Galen NSG 3600 Exam 4 | Nursing Practice: Children's
Health (2026) Actual Q&A PDF
1. A nurse is caring for a child with neutropenia. Which of the following is NOT
appropriate for this child?
A) Placing a "No rectal temps" sign over the bed
B) Screening visitors for illnesses
C) Placing the child in a semi-private room
D) Washing hands before all procedures
Correct Answer: Placing the child in a semi-private room
Rationale: Neutropenic children are at severe risk for infection and require a private
room to minimize exposure to pathogens. Rectal temperature monitoring is avoided
to prevent mucosal trauma, visitors are screened for illness, and hand hygiene is
essential. A semi-private room increases the risk of cross-contamination.
2. Which of the following conditions is characterized by a whitish pupil?
A) Congenital Glaucoma
B) Corneal Abrasion
C) Congenital Cataracts
D) Retinoblastoma
Correct Answer: Retinoblastoma
Rationale: Retinoblastoma, a malignant tumor of the retina, classically presents with
leukocoria (a whitish pupillary reflex). Congenital glaucoma presents with corneal
enlargement and tearing, corneal abrasion causes pain and tearing, and congenital
,cataracts may also cause leukocoria but retinoblastoma is the most critical diagnosis
to identify early.
3. Which of the following lab values for a child receiving chemotherapy would
require the nurse to administer prophylactic medication for PCP immediately?
A) Platelet count 450 mm³
B) Hematocrit 33%
C) WBC 2,000 mm³
D) Hemoglobin 9.2 g/dL
Correct Answer: WBC 2,000 mm³
Rationale: A WBC of 2,000 mm³ indicates severe immunosuppression and a high risk
for opportunistic infections such as Pneumocystis jirovecii pneumonia (PCP).
Prophylactic antibiotics are indicated. Platelet count, hematocrit, and hemoglobin
values are less directly associated with PCP risk.
4. Which of the following actions is NOT appropriate when caring for a child with
strep pharyngitis and nausea/vomiting?
A) Encouraging plenty of rest
B) Encouraging sips of electrolyte replacement solutions
C) Withholding insulin until vomiting stops
D) Checking every void for ketones
Correct Answer: Withholding insulin until vomiting stops
Rationale: Insulin should never be withheld during illness without a provider's order
due to the risk of diabetic ketoacidosis. Stress hormones increase blood glucose
,during illness. Rest, electrolyte solutions, and monitoring for ketones are appropriate
nursing interventions.
5. A 4-year-old child with leukemia is hospitalized for chemotherapy. Which
laboratory value should the nurse prioritize to determine the child's risk for infection?
A) Platelet count
B) Absolute Neutrophil Count (ANC)
C) Hemoglobin level
D) Serum creatinine
Correct Answer: Absolute Neutrophil Count (ANC)
Rationale: The ANC is the most accurate predictor of a child's ability to fight
infection. An ANC lower than 500/mm³ indicates severe risk for life-threatening
infections. Platelet count assesses bleeding risk, hemoglobin assesses anemia, and
creatinine assesses renal function.
6. The nurse is assessing an infant with suspected Tetralogy of Fallot. Which clinical
manifestation is most characteristic of a "tet spell"?
A) Bounding peripheral pulses
B) Bradypnea and hypertension
C) Increased urine output and lethargy
D) Sudden onset of cyanosis and hyperpnea
Correct Answer: Sudden onset of cyanosis and hyperpnea
Rationale: A hypercyanotic spell ("tet spell") is characterized by a sudden increase in
cyanosis and rapid, deep respirations due to decreased pulmonary blood flow and
, increased right-to-left shunting. Knee-chest position is the priority intervention to
increase systemic vascular resistance and improve oxygenation.
7. When caring for a child with a suspected Wilms tumor, which action is most
important for the nurse to perform?
A) Measure abdominal girth every 4 hours
B) Place a sign over the bed that says "No Abdominal Palpation"
C) Palpate the abdomen to determine tumor size
D) Prepare the child for an immediate lumbar puncture
Correct Answer: Place a sign over the bed that says "No Abdominal Palpation"
Rationale: Wilms tumor is an encapsulated kidney tumor, and palpation can cause
the capsule to rupture, leading to dissemination of cancer cells. The nurse must
ensure everyone avoids abdominal palpation to prevent metastasis. Measuring girth
and palpation are contraindicated, and lumbar puncture is unrelated.
8. A 10-year-old is admitted with diabetic ketoacidosis (DKA). Which IV fluid order
should the nurse expect to implement first?
A) Dextrose 5% in water (D5W)
B) 0.9% Normal Saline (NS) bolus
C) D5 0.45% NS with 20 mEq KCL
D) Total Parenteral Nutrition (TPN)
Correct Answer: 0.9% Normal Saline (NS) bolus
Rationale: The initial priority in treating DKA is restoring intravascular volume and
improving tissue perfusion through fluid resuscitation. Normal Saline (0.9%) is the
Health (2026) Actual Q&A PDF
1. A nurse is caring for a child with neutropenia. Which of the following is NOT
appropriate for this child?
