NSG 3600 PEDIATRIC EXAM 2: QUESTIONS
AND CORRECT ANSWERS PLUS RATIONALES
NEW 2026-2027 FALL UPDATE GALEN
97 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply developmental and pathophysiological principles to prioritize nursing care for pediatric clients with
acute and chronic conditions
2 Analyze laboratory and diagnostic data to formulate safe, evidence-based nursing interventions for
pediatric populations
3 Evaluate family-centered care strategies that integrate cultural, ethical, and interprofessional
considerations in pediatric nursing practice
4 NSG 3600 Pediatric Exam 2
5 Questions and Correct Answers plus Rationales New 2026
6 2027 Fall Update Galen
7 Foundations of Pediatric Nursing
8 Applied Pediatric Nursing
9 Advanced Pediatric Nursing
10 Pediatric Nursing Review
ABSTRACT
This study document brings together 97 carefully worded exam questions drawn from NSG 3600
Pediatric Exam 2: Questions and Correct Answers plus Rationales New 2026-2027 Fall Update
Galen, with the strongest emphasis placed on Apply developmental and pathophysiological
principles to prioritize nursing care for pediatric clients with acute and chronic conditions, Analyze
laboratory and diagnostic data to formulate safe, evidence-based nursing interventions for pediatric
populations, Evaluate family-centered care strategies that integrate cultural, ethical and and
interprofessional considerations in pediatric nursing practice. Every item follows the wording style
and level of reasoning you meet in the real paper, and each one is paired with a clear rationale so
the correct choice is never a guess. Work through the set at your own pace, mark the questions
that slow you down, then come back to them until the reasoning feels automatic. Learners who
revise this way walk into the exam room recognising the pattern behind the questions instead of
meeting them for the first time. Keep going - steady, honest practice is what turns a difficult paper
into a comfortable pass.
Page 1
,Q1 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A child with a ventricular septal defect and moderate heart failure is prescribed
digoxin. Which pre-administration assessment finding most urgently requires
withholding the dose and notifying the provider?
A. Heart rate of 88 beats/min in a sleeping infant
B. Serum digoxin level of 1.2 ng/mL
C. Apical heart rate of 78 beats/min with irregular rhythm CORRECT
D. Weight gain of 0.3 kg over 48 hours
RATIONALE: Bradycardia and irregular rhythm in a child on digoxin suggest toxicity and warrant
withholding the dose. A level of 1.2 ng/mL is therapeutic, and mild weight gain may reflect fluid
status but is not an immediate reason to hold digoxin.
Q2 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
Which statement by a caregiver of a child with sickle cell disease indicates correct
understanding of hydroxyurea therapy?
A. It will cure the disease by replacing sickled cells with normal ones.
B. It increases fetal hemoglobin production and reduces painful vaso-occlusive episodes.
CORRECT
C. It should be stopped immediately if the child develops a fever.
D. It requires weekly blood transfusions to maintain effectiveness.
RATIONALE: Hydroxyurea increases fetal hemoglobin, which reduces sickling and
vaso-occlusive crises. It is not curative, does not require transfusions, and fever should prompt
evaluation but not automatic discontinuation.
Page 2
,Q3 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A toddler with severe dehydration from gastroenteritis has been rehydrated with IV
fluids. Which assessment finding best indicates the child is ready to transition to
oral rehydration?
A. Urine output of 0.5 mL/kg/hr and dry mucous membranes
B. Alertness, moist mucous membranes, and adequate urine output CORRECT
C. Normal serum sodium and persistent sunken fontanel
D. Weight gain of 2% and continued tachycardia
RATIONALE: Readiness for oral rehydration is indicated by improved mental status, moist
mucous membranes, and adequate urine output. Persistent sunken fontanel, tachycardia, or dry
mucous membranes indicate ongoing dehydration.
Q4 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A child receiving chemotherapy has an absolute neutrophil count of 400/mm3.
Which nursing action is most appropriate to include in the plan of care?
A. Administer live attenuated vaccines to boost immunity.
B. Use a soft-bristled toothbrush and avoid rectal temperatures. CORRECT
C. Encourage fresh flowers and plants in the room.
D. Perform frequent digital rectal exams to assess for bleeding.
RATIONALE: Severe neutropenia requires protective measures such as soft toothbrush and
avoiding rectal trauma. Live vaccines are contraindicated, fresh flowers can harbor pathogens,
and rectal exams increase infection risk.
Page 3
, Q5 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A child with increased intracranial pressure from a traumatic brain injury is
prescribed mannitol. Which parameter is most critical for the nurse to monitor
during administration?
A. Serum potassium level
B. Urine output and serum osmolality CORRECT
C. Heart rate variability
D. Liver function tests
RATIONALE: Mannitol is an osmotic diuretic that can cause dehydration and hyperosmolality;
monitoring urine output and serum osmolality is essential. Potassium and liver function are less
directly affected, and heart rate variability is not the primary concern.
Q6 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A child with cystic fibrosis is prescribed pancreatic enzyme replacement. Which
instruction should the nurse include when teaching the family?
A. Give enzymes with meals and snacks, and do not crush enteric-coated beads. CORRECT
B. Administer enzymes only when the child has abdominal pain.
C. Mix enzymes in a warm beverage to enhance absorption.
D. Hold enzymes if the child's stool becomes loose.
RATIONALE: Pancreatic enzymes must be given with all meals and snacks to aid digestion;
enteric-coated beads should not be crushed. They are not given PRN, should not be mixed in
warm liquids, and loose stools may indicate need for dose adjustment, not omission.
