GALEN COLLEGE OF NURSING EXAM
NUR 254
PEDIATRIC NURSING
EXAM 1 STUDY GUIDE
2026 EDITION
Galen College of Nursing
High-Yield | NCLEX-Style | Clinical Scenario–Based
✔ Exam-style multiple choice questions
✔ Pediatric growth and developmental milestones
✔ Gastrointestinal disorders (GERD, pyloric stenosis, Hirschsprung’s)
✔ Fluid and electrolyte imbalance and dehydration
✔ Feeding, nutrition and congenital anomalies (cleft lip/palate)
✔ Urinary system disorders (UTI, VUR, neurogenic bladder)
✔ Renal conditions (nephrotic syndrome, APSGN, AKI)
✔ Surgical conditions (intussusception, appendicitis, Meckel diverticulum)
✔ Neurological assessments and common pediatric neurologic disorders
✔ Respiratory conditions (as applicable to pediatric care)
✔ Hematologic and oncologic conditions (ALL, ITP, hemophilia)
✔ Growth and developmental disorders (DDH, cerebral palsy)
✔ Pharmacologic considerations in pediatric populations
✔ Safety and priority nursing interventions
✔ Clear correct answers included
✔ NCLEX-style reasoning and clinical judgment focus
NUR 254 Galen College Exam I|| 1
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam
preparation purposes only.
, GALEN COLLEGE OF NURSING EXAM
___1. A nurse is preparing to administer digoxin to a client who has heart failure.
Which of the following findings should the nurse identify as a contraindication to the
administration of the medication?
A) Potassium level 3.6 mEq/L
B) Apical pulse 58/min
C) Potassium level 5.2 mEq/L
D) Apical pulse 68/min - Correct answer✅✅
___2. A nurse is providing teaching to a client who has a new prescription for
hydrochlorothiazide. Which of the following instructions should the nurse include in
the teaching?
A) Take the medication in the morning
B) Increase intake of potassium-rich foods - Correct answer✅✅
C) Expect weight gain of 2 lbs per week
D) Take the medication with food
___3. A client who is taking furosemide reports nausea and muscle weakness. The
nurse should identify that the client is most likely experiencing which of the
following electrolyte imbalances?
A) Hypernatremia
B) Hypokalemia - Correct answer✅✅
C) Hypercalcemia
D) Hypermagnesemia
___4. A nurse is caring for a client who has a prescription for spironolactone. The
nurse should recognize that this medication is classified as which of the following
types of diuretics?
A) Loop diuretic
B) Thiazide diuretic
C) Potassium-sparing diuretic - Correct answer✅✅
D) Osmotic diuretic
___5. A nurse is monitoring a client who is receiving an IV infusion of dopamine
hydrochloride. Which of the following findings indicates the client is experiencing an
adverse effect of the medication?
A) Increased urinary output
B) Peripheral edema
C) Elevated blood pressure - Correct answer✅✅
D) Bradycardia
NUR 254 Galen College Exam I|| 2
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam
preparation purposes only.
, GALEN COLLEGE OF NURSING EXAM
___6. A nurse is reviewing the medical record of a client who is receiving enalapril.
Which of the following findings should the nurse identify as a priority to report to
the provider?
A) Dry, persistent cough - Correct answer✅✅
B) Serum sodium 140 mEq/L
C) Heart rate 62/min
D) Occasional headache
___7. A nurse is teaching a client who has a new prescription for nitroglycerin.
Which of the following statements by the client indicates an understanding of the
teaching?
A) I will take up to five tablets if the first one does not relieve my pain
B) I will store the tablets in a cool, dry place - Correct answer✅✅
C) I will take the medication with a full glass of water
D) I will only take the medication when I have chest pain at night
___8. A nurse is assessing a client who is receiving heparin therapy for deep-vein
thrombosis. Which of the following laboratory values should the nurse monitor to
evaluate the therapeutic effect of the medication?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
C) Activated partial thromboplastin time (aPTT) - Correct answer✅✅
D) Platelet count
___9. A nurse is caring for a client who has a new prescription for atorvastatin. The
nurse should instruct the client to report which of the following adverse effects?
A) Muscle pain - Correct answer✅✅
B) Dry mouth
C) Constipation
D) Insomnia
___10. A nurse is teaching a client who has a new prescription for warfarin. Which of
the following statements by the client indicates an understanding of the teaching?
