Pediatric Nurse Exam Pediatric Nurse Respiratory and Cardiovascular Disorders

Question 1

Which medication is the first-line treatment for an acute asthma exacerbation in a pediatric patient?

Accepted Answer

Short-acting beta-2 agonists (e.g., albuterol)

Answer

Inhaled corticosteroids (e.g., fluticasone)

Answer

Leukotriene modifiers (e.g., montelukast)

Answer

Long-acting beta-2 agonists (e.g., salmeterol)

Question 2

A 3-month-old infant with confirmed RSV bronchiolitis is admitted with wheezing, tachypnea, and poor feeding. What is the priority nursing intervention?

Accepted Answer

Maintain airway patency and closely monitor respiratory status

Answer

Administer ribavirin antiviral therapy

Answer

Begin broad-spectrum antibiotics immediately

Answer

Perform vigorous chest physiotherapy every 2 hours

Question 3

A child presents to the ED with a barking cough and mild inspiratory stridor at rest, consistent with mild-to-moderate croup. Which intervention is first-line?

Accepted Answer

A single dose of oral or IM dexamethasone

Answer

Nebulized racemic epinephrine and 2-4 hours of observation

Answer

Heliox therapy via face mask

Answer

Immediate endotracheal intubation for airway protection

Question 4

Which clinical presentation best distinguishes epiglottitis from croup in a febrile child?

Accepted Answer

Tripod positioning, drooling, and high fever without cough

Answer

Barking (seal-like) cough and low-grade fever

Answer

Inspiratory stridor with a hoarse voice and gradual onset

Answer

Subglottic narrowing visible on lateral neck X-ray

Question 5

Which nursing intervention is most important for a hospitalized child with cystic fibrosis (CF) to prevent pulmonary complications?

Accepted Answer

Perform chest physiotherapy and airway clearance techniques regularly

Answer

Restrict fluid intake to reduce secretion volume

Answer

Limit all physical activity to prevent bronchospasm

Answer

Administer inhaled corticosteroids twice daily as prescribed

Question 6

A toddler presents with sudden onset of choking and coughing, followed by unilateral decreased breath sounds on the right side. What is the most likely diagnosis?

Accepted Answer

Foreign body aspiration lodged in the right mainstem bronchus

Answer

RSV bronchiolitis with mucus plugging

Answer

Epiglottitis with supraglottic obstruction

Answer

Community-acquired bilateral pneumonia

Question 7

Which oxygen delivery device provides the highest concentration of oxygen for a child in severe respiratory distress who is breathing spontaneously?

Accepted Answer

Non-rebreather mask with reservoir bag (60-95% FiO2)

Answer

Nasal cannula at 6 L/min (up to 44% FiO2)

Answer

Simple face mask (35-60% FiO2)

Answer

Partial non-rebreather mask (60-80% FiO2)