NSG 3600 Peds Exam 1 Questions and
Answers Latest 2026 | 100% Correct – Galen
College of Nursing
Q1. A 4-year-old child is diagnosed with developmental dysplasia of the hip
(DDH). Which finding would the nurse expect on physical examination?
A) Negative Ortolani sign
B) Asymmetric gluteal folds
C) Full hip abduction bilaterally
D) Valgus deformity of the knee
• ANSWER- B) Asymmetric gluteal folds
• Expert Rationale: Asymmetric gluteal folds are a classic sign of DDH in
infants and young children. The Ortolani sign (clunk of reduction) is positive
in newborns but may be negative after 3 months. Limited hip abduction is
typical, not full. Valgus knee deformity is not associated with DDH.
Q2. A nurse is providing teaching to parents of a child with newly diagnosed
Legg-Calvé-Perthes disease. Which statement by the parent indicates
understanding?
A) “My child will need to remain non-weight-bearing for several years.”
B) “This condition affects the femoral head and is more common in boys.”
C) “Surgery is always required to prevent long-term disability.”
D) “The disease is caused by a bacterial infection of the hip joint.”
• ANSWER- B) “This condition affects the femoral head and is more
common in boys.”
• Expert Rationale: Legg-Calvé-Perthes disease is avascular necrosis of the
femoral head, most common in boys aged 4-8 years. Treatment includes
containment and activity restriction, but not necessarily years of non-weight-
bearing. Surgery is not always required. It is not infectious.
Q3. After a tonsillectomy, a child is brought to the post-anesthesia care unit.
Which finding requires immediate intervention?
A) Complaints of a sore throat
,B) Frequent swallowing and clearing of the throat
C) Refusing to drink cold fluids
D) Crying for the parent
• ANSWER- B) Frequent swallowing and clearing of the throat
• Expert Rationale: Frequent swallowing after tonsillectomy can indicate
bleeding, as the child swallows blood pooling in the pharynx. This requires
immediate assessment. Sore throat and refusal to drink are expected. Crying
is common but not emergent.
Q4. A nurse is assessing a 2-month-old infant for signs of increased intracranial
pressure. Which finding is most concerning?
A) Bulging anterior fontanel
B) High-pitched cry
C) Vomiting
D) All of the above
• ANSWER- D) All of the above
• Expert Rationale: Bulging fontanel, high-pitched cry, and vomiting are all
signs of increased ICP in infants. The combination is highly concerning.
Any single sign warrants further evaluation, but all together indicate
significant pressure.
Q5. A 6-year-old child with a history of sickle cell disease presents with fever,
chest pain, and cough. The nurse suspects acute chest syndrome. Which initial
action is most appropriate?
A) Administer oral ibuprofen
B) Obtain a chest X-ray and oxygen saturation
C) Give a dose of hydroxyurea
D) Apply a warm compress to the chest
• ANSWER- B) Obtain a chest X-ray and oxygen saturation
• Expert Rationale: Acute chest syndrome is a leading cause of death in
sickle cell disease. Initial assessment includes oxygen saturation and chest
X-ray to confirm infiltrate. Hydroxyurea is chronic therapy, not acute.
Ibuprofen is supportive but not first priority.
Q6. A 3-year-old child is admitted with moderate dehydration from gastroenteritis.
The child has dry mucous membranes, sunken eyes, and capillary refill of 3
,seconds. Which IV fluid order should the nurse anticipate?
A) 0.9% normal saline bolus of 20 mL/kg
B) 0.45% saline with 5% dextrose at maintenance rate
C) 5% dextrose in water at 50 mL/hour
D) 3% saline at 10 mL/kg
• ANSWER- A) 0.9% normal saline bolus of 20 mL/kg
• Expert Rationale: Moderate dehydration with signs of hypovolemia
requires an isotonic fluid bolus (20 mL/kg of normal saline or lactated
Ringer's). Hypotonic fluids (0.45% saline) or dextrose-only solutions are not
appropriate for initial resuscitation. Hypertonic saline is for severe
hyponatremia.
Q7. A nurse is educating parents about home care for a child with a new diagnosis
of celiac disease. Which food item is safe for the child to consume?
A) Wheat crackers
B) Barley soup
C) Corn tortilla chips
D) Rye bread
• ANSWER- C) Corn tortilla chips
• Expert Rationale: Celiac disease requires a lifelong gluten-free diet. Wheat,
barley, and rye contain gluten and must be avoided. Corn and rice are
naturally gluten-free and safe. Parents must read labels carefully.
