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

Placing the child in the knee-chest position increases systemic vascular resistance by compressing femoral arteries, which reduces right-to-left shunting and improves pulmonary blood flow and oxygenation.

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

Kawasaki disease is characterized by fever lasting ≥5 days plus at least four of five classic features: conjunctival injection, oral mucosal changes (strawberry tongue, cracked lips), rash, extremity changes, and cervical lymphadenopathy.

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

In VSD, higher left ventricular pressure forces oxygenated blood across the defect into the right ventricle (left-to-right shunt), increasing pulmonary blood flow without systemic desaturation, so the child remains pink (acyanotic).

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

Coarctation of the aorta creates a mechanical obstruction that causes hypertension proximal to the narrowing (upper extremities) and hypotension or diminished pulses distal to it (lower 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

Prostaglandin E1 relaxes the smooth muscle of the ductus arteriosus to keep it open, which is essential in ductal-dependent lesions where survival depends on ductal flow for pulmonary or systemic circulation.

Pediatric Nurse Exam Practice Test

Pediatric Nurse Exam Practice Test

Pediatric Nurse Exam Pediatric Nurse Respiratory and Cardiovascular Disorders 2