NSG 3600 Actual Best Guide Exam 1 Pediatric Nursing Galen College of Nursing Updated 2026

NSG 3600 NSG 3600 Actual Best Guide Exam 1 Pediatric Nursing Galen College of Nursing Updated 2026 Turned head toward sounds - -2 months Begins to follow things with eyes - -2 months Tummy time - -2 months Copies facial movements like smiling or frowning - -4 months Begins to pass things from one hand to the other - -4 months Cries in different ways to show hunger, pain, or being tired - -4 months Reaches for you with one hand - -4 months Holds head stead, unsupported - -4 months Brings hands to mouth - -4 months When on stomach, pushes up to elbows - -4 months Likes to look at self in mirror - -6 months Responds to name - -6 months Begins to pass things from one hand to the other - -6 months Rolls over in both directions (front to back, back to front) - -6 months Rocks back and forth - -6 months Sits without support - -6 months Afraid of strangers - -9 months Clingy with familiar adults - -9 months NSG 3600 NSG 3600 NSG 3600 Understands "no" - -9 months Makes sounds like "mama", "baba", "dada" - -9 months Uses finger to point at things - -9 months Looks for things that are hidden (object permanence) - -9 months Pulls to stand - -9 months Crawls - -9 months Moves things from one hand to the other - -9 months Puts arm/leg out to help with dressing - -12 months Responds to simple spoken requests - -12 months Uses simple gestures, like shaking head "no" or waving "bye-bye" - -12 months Tries to say words you say - -12 months Can take steps without holding on - -12 months May start experiencing temper tantrums - -18 months Shows affection to familiar people - -18 months Plays simple pretend, such as feeding a doll - -18 months Clings to caregivers in new situations - -18 months Says several - -18 months Pulls toys while walking - -18 months Drinks from a cup - -18 months Eats with a spoon - -18 months Walks up steps - -18 months Gets excited when with other children - -2 years Shows defiant behavior (doing what he has been told not to) - -2 years NSG 3600 Says sentences with 2 to 4 words - -2 years Begins to sort shapes and colors - -2 years Plays make-believe games - -2 year old Stands on tiptoes - -2 years Kicks ball - -2 years Can state name, age, and sex - -3 year old Can work button and levers on toys - -3 years old Plays make-believe with dolls, animals, and people - -3 years Copies a circle - -3 years Turns book pages one at a time - -3 years Screws and unscrews jar lids or turns door handle - -3 years Pedals tricycle - -3 years Would rather play with other children than by himself - -4 years Often can't tell what's real and make believe - -4 years old Talks about what she likes and what she is interested in - -4 years Sings a song or says a poem from memory such as the "itsy bitsy spider" or the "wheels on the bus" - -4 years Names some colors and some numbers - -4 years Understands the idea of counting - -4 years Starts to understand time - -4 years Remembers part of a story - -4 years old Understands the idea of "same" and "different" - -4 years Draws a person with 2 to 4 body parts - -4 years Uses scissors - -4 years NSG 3600 NSG 3600 Starts to copy some capital letters - -4 years Plays board games - -4 years Can stand on one foot - -4 years old Wants to be like friends - -5 years More likely to agree with rules - -5 years Is aware of gender - -5 years Can tell what's real and make believe - -5 years Counts 10 or more things - -5 years old Can use the toilet on her own - -5 years Swings and climbs - -5 years Hepatitis b vaccination - -1st at birth 2nd at 1-2 months 3rd at 6-18 months Dtap vaccine - -diptheria, tetanus, pertussis 2 months 4 months 6 months 18 months 4-6 yo Rotavirus vaccine schedule - -2 months 4 months Hib vaccine schedule - -2 months 4 months 12-15 months Tdap vaccine - -11-12 years Pneumococcal vaccine - -2 months 4 months 6 months 12-15 months NSG 3600 NSG 3600 NSG 3600 Ipv - -2 months 4 months 6-18 months 4-6 years Influenza vaccine - -annually for over 6 months old Mmr vaccine - -12-15 months 4-6 years Varicella - -12-15 months 4-6 years Hepatitis a vaccine - -2 doses 12-23 months Hpv vaccine - -12-18 years Meningococcal vaccine - -11-12 years old Booster at 16 Family centered care - -- is a philosophy of care that recognizes the family as the constant in the child's life and holds that systems and personnel must