PEDS FINAL EXAM NURS 4115
COMPREHENSIVE TEST 2026 FULL QUESTIONS
AND ANSWERS GRADED A+
◉ An 11-month-old infant presents with progressive cyanosis, a
systolic murmur, and episodes of acute cyanosis and hypoxia. Which
congenital heart defect do you suspect?
A. Patent Ductus Arteriosus
B. Aortic Valve Stenosis
C. Tetralogy of Fallot
D. Coarctation of the Aorta. Answer: C. Tetralogy of Fallot
-Tetralogy of Fallot is a grouping of four defects which lead to
decreased pulmonary pressures and progressive cyanosis. Patients
with the tetralogy may also experience episodic attacks of acute
cyanosis and hypoxia called "Tet" spells.
◉ Which of the following heart defects make up the Tetralogy of
Fallot? (SATA)
A. Pulmonary Stenosis
B. Ventricular Septal Defect
C. Overriding Aorta
D. Right Ventricular Hypertrophy. Answer: Would you be mad if I
said these are all part of the Tetralogy of Fallot? There are four
,defects and only four answer options, so whatever you selected was
correct.
◉ A preschool-aged child presents with elevated BP and bounding
pulses in the upper extremities, combined with decreased BP and
cool skin in the lower extremities. On assessment, their femoral
pulses are practically absent. The child complains of dizziness,
headaches, and nosebleeds. Which condition do you suspect?
A. Patent Ductus Arteriosus
B. Aortic Valve Stenosis
C. Tetralogy of Fallot
D. Coarctation of the Aorta. Answer: D. Coarctation of the Aorta
-This condition is a narrowing of the aortic lumen, resulting in
obstructed blood flow, often to the lower extremities (this depends
on where the constriction occurs).
-Note the characteristic dichotomy between the upper extremities
(excessive blood flow) and the lower extremities (impaired blood
flow).
◉ What are four important pre-op considerations for a child who is
going to receive cardiac catheterization?. Answer: 1. Assess for
allergies to contrast media (iodine and shellfish allergies are
indicators of contrast dye allergy, which contains iodine).
2. Do a baseline neurovascular assessment.
3. Baseline labs (H&H, coagulation)
,4. NPO
◉ What are some common complications of cardiac
catheterization?. Answer: 1. Hemorrhage from the insertion site or a
retroperitoneal bleed.
2. Infection (watch for fever)
3. N/V due to medications used during the procedure.
4. Weak/absent pulses in the affected extremity (this is a normal
finding, but the pulses should return over the next several hours. If
they do not, call the provider).
5. Dysrhythmia (higher risk with interventional procedures).
◉ Which of the following congenital heart defects result in
INCREASED blood flow to the lungs? (these are good to group
together because they share many symptoms). (SATA).
A. Ventricular Septal Defect
B. Atrial Septal Defect
C. Pulmonary Stenosis
D. Patent Ductus Arteriosus. Answer: A, B, D
-Ventricular Septal Defects, Atrial Septal Defects, and Patent Ductus
Arteriosus all result in increased blood flow to the lungs by creating
openings between the left and right sides of the heart, which
inevitably leads to a shift of blood from the higher pressure left side
to the lower pressure right side.
, -The mnemonic to remember is All Very Pulmonary (ASD, VSD, PDA).
-Another good way to think about these is as "acyanotic" defects.
Note that pulmonary blood flow is enhanced, so blood oxygenation
is usually adequate.
◉ 1. Pulmonary congestion, poor weight gain, increased RR, and
decreased feeding tolerance are all manifestations of the three
congenital heart defects that (increase or decrease) pulmonary
blood flow.
2. Name these three heart defects.. Answer: 1. Pulmonary
congestion, poor weight gain, increased RR, and decreased feeding
tolerance are all manifestations of heart defects with increased
pulmonary blood flow.
2. Atrial Septal Defect. Ventricular Septal Defect, Patent Ductus
Arteriosus.
◉ Which of the following are S/S of a Ventricular Septal Defect?
(SATA)
A. Loud, harsh murmur at the Left Sternal Border
B. Loud, harsh murmur with a fixed, split S2.
C. Manifestations of HF
D. Bounding pulses. Answer: A and C are correct. (Loud, harsh
murmur at the Left Sternal Border and Manifestations of HF).
-B ( A loud, harsh murmur with a fixed, split S2) is a sign of an Atrial
Septal Defect, not a VSD.
