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

Digoxin should be held and the prescriber notified if the apical pulse is below 90-100 bpm in young children (1-5 years), as bradycardia may indicate digoxin toxicity.

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

Indomethacin, an NSAID, inhibits prostaglandin synthesis and thereby removes the stimulus that keeps the ductus arteriosus open, promoting spontaneous closure in premature neonates.

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

Parents of infants with BPD must vigilantly monitor respiratory rate, color, and work of breathing, and maintain close follow-up because the condition requires ongoing assessment and management adjustments.

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

Eisenmenger syndrome occurs when longstanding left-to-right shunting causes irreversible pulmonary hypertension, eventually exceeding systemic pressure and reversing the shunt to right-to-left, causing cyanosis.

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

The priority post-cardiac catheterization is assessing the femoral insertion site for hemorrhage or hematoma formation and checking distal pulses, capillary refill, and extremity color to detect vascular compromise.

Pediatric Nurse Exam Practice Test

Pediatric Nurse Exam Practice Test

Pediatric Nurse Exam Pediatric Nurse Respiratory and Cardiovascular Disorders 3