West Coast University - NURS 307 Pediatric Nursing Group Performance Profile | Quiz 5 | Total: 50 Questions | One Best Answer
West Coast University | NURS 307 Pediatric Nursing
GROUP PERFORMANCE PROFILE
NURS 307 PEDS QUIZ 5
Questions and Answers - Solved 100% Correct
2026/2027 Updated Edition | Aligned with West Coast University NURS 307 Curriculum Standards
50 Questions | Sections I-V | Multiple Choice (A-D), One Best Answer | Time Allowed: 75 Minutes
Cognitive Levels: 25% Recall | 55% Application | 20% Analysis | NCLEX-Style Scenario-Based and Direct Recall
Items
Verified answers with comprehensive West Coast University-specific rationales are provided immediately after
each question for faculty review and self-assessment use.
SECTION 1: CARDIOVASCULAR DISORDERS IN CHILDREN (Q1-Q15)
Congenital Heart Defects (Acyanotic and Cyanotic), Acquired Heart Disease, Congestive Heart Failure, and Cardiac
Assessment
Q1. A 6-month-old infant is brought to the pediatric clinic for a well-child visit. The nurse
auscultates a continuous, machine-like murmur at the left infraclavicular area, palpates bounding
peripheral pulses, and notes a widened pulse pressure. The infant's growth has been slowing despite
adequate caloric intake. Which congenital heart defect should the nurse suspect?
A. Patent ductus arteriosus (PDA) [CORRECT]
B. Ventricular septal defect (VSD)
C. Tetralogy of Fallot (TOF)
D. Tricuspid atresia
Correct Answer: A
Rationale: A continuous machine-like murmur with bounding pulses and a widened pulse pressure is the classic
presentation of a PDA, in which blood flows from the higher-pressure aorta through the persistently patent ductus
into the pulmonary artery during both systole and diastole, causing a runoff of blood and progressively increasing
pulmonary blood flow. A VSD produces a harsh holosystolic murmur at the lower left sternal border with a
left-to-right shunt, not a continuous murmur with bounding pulses. Tetralogy of Fallot and tricuspid atresia are
cyanotic lesions presenting with desaturation and clubbing over time rather than a widened pulse pressure.
NURS 307 PEDS Quiz 5 - 2026/2027 Updated Edition 1
,West Coast University - NURS 307 Pediatric Nursing Group Performance Profile | Quiz 5 | Total: 50 Questions | One Best Answer
Q2. Which statement accurately describes ventricular septal defect (VSD), the most common
congenital heart defect in children?
A. It is a cyanotic defect in which deoxygenated blood enters the systemic circulation
B. It is an acyanotic defect in which blood shunts from the higher-pressure left ventricle to the
lower-pressure right ventricle [CORRECT]
C. It is an obstructive defect caused by narrowing of the aortic valve
D. It is a mixing lesion that requires prostaglandin E1 to maintain ductal patency
Correct Answer: B
Rationale: A VSD is an acyanotic (increased pulmonary blood flow) defect in which the higher pressure in the
left ventricle drives oxygenated blood through the septal opening into the right ventricle (a left-to-right shunt), so
no unoxygenated blood enters the systemic circulation and the child does not become cyanotic. Option A describes
a cyanotic defect physiology such as tricuspid atresia, Option B is the correct definition, Option C describes an
obstructive lesion such as aortic stenosis or coarctation, and Option D describes ductal-dependent lesions such as
TGA or hypoplastic left heart syndrome. Recognizing that most small VSDs close spontaneously and many
children are monitored without surgery is an important nursing teaching point for families.
Q3. A 3-year-old child with unrepaired tetralogy of Fallot suddenly becomes deeply cyanotic and
dyspneic while crying during a painful procedure. The child becomes limp and unresponsive to
voice. Which nursing intervention should the nurse implement FIRST?
A. Administer 100% oxygen via non-rebreather and call the rapid response team
B. Place the child flat in bed with legs elevated and begin chest compressions
C. Give the child a cold oral fluid to interrupt the crying spell
D. Place the child in the knee-chest position and attempt to calm and soothe [CORRECT]
Correct Answer: D
Rationale: This is a hypercyanotic 'tet' spell caused by acute right ventricular outflow obstruction and increased
right-to-left shunting; the knee-chest position increases systemic vascular resistance, which decreases the
right-to-left shunt and improves pulmonary blood flow while calming reduces oxygen demand. Placing the child
flat with legs elevated would worsen venous return dynamics for this lesion, and chest compressions are not
indicated because the child has a pulse. Fluids are unsafe in a limp, dyspneic child at risk for aspiration, and
although oxygen and escalation are appropriate if knee-chest and calming fail, positioning is the immediate
first-line nursing action taught in NURS 307.
