ATI RN
Pediatric Nursing Cardiovascular NCLEX Practice Quiz Questions
Question 1 of 5
A 2-month-old male presents with tachycardia, dyspnea, tachypnea, and a gallop rhythm with no heart murmur. He was perfectly well until 1 day prior to the episode. The physical examination reveals a heart rate of 235, a temperature of 37.8°C, and a normal blood pressure with warm, well-perfused extremities. The most likely diagnosis is
Correct Answer: B
Rationale: In this scenario, the most likely diagnosis is supraventricular tachycardia (SVT) (Option B). SVT is a common arrhythmia in infants, characterized by sudden onset tachycardia, which can present with symptoms like dyspnea, tachypnea, and a gallop rhythm. The absence of a heart murmur suggests a non-structural cause, further supporting SVT as the diagnosis. Option A, sepsis, is less likely due to the absence of other systemic signs like hypotension and poor perfusion. Ingestion (Option C) would typically present with other symptoms and signs related to the specific ingested substance. Ventricular tachycardia (Option D) is less common in infants without underlying structural heart disease. Educationally, understanding cardiac arrhythmias in pediatric patients is crucial for nurses. Recognizing the signs and symptoms of SVT in infants, along with appropriate interventions like vagal maneuvers or adenosine administration, is essential for providing safe and effective care. This case highlights the importance of quick and accurate assessment in pediatric cardiovascular emergencies.
Question 2 of 5
An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?
Correct Answer: A
Rationale: In this scenario, option A "I get short of breath when I climb stairs" is the correct answer that should alert the nurse to the occurrence of heart failure. Shortness of breath, especially during exertion like climbing stairs, is a common symptom of heart failure due to the heart's inability to pump effectively. This symptom is indicative of pulmonary congestion, a hallmark sign of heart failure. Option B "I see halos floating around my head" is unrelated to heart failure and is more suggestive of visual disturbances, possibly related to migraines or ocular issues. Option C "I have trouble remembering things" is not a typical symptom of heart failure. Memory issues could be related to various factors, but not directly indicative of heart failure. Option D "I have lost weight over the past month" is also not a specific symptom of heart failure. Weight loss in heart failure is often associated with severe cases and is usually accompanied by other symptoms like fluid retention and muscle wasting. In an educational context, understanding the specific symptoms of heart failure is crucial for nurses caring for pediatric patients. Recognizing these signs promptly can lead to early intervention and improved outcomes for the child. Educating nurses on differentiating symptoms of heart failure from other conditions is essential in providing high-quality care and ensuring patient safety.
Question 3 of 5
A nurse assesses a client who is scheduled for a cardiac catheterization. Which assessment should the nurse complete before this procedure?
Correct Answer: D
Rationale: In the context of a pediatric client scheduled for a cardiac catheterization, assessing for allergies to iodine-based agents before the procedure is crucial because iodine-based contrast media are commonly used during cardiac catheterizations. An allergic reaction to these agents can range from mild skin rashes to severe anaphylactic reactions, which can be life-threatening. Therefore, identifying any potential allergies beforehand is essential to prevent adverse reactions and provide safe care to the child. Option A, assessing the client's level of anxiety, while important for overall patient comfort and well-being, is not the priority before a cardiac catheterization. Option B, evaluating the ability to turn self in bed, is also important but is not directly related to the safety and success of the procedure. Option C, monitoring cardiac rhythm and heart rate, although relevant in cardiac care, is typically done during or after the cardiac catheterization to assess for any procedural complications. In an educational context, this question highlights the importance of thorough pre-procedural assessments in pediatric nursing. It emphasizes the significance of identifying potential risks and ensuring the safety of pediatric patients undergoing invasive procedures. By understanding the rationale behind the correct answer and the implications of the incorrect options, nursing students can enhance their critical thinking skills and clinical judgment when caring for pediatric clients with cardiovascular conditions.
Question 4 of 5
A nurse cares for a client who has advanced cardiac disease and states, I am having trouble sleeping at night. How should the nurse respond?
Correct Answer: D
Rationale: The correct answer to the question is option D) Use pillows to elevate your head and chest while you are sleeping. Rationale for the correct answer: Elevating the head and chest while sleeping helps reduce venous return to the heart, which decreases the workload on the heart. In patients with advanced cardiac disease, this position can help improve cardiac output and relieve symptoms like shortness of breath, which can occur when lying flat. Explanation for why the other options are wrong: A) Ordering a sleep study may be useful in some cases of sleep disturbances, but in this scenario, the client's issue is related to the cardiac disease, not a sleep disorder. B) Oxygen therapy is not indicated without assessing the client's oxygen saturation levels first. It is not the most appropriate initial intervention for difficulty sleeping. C) CPAP is primarily used for sleep apnea and may not be necessary for this client unless sleep apnea is diagnosed. Educational context: Understanding the appropriate positioning for clients with cardiac disease is crucial in managing their symptoms and improving outcomes. Elevating the head and chest can help alleviate symptoms like dyspnea and improve cardiac function by reducing the workload on the heart. Nurses need to be knowledgeable about these interventions to provide optimal care for patients with cardiovascular conditions.
Question 5 of 5
A chest radiograph film is ordered for a child with suspected cardiac problems. The child’s parent asks the nurse, “What will the radiograph show about the heart?” What knowledge about the x-ray should the nurse include in the response to the parents?
Correct Answer: C
Rationale: A chest radiograph will provide information on the heart size and pulmonary blood-flow patterns. It will provide a baseline for future comparisons. The heart will be visible, as well as the sternum and ribs. Electrocardiography (ECG) measures the electrical potential generated from heart muscle. Echocardiography will produce a computerized image of the heart vessels and tissues by using sound waves.