Peds- Exam 1 Ricci chapters UPDATED
ACTUAL Exam Questions and CORRECT
Answers
1.The nurse is conducting a physical examination of a child with a ventricular septal
defect. Which finding would the nurse expect to assess?
A) Right ventricular heave
B) Holosystolic harsh murmur along the left sternal border
C) Fixed split-second heart sound
D) Systolic ejection murmur - CORRECT ANSWER - Ans: B
Feedback:
With ventricular septal defects, there is often a characteristic holosystolic harsh
murmur along the left sternal border. Right ventricular heave, fixed split-second
heart sound, and systolic ejection murmur are typically found with atrial septal
defects.
2.The nurse is administering digoxin as ordered and the child vomits the dose. What
should the nurse do next?
A) Contact the healthcare provider.
B) Offer a snack and administer another dose.
C) Immediately administer another dose.
D) Administer next dose as ordered in 12 hours. - CORRECT ANSWER - Ans: D
Feedback:
Digoxin should be administered at regular intervals, every 12 hours, 1 hour before or
2 hours after feeding. If the child vomits digoxin, the nurse should not give a second
dose and should wait until the next scheduled dose. It is not necessary to contact the
healthcare provider.
,3.The nurse is caring for an infant with suspected patent ductus arteriosus. Which
assessment finding would the nurse identify as helping to confirm this suspicion?
A) Thrill at the base of the heart
B) Harsh, continuous, machine-like murmur under the left clavicle
C) Faint pulses
D) Systolic murmur best heard along the left sternal border - CORRECT ANSWER - Ans:
B
Feedback:
With patent ductus arteriosus, a harsh, continuous, machine-like murmur (usually
loudest under the left clavicle) is heard at the first and second intercostal spaces. A
thrill at the base, faint pulses, and systolic murmur heard best along the left sternal
border point to aortic stenosis.
4.The nurse is conducting a physical examination of a child with a suspected
cardiovascular disorder. Which finding would the nurse most likely expect to assess
if the child had transposition of the great vessels?
A) Significant cyanosis without presence of a murmur
B) Abrupt cessation of chest output with an increase in heart rate/filling
pressure
C) Soft systolic ejection
D) Holosystolic murmur - CORRECT ANSWER - Ans: A
Feedback:
Significant cyanosis without presence of a murmur is highly indicative of
transposition. Abrupt cessation of chest output accompanied by an increase in heart rate and
filling pressure is indicative of cardiac tamponade. A soft systolic ejection or
holosystolic murmur can be found with other disorders, such as hypoplastic left heart
syndrome, but is not highly suspicious of transposition.
5.The nurse is assessing a child with suspected infective endocarditis. Which
,assessment finding would the nurse interpret as a sign of extracardiac emboli?
A) Pruritus
B) Roth spots
C) Delayed capillary refill
D) Erythema marginatum - CORRECT ANSWER - Ans: B
Feedback:
Roth spots are splinter hemorrhages with pale centers on the sclerae, palate, buccal
mucosa, chest, fingers, or toes, and are signs of extracardiac emboli. Delayed
capillary refill time does not point to extracardiac emboli. Wheezing and pruritus are
indicative of a hypersensitivity reaction. Erythema marginatum is a classic rash
associated with acute rheumatic fever.
6.When conducting a physical examination of a child with suspected Kawasaki
disease, which finding would the nurse expect to assess?
A) Hirsutism or striae
B) Strawberry tongue
C) Malar rash
D) Café au lait spots - CORRECT ANSWER - Ans: B
Feedback:
Dry, fissured lips and a strawberry tongue are common findings with Kawasaki
disease. Acne, hirsutism, and striae are associated with anabolic steroid use. Malar
rash is associated with lupus. Café au lait spots are associated with
neurofibromatosis.
7.After teaching a group of students about acute rheumatic fever, the instructor
determines that the teaching was successful when the students identify which
assessment finding?
A) Janeway lesions
, B) Jerky movements of the face and upper extremities
C) Black lines
D) Osler nodes - CORRECT ANSWER - Ans: B
Feedback:
Sydenham chorea is a movement disorder of the face and upper extremities
associated with acute rheumatic fever. Janeway lesions, black lines, and Osler nodes
are associated with infective endocarditis.
9.The nurse is caring for a 2-month-old infant who has been diagnosed with acute
heart failure. The nurse is providing teaching about nutrition. Which statement by the
mother indicates a need for further teaching?
A) "The baby may need as much as 150 calories/kg/day."
B) "Small, frequent feedings are best if tolerated."
C) "I need to feed him every hour to make sure he eats enough."
D) "Gavage feedings may be required for now." - CORRECT ANSWER - Ans: C
Feedback:
Although offering small frequent feedings is appropriate if the infant tolerates them,
feeding every hour is not necessary. During the acute phase, continuous or
intermittent gavage feedings may be needed to help the infant maintain or gain weight. Due to
the increased metabolic demands, the infant may require as much as
150 calories/kg/day.
10.The nurse is caring for an infant girl with a suspected cardiovascular disorder.
Which statement by the mother would warrant further investigation?
A) "My baby does not make any grunting noises."
B) "The baby seems more comfortable over my shoulder."
C) "The baby usually drinks all of her bottle."