Page 4
AND CORRECT ANSWERS PLUS RATIONALES
NEW 2026-2027 FALL UPDATE GALEN
97 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply developmental and pathophysiological principles to prioritize nursing care for pediatric clients with
acute and chronic conditions
2 Analyze laboratory and diagnostic data to formulate safe, evidence-based nursing interventions for
pediatric populations
3 Evaluate family-centered care strategies that integrate cultural, ethical, and interprofessional
considerations in pediatric nursing practice
4 NSG 3600 Pediatric Exam 2
5 Questions and Correct Answers plus Rationales New 2026
6 2027 Fall Update Galen
7 Foundations of Pediatric Nursing
8 Applied Pediatric Nursing
9 Advanced Pediatric Nursing
10 Pediatric Nursing Review
ABSTRACT
This study document brings together 97 carefully worded exam questions drawn from NSG 3600
Pediatric Exam 2: Questions and Correct Answers plus Rationales New 2026-2027 Fall Update
Galen, with the strongest emphasis placed on Apply developmental and pathophysiological
principles to prioritize nursing care for pediatric clients with acute and chronic conditions, Analyze
laboratory and diagnostic data to formulate safe, evidence-based nursing interventions for pediatric
populations, Evaluate family-centered care strategies that integrate cultural, ethical and and
interprofessional considerations in pediatric nursing practice. Every item follows the wording style
and level of reasoning you meet in the real paper, and each one is paired with a clear rationale so
the correct choice is never a guess. Work through the set at your own pace, mark the questions
that slow you down, then come back to them until the reasoning feels automatic. Learners who
revise this way walk into the exam room recognising the pattern behind the questions instead of
meeting them for the first time. Keep going - steady, honest practice is what turns a difficult paper
into a comfortable pass.
Page 1
,Q1 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A child with a ventricular septal defect and moderate heart failure is prescribed
digoxin. Which pre-administration assessment finding most urgently requires
withholding the dose and notifying the provider?
A. Heart rate of 88 beats/min in a sleeping infant
B. Serum digoxin level of 1.2 ng/mL
C. Apical heart rate of 78 beats/min with irregular rhythm CORRECT
D. Weight gain of 0.3 kg over 48 hours
RATIONALE: Bradycardia and irregular rhythm in a child on digoxin suggest toxicity and warrant
withholding the dose. A level of 1.2 ng/mL is therapeutic, and mild weight gain may reflect fluid
status but is not an immediate reason to hold digoxin.
Q2 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
Which statement by a caregiver of a child with sickle cell disease indicates correct
understanding of hydroxyurea therapy?
A. It will cure the disease by replacing sickled cells with normal ones.
B. It increases fetal hemoglobin production and reduces painful vaso-occlusive episodes.
CORRECT
C. It should be stopped immediately if the child develops a fever.
D. It requires weekly blood transfusions to maintain effectiveness.
RATIONALE: Hydroxyurea increases fetal hemoglobin, which reduces sickling and
vaso-occlusive crises. It is not curative, does not require transfusions, and fever should prompt
evaluation but not automatic discontinuation.
Page 2
,Q3 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A toddler with severe dehydration from gastroenteritis has been rehydrated with IV
fluids. Which assessment finding best indicates the child is ready to transition to
oral rehydration?
A. Urine output of 0.5 mL/kg/hr and dry mucous membranes
B. Alertness, moist mucous membranes, and adequate urine output CORRECT
C. Normal serum sodium and persistent sunken fontanel
D. Weight gain of 2% and continued tachycardia
RATIONALE: Readiness for oral rehydration is indicated by improved mental status, moist
mucous membranes, and adequate urine output. Persistent sunken fontanel, tachycardia, or dry
mucous membranes indicate ongoing dehydration.
Q4 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A child receiving chemotherapy has an absolute neutrophil count of 400/mm3.
Which nursing action is most appropriate to include in the plan of care?
A. Administer live attenuated vaccines to boost immunity.
B. Use a soft-bristled toothbrush and avoid rectal temperatures. CORRECT
C. Encourage fresh flowers and plants in the room.
D. Perform frequent digital rectal exams to assess for bleeding.
RATIONALE: Severe neutropenia requires protective measures such as soft toothbrush and
avoiding rectal trauma. Live vaccines are contraindicated, fresh flowers can harbor pathogens,
and rectal exams increase infection risk.
Page 3
, Q5 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A child with increased intracranial pressure from a traumatic brain injury is
prescribed mannitol. Which parameter is most critical for the nurse to monitor
during administration?
A. Serum potassium level
B. Urine output and serum osmolality CORRECT
C. Heart rate variability
D. Liver function tests
RATIONALE: Mannitol is an osmotic diuretic that can cause dehydration and hyperosmolality;
monitoring urine output and serum osmolality is essential. Potassium and liver function are less
directly affected, and heart rate variability is not the primary concern.
Q6 APPLY DEVELOPMENTAL AND PATHOPHYSIOLOGICAL PRINCIPLES TO PRIORITIZE
NURSING CARE FOR PEDIATRIC CLIENTS WITH ACUTE AND CHRONIC CONDITIONS
A child with cystic fibrosis is prescribed pancreatic enzyme replacement. Which
instruction should the nurse include when teaching the family?
A. Give enzymes with meals and snacks, and do not crush enteric-coated beads. CORRECT
B. Administer enzymes only when the child has abdominal pain.
C. Mix enzymes in a warm beverage to enhance absorption.
D. Hold enzymes if the child's stool becomes loose.
RATIONALE: Pancreatic enzymes must be given with all meals and snacks to aid digestion;
enteric-coated beads should not be crushed. They are not given PRN, should not be mixed in
warm liquids, and loose stools may indicate need for dose adjustment, not omission.
Page 4
