Galen NSG 3600 Exam 2 | Nursing Practice – Leadership (2026)
Actual Q&A PDF
1. A nurse is assessing a newborn with a suspected congenital heart defect. Which finding is
most suggestive of a cyanotic defect?
A) Bounding peripheral pulses
B) Oxygen saturation of 85% on room air
C) Hepatomegaly
D) Systolic murmur
Correct Answer: Oxygen saturation of 85% on room air
Rationale: Cyanotic defects result in right-to-left shunting, causing deoxygenated blood to enter
systemic circulation, leading to hypoxemia (SpO2 typically <90%). Bounding pulses suggest a
patent ductus arteriosus (acyanotic), hepatomegaly suggests heart failure, and murmurs can
occur in both types.
2. The nurse is caring for a child with a ventricular septal defect (VSD). Which pathophysiologic
change does the nurse expect?
A) Increased pulmonary blood flow
B) Decreased pulmonary blood flow
C) Mixed blood flow with cyanosis
D) Obstruction of blood flow from the left ventricle
Correct Answer: Increased pulmonary blood flow
Rationale: VSD is an acyanotic defect with left-to-right shunting. Higher pressure in the left
ventricle forces blood through the hole into the right ventricle and pulmonary artery, increasing
pulmonary blood flow.
,3. A 4-month-old infant with a large VSD is showing signs of heart failure. Which finding would
the nurse expect?
A) Weight gain
B) Tachypnea and crackles
C) Decreased respiratory rate
D) Hypertension
Correct Answer: Tachypnea and crackles
Rationale: Heart failure in infants with a large VSD leads to pulmonary congestion, resulting in
tachypnea, crackles, and poor feeding. Weight loss, tachycardia, and hepatomegaly are also
common. Hypotension and decreased respiratory rate are not typical.
4. A child with tetralogy of Fallot (TOF) is experiencing a hypercyanotic (“tet”) spell. Which
nursing action is a priority?
A) Administer oxygen and place the child in a knee-chest position
B) Prepare the child for immediate surgery
C) Administer a beta-blocker
D) Place the child in a supine position
Correct Answer: Administer oxygen and place the child in a knee-chest position
Rationale: During a tet spell, the knee-chest position increases systemic vascular resistance,
reducing the right-to-left shunt and improving oxygenation. Oxygen should also be
administered. This is a priority intervention before considering other measures.
5. What is the priority nursing intervention for a child after a cardiac catheterization?
,A) Restrict activities for 2 weeks
B) Assess the pulse and circulation of the extremity used for the procedure
C) Administer antibiotics for 24 hours
D) Encourage ambulation immediately
Correct Answer: Assess the pulse and circulation of the extremity used for the procedure
Rationale: After cardiac catheterization, the nurse must monitor the extremity used for the
procedure for pulses, color, warmth, and capillary refill. The pulse should be weaker than the
untouched leg. Restricting activities for 2 weeks is also recommended.
6. The nurse is educating parents of a child with a congenital heart defect about the need for
infective endocarditis prophylaxis. Which statement is correct?
A) “Your child will need antibiotics before any dental procedures for life.”
B) “Your child will need to avoid all physical activity.”
C) “Your child will need a special diet.”
D) “Your child will need to take aspirin daily.”
Correct Answer: “Your child will need antibiotics before any dental procedures for life.”
Rationale: Children with certain congenital heart defects are at risk for infective endocarditis
and require antibiotic prophylaxis before dental procedures. This is a key discharge teaching
point.
7. A 3-month-old infant has a scheduled dose of digoxin at 2000. The nurse assesses the infant
and notes an apical heart rate of 112 bpm. What should the nurse do next?
A) Administer the digoxin as ordered
B) Hold the dose and notify the healthcare provider
, C) Double-check the digoxin dose with another nurse
D) Administer a half dose
Correct Answer: Double-check the digoxin dose with another nurse
Rationale: For digoxin, the apical pulse should be assessed for 1 minute and held if the heart
rate is less than 90-100 in infants. Since the heart rate is 112 bpm (above 100), the medication
can be given, but it is a high-alert medication and should be double-checked with another
nurse.
8. A child with Kawasaki disease is in the subacute phase. Which finding does the nurse expect?
A) High fever unresponsive to antibiotics
B) Strawberry tongue and conjunctival injection
C) Peeling of the skin on the fingers and toes (desquamation)
D) Hypotension and shock
Correct Answer: Peeling of the skin on the fingers and toes (desquamation)
Rationale: Desquamation (peeling skin) occurs in the subacute phase (weeks 2-4). The acute
phase (first 1-2 weeks) includes high fever, strawberry tongue, and conjunctival injection.
9. A child with Kawasaki disease is admitted to the unit. The nurse should prepare to administer
which medication?
