Question 1

As a pediatric nurse, what action should you take if you observe an elevated blood pressure in a child as measured by an automated device?&#10;A) Obtain a reading in the other arm&#10;B) Obtain a reading with a larger cuff&#10;C) Obtain a reading with a smaller cuff&#10;D) Obtain a reading via auscultation

Accepted Answer

Automated devices can sometimes give inaccurate readings, especially in children. Obtaining a reading via auscultation (manual measurement) is the most reliable method to confirm elevated blood pressure.

Question 2

As a pediatric nurse, you should be aware that which lab value may be elevated in patients with cardiomyopathy, myocarditis, or sepsis, all of which will ultimately lead to decreased cardiac perfusion?

A) Blood calcium
B) Brain natriuretic peptide
C) Cardiac troponin
D) Erythrocyte sedimentation rate

C

Accepted Answer

Cardiac troponin is a biomarker that is elevated in conditions that cause damage to the heart muscle, such as cardiomyopathy, myocarditis, or sepsis, which can lead to decreased cardiac perfusion.

Question 3

The Newborn Screening for Critical Congenital Heart Defects Program can detect 12 critical defects needing repair in the first year of life. How would the pediatric nurse conduct this screening?&#10;A) Placing one pulse oximetry probe on the right hand and a second pulse oximetry probe on the left hand&#10;B) Placing one pulse oximetry probe on the right foot and a second pulse oximetry probe on the left foot&#10;C) Placing one pulse oximetry probe on the left hand and a second pulse oximetry probe on either foot&#10;D) Placing one pulse oximetry probe on the right hand and a second pulse oximetry probe on either foot

Accepted Answer

The correct method for conducting newborn screening for critical congenital heart defects involves placing one pulse oximetry probe on the right hand and another on either foot. This setup allows for the comparison of oxygen saturation levels between pre- and post-ductal blood flow, which can help identify heart defects.

Question 4

As a pediatric nurse, what method would be most useful in detecting suboptimal oxygenation in a child that has not reached the threshold for cyanosis?&#10;A) Spirometry&#10;B) Telemetry&#10;C) Pulse oximetry&#10;D) Arterial blood gases

Accepted Answer

Pulse oximetry is a non-invasive method that measures the oxygen saturation level of the blood, which is useful for detecting suboptimal oxygenation before clinical signs such as cyanosis become apparent.

Question 5

A pediatric patient presents with shortness of breath, failure to thrive, feeding difficulties, and a lower left sternal border systolic thrill. An echocardiogram was obtained, which showed an enlarged left atrium. From this presentation, what diagnosis can be made for this child?

A) Atrial septal defect
B) Ventricular septal defect
C) Tetralogy of Fallot
D) Aortic stenosis

Accepted Answer

Ventricular septal defect (VSD) is indicated by symptoms of shortness of breath, failure to thrive, and feeding difficulties in pediatric patients, along with a systolic thrill at the lower left sternal border and an enlarged left atrium on echocardiogram, as it leads to increased blood flow to the lungs and left atrium enlargement due to the left-to-right shunt.

Question 6

The hyperoxygenation test is a simple bedside test that can help distinguish between cardiac and respiratory causes in children who are hypoxemic. How will infants with cyanotic congenital heart defects respond to this test?

A) Their PO₂ will increase significantly
B) Their PO₂ will not increase significantly
C) Their PCO₂ will increase significantly
D) Their PCO₂ will decrease significantly

Accepted Answer

Infants with cyanotic congenital heart defects will not show a significant increase in oxygen saturation (SpO2) during the hyperoxygenation test because their hypoxemia is due to a cardiac, not a respiratory, cause.

Question 7

What anticipatory guidance should you give to the parents of a child who must take digoxin?&#10;A) Only give if the child's heart rate is less than 60 beats/minute&#10;B) Digoxin must be administered with food.&#10;C) Re-dose the child if the child vomits the first dose.&#10;D) Give water after the dose to prevent tooth decay.

Accepted Answer

Digoxin can cause tooth decay due to its sugary formulation, so it's recommended to give water after the dose to rinse the child's mouth and prevent tooth decay. The other options are incorrect: A) Digoxin should not be given if the heart rate is too low, but the specific threshold can vary; B) Digoxin does not necessarily need to be administered with food; C) If a child vomits after taking digoxin, re-dosing can lead to toxicity, so it's not advised without consulting a healthcare provider.

Question 8

For children with Kawasaki disease, high-dose aspirin therapy is used for 6 to 8 weeks, which is lifesaving for the child. However, what medical condition may develop as a result of this treatment regimen?

A) Reye syndrome
B) Guillain-Barre syndrome
C) Metabolic syndrome
D) Malabsorption syndrome

Accepted Answer

Reye syndrome is a rare but serious condition that can develop in children who are given aspirin, especially during viral infections or when given for an extended period, such as in the treatment regimen for Kawasaki disease.

Question 9

A child with a history of strep throat presents with fever, shortness of breath, abdominal pain, and a very painful and swollen shoulder joint. Based on this history and presentation, what medical condition should be suspected?

A) Kawasaki disease
B) Rheumatoid heart disease
C) Coarctation of the Aorta
D) Dextro-transposition of the great arteries

Accepted Answer

The child's symptoms and history of strep throat suggest rheumatic fever, which can lead to rheumatic heart disease. The joint pain and swelling, fever, and abdominal pain align with this condition.

Question 10

When performing an assessment on a child, the child is found to be cyanotic and tachypneic. The hyperoxygenation test was negative and the chest X-ray reveals an "egg on a string" cardiac silhouette. Based on these findings, for what medical condition should this child be treated?

A) Tricuspid atresia
B) Tetralogy of Fallot
C) Coarctation of the aorta
D) Dextro-transposition of the great arteries

Accepted Answer

The answer of When performing an assessment on a child,...

Deck 19: Cardiovascular: Perfusion