ATI Pediatrics: Cardiac and Hematologic Nursing Exam Study Guide
2026 |Questions |Answers |Rationales
1. A nurse is caring for an infant with a large Ventricular Septal Defect (VSD).
Which clinical manifestation should the nurse expect to observe?
A. Loud, harsh systolic murmur
B. Bounding peripheral pulses
C. Cyanosis during feeding
D. Weak femoral pulses
Answer: A
Rationale: A ventricular septal defect (VSD) typically causes a loud, harsh systolic murmur
heard at the left sternal border due to the high-pressure left-to-right shunting of blood.
2. A toddler is diagnosed with Tetralogy of Fallot. The nurse observes the child
squatting while playing. This behavior is a compensatory mechanism to:
A. Decrease systemic vascular resistance
B. Lower the arterial oxygen saturation
C. Increase pulmonary blood flow
D. Increase the right-to-left shunt
Answer: C
Rationale: Squatting (knee-chest position) increases systemic vascular resistance, which
decreases the right-to-left shunt and forces more blood into the pulmonary artery,
improving oxygenation.
,3. A nurse is preparing to administer Digoxin to a 6-month-old infant. Which of
the following findings should lead the nurse to withhold the medication?
A. Apical heart rate of 88/min
B. Respiratory rate of 30/min
C. Blood pressure of 90/60 mmHg
D. Potassium level of 4.5 mEq/L
Answer: A
Rationale: For an infant, Digoxin should be withheld if the apical pulse is less than 90/min.
For older children, the cutoff is usually 70/min.
4. Which of the following medications is used to maintain the patency of the
ductus arteriosus in a newborn with transposition of the great arteries?
A. Indomethacin
B. Ibuprofen
C. Alprostadil (Prostaglandin E1)
D. Furosemide
Answer: C
Rationale: Prostaglandin E1 is administered to keep the ductus arteriosus open to allow
for mixing of oxygenated and unoxygenated blood in certain cyanotic defects.
5. A child is admitted with suspected Kawasaki Disease. Which of the following
is a classic clinical manifestation of the acute phase?
A. Desquamation of the hands and feet
B. Low-grade fever for 2 days
C. High fever unresponsive to antibiotics
D. Decreased platelet count
Answer: C
Rationale: The acute phase of Kawasaki disease is characterized by a high fever (often
>102F) that lasts more than 5 days and is unresponsive to antibiotics or antipyretics.
, 6. A nurse is providing teaching to the parents of a child with Sickle Cell Anemia.
Which of the following triggers for a vaso-occlusive crisis should be highlighted?
A. Dehydration
B. Humid climates
C. Increased fluid intake
D. Light exercise
Answer: A
Rationale: Dehydration increases blood viscosity, which promotes the sickling of red blood
cells, leading to vaso-occlusive crisis.
7. In a child with Coarctation of the Aorta, the nurse would expect to find which
of the following?
A. Higher blood pressure in the legs than the arms
B. Cyanosis of the upper extremities
C. Weak or absent femoral pulses
D. Severe hypotension in the upper body
Answer: C
Rationale: Coarctation of the aorta involves narrowing near the ductus arteriosus,
resulting in high blood pressure/bounding pulses in the arms and low blood
pressure/weak pulses in the lower extremities.
8. A nurse is teaching the mother of a child with Hemophilia A. Which of the
following statements indicates a need for further teaching?
A. I should apply pressure if my son starts bleeding.
B. I should encourage non-contact sports like swimming.
C. I will give him aspirin for his joint pain.
D. I will keep factor replacement therapy available.
Answer: C
2026 |Questions |Answers |Rationales
1. A nurse is caring for an infant with a large Ventricular Septal Defect (VSD).
Which clinical manifestation should the nurse expect to observe?
A. Loud, harsh systolic murmur
B. Bounding peripheral pulses
C. Cyanosis during feeding
D. Weak femoral pulses
Answer: A
Rationale: A ventricular septal defect (VSD) typically causes a loud, harsh systolic murmur
heard at the left sternal border due to the high-pressure left-to-right shunting of blood.
2. A toddler is diagnosed with Tetralogy of Fallot. The nurse observes the child
squatting while playing. This behavior is a compensatory mechanism to:
A. Decrease systemic vascular resistance
B. Lower the arterial oxygen saturation
C. Increase pulmonary blood flow
D. Increase the right-to-left shunt
Answer: C
Rationale: Squatting (knee-chest position) increases systemic vascular resistance, which
decreases the right-to-left shunt and forces more blood into the pulmonary artery,
improving oxygenation.
,3. A nurse is preparing to administer Digoxin to a 6-month-old infant. Which of
the following findings should lead the nurse to withhold the medication?
A. Apical heart rate of 88/min
B. Respiratory rate of 30/min
C. Blood pressure of 90/60 mmHg
D. Potassium level of 4.5 mEq/L
Answer: A
Rationale: For an infant, Digoxin should be withheld if the apical pulse is less than 90/min.
For older children, the cutoff is usually 70/min.
4. Which of the following medications is used to maintain the patency of the
ductus arteriosus in a newborn with transposition of the great arteries?
A. Indomethacin
B. Ibuprofen
C. Alprostadil (Prostaglandin E1)
D. Furosemide
Answer: C
Rationale: Prostaglandin E1 is administered to keep the ductus arteriosus open to allow
for mixing of oxygenated and unoxygenated blood in certain cyanotic defects.
5. A child is admitted with suspected Kawasaki Disease. Which of the following
is a classic clinical manifestation of the acute phase?
A. Desquamation of the hands and feet
B. Low-grade fever for 2 days
C. High fever unresponsive to antibiotics
D. Decreased platelet count
Answer: C
Rationale: The acute phase of Kawasaki disease is characterized by a high fever (often
>102F) that lasts more than 5 days and is unresponsive to antibiotics or antipyretics.
, 6. A nurse is providing teaching to the parents of a child with Sickle Cell Anemia.
Which of the following triggers for a vaso-occlusive crisis should be highlighted?
A. Dehydration
B. Humid climates
C. Increased fluid intake
D. Light exercise
Answer: A
Rationale: Dehydration increases blood viscosity, which promotes the sickling of red blood
cells, leading to vaso-occlusive crisis.
7. In a child with Coarctation of the Aorta, the nurse would expect to find which
of the following?
A. Higher blood pressure in the legs than the arms
B. Cyanosis of the upper extremities
C. Weak or absent femoral pulses
D. Severe hypotension in the upper body
Answer: C
Rationale: Coarctation of the aorta involves narrowing near the ductus arteriosus,
resulting in high blood pressure/bounding pulses in the arms and low blood
pressure/weak pulses in the lower extremities.
8. A nurse is teaching the mother of a child with Hemophilia A. Which of the
following statements indicates a need for further teaching?
A. I should apply pressure if my son starts bleeding.
B. I should encourage non-contact sports like swimming.
C. I will give him aspirin for his joint pain.
D. I will keep factor replacement therapy available.
Answer: C