Q8. A 10-year-old child with type 1 diabetes mellitus is found unconscious. The
nurse checks a blood glucose level and it reads 45 mg/dL. What is the priority
nursing action?
A) Administer glucagon intramuscularly
B) Give 4 oz of orange juice orally if able to swallow
C) Start an IV of 0.9% normal saline
D) Call the provider for an insulin order
• ANSWER- A) Administer glucagon intramuscularly
• Expert Rationale: The child is unconscious from severe hypoglycemia
(glucose <50 mg/dL). Oral glucose is contraindicated due to risk of
aspiration. Glucagon IM is the standard emergency treatment for
, unconscious hypoglycemia. IV dextrose is an alternative if IV access is
available, but glucagon is often first-line in prehospital or non-ICU settings.
Q9. A nurse is performing a developmental screening on a 9-month-old infant.
Which milestone would the nurse expect the infant to have achieved?
A) Walks independently
B) Says “mama” and “dada” specifically
C) Pulls to stand
D) Uses a spoon
• ANSWER- C) Pulls to stand
• Expert Rationale: By 9 months, most infants can pull to stand. Walking
independently typically occurs around 12 months. Specific babbling
“mama/dada” occurs around 10-12 months. Spoon use is a toddler skill (15-
18 months).
Q10. A child with a ventriculoperitoneal (VP) shunt presents with vomiting,
headache, and irritability. The nurse suspects shunt malfunction. Which assessment
finding would further support this suspicion?
A) Sunken fontanel
B) Rapid improvement after acetaminophen
C) Abdominal distension
D) Decreased level of consciousness
• ANSWER- D) Decreased level of consciousness
• Expert Rationale: VP shunt malfunction leads to increased intracranial
pressure. Decreased LOC is a late but critical sign. Sunken fontanel suggests
dehydration, not increased ICP. Abdominal distension could indicate shunt
infection or pseudocyst but is not the most direct sign of malfunction.
Improvement with acetaminophen is not typical.
Q11. A nurse is caring for a 4-year-old child with a newly placed cast for a
fractured femur. Which finding indicates a possible complication of compartment
syndrome?
A) Capillary refill of 2 seconds
B) Toes that are pink and warm
C) Pain that is relieved by elevation
D) Pain that worsens with passive toe extension
Answers Latest 2026 | 100% Correct – Galen
College of Nursing
Q1. A 4-year-old child is diagnosed with developmental dysplasia of the hip
(DDH). Which finding would the nurse expect on physical examination?
A) Negative Ortolani sign
B) Asymmetric gluteal folds
C) Full hip abduction bilaterally
D) Valgus deformity of the knee
• ANSWER- B) Asymmetric gluteal folds
• Expert Rationale: Asymmetric gluteal folds are a classic sign of DDH in
infants and young children. The Ortolani sign (clunk of reduction) is positive
in newborns but may be negative after 3 months. Limited hip abduction is
typical, not full. Valgus knee deformity is not associated with DDH.
Q2. A nurse is providing teaching to parents of a child with newly diagnosed
Legg-Calvé-Perthes disease. Which statement by the parent indicates
understanding?
A) “My child will need to remain non-weight-bearing for several years.”
B) “This condition affects the femoral head and is more common in boys.”
C) “Surgery is always required to prevent long-term disability.”
D) “The disease is caused by a bacterial infection of the hip joint.”
• ANSWER- B) “This condition affects the femoral head and is more
common in boys.”
• Expert Rationale: Legg-Calvé-Perthes disease is avascular necrosis of the
femoral head, most common in boys aged 4-8 years. Treatment includes
containment and activity restriction, but not necessarily years of non-weight-
bearing. Surgery is not always required. It is not infectious.
Q3. After a tonsillectomy, a child is brought to the post-anesthesia care unit.
Which finding requires immediate intervention?
A) Complaints of a sore throat
,B) Frequent swallowing and clearing of the throat
C) Refusing to drink cold fluids
D) Crying for the parent
• ANSWER- B) Frequent swallowing and clearing of the throat
• Expert Rationale: Frequent swallowing after tonsillectomy can indicate
bleeding, as the child swallows blood pooling in the pharynx. This requires
immediate assessment. Sore throat and refusal to drink are expected. Crying
is common but not emergent.
Q4. A nurse is assessing a 2-month-old infant for signs of increased intracranial
pressure. Which finding is most concerning?
