Pediatric Cardiac Disorders NCLEX Questions

Extract:

Question 1 of 5

The client who has had a myocardial infarction is admitted to the telemetry unit from intensive care. Which referral would be most appropriate for the client?

Correct Answer: C

Rationale: Cardiac rehabilitation (
C) promotes recovery through exercise and education post-MI. Social work (
A), physical therapy (
B), and occupational therapy (
D) are less specific.

Question 2 of 5

The nurse is developing a nursing care plan for a client diagnosed with congestive heart failure. A nursing diagnosis of 'decreased cardiac output related to inability of the heart to pump effectively' is written. Which short-term goal would be best for the client?

A. The client will be able to ambulate in the hall by date of discharge. B. The client will have an audible S1 and S2 with no S3 heard by end of shift. C. The client will turn, cough, and deep breathe every two (2) hours. D. The client will have a SaO2 reading of 98% by day two (2) of care.

Correct Answer: B

Rationale: Absence of an S3 heart sound (
B) indicates improved cardiac function, directly addressing decreased cardiac output. Ambulation (
A) is long-term, turning/coughing (
C) is an intervention, and SaO2 of 98% (
D) is less specific to cardiac output.

Question 3 of 5

The home health nurse is assigned a client diagnosed with heart failure. Which should the nurse implement? Select all that apply.

A. Request a dietary consult for a sodium-restricted diet. B. Instruct the client to elevate the feet during the day. C. Teach the client to weigh every morning wearing the same type of clothing. D. Assess for edema in dependent areas of the body. E. Encourage the client to drink at least 3,000 mL of fluid per day. F. Have the client repeat back instructions to the nurse.

Correct Answer: A,B,C,D,F

Rationale: Sodium restriction (
A), elevating feet (
B), daily weights (
C), edema assessment (
D), and teach-back (F) manage CHF. 3,000 mL fluid (E) risks overload.

Question 4 of 5

The client is diagnosed with acute pericarditis. Which sign/symptom warrants immediate attention by the nurse?

A. Muffled heart sounds. B. Nondistended jugular veins. C. Bounding peripheral pulses. D. Pericardial friction rub.

Correct Answer: A

Rationale: Muffled heart sounds (
A) suggest cardiac tamponade, a life-threatening complication requiring immediate attention. Non-distended JVD (
B) is normal, bounding pulses (
C) are unrelated, and friction rub (
D) is expected.

Question 5 of 5

Which intervention should the nurse implement when defibrillating a client who is in ventricular fibrillation?

A. Defibrillate the client at 50, 100, and 200 joules. B. Do not remove the oxygen source during defibrillation. C. Place petroleum jelly on the defibrillator pads. D. Shout 'all clear' prior to defibrillating the client.

Correct Answer: D

Rationale: Shouting 'all clear' (
D) ensures safety before defibrillation. Energy levels (
A) are 200–360 joules, oxygen (
B) is removed to prevent fire, and petroleum jelly (
C) is not used.

Pediatric Cardiac Disorders NCLEX Questions | Nurselytic

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