A) Placing a "No rectal temps" sign over the bed
B) Screening visitors for illnesses
C) Placing the child in a semi-private room
D) Washing hands before all procedures
Correct Answer: Placing the child in a semi-private room
Rationale: Neutropenic children are at severe risk for infection and require a private
room to minimize exposure to pathogens. Rectal temperature monitoring is avoided
to prevent mucosal trauma, visitors are screened for illness, and hand hygiene is
essential. A semi-private room increases the risk of cross-contamination.
2. Which of the following conditions is characterized by a whitish pupil?
A) Congenital Glaucoma
B) Corneal Abrasion
C) Congenital Cataracts
D) Retinoblastoma
Correct Answer: Retinoblastoma
Rationale: Retinoblastoma, a malignant tumor of the retina, classically presents with
leukocoria (a whitish pupillary reflex). Congenital glaucoma presents with corneal
enlargement and tearing, corneal abrasion causes pain and tearing, and congenital
,cataracts may also cause leukocoria but retinoblastoma is the most critical diagnosis
to identify early.
3. Which of the following lab values for a child receiving chemotherapy would
require the nurse to administer prophylactic medication for PCP immediately?
A) Platelet count 450 mm³
B) Hematocrit 33%
C) WBC 2,000 mm³
D) Hemoglobin 9.2 g/dL
Correct Answer: WBC 2,000 mm³
Rationale: A WBC of 2,000 mm³ indicates severe immunosuppression and a high risk
for opportunistic infections such as Pneumocystis jirovecii pneumonia (PCP).
Prophylactic antibiotics are indicated. Platelet count, hematocrit, and hemoglobin
values are less directly associated with PCP risk.
4. Which of the following actions is NOT appropriate when caring for a child with
strep pharyngitis and nausea/vomiting?
A) Encouraging plenty of rest
B) Encouraging sips of electrolyte replacement solutions
C) Withholding insulin until vomiting stops
D) Checking every void for ketones
Correct Answer: Withholding insulin until vomiting stops
Rationale: Insulin should never be withheld during illness without a provider's order
due to the risk of diabetic ketoacidosis. Stress hormones increase blood glucose
,during illness. Rest, electrolyte solutions, and monitoring for ketones are appropriate
nursing interventions.
5. A 4-year-old child with leukemia is hospitalized for chemotherapy. Which
laboratory value should the nurse prioritize to determine the child's risk for infection?
A) Platelet count
B) Absolute Neutrophil Count (ANC)
C) Hemoglobin level
D) Serum creatinine
Correct Answer: Absolute Neutrophil Count (ANC)
Rationale: The ANC is the most accurate predictor of a child's ability to fight
infection. An ANC lower than 500/mm³ indicates severe risk for life-threatening
infections. Platelet count assesses bleeding risk, hemoglobin assesses anemia, and
creatinine assesses renal function.
6. The nurse is assessing an infant with suspected Tetralogy of Fallot. Which clinical
manifestation is most characteristic of a "tet spell"?
A) Bounding peripheral pulses
B) Bradypnea and hypertension
C) Increased urine output and lethargy
D) Sudden onset of cyanosis and hyperpnea
Correct Answer: Sudden onset of cyanosis and hyperpnea
Rationale: A hypercyanotic spell ("tet spell") is characterized by a sudden increase in
cyanosis and rapid, deep respirations due to decreased pulmonary blood flow and
, increased right-to-left shunting. Knee-chest position is the priority intervention to
increase systemic vascular resistance and improve oxygenation.
7. When caring for a child with a suspected Wilms tumor, which action is most
important for the nurse to perform?
A) Measure abdominal girth every 4 hours
B) Place a sign over the bed that says "No Abdominal Palpation"
C) Palpate the abdomen to determine tumor size
D) Prepare the child for an immediate lumbar puncture
Correct Answer: Place a sign over the bed that says "No Abdominal Palpation"
Rationale: Wilms tumor is an encapsulated kidney tumor, and palpation can cause
the capsule to rupture, leading to dissemination of cancer cells. The nurse must
ensure everyone avoids abdominal palpation to prevent metastasis. Measuring girth
and palpation are contraindicated, and lumbar puncture is unrelated.
8. A 10-year-old is admitted with diabetic ketoacidosis (DKA). Which IV fluid order
should the nurse expect to implement first?
A) Dextrose 5% in water (D5W)
B) 0.9% Normal Saline (NS) bolus
C) D5 0.45% NS with 20 mEq KCL
D) Total Parenteral Nutrition (TPN)
Correct Answer: 0.9% Normal Saline (NS) bolus
Rationale: The initial priority in treating DKA is restoring intravascular volume and
improving tissue perfusion through fluid resuscitation. Normal Saline (0.9%) is the