A) I can take ibuprofen for headaches
B) I will increase my intake of green leafy vegetables
C) I will have my blood drawn to monitor the INR - Correct answer✅✅
D) I can take ginkgo biloba to improve my memory
NUR 254 Galen College Exam I|| 3
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam
preparation purposes only.
, GALEN COLLEGE OF NURSING EXAM
___11. A nurse is administering a beta blocker to a client who has hypertension.
Which of the following findings should the nurse expect as a therapeutic effect?
A) Increased heart rate
B) Decreased blood pressure - Correct answer✅✅
C) Increased respiratory rate
D) Increased urine output
___12. A nurse is preparing to administer a dose of insulin lispro to a client who has
type 1 diabetes mellitus. The nurse should understand that this medication is
characterized by which of the following pharmacokinetic properties?
A) Onset of action 30 to 60 minutes
B) Onset of action within 15 minutes - Correct answer✅✅
C) Peak action in 4 to 6 hours
D) Duration of action up to 24 hours
___13. A nurse is teaching a client who is starting therapy with metformin for type 2
diabetes mellitus. Which of the following instructions should the nurse include?
A) Take the medication with your first bite of each meal
B) Take the medication on an empty stomach
C) Take the medication at bedtime
D) Avoid drinking alcohol while taking this medication - Correct answer✅✅
___14. A nurse is assessing a client who is experiencing anaphylaxis. Which of the
following medications should the nurse administer first?
A) Methylprednisolone
B) Diphenhydramine
C) Epinephrine - Correct answer✅✅
D) Albuterol
___15. A nurse is caring for a client who has a prescription for morphine sulfate 4 mg
IV bolus every 4 hr as needed for pain. The client reports pain of 8 on a scale of 0 to
10. Which of the following actions should the nurse take?
A) Administer the morphine sulfate 4 mg IV now - Correct answer✅✅
B) Give a placebo because the client is drug-seeking
C) Wait 30 minutes and then reassess the pain
D) Call the provider to request a higher dosage
NUR 254 Galen College Exam I|| 4
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam
preparation purposes only.
NUR 254
PEDIATRIC NURSING
EXAM 1 STUDY GUIDE
2026 EDITION
Galen College of Nursing
High-Yield | NCLEX-Style | Clinical Scenario–Based
✔ Exam-style multiple choice questions
✔ Pediatric growth and developmental milestones
✔ Gastrointestinal disorders (GERD, pyloric stenosis, Hirschsprung’s)
✔ Fluid and electrolyte imbalance and dehydration
✔ Feeding, nutrition and congenital anomalies (cleft lip/palate)
✔ Urinary system disorders (UTI, VUR, neurogenic bladder)
✔ Renal conditions (nephrotic syndrome, APSGN, AKI)
✔ Surgical conditions (intussusception, appendicitis, Meckel diverticulum)
✔ Neurological assessments and common pediatric neurologic disorders
✔ Respiratory conditions (as applicable to pediatric care)
✔ Hematologic and oncologic conditions (ALL, ITP, hemophilia)
✔ Growth and developmental disorders (DDH, cerebral palsy)
✔ Pharmacologic considerations in pediatric populations
✔ Safety and priority nursing interventions
✔ Clear correct answers included
✔ NCLEX-style reasoning and clinical judgment focus
NUR 254 Galen College Exam I|| 1
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam
preparation purposes only.
, GALEN COLLEGE OF NURSING EXAM
___1. A nurse is preparing to administer digoxin to a client who has heart failure.
Which of the following findings should the nurse identify as a contraindication to the
administration of the medication?
A) Potassium level 3.6 mEq/L
B) Apical pulse 58/min
C) Potassium level 5.2 mEq/L
D) Apical pulse 68/min - Correct answer✅✅
___2. A nurse is providing teaching to a client who has a new prescription for
hydrochlorothiazide. Which of the following instructions should the nurse include in
the teaching?
A) Take the medication in the morning
B) Increase intake of potassium-rich foods - Correct answer✅✅
C) Expect weight gain of 2 lbs per week
D) Take the medication with food
___3. A client who is taking furosemide reports nausea and muscle weakness. The
nurse should identify that the client is most likely experiencing which of the
following electrolyte imbalances?
