NUR 425 Peds Exam 2
Which statement regarding the systolic and diastolic blood pressure of an infant less
than a year of age reflects a normal finding?
A. The blood pressure in the upper extremities should be higher than in the lower
extremities
B. The blood pressure in the lower extremities should be higher than the blood pressure
in the upper extremities
C. The blood pressure in the upper and lower extremities should be approximately the
same.
D. The blood pressure on the right side should be higher than the blood pressure on the
left side of the body - answerC. The blood pressure in the upper and lower extremities
should be approximately the same.
Maternal risk factors for an increased incidence in congenital heart disease in the infant
include the following: (Select all that apply)
A. Exposure to environmental toxins
B. Taking folic acid
C. Family history of congenital heart disease
D. Alcohol consumption during pregnancy
E. Infections during pregnancy - answerA. Exposure to environmental toxins
C. Family history of congenital heart disease
D. Alcohol consumption during pregnancy
E. Infections during pregnancy
A nurse is explaining the role of gradient pressure related to congenital heart disease to
a new CVICU nurse. What statement(s) would indicate an understanding of the concept
by the new nurse? (Select all that apply)
A. Blood flow through the heart takes the path of least resistance
B. The higher the pressure gradient, the slower the flow of blood
C. Blood flows from an area of high pressure to an area of low pressure in CHD
D. The greater the resistance the slower the flow of blood - answerA. Blood flow through
the heart takes the path of least resistance
C. Blood flows from an area of high pressure to an area of low pressure in CHD
D. The greater the resistance the slower the flow of blood
The new classification of heart defects is more descriptive regarding the flow of blood
through the heart. Match the classification with the type of congenital heart disease
found in that classification.
,A. increased pulmonary blood flow
B. decreased pulmonary blood flow
C. obstruction of blood flow out of the heart
1. TOF
2. CoA
3. VSD - answerA. increased pulmonary blood flow = VSD
B. decreased pulmonary blood flow = TOF
C. obstruction of blood flow out of the heart = CoA
You are the nurse caring for an infant who has been diagnosed with coarctation of the
aorta. The child is scheduled for a repair of this defect tomorrow. When doing your
assessment what deviations from normal would you expect to find? (Select all that
apply)
A. Poor peripheral pulses in the lower extremities
B. Equal blood pressure measurements in upper and lower extremities
C. Bounding pulses in upper extremities
D. A normal exam - answerA. Poor peripheral pulses in the lower extremities
C. Bounding pulses in upper extremities
The nurse in the CVICU has been educating a new nurse about the signs and
symptoms of heart failure in a child. Which statement by the new nurse would indicate a
need for further education?
A. "Children with heart failure often have edema and should be weighed daily."
B. "Children with heart failure should eat larger meals more often."
C. "Heart failure in children can present with inappropriate sweating and fatigue with
eating."
D. "It is often difficult for children with heart failure to breathe well when lying flat in bed."
- answerB. "Children with heart failure should eat larger meals more often."
Digoxin is a drug that is used frequently to treat heart failure in the pediatric client. What
are some signs and symptoms of digoxin toxicity? (Select all that apply)
A. N/V
B. Tachycardia
C. Bradycardia
D. Vision changes
E. Arrythmias - answerA. N/V
C. Bradycardia
D. Vision changes
E. Arrythmias
, You are caring for a child with heart failure in the CVICU. What are some nursing
interventions that you can implement to decrease the cardiac demand of your pediatric
client? (Select all that apply)
A. Cluster care to promote rest
B. Keep the room hot
C. Provide a lot of stimulation
D. Provide large meals three times a day
E. Treat fevers with antipyretics - answerA. Cluster care to promote rest
E. Treat fevers with antipyretics
You are the nurse caring for an infant in the CVICU who has just been diagnosed with
Tetralogy of Fallot. After speaking to the healthcare provider, the parents are still
unclear as to what the defect is. You would explain that Tetralogy of Fallot is made up of
which of the following defects? (Select all that apply)
A. VSD
B. ASD
C. Overriding aorta
D. Pulmonary stenosis
E. Left ventricular hypertrophy
F. Right ventricular hypertrophy - answerA. VSD
C. Overriding aorta
D. Pulmonary stenosis
F. Right ventricular hypertrophy
You are the nurse caring for a child in the NICU who has a history of prematurity and
has just been diagnosed with a patent ductus arteriosus. What medication would be an
appropriate treatment to promote the closure of this type of congenital heart defect?
A. Prostaglandin E
B. Morphine
C. Indomethacin
E. Digoxin - answerC. Indomethacin
A 13-year-old child has been admitted to the emergency room after collapsing during
football practice with moderate dehydration (8%). The child weighs 30 kg. The coach
informs the nurse that they had been practicing all afternoon and that the only water
available was inside the school which had been locked up for the past 4 hours. The
nurse notes on the child's assessment that the heart rate is 132 beats per minute,
respiratory rate is 26 breaths per minute, blood pressure is 112/78, capillary refill is 3
seconds, skin is dry, and mucous membranes are dry. The child is able to follow
commands but is lethargic and slow to respond.
What would the nurse expect for the initial intervention for this child?