support, -- respect, encourage, and enhance the strengths and competence of the family Atraumatic care - -- therapeutic care that minimizes or eliminates the psychological and - physical distress experienced by children and their families in the health care system Growth - -- increase in number and size of cells - physiological size Development - -- advancement from lower to more advanced stage of complexity Ongoing process - increased capacity through growth, maturation, and learning Sequential trends - -- based on the concept that each child will normally pass through each stage of growth and development in a predictable sequence - universal and basic to all human beings - accomplishes these in a manner and time unique to that individual Newborn/infant reflexes and neuro development - -- primitive reflexes (disappear around 6 mo and should be gone by 1 year): rooting, sucking, palmar and plantar grasp, moro, babinski - lower nervous system develops at birth and higher section develops with maturity Moro reflex - -startle reflex in response to a loud noise or the sensation of being dropped NSG 3600 NSG 3600 Babinski reflex - -in response to the sole of the foot being stroked, a baby's big toe moves upward or toward the top surface of the foot and the other toes fan out Newborn/infant sensory development - -- touch develops first - smell and taste develop in utero - hearing and vision is least developed and is limited Newborn/infant physical development - -- rapid growth - double birth weight at 6mo and triple by 12mo - gross motor: raise head and chest while on belly, roll side to side (3m), turn over (6m), crawl and pull up (8m) - fine motor: transfer objects between hands, scribble, stack large object (6-12 months) - Freud oral stage - -birth - 1 year - oral curiosity (pacifiers, thumbs) Freud anal stage - -1 year - 3 years - potty training Freud phallic stage - -3-6 years - difference in genders noticed Freud latency stage - -6-12 years - focus on other aspects of growth Freud genital stage - -12-18 years - puberty, dating Erickson: trust v. Mistrust - -birth - 1 year - recognize that there are people that will meet their basic needs Erickson: autonomy vs. Shame and doubt - -1-3 years - balance independence and self-sufficiency against sense of uncertainty Erickson: initiative vs guilt - -3-6 years - develop resourcefulness to achieve and learn new things without receiving self reproach Erickson: industry vs. Inferiority - -6-12 years - develop a sense of confidence through mastery of task - can be hindered by a sense of inadequacy or inferiority Erickson: identity vs. Role confusion - -12-18 years - acquiring a clear sense of self and purpose NSG 3600 Piaget: sensorimotor stage - -birth to age 2 - primary means of cognition is through senses Piaget preoperational stage - -2-7 years - takes into account the development of motor skills - divided into preconceptual and intuitive Piaget concrete operational stage - -7-11 years - able to organize thoughts into a logical order Piaget: formal operational - -11-15 years - uses abstract thinking to handle difficult concepts and can analyze both sides of an issue Breast milk or formula - -birth - 1 year Introduce solid foods - -4-6 months Encourage self-feeding and finger foods - -infants Ween to cup - -9-12 months Introduce whole milk - -1 year Allow self feed and to use cup - -toddle 2-3 snacks per day - -toddler Do not force eating - -toddler 3 meals and 2 snacks per day - -toddler 3 meals and 2-3 snacks per day - -school age Manage weight through exercise and healthy choice - -school age Numeric scale - -ages 12 and up Wong-baker faces scale - -ages 3-12 Flacc - -observation scale for under age 3 Paint management for infants/toddlers - -use treatment room with minimal noise, parents to comfort. Distract and comfort after procedure with music, books, rocking, swaddling, pacifier NSG 3600 NSG 3600 NSG 3600 Pain management for preschooler - -treatment room, minimal noise, distract with music, bubbles, counting, singing, parents present, medical play/participation, tell what see/hear/feel, praise and reward will post-procedure Pain management for school age - -treatment room with minimal noise, distract with deep breathing, trivia, talking, holding hands, parental presence, explanation in simple terms, allow play with equipment, allow participation, praise and reward, evaluate procedure and