FNP PEDIATRIC EXAM PREP GUIDE 2026
QUESTIONS AND ANSWERS GRADED A
PLUS
◉ Cardio - Myocarditis and cardiomyopathy - Physical exam
Answer: Pallor, cyanosis, cool, mottled skin
Rapid, labored respirations
Tachycardia, gallop rhythm, muffled heart sounds, murmur, weak
peripheral pulses
Hepatomegaly, jugular vein distension
◉ Cardio - Myocarditis and cardiomyopathy - Management/
Diagnostic
Answer: Diagnostic studies
Refer to pediatric cardiology if suspected, for CXR, ECG,
echocardiogram, other labs
Management
Supportive treatment; may take months, with lifelong follow-up
Complications and prognosis
,Pericardial effusion, scarring with persistent heart failure
◉ Cardio - Grading of the intensity of heart murmurs
Answer: Grade 1: Faintest sound that can be detected; often detected
by cardiologists but not by general physicians
Grade 2: Soft murmur that is readily detectable
Grade 3: Louder than grade 2 but not associated with a palpable
thrill
Grade 4: Easily detected murmur associated with a palpable thrill*
Grade 5: Very loud murmur audible with the stethoscope placed
lightly on the chest
Grade 6: Extremely loud murmur audible with the stethoscope off
the chest
A grade 4 murmur requires the presence of a precordial thrill. A
thrill located only in the suprasternal notch or neck and not on the
precordium does not fulfill this criterion
, ◉ Cardio - auscultation sites of murmurs
Answer:
◉ Cardio - Murmur
Answer: Murmurs are produced by blood flow turbulence and are
more prolonged than heart sounds; they may be systolic, diastolic, or
continuous. They are graded by intensity and are described by their
location and when they occur within the cardiac cycle. Murmurs are
graded in intensity on a scale of 1 to 6
◉ Cardio - · Be able to identify murmurs by site
Answer:
◉ Respiratory - Pertussis
Answer: Primary disease or reinfection - whooping cough
Bordetella pertussis - six species
Transmission by aerosol droplet; incubation 7-10 days (range from
5 to 21 days)
Usual source in infants is unrecognized infection in adult family
members
Outbreaks occurring with older children/adults as likely vectors
Classic cough lasts 6-10 weeks
QUESTIONS AND ANSWERS GRADED A
PLUS
◉ Cardio - Myocarditis and cardiomyopathy - Physical exam
Answer: Pallor, cyanosis, cool, mottled skin
Rapid, labored respirations
Tachycardia, gallop rhythm, muffled heart sounds, murmur, weak
peripheral pulses
Hepatomegaly, jugular vein distension
◉ Cardio - Myocarditis and cardiomyopathy - Management/
Diagnostic
Answer: Diagnostic studies
Refer to pediatric cardiology if suspected, for CXR, ECG,
echocardiogram, other labs
Management
Supportive treatment; may take months, with lifelong follow-up
Complications and prognosis
,Pericardial effusion, scarring with persistent heart failure
◉ Cardio - Grading of the intensity of heart murmurs
Answer: Grade 1: Faintest sound that can be detected; often detected
by cardiologists but not by general physicians
Grade 2: Soft murmur that is readily detectable
Grade 3: Louder than grade 2 but not associated with a palpable
thrill
Grade 4: Easily detected murmur associated with a palpable thrill*
Grade 5: Very loud murmur audible with the stethoscope placed
lightly on the chest
Grade 6: Extremely loud murmur audible with the stethoscope off
the chest
A grade 4 murmur requires the presence of a precordial thrill. A
thrill located only in the suprasternal notch or neck and not on the
precordium does not fulfill this criterion
, ◉ Cardio - auscultation sites of murmurs
Answer:
◉ Cardio - Murmur
Answer: Murmurs are produced by blood flow turbulence and are
more prolonged than heart sounds; they may be systolic, diastolic, or
continuous. They are graded by intensity and are described by their
location and when they occur within the cardiac cycle. Murmurs are
graded in intensity on a scale of 1 to 6
◉ Cardio - · Be able to identify murmurs by site
Answer:
◉ Respiratory - Pertussis
Answer: Primary disease or reinfection - whooping cough
Bordetella pertussis - six species
Transmission by aerosol droplet; incubation 7-10 days (range from
5 to 21 days)
Usual source in infants is unrecognized infection in adult family
members
Outbreaks occurring with older children/adults as likely vectors
Classic cough lasts 6-10 weeks