D) "I don't notice any rapid breathing patterns." - CORRECT ANSWER - Ans: B
ACTUAL Exam Questions and CORRECT
Answers
1.The nurse is conducting a physical examination of a child with a ventricular septal
defect. Which finding would the nurse expect to assess?
A) Right ventricular heave
B) Holosystolic harsh murmur along the left sternal border
C) Fixed split-second heart sound
D) Systolic ejection murmur - CORRECT ANSWER - Ans: B
Feedback:
With ventricular septal defects, there is often a characteristic holosystolic harsh
murmur along the left sternal border. Right ventricular heave, fixed split-second
heart sound, and systolic ejection murmur are typically found with atrial septal
defects.
2.The nurse is administering digoxin as ordered and the child vomits the dose. What
should the nurse do next?
A) Contact the healthcare provider.
B) Offer a snack and administer another dose.
C) Immediately administer another dose.
D) Administer next dose as ordered in 12 hours. - CORRECT ANSWER - Ans: D
Feedback:
Digoxin should be administered at regular intervals, every 12 hours, 1 hour before or
2 hours after feeding. If the child vomits digoxin, the nurse should not give a second
dose and should wait until the next scheduled dose. It is not necessary to contact the
healthcare provider.
,3.The nurse is caring for an infant with suspected patent ductus arteriosus. Which
assessment finding would the nurse identify as helping to confirm this suspicion?
A) Thrill at the base of the heart
B) Harsh, continuous, machine-like murmur under the left clavicle
C) Faint pulses
D) Systolic murmur best heard along the left sternal border - CORRECT ANSWER - Ans:
B
Feedback:
With patent ductus arteriosus, a harsh, continuous, machine-like murmur (usually
loudest under the left clavicle) is heard at the first and second intercostal spaces. A
thrill at the base, faint pulses, and systolic murmur heard best along the left sternal
border point to aortic stenosis.
4.The nurse is conducting a physical examination of a child with a suspected
cardiovascular disorder. Which finding would the nurse most likely expect to assess
if the child had transposition of the great vessels?
A) Significant cyanosis without presence of a murmur
B) Abrupt cessation of chest output with an increase in heart rate/filling
pressure
C) Soft systolic ejection
D) Holosystolic murmur - CORRECT ANSWER - Ans: A
Feedback:
Significant cyanosis without presence of a murmur is highly indicative of
transposition. Abrupt cessation of chest output accompanied by an increase in heart rate and
filling pressure is indicative of cardiac tamponade. A soft systolic ejection or
holosystolic murmur can be found with other disorders, such as hypoplastic left heart
syndrome, but is not highly suspicious of transposition.
5.The nurse is assessing a child with suspected infective endocarditis. Which
,assessment finding would the nurse interpret as a sign of extracardiac emboli?
A) Pruritus
B) Roth spots
C) Delayed capillary refill
D) Erythema marginatum - CORRECT ANSWER - Ans: B
Feedback:
Roth spots are splinter hemorrhages with pale centers on the sclerae, palate, buccal
mucosa, chest, fingers, or toes, and are signs of extracardiac emboli. Delayed
capillary refill time does not point to extracardiac emboli. Wheezing and pruritus are
indicative of a hypersensitivity reaction. Erythema marginatum is a classic rash
associated with acute rheumatic fever.
6.When conducting a physical examination of a child with suspected Kawasaki
disease, which finding would the nurse expect to assess?
A) Hirsutism or striae
B) Strawberry tongue
C) Malar rash
D) Café au lait spots - CORRECT ANSWER - Ans: B
Feedback:
Dry, fissured lips and a strawberry tongue are common findings with Kawasaki
disease. Acne, hirsutism, and striae are associated with anabolic steroid use. Malar
rash is associated with lupus. Café au lait spots are associated with
neurofibromatosis.
7.After teaching a group of students about acute rheumatic fever, the instructor
determines that the teaching was successful when the students identify which
assessment finding?
A) Janeway lesions
, B) Jerky movements of the face and upper extremities
C) Black lines
D) Osler nodes - CORRECT ANSWER - Ans: B
Feedback:
Sydenham chorea is a movement disorder of the face and upper extremities
associated with acute rheumatic fever. Janeway lesions, black lines, and Osler nodes
are associated with infective endocarditis.
9.The nurse is caring for a 2-month-old infant who has been diagnosed with acute
heart failure. The nurse is providing teaching about nutrition. Which statement by the
mother indicates a need for further teaching?
A) "The baby may need as much as 150 calories/kg/day."
B) "Small, frequent feedings are best if tolerated."
C) "I need to feed him every hour to make sure he eats enough."
D) "Gavage feedings may be required for now." - CORRECT ANSWER - Ans: C
Feedback:
Although offering small frequent feedings is appropriate if the infant tolerates them,
feeding every hour is not necessary. During the acute phase, continuous or
intermittent gavage feedings may be needed to help the infant maintain or gain weight. Due to
the increased metabolic demands, the infant may require as much as
150 calories/kg/day.
10.The nurse is caring for an infant girl with a suspected cardiovascular disorder.
Which statement by the mother would warrant further investigation?
A) "My baby does not make any grunting noises."
B) "The baby seems more comfortable over my shoulder."
C) "The baby usually drinks all of her bottle."
D) "I don't notice any rapid breathing patterns." - CORRECT ANSWER - Ans: B