make suggestions for next time Pain management for teenagers - -treatment room with minimal noise, distract with imagery, tablet, talking, deep breathing, talking, jokes, ask patient permission for parental involvement, allow participation, explain procedures, give choices, praise and reward, evaluate procedure and make suggestions for next time Acute pain treatment - -occurs 24-48 hours after trauma or surgery, is initially experienced as severe pain but gradually subsides—narcotics will not relieve all pain so also use comfort measures Chronic pain treatment - -pain lasting 3 months, may cause anorexia, weight loss, changes in sleep, guarded movement, rigid facial expression, decreased happiness, fear of reinjury—pain relief measures vary by child Mild pain treatment - -nsaid (ibuprofen); non-opioid analgesic (acetaminophen), comfort measures, distraction Moderate pain treatment - -distraction, regularly times analgesics including milder opioids combined with acetaminophen Severe pain treatment - -produces signs such as pallor, sweating, dilated pupils, increased bp and rr, muscle tension Give strong analgesics like morphine Reaction to hospitalization: infant - -separation and stranger anxiety communicate with parents hold/cuddle/swaddle Reaction to hospitalization: toddler - -separation anxiety Regression Tantrums Reaction to hospitalization: preschooler - -views hospitalization as punishment Simple explanation and choices Encourage child to ask questions Reactions to hospitalization: school age - -questions identity Increased need for attention NSG 3600 NSG 3600 Regression Fears bodily mutilation Simple explanations and choices Respect privacy Encourage verbalization of fears Alleviate fears about changes in body image when possible) Reactions to hospitalization: adolescent - -body image concerns Loss of independence, Separation from peers, Decreased socialization: encourage peer visits, use of teen room Be honest, explain in understandable terms, allow questions/ verbalization of fears/ choices Respect privacy Encourage parental involvement Recognize tendency to reject authority Functions of play - -sensorimotor development Intellectual development Creativity Self-awareness Therapeutic value Distraction with toys, music, games Let child handle equipment and simulate the procedure Guided imagery Moral value Infant play - -solitary play - books, blocks, musical toys, mobiles, finger/hand games Toddler play - -parallel play - push-pull toys, books/movies, matching games, ride on toys, imitative toys such as dishes, playhouse, blowing bubbles Preschool play - -associative play - role playing, simple board games, alphabet or color games, simple computerized games School age play - -cooperative play - music, books, crafts, team sports, bike, skateboard, card or board games, video movie or games, puzzles Adolescent play - -cooperative play - team sports, video/computer games, card or board games, art, concerts, "hanging out", social events with friends NSG 3600 NSG 3600 Common infant injuries - -head injury, fracture from falls, burns from sun/stove/cigarette/water/outlets, mva/improperly installed car seat, choking, suffocation by cord/string Injury prevention: infants - -child proofing house, smoke and carbon monoxide detectors, fire extinguisher, safety locks, recommended crib model, properly installed car seat, warming bottles, keep hot food and liquids away from baby, close supervision, no walkers, caution with powder and lotion, no long cords or removable parts on toys, safety gates/latches, test water temp (120⁰f) Common injuries: toddler - -head injury, fracture, sprain from falls, mva, drowning, poisoning, burns from sun/stove/cigarette/water/outlets Injury prevention: toddlers - -constant supervision, kitchen and bathroom off limits, turn pot handles on stove, hot items out of reach, toxic chemicals put away, refrigerator/attic/ basement locked or sealed, fenced in yard Common injuries: preschooler - -head injury, fracture, sprain from falls, mva, poisoning, firearms, burns from sun/stove/cigarette/ water/outlets Injury prevention: preschooler - -teach about stranger danger and inappropriate touching (could be known person), fire safety, check playground for unsafe objects, wear helmet Common injuries: school age - -head injury, fracture, sprain from falls, being struck by another person or object, animal or insect bites, overexertion