the world.
2. A 2-year-old child is admitted with a suspected case of epiglottitis. Which nursing action is
the highest priority?
A. Obtain a throat culture to identify the causative organism.
B. Assess the child’s throat using a tongue depressor.
C. Ensure emergency intubation equipment is at the bedside.
D. Place the child in a supine position to facilitate breathing.
Answer: C
Rationale: Epiglottitis is a medical emergency that can lead to rapid airway obstruction.
The nurse should never examine the throat with a tongue depressor as it can trigger a
laryngospasm. Airway maintenance is the absolute priority, so intubation or tracheostomy
equipment must be immediately available.
3. A 4-year-old is hospitalized for a surgical procedure. Which tool is most appropriate for the
nurse to use when assessing this child’s pain level?
A. The Wong-Baker FACES scale
B. The FLACC scale
C. The Numeric Rating Scale (0-10)
D. Visual Analog Scale
Answer: A
,Rationale: The Wong-Baker FACES scale is designed for children as young as 3 years old
because they can point to a face that represents their pain level. The FLACC scale is
behavior-based and usually used for non-verbal infants or children. Numeric scales are
usually reserved for children older than 8 who understand numerical values.
4. The nurse is providing discharge education to the parents of a child with Tetralogy of Fallot.
Which position should the nurse instruct the parents to use if the child experiences a ‘Tet
spell’?
A. High Fowler’s position
B. Prone position
C. Knee-chest position
D. Trendelenburg position
Answer: C
Rationale: A ‘Tet spell’ or hypercyanotic spell involves a sudden decrease in pulmonary
blood flow. The knee-chest position increases systemic vascular resistance, which helps
shunt blood back into the pulmonary artery. This is a critical evidence-based intervention
to improve oxygenation during acute cyanosis.
5. A school-age child is admitted with a vaso-occlusive sickle cell crisis. Which of the following
provider orders should the nurse implement first?
A. Administer 0.9% Normal Saline at 150 mL/hr.
B. Administer Meperidine (Demerol) 2mg/kg IV for pain.
C. Apply cold compresses to the affected joints.
D. Administer oxygen via nasal cannula at 2L/min.
Answer: A
Rationale: Hydration is the priority in a sickle cell crisis to reduce blood viscosity and
prevent further sickling/infarction. While oxygen and pain management are important,
hydration directly addresses the underlying cause of the occlusion. Meperidine is
contraindicated in pediatric sickle cell patients due to the risk of seizures.
6. Which of the following findings would the nurse expect to assess in a 10-month-old infant
with Intussusception?
A. Ribbon-like, foul-smelling stools
B. Projectile vomiting after feedings
C. Pain localized in the lower left quadrant
D. Currant jelly-like stools containing blood and mucus
, Answer: D
Rationale: Intussusception is the telescoping of one part of the intestine into another,
leading to ischemia. The ‘currant jelly’ stool is a hallmark sign caused by the leakage of
blood and mucus into the intestinal lumen. Ribbon-like stools are associated with
Hirschsprung’s disease, and projectile vomiting is a sign of pyloric stenosis.
7. A nurse is teaching the parents of a toddler with Cystic Fibrosis (CF) about nutritional
management. Which instruction is most important?
A. Restricting salt intake during summer months.
B. Providing a low-fat, low-protein diet.
C. Administering pancreatic enzymes with all meals and snacks.
D. Feeding the child immediately before chest physiotherapy.
Answer: C
Rationale: In CF, thick mucus blocks the pancreatic ducts, preventing digestive enzymes
from reaching the duodenum. Pancreatic enzymes must be taken with all food to ensure the
absorption of nutrients and fat-soluble vitamins. CF patients actually require high-calorie,
high-protein, and high-fat diets with liberal salt intake.
8. A 7-year-old child with Glomerulonephritis is being monitored for complications. Which
finding should the nurse report to the provider immediately?
A. Brown ‘tea-colored’ urine
B. Periorbital edema
C. Mild proteinuria
D. Blood pressure of 145/95 mmHg
Answer: D
Rationale: Acute Glomerulonephritis can lead to severe hypertension and encephalopathy.
A blood pressure of 145/95 is significantly elevated for a 7-year-old and requires
immediate intervention to prevent seizures or cardiac strain. Tea-colored urine and
periorbital edema are expected findings of the disease process.
9. The nurse is assessing a child with suspected Nephrotic Syndrome. Which of the following
clinical manifestations are characteristic of this disorder? (Select all that apply: 1. Proteinuria,
2. Hypoalbuminemia, 3. Gross hematuria, 4. Edema)
A. 1, 2, and 4
B. 2, 3, and 4
C. 1, 2, and 3