COMPREHENSIVE TEST 2026 FULL QUESTIONS
AND ANSWERS GRADED A+
◉ An 11-month-old infant presents with progressive cyanosis, a
systolic murmur, and episodes of acute cyanosis and hypoxia. Which
congenital heart defect do you suspect?
A. Patent Ductus Arteriosus
B. Aortic Valve Stenosis
C. Tetralogy of Fallot
D. Coarctation of the Aorta. Answer: C. Tetralogy of Fallot
-Tetralogy of Fallot is a grouping of four defects which lead to
decreased pulmonary pressures and progressive cyanosis. Patients
with the tetralogy may also experience episodic attacks of acute
cyanosis and hypoxia called "Tet" spells.
◉ Which of the following heart defects make up the Tetralogy of
Fallot? (SATA)
A. Pulmonary Stenosis
B. Ventricular Septal Defect
C. Overriding Aorta
D. Right Ventricular Hypertrophy. Answer: Would you be mad if I
said these are all part of the Tetralogy of Fallot? There are four
,defects and only four answer options, so whatever you selected was
correct.
◉ A preschool-aged child presents with elevated BP and bounding
pulses in the upper extremities, combined with decreased BP and
cool skin in the lower extremities. On assessment, their femoral
pulses are practically absent. The child complains of dizziness,
headaches, and nosebleeds. Which condition do you suspect?
A. Patent Ductus Arteriosus
B. Aortic Valve Stenosis
C. Tetralogy of Fallot
D. Coarctation of the Aorta. Answer: D. Coarctation of the Aorta
-This condition is a narrowing of the aortic lumen, resulting in
obstructed blood flow, often to the lower extremities (this depends
on where the constriction occurs).
-Note the characteristic dichotomy between the upper extremities
(excessive blood flow) and the lower extremities (impaired blood
flow).
◉ What are four important pre-op considerations for a child who is
going to receive cardiac catheterization?. Answer: 1. Assess for
allergies to contrast media (iodine and shellfish allergies are
indicators of contrast dye allergy, which contains iodine).
2. Do a baseline neurovascular assessment.
3. Baseline labs (H&H, coagulation)
,4. NPO
◉ What are some common complications of cardiac
catheterization?. Answer: 1. Hemorrhage from the insertion site or a
retroperitoneal bleed.
2. Infection (watch for fever)
3. N/V due to medications used during the procedure.
4. Weak/absent pulses in the affected extremity (this is a normal
finding, but the pulses should return over the next several hours. If
they do not, call the provider).
5. Dysrhythmia (higher risk with interventional procedures).
◉ Which of the following congenital heart defects result in
INCREASED blood flow to the lungs? (these are good to group
together because they share many symptoms). (SATA).
A. Ventricular Septal Defect
B. Atrial Septal Defect
C. Pulmonary Stenosis
D. Patent Ductus Arteriosus. Answer: A, B, D
-Ventricular Septal Defects, Atrial Septal Defects, and Patent Ductus
Arteriosus all result in increased blood flow to the lungs by creating
openings between the left and right sides of the heart, which
inevitably leads to a shift of blood from the higher pressure left side
to the lower pressure right side.
, -The mnemonic to remember is All Very Pulmonary (ASD, VSD, PDA).
-Another good way to think about these is as "acyanotic" defects.
Note that pulmonary blood flow is enhanced, so blood oxygenation
is usually adequate.
◉ 1. Pulmonary congestion, poor weight gain, increased RR, and
decreased feeding tolerance are all manifestations of the three
congenital heart defects that (increase or decrease) pulmonary
blood flow.
2. Name these three heart defects.. Answer: 1. Pulmonary
congestion, poor weight gain, increased RR, and decreased feeding
tolerance are all manifestations of heart defects with increased
pulmonary blood flow.
2. Atrial Septal Defect. Ventricular Septal Defect, Patent Ductus
Arteriosus.
◉ Which of the following are S/S of a Ventricular Septal Defect?
(SATA)
A. Loud, harsh murmur at the Left Sternal Border
B. Loud, harsh murmur with a fixed, split S2.
C. Manifestations of HF
D. Bounding pulses. Answer: A and C are correct. (Loud, harsh
murmur at the Left Sternal Border and Manifestations of HF).
-B ( A loud, harsh murmur with a fixed, split S2) is a sign of an Atrial
Septal Defect, not a VSD.
