CAPSTONE NURSING CARE OF CHILDREN
COMPREHENSIVE TEST 2026 FULL QUESTIONS
WITH ANSWERS
▶ Symptoms of inc LAP and Pulm Ven Press in heart failure. Answer: -
Pulmonary edema made worse with tachycardia (exercise)
-dyspnea and fatigue
▶ R Heart Failure. Answer: -caused by severe L heart failure, RV MI,
cardiomyopathies, and pulmonic valvular disease, PH, COPD, Cystic
fibrosis
-Sx: RV hypertrophy, JVD, peripheral edema, progressive diastolic and
systolic deterioration, hepatosplenomegaly
▶ L vs R heart failure. Answer: L: Blood backs up into pulmonary
(inadequate systemic circulation)
Sx:pulmonary edema, waking in the middle of the night, SOB, fatigue
R: Blood backs up in the body (inadequate pulmonary circulation)
Sx:Peripheral edema, HTN, JVD, Dep. edema, hepatosplenomegaly
▶ infective endocarditis. Answer: -Infection and inflammation of the
endocardium (esp valves).
- Most common cause: Staphylococcus aureus.
- Risk fx: prosthetic valve, congenital lesions associated with highly
turbulent flow, IV drug use, long-term IV catheter, Pacemaker, heart
transplant with defective valve, dental procedures with manipulation of
gingiva,
- Endocardial damage, Bacterial adherence, and formation of vegetations
- Sx: fever, cardiac murmur, petechial lesions of the skin conjunctiva and
oral mucosa, night sweats, weight loss, back pain, heart failure, Osler
nodes (erythematous nodules on the pads of fingers or toes)
▶ Patho of DVT. Answer: Accumulation of clotting factors leads to
thrombus formation (often near a valve). Inflammation leads to further
platelet aggregation. Thrombus grows proximally
,▶ Virchow's Triad. Answer: 1) Venous stasis (associated with immobility,
obesity, age, CHF)
2) Venous intimal damage (related to trauma, venipuncture, IV meds)
3) Hypercoagulable state ( from inherited disorders, smoking, liver disease,
pregnancy, oral contraceptives, hormone replacement, malignancy)
▶ Physiologic response to anemia. Answer: - Compensation for reduced
blood volume causes interstitial fluid to move intravascularly (inc. plasma
volume, dec. viscosity) causing hyperdynamic circulatory state (inc
SV/HR/cardiac dilation and heart valve insufficiency).
-Inc rate and depth of breathing, dizziness, fatigue, heart failure,
▶ Folate Deficiency Anemia. Answer: People at risk: Pregnant/ lactating,
alcoholics, chronic malnourishment,
▶ Labs for Iron def. anemia. Answer: - Low- HGB/Hct/ mcv/plasma
iron/ferritin, transferrin
- High- Total iron binding capacity/free erythrocyte protoporphyrin
-Normal- reticulocyte count/B12, Folate, Bili
▶ sickle cell anemia. Answer: a genetic disorder that causes abnormal
hemoglobin, resulting in some red blood cells assuming an abnormal sickle
shape
-Chronic hemolysis, microvascular occlusions, and tissue damage, vaso
occlusive crisis
-abnormal or absent splenic function
▶ Cause of aplastic anemia. Answer: Failure of bone marrow to produce
mature cells causing pancytopenia (reduction of all 3 blood cell types)
- Idiopathic, acquired stem cell defects, immune mediated
- whole-body irradiation, viral infections, hepatitis, CMV, epstein-barr virus,
herpes zoster, inherited
-Chemica: alkylating agents, antimetabolites, benzene, chloramphenicol,
arsenicals, carbamazepine, gold salts
▶ Autoimmune Hemolytic Anemia. Answer: 1) Warm reactive antibody
type- IgG binds optimally to erythrocytes at a normal body temperature.
, 2) Cold agglutinin type- IgM antibodies optimally bind to erythrocytes at
colder temps (lower than 31 deg. Celsius). Recognized by phagocytes in
the liver and spleen. Fingers, toes, ears, may have obstructed blood flow
3) Cold hemolysin type- Hemoglobinuria
Acquired disorders caused by autoantibodies or complement or both, on
RBCs against antigens normally on the surface of erythrocytes.
▶ Secondary Polycythemia. Answer: -physiologic response from increased
erythropoietin secretion in response to chronic hypoxia.
-Noted in people living in high altitudes, smokers, COPD, CHF
-Abnormal hgb
▶ Anemia of chronic renal failure. Answer: - Kidney damage affects
secretion of erythropoietin, diminishes bone marrow erythropoiesis.
- Uremic toxins that increase in the blood d/t renal failure may suppress
bone marrow function and damage erythrocytes
- Platelet dysfunction (bleeding)
- loss of erythrocytes
▶ Hypovolemic shock. Answer: Loss of whole blood (hemorrhage), plasma
(burns), or interstitial fluid (sweat, DM, DI, emesis, diuresis) in large
amounts.
-When intravascular volume decreases by 15%
▶ Glucose regulation in shock. Answer: glycogenolysis, gluconeogenesis,
and lipolysis.
-total body stores can fuel metabolism for 10 hours
▶ Ovulation. Answer: - Marks the beginning of the luteal/secretory phase
of the cycle.
▶ Uterine prolapse. Answer: descent of cervix or entire uterus into the
vaginal canal
▶ polycystic ovary syndrome. Answer: -at least two of these features:
irregular ovulation, elevated levels of androgens (testosterone), and
appearance of polycystic ovaries on ultrasound.