A. Start IV fluids D5 NS at 71 mL/hr
Which statement regarding the systolic and diastolic blood pressure of an infant less
than a year of age reflects a normal finding?
A. The blood pressure in the upper extremities should be higher than in the lower
extremities
B. The blood pressure in the lower extremities should be higher than the blood pressure
in the upper extremities
C. The blood pressure in the upper and lower extremities should be approximately the
same.
D. The blood pressure on the right side should be higher than the blood pressure on the
left side of the body - answerC. The blood pressure in the upper and lower extremities
should be approximately the same.
Maternal risk factors for an increased incidence in congenital heart disease in the infant
include the following: (Select all that apply)
A. Exposure to environmental toxins
B. Taking folic acid
C. Family history of congenital heart disease
D. Alcohol consumption during pregnancy
E. Infections during pregnancy - answerA. Exposure to environmental toxins
C. Family history of congenital heart disease
D. Alcohol consumption during pregnancy
E. Infections during pregnancy
A nurse is explaining the role of gradient pressure related to congenital heart disease to
a new CVICU nurse. What statement(s) would indicate an understanding of the concept
by the new nurse? (Select all that apply)
A. Blood flow through the heart takes the path of least resistance
B. The higher the pressure gradient, the slower the flow of blood
C. Blood flows from an area of high pressure to an area of low pressure in CHD
D. The greater the resistance the slower the flow of blood - answerA. Blood flow through
the heart takes the path of least resistance
C. Blood flows from an area of high pressure to an area of low pressure in CHD
D. The greater the resistance the slower the flow of blood
The new classification of heart defects is more descriptive regarding the flow of blood
through the heart. Match the classification with the type of congenital heart disease
found in that classification.
,A. increased pulmonary blood flow
B. decreased pulmonary blood flow
C. obstruction of blood flow out of the heart
1. TOF
2. CoA
3. VSD - answerA. increased pulmonary blood flow = VSD
B. decreased pulmonary blood flow = TOF
C. obstruction of blood flow out of the heart = CoA
You are the nurse caring for an infant who has been diagnosed with coarctation of the
aorta. The child is scheduled for a repair of this defect tomorrow. When doing your
assessment what deviations from normal would you expect to find? (Select all that
apply)
A. Poor peripheral pulses in the lower extremities
B. Equal blood pressure measurements in upper and lower extremities
C. Bounding pulses in upper extremities
D. A normal exam - answerA. Poor peripheral pulses in the lower extremities
C. Bounding pulses in upper extremities
The nurse in the CVICU has been educating a new nurse about the signs and
symptoms of heart failure in a child. Which statement by the new nurse would indicate a
need for further education?
A. "Children with heart failure often have edema and should be weighed daily."
B. "Children with heart failure should eat larger meals more often."
C. "Heart failure in children can present with inappropriate sweating and fatigue with
eating."
D. "It is often difficult for children with heart failure to breathe well when lying flat in bed."
- answerB. "Children with heart failure should eat larger meals more often."
Digoxin is a drug that is used frequently to treat heart failure in the pediatric client. What
are some signs and symptoms of digoxin toxicity? (Select all that apply)
A. N/V
B. Tachycardia
C. Bradycardia
D. Vision changes
E. Arrythmias - answerA. N/V
C. Bradycardia
D. Vision changes
E. Arrythmias
, You are caring for a child with heart failure in the CVICU. What are some nursing
interventions that you can implement to decrease the cardiac demand of your pediatric
client? (Select all that apply)
A. Cluster care to promote rest
B. Keep the room hot
C. Provide a lot of stimulation
D. Provide large meals three times a day
E. Treat fevers with antipyretics - answerA. Cluster care to promote rest
E. Treat fevers with antipyretics
You are the nurse caring for an infant in the CVICU who has just been diagnosed with
Tetralogy of Fallot. After speaking to the healthcare provider, the parents are still
unclear as to what the defect is. You would explain that Tetralogy of Fallot is made up of
which of the following defects? (Select all that apply)
A. VSD
B. ASD
C. Overriding aorta
D. Pulmonary stenosis
E. Left ventricular hypertrophy
F. Right ventricular hypertrophy - answerA. VSD
C. Overriding aorta
D. Pulmonary stenosis
F. Right ventricular hypertrophy
You are the nurse caring for a child in the NICU who has a history of prematurity and
has just been diagnosed with a patent ductus arteriosus. What medication would be an
appropriate treatment to promote the closure of this type of congenital heart defect?
A. Prostaglandin E
B. Morphine
C. Indomethacin
E. Digoxin - answerC. Indomethacin
A 13-year-old child has been admitted to the emergency room after collapsing during
football practice with moderate dehydration (8%). The child weighs 30 kg. The coach
informs the nurse that they had been practicing all afternoon and that the only water
available was inside the school which had been locked up for the past 4 hours. The
nurse notes on the child's assessment that the heart rate is 132 beats per minute,
respiratory rate is 26 breaths per minute, blood pressure is 112/78, capillary refill is 3
seconds, skin is dry, and mucous membranes are dry. The child is able to follow
commands but is lethargic and slow to respond.
What would the nurse expect for the initial intervention for this child?
A. Start IV fluids D5 NS at 71 mL/hr