NURS 307 PEDS Quiz 5 - 2026/2027 Updated Edition 2
, West Coast University - NURS 307 Pediatric Nursing Group Performance Profile | Quiz 5 | Total: 50 Questions | One Best Answer
Q4. A 2-month-old infant is being evaluated in the pediatric clinic. The mother reports that the
infant sweats heavily during bottle feeds, takes more than 30 minutes to finish each feeding, and has
had poor weight gain. The nurse notes tachypnea, mild intercostal retractions, and an enlarged liver
palpated 3 cm below the costal margin. These findings are MOST consistent with which condition?
A. Congestive heart failure [CORRECT]
B. Gastroesophageal reflux disease
C. Cystic fibrosis
D. Normal newborn positional congested breathing
Correct Answer: A
Rationale: Diaphoresis with feeds, prolonged feeding times, poor weight gain, tachypnea, retractions, and
hepatomegaly are hallmark signs of congestive heart failure in infants, because feeding is the infant's major
exercise and the failing heart cannot meet the increased metabolic and circulatory demand. GERD may cause
spitting up and irritability but does not produce retractions, hepatomegaly, or sweating with feeds. Cystic fibrosis
causes failure to thrive with steatorrheal stools and chronic respiratory symptoms rather than acute cardiac effort
signs. Positional congestion resolves with position changes and is not associated with hepatomegaly or poor
growth.
Q5. A 4-year-old child has had a fever of 39.5 degrees C (103.1 degrees F) for 6 days with bilateral
nonexudative conjunctivitis, a strawberry tongue, cracked lips, a polymorphous rash, and unilateral
cervical lymphadenopathy of 1.6 cm. Which intervention should the nurse anticipate being
prescribed?
A. Oral amoxicillin for 10 days and aspirin for fever control
B. Intravenous immunoglobulin (IVIG) and aspirin therapy, ideally within 10 days of fever
onset [CORRECT]
C. Intravenous vancomycin and droplet precautions
D. Supportive care with antipyretics and outpatient follow-up in 2 weeks
Correct Answer: B
Rationale: This child meets criteria for Kawasaki disease (fever 5 or more days plus at least four clinical
features), and IVIG with high-dose aspirin administered within the first 10 days of illness significantly reduces the
risk of coronary artery aneurysms, the most serious complication. Antibiotics do not treat this vasculitis, which is
not an infection, and delaying treatment risks irreversible coronary damage. Supportive care alone is inappropriate
because treatment is time-sensitive, and the child will need baseline and serial echocardiograms plus cardiac
follow-up even after fever resolves.
NURS 307 PEDS Quiz 5 - 2026/2027 Updated Edition 3
West Coast University | NURS 307 Pediatric Nursing
GROUP PERFORMANCE PROFILE
NURS 307 PEDS QUIZ 5
Questions and Answers - Solved 100% Correct
2026/2027 Updated Edition | Aligned with West Coast University NURS 307 Curriculum Standards
50 Questions | Sections I-V | Multiple Choice (A-D), One Best Answer | Time Allowed: 75 Minutes
Cognitive Levels: 25% Recall | 55% Application | 20% Analysis | NCLEX-Style Scenario-Based and Direct Recall
Items
Verified answers with comprehensive West Coast University-specific rationales are provided immediately after
each question for faculty review and self-assessment use.
SECTION 1: CARDIOVASCULAR DISORDERS IN CHILDREN (Q1-Q15)
Congenital Heart Defects (Acyanotic and Cyanotic), Acquired Heart Disease, Congestive Heart Failure, and Cardiac
Assessment
Q1. A 6-month-old infant is brought to the pediatric clinic for a well-child visit. The nurse
auscultates a continuous, machine-like murmur at the left infraclavicular area, palpates bounding
peripheral pulses, and notes a widened pulse pressure. The infant's growth has been slowing despite
adequate caloric intake. Which congenital heart defect should the nurse suspect?
A. Patent ductus arteriosus (PDA) [CORRECT]
B. Ventricular septal defect (VSD)
C. Tetralogy of Fallot (TOF)
D. Tricuspid atresia
Correct Answer: A
Rationale: A continuous machine-like murmur with bounding pulses and a widened pulse pressure is the classic
presentation of a PDA, in which blood flows from the higher-pressure aorta through the persistently patent ductus
into the pulmonary artery during both systole and diastole, causing a runoff of blood and progressively increasing
pulmonary blood flow. A VSD produces a harsh holosystolic murmur at the lower left sternal border with a
left-to-right shunt, not a continuous murmur with bounding pulses. Tetralogy of Fallot and tricuspid atresia are
cyanotic lesions presenting with desaturation and clubbing over time rather than a widened pulse pressure.
NURS 307 PEDS Quiz 5 - 2026/2027 Updated Edition 1
,West Coast University - NURS 307 Pediatric Nursing Group Performance Profile | Quiz 5 | Total: 50 Questions | One Best Answer
Q2. Which statement accurately describes ventricular septal defect (VSD), the most common
congenital heart defect in children?
