ATI RN
Pediatric Nursing Cardiovascular NCLEX Practice Quiz Questions
Question 1 of 5
A child born with Down syndrome should be evaluated for which associated cardiac manifestation?
Correct Answer: A
Rationale: In the context of pediatric nursing and pharmacology, understanding cardiac manifestations associated with Down syndrome is crucial for providing comprehensive care to children with this condition. The correct answer is A) Congenital heart defect (CHD). Down syndrome is commonly associated with congenital heart defects, with nearly half of infants born with Down syndrome having some form of CHD. These defects can range from atrioventricular septal defects to ventricular septal defects. Option B) Systemic hypertension is not a common cardiac manifestation seen in children with Down syndrome. While individuals with Down syndrome may have an increased risk of developing hypertension later in life, it is not a primary cardiac concern in the pediatric population with Down syndrome. Option C) Hyperlipidemia is not a cardiac manifestation specifically associated with Down syndrome. While individuals with Down syndrome may have alterations in lipid profiles, it is not a primary cardiac manifestation seen in this population. Option D) Cardiomyopathy is not a common cardiac manifestation in children with Down syndrome. While cardiomyopathy can occur in some individuals with Down syndrome, it is not as prevalent or strongly associated as congenital heart defects. Educationally, understanding the cardiac manifestations associated with Down syndrome is essential for nurses caring for pediatric patients. Recognizing the increased risk of CHD in children with Down syndrome allows for timely assessment, monitoring, and intervention to optimize outcomes and provide holistic care to these individuals.
Question 2 of 5
BP screenings to detect end-organ damage should be done routinely beginning at what age?
Correct Answer: B
Rationale: In pediatric nursing, conducting blood pressure (BP) screenings is crucial to detect end-organ damage early. The correct age to start routine BP screenings is at 3 years old (Option B) because this is when most children can cooperate with the procedure and accurate readings can be obtained. Starting BP screenings at birth (Option A) is not necessary as newborns may have transient fluctuations in BP due to various factors such as delivery stress. Waiting until 8 years (Option C) or 13 years (Option D) to begin BP screenings is too late as early detection of hypertension or other cardiovascular issues is essential for timely intervention and prevention of end-organ damage. Educationally, understanding the rationale behind the timing of BP screenings in children is vital for pediatric nurses to provide evidence-based care. It ensures that healthcare providers can monitor and intervene early in case of abnormal BP readings, thus safeguarding the cardiovascular health of pediatric patients. By starting screenings at 3 years old, healthcare professionals can establish a baseline for each child and track any deviations over time, contributing to comprehensive pediatric care.
Question 3 of 5
In which congenital heart defect (CHD) would the nurse need to take upper and lower extremity BPs?
Correct Answer: C
Rationale: In pediatric nursing, understanding congenital heart defects (CHDs) is crucial for providing safe and effective care to pediatric patients. In the context of this question, the correct answer is C) Coarctation of the aorta (COA). This defect involves a narrowing of the aorta, leading to decreased blood flow to the lower extremities. When assessing a child with COA, it is essential to take blood pressure measurements in both the upper and lower extremities. Discrepancies in blood pressure readings between the two extremities can indicate the presence of COA. The higher blood pressure in the upper extremities compared to the lower extremities suggests obstruction in blood flow, a hallmark feature of COA. Regarding the incorrect options: A) Transposition of the great vessels: This defect involves a complete switch of the aorta and pulmonary artery, but it does not typically present with discrepancies in blood pressure between upper and lower extremities. B) Aortic stenosis (AS): While AS involves narrowing of the aortic valve, it does not specifically result in differences in blood pressure measurements between upper and lower extremities. D) Tetralogy of Fallot (TOF): TOF is characterized by four specific heart defects, including pulmonary stenosis, overriding aorta, ventricular septal defect, and right ventricular hypertrophy. However, it does not typically manifest with differences in blood pressure between the upper and lower extremities. Educationally, understanding the rationale behind why blood pressure measurements in both upper and lower extremities are crucial in COA helps nurses in early identification and prompt management of this condition in pediatric patients. This knowledge can lead to improved patient outcomes and prevent potential complications associated with untreated COA.
Question 4 of 5
The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to:
Correct Answer: D
Rationale: In this scenario, the correct action for the nurse to take is option D, which is to apply direct pressure 1 inch above the puncture site. This is the most appropriate initial intervention to control the bleeding from the cardiac catheterization site. Direct pressure helps to promote hemostasis and prevent further blood loss, which is crucial in this situation to stabilize the child. Option A, calling the interventional cardiologist, and option B, notifying the cardiac catheterization laboratory, are not the first actions to take in a situation where active bleeding is present. These actions may lead to delays in providing immediate care to the child. Option C, applying a bulky pressure dressing over the present dressing, is also not the best initial action as it does not address the source of bleeding directly. In cases of active bleeding, direct pressure is more effective in controlling and stopping the bleeding. In an educational context, it is important for nurses caring for pediatric patients post-cardiac catheterization to be prepared to manage potential complications such as bleeding. Understanding the correct steps to take in emergency situations like this can help nurses provide prompt and effective care to ensure the safety and well-being of their patients.
Question 5 of 5
Treatment for congestive heart failure (CHF) in an infant began 3 days ago and has included digoxin and furosemide. The child no longer has retractions, lungs are clear, and HR is 96 beats per minute while sleeping. The nurse is confident that the child has diuresed successfully and has good renal perfusion when the nurse notes the child's urine output is:
Correct Answer: B
Rationale: In this scenario, the correct answer is B) 1 cc/kg/hr. A urine output of 1 cc/kg/hr indicates adequate renal perfusion and successful diuresis in an infant being treated for congestive heart failure with digoxin and furosemide. This level of urine output signifies that the kidneys are effectively eliminating excess fluid and waste from the body, helping to alleviate the symptoms of CHF. Option A) 0.5 cc/kg/hr would indicate inadequate diuresis and may suggest ongoing fluid retention and poor renal perfusion, which is not ideal for a child with CHF. Option C) 30 cc/hr and Option D) 1 oz/hr do not account for the infant's weight, which is crucial in determining appropriate urine output in pediatrics. Using weight-based calculations ensures that the urine output is tailored to the individual needs of the child. Educationally, this question highlights the importance of monitoring urine output as an indicator of renal function and the effectiveness of treatment in pediatric patients with CHF. Understanding the significance of urine output in assessing renal perfusion and diuresis is essential for nurses caring for infants with cardiac conditions.