A) High-dose aspirin
B) Low-dose aspirin
C) Acetaminophen
D) Ibuprofen
Actual Q&A PDF
1. A nurse is assessing a newborn with a suspected congenital heart defect. Which finding is
most suggestive of a cyanotic defect?
A) Bounding peripheral pulses
B) Oxygen saturation of 85% on room air
C) Hepatomegaly
D) Systolic murmur
Correct Answer: Oxygen saturation of 85% on room air
Rationale: Cyanotic defects result in right-to-left shunting, causing deoxygenated blood to enter
systemic circulation, leading to hypoxemia (SpO2 typically <90%). Bounding pulses suggest a
patent ductus arteriosus (acyanotic), hepatomegaly suggests heart failure, and murmurs can
occur in both types.
2. The nurse is caring for a child with a ventricular septal defect (VSD). Which pathophysiologic
change does the nurse expect?
A) Increased pulmonary blood flow
B) Decreased pulmonary blood flow
C) Mixed blood flow with cyanosis
D) Obstruction of blood flow from the left ventricle
Correct Answer: Increased pulmonary blood flow
Rationale: VSD is an acyanotic defect with left-to-right shunting. Higher pressure in the left
ventricle forces blood through the hole into the right ventricle and pulmonary artery, increasing
pulmonary blood flow.
,3. A 4-month-old infant with a large VSD is showing signs of heart failure. Which finding would
the nurse expect?
A) Weight gain
B) Tachypnea and crackles
C) Decreased respiratory rate
D) Hypertension
Correct Answer: Tachypnea and crackles
Rationale: Heart failure in infants with a large VSD leads to pulmonary congestion, resulting in
tachypnea, crackles, and poor feeding. Weight loss, tachycardia, and hepatomegaly are also
common. Hypotension and decreased respiratory rate are not typical.
4. A child with tetralogy of Fallot (TOF) is experiencing a hypercyanotic (“tet”) spell. Which
nursing action is a priority?
A) Administer oxygen and place the child in a knee-chest position
B) Prepare the child for immediate surgery
C) Administer a beta-blocker
D) Place the child in a supine position
Correct Answer: Administer oxygen and place the child in a knee-chest position
Rationale: During a tet spell, the knee-chest position increases systemic vascular resistance,
reducing the right-to-left shunt and improving oxygenation. Oxygen should also be
administered. This is a priority intervention before considering other measures.
5. What is the priority nursing intervention for a child after a cardiac catheterization?
,A) Restrict activities for 2 weeks
B) Assess the pulse and circulation of the extremity used for the procedure
C) Administer antibiotics for 24 hours
D) Encourage ambulation immediately
Correct Answer: Assess the pulse and circulation of the extremity used for the procedure
Rationale: After cardiac catheterization, the nurse must monitor the extremity used for the
procedure for pulses, color, warmth, and capillary refill. The pulse should be weaker than the
untouched leg. Restricting activities for 2 weeks is also recommended.
6. The nurse is educating parents of a child with a congenital heart defect about the need for
infective endocarditis prophylaxis. Which statement is correct?
A) “Your child will need antibiotics before any dental procedures for life.”
B) “Your child will need to avoid all physical activity.”
C) “Your child will need a special diet.”
D) “Your child will need to take aspirin daily.”
Correct Answer: “Your child will need antibiotics before any dental procedures for life.”
Rationale: Children with certain congenital heart defects are at risk for infective endocarditis
and require antibiotic prophylaxis before dental procedures. This is a key discharge teaching
point.
7. A 3-month-old infant has a scheduled dose of digoxin at 2000. The nurse assesses the infant
and notes an apical heart rate of 112 bpm. What should the nurse do next?
A) Administer the digoxin as ordered
B) Hold the dose and notify the healthcare provider
, C) Double-check the digoxin dose with another nurse
D) Administer a half dose
Correct Answer: Double-check the digoxin dose with another nurse
Rationale: For digoxin, the apical pulse should be assessed for 1 minute and held if the heart
rate is less than 90-100 in infants. Since the heart rate is 112 bpm (above 100), the medication
can be given, but it is a high-alert medication and should be double-checked with another
nurse.
8. A child with Kawasaki disease is in the subacute phase. Which finding does the nurse expect?
A) High fever unresponsive to antibiotics
B) Strawberry tongue and conjunctival injection
C) Peeling of the skin on the fingers and toes (desquamation)
D) Hypotension and shock
Correct Answer: Peeling of the skin on the fingers and toes (desquamation)
Rationale: Desquamation (peeling skin) occurs in the subacute phase (weeks 2-4). The acute
phase (first 1-2 weeks) includes high fever, strawberry tongue, and conjunctival injection.
9. A child with Kawasaki disease is admitted to the unit. The nurse should prepare to administer
which medication?
A) High-dose aspirin
B) Low-dose aspirin
C) Acetaminophen
D) Ibuprofen
