PEDIATRICS NURSING EXAM 2 QUESTIONS AND CORRECT
ANSWERS 2025 WITH RATIONALES
What does the nurse explain that a ventricular septal defect will allow?
a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
b. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis
c. No shunting because of high pressure in the left ventricle
d. Increased pressure in the left atrium, impeding circulation of oxygenated blood in
the circulating volume
A
Rationale: Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts
from left to right because of the higher pressure in the left ventricle. This particular shift does not cause
cyanosis.
Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal
defect?
a. A loud, harsh murmur with a systolic thrill
b. Cyanosis when crying
c. Blood pressure higher in the arms than in the legs
d. A machinery-like murmur
A
Rationale: A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal
defect.
,What finding would the nurse expect when measuring blood pressure on all four extremities of a child
with coarctation of the aorta?
a. Blood pressure higher on the right side
b. Blood pressure higher on the left side
c. Blood pressure lower in the arms than in the legs
d. Blood pressure lower in the legs than in the arms
D
Rationale: The characteristic symptoms of coarctation of the aorta are a marked difference in blood
pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the
defect and decreased distal to the coarctation.
A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the
nurse's best response?
a. Squatting increases the return of venous blood back to the heart.
b. Squatting decreases arterial blood flow away from the heart.
c. Squatting is a common resting position when a child is tachycardic.
d. Squatting increases the workload of the heart.
A
Rationale: The squatting position allows the child to breathe more easily because systemic venous
return is increased.
An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse
understand regarding why dyspnea occurs?
, a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
b. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
c. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
d. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side
of the heart.
A
Rationale: When PDA is present, oxygenated blood recycles through the lungs, overburdening the
pulmonary circulation.
Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an
infant?
a. Counting the apical rate for 30 seconds before administering the medication
b. Withholding a dose if the apical heart rate is less than 100 beats/minute
c. Repeating a dose if the child vomits within 30 minutes of the previous dose
d. Checking respiratory rate and blood pressure before each dose
B
Rationale: As a rule, if the pulse rate of an infant is less than 100 beats/minute, the medication is
withheld and the physician is notified.
A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis?
a. Coronary arteries
b. Heart muscle and the mitral valve
c. Aortic and pulmonic valves
d. Contractility of the ventricles
ANSWERS 2025 WITH RATIONALES
What does the nurse explain that a ventricular septal defect will allow?
a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
b. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis
c. No shunting because of high pressure in the left ventricle
d. Increased pressure in the left atrium, impeding circulation of oxygenated blood in
the circulating volume
A
Rationale: Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts
from left to right because of the higher pressure in the left ventricle. This particular shift does not cause
cyanosis.
Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal
defect?
a. A loud, harsh murmur with a systolic thrill
b. Cyanosis when crying
c. Blood pressure higher in the arms than in the legs
d. A machinery-like murmur
A
Rationale: A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal
defect.
,What finding would the nurse expect when measuring blood pressure on all four extremities of a child
with coarctation of the aorta?
a. Blood pressure higher on the right side
b. Blood pressure higher on the left side
c. Blood pressure lower in the arms than in the legs
d. Blood pressure lower in the legs than in the arms
D
Rationale: The characteristic symptoms of coarctation of the aorta are a marked difference in blood
pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the
defect and decreased distal to the coarctation.
A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the
nurse's best response?
a. Squatting increases the return of venous blood back to the heart.
b. Squatting decreases arterial blood flow away from the heart.
c. Squatting is a common resting position when a child is tachycardic.
d. Squatting increases the workload of the heart.
A
Rationale: The squatting position allows the child to breathe more easily because systemic venous
return is increased.
An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse
understand regarding why dyspnea occurs?
, a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
b. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
c. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
d. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side
of the heart.
A
Rationale: When PDA is present, oxygenated blood recycles through the lungs, overburdening the
pulmonary circulation.
Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an
infant?
a. Counting the apical rate for 30 seconds before administering the medication
b. Withholding a dose if the apical heart rate is less than 100 beats/minute
c. Repeating a dose if the child vomits within 30 minutes of the previous dose
d. Checking respiratory rate and blood pressure before each dose
B
Rationale: As a rule, if the pulse rate of an infant is less than 100 beats/minute, the medication is
withheld and the physician is notified.
A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis?
a. Coronary arteries
b. Heart muscle and the mitral valve
c. Aortic and pulmonic valves
d. Contractility of the ventricles
