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Exam (elaborations)

NSG 3500 Exam 4 Review — Children’s Health Nursing Practice

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NSG 3500 Exam 4 Review — Children’s Health Nursing Practice

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NSG 3500 Exam 4 Review — Children’s
Health Nursing Practice
Galen College of Nursing | 2026/2027 Study Guide

Current online materials associated with NSG 3500 Exam 4 include pediatric/newborn content
such as newborn assessment, transition to extrauterine life, respiratory problems, neonatal
complications, and pediatric nursing topics.

I can create an original practice review rather than reproduce actual Galen exam questions or a
proprietary test bank.

High-Yield Exam 4 Topics
1. Newborn assessment and transition
2. APGAR scoring
3. Normal newborn vital signs
4. Thermoregulation
5. Newborn reflexes
6. Jaundice and hyperbilirubinemia
7. Phototherapy
8. Neonatal hypoglycemia
9. Respiratory distress
10. Prematurity and post-term infants
11. Newborn medications and screening
12. Congenital abnormalities
13. Pediatric growth and development
14. Pediatric respiratory disorders
15. Pediatric cardiovascular disorders
16. Fluid and electrolyte problems
17. Pediatric infections
18. Sickle-cell disease
19. Diabetes and endocrine disorders
20. ADHD/autism and psychosocial development
21. Child safety and abuse recognition
22. Pediatric medication administration
23. Family-centered care
24. Prioritization and delegation

Sample Questions

1. A nurse assesses a newborn 30 minutes after birth. Which finding requires the most immediate
follow-up?

,A. Heart rate 138/min
B. Respiratory rate 68/min with nasal flaring
C. Temperature 36.8°C (98.2°F)
D. Acrocyanosis of the hands and feet

Answer: B

Rationale: A respiratory rate above the expected newborn range, particularly when accompanied
by nasal flaring, may indicate respiratory distress and requires prompt assessment.



2. A newborn receiving phototherapy is being cared for by the nurse. Which intervention is
appropriate?

A. Apply lotion to prevent dry skin
B. Monitor the newborn's temperature
C. Keep the newborn fully clothed
D. Cover the newborn's eyes only during feeding

Answer: B

Rationale: Temperature monitoring is important during phototherapy because newborns can
experience temperature instability. Eye protection should also be used appropriately during
treatment. (Studocu)



3. A newborn has bluish discoloration of the hands and feet while the trunk remains pink. How
should the nurse interpret this finding?

A. Central cyanosis
B. Acrocyanosis
C. Severe hypoxemia
D. Cardiac arrest

Answer: B

Rationale: Peripheral bluish discoloration of the hands and feet can occur normally during early
newborn transition. Central cyanosis involving the lips and trunk requires immediate evaluation.



4. Which newborn finding should the nurse report promptly?

,A. Strong sucking reflex
B. Passage of meconium
C. Abdominal distention with failure to pass stool
D. Brief sneezing

Answer: C

Rationale: Abdominal distention combined with failure to pass stool can indicate an intestinal
obstruction or another gastrointestinal abnormality and requires evaluation.



5. A newborn is at risk for hypoglycemia. Which assessment finding is concerning?

A. Jitteriness
B. Strong cry
C. Pink skin
D. Regular respirations

Answer: A

Rationale: Jitteriness, poor feeding, lethargy, temperature instability, and abnormal respiratory
patterns can occur with neonatal hypoglycemia.



6. Which action is most appropriate when caring for a newborn who is cold?

A. Bathe the newborn immediately
B. Place the newborn skin-to-skin with the parent
C. Remove the newborn's hat
D. Place the newborn near an open window

Answer: B

Rationale: Skin-to-skin contact is an effective method of supporting newborn thermoregulation
while promoting bonding.



7. A nurse is assessing a child with suspected respiratory distress. Which finding is most
concerning?

A. Mild cough
B. Nasal congestion

, C. Retractions and increasing work of breathing
D. Respiratory rate appropriate for age

Answer: C

Rationale: Retractions indicate increased work of breathing. Progressive respiratory distress
requires rapid assessment and intervention.



8. A child with sickle-cell disease reports severe pain. Which nursing intervention is appropriate?

A. Restrict fluids
B. Encourage hydration and administer prescribed analgesia
C. Apply prolonged cold therapy
D. Encourage strenuous exercise

Answer: B

Rationale: Hydration and appropriate pain management are important components of care
during a vaso-occlusive episode.



9. Which approach is most appropriate when communicating with a hospitalized toddler?

A. Give lengthy explanations
B. Use simple words and allow the child to make limited choices
C. Speak only with the parent
D. Avoid therapeutic play

Answer: B

Rationale: Toddlers benefit from simple explanations, consistency, play, and limited choices
that provide an appropriate sense of control.



10. A nurse suspects child abuse based on inconsistent explanations for injuries. What is the
priority nursing responsibility?

A. Conduct an independent investigation
B. Confront the caregiver
C. Follow mandated-reporting requirements and facility policy
D. Wait until the child confirms abuse

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