A. It is a cyanotic defect in which deoxygenated blood enters the systemic circulation
B. It is an acyanotic defect in which blood shunts from the higher-pressure left ventricle to the
lower-pressure right ventricle [CORRECT]
C. It is an obstructive defect caused by narrowing of the aortic valve
D. It is a mixing lesion that requires prostaglandin E1 to maintain ductal patency
Correct Answer: B
Rationale: A VSD is an acyanotic (increased pulmonary blood flow) defect in which the higher pressure in the
left ventricle drives oxygenated blood through the septal opening into the right ventricle (a left-to-right shunt), so
no unoxygenated blood enters the systemic circulation and the child does not become cyanotic. Option A describes
a cyanotic defect physiology such as tricuspid atresia, Option B is the correct definition, Option C describes an
obstructive lesion such as aortic stenosis or coarctation, and Option D describes ductal-dependent lesions such as
TGA or hypoplastic left heart syndrome. Recognizing that most small VSDs close spontaneously and many
children are monitored without surgery is an important nursing teaching point for families.
Q3. A 3-year-old child with unrepaired tetralogy of Fallot suddenly becomes deeply cyanotic and
dyspneic while crying during a painful procedure. The child becomes limp and unresponsive to
voice. Which nursing intervention should the nurse implement FIRST?
A. Administer 100% oxygen via non-rebreather and call the rapid response team
B. Place the child flat in bed with legs elevated and begin chest compressions
C. Give the child a cold oral fluid to interrupt the crying spell
D. Place the child in the knee-chest position and attempt to calm and soothe [CORRECT]
Correct Answer: D
Rationale: This is a hypercyanotic 'tet' spell caused by acute right ventricular outflow obstruction and increased
right-to-left shunting; the knee-chest position increases systemic vascular resistance, which decreases the
right-to-left shunt and improves pulmonary blood flow while calming reduces oxygen demand. Placing the child
flat with legs elevated would worsen venous return dynamics for this lesion, and chest compressions are not
indicated because the child has a pulse. Fluids are unsafe in a limp, dyspneic child at risk for aspiration, and
although oxygen and escalation are appropriate if knee-chest and calming fail, positioning is the immediate
first-line nursing action taught in NURS 307.
NURS 307 PEDS Quiz 5 - 2026/2027 Updated Edition 2
, West Coast University - NURS 307 Pediatric Nursing Group Performance Profile | Quiz 5 | Total: 50 Questions | One Best Answer
Q4. A 2-month-old infant is being evaluated in the pediatric clinic. The mother reports that the
infant sweats heavily during bottle feeds, takes more than 30 minutes to finish each feeding, and has
had poor weight gain. The nurse notes tachypnea, mild intercostal retractions, and an enlarged liver
palpated 3 cm below the costal margin. These findings are MOST consistent with which condition?
A. Congestive heart failure [CORRECT]
B. Gastroesophageal reflux disease
C. Cystic fibrosis
D. Normal newborn positional congested breathing
Correct Answer: A
Rationale: Diaphoresis with feeds, prolonged feeding times, poor weight gain, tachypnea, retractions, and
hepatomegaly are hallmark signs of congestive heart failure in infants, because feeding is the infant's major
exercise and the failing heart cannot meet the increased metabolic and circulatory demand. GERD may cause
spitting up and irritability but does not produce retractions, hepatomegaly, or sweating with feeds. Cystic fibrosis
causes failure to thrive with steatorrheal stools and chronic respiratory symptoms rather than acute cardiac effort
signs. Positional congestion resolves with position changes and is not associated with hepatomegaly or poor
growth.
Q5. A 4-year-old child has had a fever of 39.5 degrees C (103.1 degrees F) for 6 days with bilateral
nonexudative conjunctivitis, a strawberry tongue, cracked lips, a polymorphous rash, and unilateral
cervical lymphadenopathy of 1.6 cm. Which intervention should the nurse anticipate being
prescribed?
A. Oral amoxicillin for 10 days and aspirin for fever control
B. Intravenous immunoglobulin (IVIG) and aspirin therapy, ideally within 10 days of fever
onset [CORRECT]
C. Intravenous vancomycin and droplet precautions
D. Supportive care with antipyretics and outpatient follow-up in 2 weeks
Correct Answer: B
Rationale: This child meets criteria for Kawasaki disease (fever 5 or more days plus at least four clinical
features), and IVIG with high-dose aspirin administered within the first 10 days of illness significantly reduces the
risk of coronary artery aneurysms, the most serious complication. Antibiotics do not treat this vasculitis, which is
not an infection, and delaying treatment risks irreversible coronary damage. Supportive care alone is inappropriate
because treatment is time-sensitive, and the child will need baseline and serial echocardiograms plus cardiac
follow-up even after fever resolves.
NURS 307 PEDS Quiz 5 - 2026/2027 Updated Edition 3