-strong genetic component
-Low FSH, high LH (causes high androgens), and high LH bioactivity
COMPREHENSIVE TEST 2026 FULL QUESTIONS
WITH ANSWERS
▶ Symptoms of inc LAP and Pulm Ven Press in heart failure. Answer: -
Pulmonary edema made worse with tachycardia (exercise)
-dyspnea and fatigue
▶ R Heart Failure. Answer: -caused by severe L heart failure, RV MI,
cardiomyopathies, and pulmonic valvular disease, PH, COPD, Cystic
fibrosis
-Sx: RV hypertrophy, JVD, peripheral edema, progressive diastolic and
systolic deterioration, hepatosplenomegaly
▶ L vs R heart failure. Answer: L: Blood backs up into pulmonary
(inadequate systemic circulation)
Sx:pulmonary edema, waking in the middle of the night, SOB, fatigue
R: Blood backs up in the body (inadequate pulmonary circulation)
Sx:Peripheral edema, HTN, JVD, Dep. edema, hepatosplenomegaly
▶ infective endocarditis. Answer: -Infection and inflammation of the
endocardium (esp valves).
- Most common cause: Staphylococcus aureus.
- Risk fx: prosthetic valve, congenital lesions associated with highly
turbulent flow, IV drug use, long-term IV catheter, Pacemaker, heart
transplant with defective valve, dental procedures with manipulation of
gingiva,
- Endocardial damage, Bacterial adherence, and formation of vegetations
- Sx: fever, cardiac murmur, petechial lesions of the skin conjunctiva and
oral mucosa, night sweats, weight loss, back pain, heart failure, Osler
nodes (erythematous nodules on the pads of fingers or toes)
▶ Patho of DVT. Answer: Accumulation of clotting factors leads to
thrombus formation (often near a valve). Inflammation leads to further
platelet aggregation. Thrombus grows proximally
,▶ Virchow's Triad. Answer: 1) Venous stasis (associated with immobility,
obesity, age, CHF)
2) Venous intimal damage (related to trauma, venipuncture, IV meds)
3) Hypercoagulable state ( from inherited disorders, smoking, liver disease,
pregnancy, oral contraceptives, hormone replacement, malignancy)
▶ Physiologic response to anemia. Answer: - Compensation for reduced
blood volume causes interstitial fluid to move intravascularly (inc. plasma
volume, dec. viscosity) causing hyperdynamic circulatory state (inc
SV/HR/cardiac dilation and heart valve insufficiency).
-Inc rate and depth of breathing, dizziness, fatigue, heart failure,
▶ Folate Deficiency Anemia. Answer: People at risk: Pregnant/ lactating,
alcoholics, chronic malnourishment,
▶ Labs for Iron def. anemia. Answer: - Low- HGB/Hct/ mcv/plasma
iron/ferritin, transferrin
- High- Total iron binding capacity/free erythrocyte protoporphyrin
-Normal- reticulocyte count/B12, Folate, Bili
▶ sickle cell anemia. Answer: a genetic disorder that causes abnormal
hemoglobin, resulting in some red blood cells assuming an abnormal sickle
shape
-Chronic hemolysis, microvascular occlusions, and tissue damage, vaso
occlusive crisis
-abnormal or absent splenic function
▶ Cause of aplastic anemia. Answer: Failure of bone marrow to produce
mature cells causing pancytopenia (reduction of all 3 blood cell types)
- Idiopathic, acquired stem cell defects, immune mediated
- whole-body irradiation, viral infections, hepatitis, CMV, epstein-barr virus,
herpes zoster, inherited
-Chemica: alkylating agents, antimetabolites, benzene, chloramphenicol,
arsenicals, carbamazepine, gold salts
▶ Autoimmune Hemolytic Anemia. Answer: 1) Warm reactive antibody
type- IgG binds optimally to erythrocytes at a normal body temperature.
, 2) Cold agglutinin type- IgM antibodies optimally bind to erythrocytes at
colder temps (lower than 31 deg. Celsius). Recognized by phagocytes in
the liver and spleen. Fingers, toes, ears, may have obstructed blood flow
3) Cold hemolysin type- Hemoglobinuria
Acquired disorders caused by autoantibodies or complement or both, on
RBCs against antigens normally on the surface of erythrocytes.
▶ Secondary Polycythemia. Answer: -physiologic response from increased
erythropoietin secretion in response to chronic hypoxia.
-Noted in people living in high altitudes, smokers, COPD, CHF
-Abnormal hgb
▶ Anemia of chronic renal failure. Answer: - Kidney damage affects
secretion of erythropoietin, diminishes bone marrow erythropoiesis.
- Uremic toxins that increase in the blood d/t renal failure may suppress
bone marrow function and damage erythrocytes
- Platelet dysfunction (bleeding)
- loss of erythrocytes
▶ Hypovolemic shock. Answer: Loss of whole blood (hemorrhage), plasma
(burns), or interstitial fluid (sweat, DM, DI, emesis, diuresis) in large
amounts.
-When intravascular volume decreases by 15%
▶ Glucose regulation in shock. Answer: glycogenolysis, gluconeogenesis,
and lipolysis.
-total body stores can fuel metabolism for 10 hours
▶ Ovulation. Answer: - Marks the beginning of the luteal/secretory phase
of the cycle.
▶ Uterine prolapse. Answer: descent of cervix or entire uterus into the
vaginal canal
▶ polycystic ovary syndrome. Answer: -at least two of these features:
irregular ovulation, elevated levels of androgens (testosterone), and
appearance of polycystic ovaries on ultrasound.
-strong genetic component
-Low FSH, high LH (causes high androgens), and high LH bioactivity