A) Hypernatremia
B) Hypokalemia - Correct answer✅✅
C) Hypercalcemia
D) Hypermagnesemia
___4. A nurse is caring for a client who has a prescription for spironolactone. The
nurse should recognize that this medication is classified as which of the following
types of diuretics?
A) Loop diuretic
B) Thiazide diuretic
C) Potassium-sparing diuretic - Correct answer✅✅
D) Osmotic diuretic
___5. A nurse is monitoring a client who is receiving an IV infusion of dopamine
hydrochloride. Which of the following findings indicates the client is experiencing an
adverse effect of the medication?
A) Increased urinary output
B) Peripheral edema
C) Elevated blood pressure - Correct answer✅✅
D) Bradycardia
NUR 254 Galen College Exam I|| 2
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam
preparation purposes only.
, GALEN COLLEGE OF NURSING EXAM
___6. A nurse is reviewing the medical record of a client who is receiving enalapril.
Which of the following findings should the nurse identify as a priority to report to
the provider?
A) Dry, persistent cough - Correct answer✅✅
B) Serum sodium 140 mEq/L
C) Heart rate 62/min
D) Occasional headache
___7. A nurse is teaching a client who has a new prescription for nitroglycerin.
Which of the following statements by the client indicates an understanding of the
teaching?
A) I will take up to five tablets if the first one does not relieve my pain
B) I will store the tablets in a cool, dry place - Correct answer✅✅
C) I will take the medication with a full glass of water
D) I will only take the medication when I have chest pain at night
___8. A nurse is assessing a client who is receiving heparin therapy for deep-vein
thrombosis. Which of the following laboratory values should the nurse monitor to
evaluate the therapeutic effect of the medication?
A) Prothrombin time (PT)
B) International normalized ratio (INR)
C) Activated partial thromboplastin time (aPTT) - Correct answer✅✅
D) Platelet count
___9. A nurse is caring for a client who has a new prescription for atorvastatin. The
nurse should instruct the client to report which of the following adverse effects?
A) Muscle pain - Correct answer✅✅
B) Dry mouth
C) Constipation
D) Insomnia
___10. A nurse is teaching a client who has a new prescription for warfarin. Which of
the following statements by the client indicates an understanding of the teaching?
A) I can take ibuprofen for headaches
B) I will increase my intake of green leafy vegetables
C) I will have my blood drawn to monitor the INR - Correct answer✅✅
D) I can take ginkgo biloba to improve my memory
NUR 254 Galen College Exam I|| 3
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam
preparation purposes only.
, GALEN COLLEGE OF NURSING EXAM
___11. A nurse is administering a beta blocker to a client who has hypertension.
Which of the following findings should the nurse expect as a therapeutic effect?
A) Increased heart rate
B) Decreased blood pressure - Correct answer✅✅
C) Increased respiratory rate
D) Increased urine output
___12. A nurse is preparing to administer a dose of insulin lispro to a client who has
type 1 diabetes mellitus. The nurse should understand that this medication is
characterized by which of the following pharmacokinetic properties?
A) Onset of action 30 to 60 minutes
B) Onset of action within 15 minutes - Correct answer✅✅
C) Peak action in 4 to 6 hours
D) Duration of action up to 24 hours
___13. A nurse is teaching a client who is starting therapy with metformin for type 2
diabetes mellitus. Which of the following instructions should the nurse include?
A) Take the medication with your first bite of each meal
B) Take the medication on an empty stomach
C) Take the medication at bedtime
D) Avoid drinking alcohol while taking this medication - Correct answer✅✅
___14. A nurse is assessing a client who is experiencing anaphylaxis. Which of the
following medications should the nurse administer first?
A) Methylprednisolone
B) Diphenhydramine
C) Epinephrine - Correct answer✅✅
D) Albuterol
___15. A nurse is caring for a client who has a prescription for morphine sulfate 4 mg
IV bolus every 4 hr as needed for pain. The client reports pain of 8 on a scale of 0 to
10. Which of the following actions should the nurse take?
A) Administer the morphine sulfate 4 mg IV now - Correct answer✅✅
B) Give a placebo because the client is drug-seeking
C) Wait 30 minutes and then reassess the pain
D) Call the provider to request a higher dosage
NUR 254 Galen College Exam I|| 4
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam
preparation purposes only.
