Pediatric CCRN Exam Pediatric CCRN Cardiovascular 1

Question 1

A 6-month-old with Tetralogy of Fallot develops a sudden hypercyanotic (tet) spell. What is the FIRST intervention?

Accepted Answer

Place the infant in the knee-chest position

Answer

The knee-chest position increases systemic vascular resistance and decreases right-to-left shunting, immediately improving oxygenation during a tet spell.

Question 2

Which congenital heart defect produces a continuous 'machinery' murmur best heard at the left upper sternal border?

Accepted Answer

Patent ductus arteriosus

Answer

A patent ductus arteriosus produces a continuous machinery-type murmur because blood flows through it in both systole and diastole.

Question 3

A neonate post-cardiac surgery has a central venous pressure of 18 mmHg, decreased urine output, and hepatomegaly. These findings are MOST consistent with:

Accepted Answer

Right ventricular failure

Answer

Elevated CVP, hepatomegaly, and oliguria indicate right-sided heart failure with systemic venous congestion following cardiac surgery.

Question 4

Which medication is the drug of choice to close a hemodynamically significant patent ductus arteriosus in a premature neonate?

Accepted Answer

Indomethacin

Answer

Indomethacin, a prostaglandin synthesis inhibitor (NSAID), promotes ductal closure by reducing prostaglandin E2, which normally keeps the ductus open.

Question 5

A child with a large ventricular septal defect is at greatest risk for developing which complication over time if left unrepaired?

Accepted Answer

Eisenmenger syndrome

Answer

Chronic left-to-right shunting from a large VSD causes pulmonary hypertension; when pulmonary pressure exceeds systemic, Eisenmenger syndrome (reversal of shunt) develops.

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Practice Test

Pediatric CCRN Exam Pediatric CCRN Cardiovascular 1