Injury prevention: school age - -keep car doors locked, buddy system, safe touch, keep poison center phone number handy Common injuries: adolescent - -being struck by another person or object, sports injuries, overexertion, mva Injury prevention: adolescents - -alcohol, tobacco, and drug education, safe driving, seatbelts, safety equipment for sports) Immunizations: 2 months Dr harry hip - -dtap Rotavirus Hep b Hib Ipv Pneumococcal Immunizations: 4 months Dr hip - -dtap NSG 3600 Rotavirus Hib Ipv Pneumococcal Immunizations: 6 months Dr harry hip - -dtap Rotavirus Hep b Hib Ipv Pneumococcal Immunizations: 12-15 months Hewlett v, packard md - -hib Varicella Pneumococcal Mmr Dtap Immunizations: 4-6 years I did my vaccinations - -ipv Dtap Mmr Varicella Immunizations: 7-18 years old Don't have money - -dtap Hpv Meningicoccal Immunizations in pregnancy - -live virus vaccines are contraindicated during pregnancy No: mmr, polio, varicella Varicella etiology: - -varicella zoster virus Varicella clinical manifestations: - -rash on trunk and face, lesions begin as macule and progress to vesicle then crust, pruritic Varicella isolation: - -contact & airborne precautions Varicella nursing care: - -supportive (anti-pruritic lotions, baths, antihistamines) oral acyclovir to shorten duration no aspirin Rubella etiology - -rubeola virus, NSG 3600 NSG 3600 NSG 3600 Rubella clinical manfestations - -sore throat, lymphadenopathy, mild fever, fine light pink maculopapular rash face to chest to body Rubella isolation - -droplet and contact Rubella nursing care - -supportive care (antipyretics) educate on isolation while active (1 week after rash starts) Rubeola etiology - -caused by morbillivirus Rubeola clinical manifestations - -moderate fever, cough, conjunctivitis, photophobia, koplick's spots appear 2 days before rash, rash 3-4 days, fever to 105⁰, rash fades and temperature drops 4-7 days Rubeola isolation - -airborne and contact Rubeola nursing care - -supportive (antipyretics, bedrest, fluids) Haemophilus influenza type b etiology - -haemophilus influenza type b bacteria Haemophilus influenza type b clinical manifestations - -upper respiratory infection, om, sinusitis Haemophilus influenza type b isolation - -droplet and contact Haemophilus influenza type b nursing care - -antibiotic as prescribed Influenza etiology - -influenza virus a, b, or c, Influenza clinical manifestations - -rapid onset of high fever, myalgia, headache, sore throat, nonproductive cough Influenza isolation - -droplet and contact Influenza nursing care - -supportive (antipyretics, bedrest), isolated until sx subside, no aspirin Mumps etiology - -paramyxovirus Mumps clinical manifestations - -mild and systemic-low-grade fever, malaise, anorexia, ear pain, headache, parotid glands enlarge Mumps isolation - -droplet and contact Mumps nursing care - -supportive NSG 3600 Pertussis etiology - -bordatella pertussis bacteria Pertussis clinical manifestations - -mild respiratory illness with "whooping" cough Pertussis isolation - -droplet and contact Pertussis nursing care - -antibiotics as prescribed, keep open airway, monitor oxygen saturation Tetanus etiology - -clostridium tetani, occurs in cut or deep puncture wound Tetanus clinical manifestations - -headache, stiff neck and jaw that become muscle spasms, may progress in body and lead to seizures Tetanus isolation - -standard Tetanus nursing care - -antibiotics as prescribed, surgical debridement, tetanus immune globulin (tig) Scarlet fever etiology - -group a beta-hemolytic streptococci, often follows pharyngeal infection with gas, Scarlet fever clinical manifestations - -acute onset fever, sore throat, rhinitis, tender cervical nodes, sandpaper-like rash appears 12-48 hours after onset of sx, fades 3-4 days, tips toes and fingers peel, day 4-5 bright red strawberry tongue appearance Scarlet fever isolation - -droplet and contact Scarlet fever nursing care - -antibiotic as prescribed, supportive care for pharyngitis and fever Pneumococcal etiology - -streptococcus pneumonia bacteria Pneumococcal clinical manifestations - -upper respiratory infection, high fever, pleuritic chest pain, cough, chills, dyspnea, dry or productive cough with hemoptysis Pneumococcal isolation - -droplet and contact Pneumococcal nursing care - -penicillin or other antibiotics, ivf, note: viral pneumonia treated with supportive care only NSG 3600