Pediatric Nurse Exam Pediatric Nurse Respiratory and Cardiovascular Disorders 2

Question 1

A 4-year-old with Tetralogy of Fallot is experiencing a hypercyanotic (tet) spell with sudden severe cyanosis and irritability. What is the priority nursing intervention?

Accepted Answer

Place the child in a knee-chest (squatting) position

Answer

Administer supplemental oxygen via non-rebreather mask only

Answer

Immediately administer IV morphine sulfate

Answer

Prepare the child for emergent surgical repair

Question 2

A 2-year-old is admitted with prolonged fever, bilateral conjunctival injection, cracked lips, and a strawberry tongue. Which diagnosis is most likely?

Accepted Answer

Kawasaki disease

Answer

Scarlet fever

Answer

Measles (rubeola)

Answer

Staphylococcal scalded skin syndrome

Question 3

Why is a ventricular septal defect (VSD) classified as an acyanotic congenital heart defect?

Accepted Answer

Oxygenated blood shunts from the left ventricle to the right ventricle, recirculating to the lungs

Answer

It involves a right-to-left shunt that bypasses the lungs

Answer

It requires emergent surgical correction at birth

Answer

Pulmonary blood flow is significantly decreased

Question 4

A child diagnosed with coarctation of the aorta would most likely demonstrate which blood pressure finding on assessment?

Accepted Answer

Higher blood pressure in the upper extremities than the lower extremities

Answer

Equal blood pressures in all four extremities

Answer

Lower blood pressure in the upper extremities than the lower extremities

Answer

Bounding, equal pulses throughout all extremities

Question 5

Which medication is administered to a neonate with ductal-dependent congenital heart disease to maintain patency of the ductus arteriosus?

Accepted Answer

Prostaglandin E1 (alprostadil)

Answer

Indomethacin (a prostaglandin inhibitor)

Answer

Furosemide to reduce pulmonary congestion

Answer

Digoxin to improve cardiac contractility

Question 6

Which is the most serious long-term complication of untreated or inadequately treated rheumatic fever?

Accepted Answer

Cardiac valve damage leading to rheumatic heart disease

Answer

Chronic renal failure from immune complex deposition

Answer

Peripheral arterial occlusive disease

Answer

Persistent pulmonary hypertension

Question 7

A child with congestive heart failure is assessed. Which clinical findings are most consistent with right-sided heart failure?

Accepted Answer

Hepatomegaly and dependent pitting edema

Answer

Pulmonary crackles and pink frothy sputum

Answer

Severe dyspnea at rest and orthopnea

Answer

Decreased oxygen saturation and tachypnea