A) Bulging anterior fontanel
B) High-pitched cry
C) Vomiting
D) All of the above
• ANSWER- D) All of the above
• Expert Rationale: Bulging fontanel, high-pitched cry, and vomiting are all
signs of increased ICP in infants. The combination is highly concerning.
Any single sign warrants further evaluation, but all together indicate
significant pressure.
Q5. A 6-year-old child with a history of sickle cell disease presents with fever,
chest pain, and cough. The nurse suspects acute chest syndrome. Which initial
action is most appropriate?
A) Administer oral ibuprofen
B) Obtain a chest X-ray and oxygen saturation
C) Give a dose of hydroxyurea
D) Apply a warm compress to the chest
• ANSWER- B) Obtain a chest X-ray and oxygen saturation
• Expert Rationale: Acute chest syndrome is a leading cause of death in
sickle cell disease. Initial assessment includes oxygen saturation and chest
X-ray to confirm infiltrate. Hydroxyurea is chronic therapy, not acute.
Ibuprofen is supportive but not first priority.
Q6. A 3-year-old child is admitted with moderate dehydration from gastroenteritis.
The child has dry mucous membranes, sunken eyes, and capillary refill of 3
,seconds. Which IV fluid order should the nurse anticipate?
A) 0.9% normal saline bolus of 20 mL/kg
B) 0.45% saline with 5% dextrose at maintenance rate
C) 5% dextrose in water at 50 mL/hour
D) 3% saline at 10 mL/kg
• ANSWER- A) 0.9% normal saline bolus of 20 mL/kg
• Expert Rationale: Moderate dehydration with signs of hypovolemia
requires an isotonic fluid bolus (20 mL/kg of normal saline or lactated
Ringer's). Hypotonic fluids (0.45% saline) or dextrose-only solutions are not
appropriate for initial resuscitation. Hypertonic saline is for severe
hyponatremia.
Q7. A nurse is educating parents about home care for a child with a new diagnosis
of celiac disease. Which food item is safe for the child to consume?
A) Wheat crackers
B) Barley soup
C) Corn tortilla chips
D) Rye bread
• ANSWER- C) Corn tortilla chips
• Expert Rationale: Celiac disease requires a lifelong gluten-free diet. Wheat,
barley, and rye contain gluten and must be avoided. Corn and rice are
naturally gluten-free and safe. Parents must read labels carefully.
Q8. A 10-year-old child with type 1 diabetes mellitus is found unconscious. The
nurse checks a blood glucose level and it reads 45 mg/dL. What is the priority
nursing action?
A) Administer glucagon intramuscularly
B) Give 4 oz of orange juice orally if able to swallow
C) Start an IV of 0.9% normal saline
D) Call the provider for an insulin order
• ANSWER- A) Administer glucagon intramuscularly
• Expert Rationale: The child is unconscious from severe hypoglycemia
(glucose <50 mg/dL). Oral glucose is contraindicated due to risk of
aspiration. Glucagon IM is the standard emergency treatment for
, unconscious hypoglycemia. IV dextrose is an alternative if IV access is
available, but glucagon is often first-line in prehospital or non-ICU settings.
Q9. A nurse is performing a developmental screening on a 9-month-old infant.
Which milestone would the nurse expect the infant to have achieved?
A) Walks independently
B) Says “mama” and “dada” specifically
C) Pulls to stand
D) Uses a spoon
• ANSWER- C) Pulls to stand
• Expert Rationale: By 9 months, most infants can pull to stand. Walking
independently typically occurs around 12 months. Specific babbling
“mama/dada” occurs around 10-12 months. Spoon use is a toddler skill (15-
18 months).
Q10. A child with a ventriculoperitoneal (VP) shunt presents with vomiting,
headache, and irritability. The nurse suspects shunt malfunction. Which assessment
finding would further support this suspicion?
A) Sunken fontanel
B) Rapid improvement after acetaminophen
C) Abdominal distension
D) Decreased level of consciousness
• ANSWER- D) Decreased level of consciousness
• Expert Rationale: VP shunt malfunction leads to increased intracranial
pressure. Decreased LOC is a late but critical sign. Sunken fontanel suggests
dehydration, not increased ICP. Abdominal distension could indicate shunt
infection or pseudocyst but is not the most direct sign of malfunction.
Improvement with acetaminophen is not typical.
Q11. A nurse is caring for a 4-year-old child with a newly placed cast for a
fractured femur. Which finding indicates a possible complication of compartment
syndrome?
A) Capillary refill of 2 seconds
B) Toes that are pink and warm
C) Pain that is relieved by elevation
D) Pain that worsens with passive toe extension
