Pediatric Nurse Exam Pediatric Nurse Respiratory and Cardiovascular Disorders 3

Question 1

A nurse is about to administer digoxin to a 2-year-old child with heart failure. The child's apical heart rate is 82 beats per minute. What is the correct action?

Accepted Answer

Hold the dose and notify the prescriber, as the rate is below the threshold for this age group

Answer

Administer the dose as ordered, since 82 bpm is within the normal range

Answer

Administer half the dose and reassess in 30 minutes

Answer

Increase the dose slightly to improve cardiac contractility

Question 2

A premature neonate is diagnosed with a patent ductus arteriosus (PDA) causing significant left-to-right shunting. Which pharmacological agent promotes ductal closure?

Accepted Answer

Indomethacin, a prostaglandin synthesis inhibitor

Answer

Prostaglandin E1, which relaxes ductal smooth muscle

Answer

Furosemide, which reduces pulmonary fluid overload

Answer

Atropine, which increases heart rate and cardiac output

Question 3

An infant with bronchopulmonary dysplasia (BPD) is being discharged home on supplemental oxygen. What is the most critical teaching for the parents?

Accepted Answer

Monitor the infant's respiratory rate and skin color, and keep all scheduled follow-up appointments

Answer

Discontinue the oxygen once the infant appears comfortable and pink

Answer

Permanently restrict all physical activity to prevent desaturation episodes

Answer

Oxygen is only needed during sleep; remove it during waking hours

Question 4

A child with a large, longstanding unrepaired VSD develops increasing cyanosis, decreased exercise tolerance, and reversal of blood flow through the defect. The nurse recognizes this as:

Accepted Answer

Eisenmenger syndrome, where pulmonary hypertension reverses the shunt

Answer

Tetralogy of Fallot developing after an acyanotic defect

Answer

Coarctation syndrome with progressive aortic narrowing

Answer

Pulmonary stenosis with compensatory right ventricular hypertrophy

Question 5

A child returns to the pediatric unit after cardiac catheterization via the femoral artery. What is the priority nursing assessment in the immediate post-procedure period?

Accepted Answer

Assessing the catheter insertion site for bleeding and evaluating distal pulses in the affected extremity

Answer

Monitoring for nausea and vomiting from contrast dye administration

Answer

Measuring urine output to assess for contrast-induced nephropathy

Answer

Checking blood glucose levels due to the prolonged fasting period

Question 6

Which set of findings is most consistent with left-sided heart failure in a pediatric patient?

Accepted Answer

Pulmonary congestion, crackles in the lung bases, and respiratory distress

Answer

Hepatomegaly, jugular venous distension, and peripheral edema

Answer

Ascites, facial edema, and splenomegaly

Answer

Bradycardia, hypotension, and cool mottled extremities

Question 7

A child with persistent asthma is prescribed salmeterol (a long-acting beta-2 agonist, LABA). The nurse provides education to the family. Which statement is most accurate regarding LABA use in children?

Accepted Answer

Salmeterol must always be prescribed and used in combination with an inhaled corticosteroid

Answer

Salmeterol should be used as the primary rescue inhaler during acute attacks

Answer

LABAs may replace short-acting bronchodilators in well-controlled asthma

Answer

LABAs are administered exclusively via nebulizer for pediatric patients