NSG 3600 Exam 2 – Pediatric Nursing Complete Practice
Questions | Galen College (2025/2026)
QUESTIONS 1–50: Cardiac Defects & Cardiovascular Disorders
1. A nurse is assessing a newborn with a suspected congenital heart defect. Which
finding is most suggestive of a cyanotic defect?
A) Bounding peripheral pulses
B) Oxygen saturation of 85% on room air
C) Hepatomegaly
D) Systolic murmur
Correct Answer: B) Oxygen saturation of 85% on room air
Rationale: Cyanotic defects result in right-to-left shunting, causing deoxygenated blood to
enter systemic circulation, leading to hypoxemia (SpO2 typically <90%). Bounding pulses
suggest PDA (acyanotic). Hepatomegaly suggests heart failure .
2. The nurse is caring for a child with a ventricular septal defect (VSD). Which
pathophysiologic change does the nurse expect?
A) Increased pulmonary blood flow
B) Decreased pulmonary blood flow
C) Mixed blood flow with cyanosis
D) Obstruction of blood flow from the left ventricle
Correct Answer: A) Increased pulmonary blood flow
,Rationale: VSD is an acyanotic defect with left-to-right shunting. Higher pressure in the
left ventricle forces blood through the hole into the right ventricle and pulmonary artery,
increasing pulmonary blood flow .
3. The nurse is performing the cardiac screening on a newborn before discharge.
Which assessment finding would be suggestive of a Coarctation of the Aorta?
A) Higher BP in the right arm than the right leg
B) Higher BP in the right leg than the right arm
C) Equal BP in all four extremities
D) Bounding pulses in the lower extremities
Correct Answer: A) Higher BP in the right arm than the right leg
Rationale: Coarctation of the aorta causes narrowing of the aorta, leading to higher blood
pressure in the upper extremities compared to the lower extremities. Femoral pulses are
weak or absent .
4. The nurse is getting vital signs on a 36-hour-old infant and notes bounding
peripheral pulses and a BP of 96/25. The nurse suspects which diagnosis?
A) Coarctation of the aorta
B) Patent Ductus Arteriosus (PDA)
C) Ventricular Septal Defect (VSD)
D) Tetralogy of Fallot
Correct Answer: B) Patent Ductus Arteriosus (PDA)
Rationale: PDA is characterized by a continuous machinery-like murmur, bounding
peripheral pulses, and a wide pulse pressure. The ductus arteriosus fails to close, allowing
blood to flow from the aorta to the pulmonary artery .
5. Which of the following is NOT a component of Tetralogy of Fallot?
,A) Pulmonary stenosis
B) Ventricular septal defect (VSD)
C) Hypertrophic Left Ventricle
D) Overriding aorta
Correct Answer: C) Hypertrophic Left Ventricle
Rationale: Tetralogy of Fallot consists of four defects: pulmonary stenosis, ventricular
septal defect, overriding aorta, and right ventricular hypertrophy (not left). The right
ventricle becomes hypertrophied due to increased pressure from pulmonary stenosis .
6. A 3-month-old infant has Digoxin scheduled at 2000. The nurse assesses the
infant and notes an apical HR of 112, RR 42, and BP 96/60. What should the nurse
do next?
A) Administer the digoxin as ordered
B) Hold the digoxin and notify the provider
C) Double-check the digoxin dose with another nurse
D) Recheck the heart rate in 30 minutes
Correct Answer: C) Double-check the digoxin dose with another nurse
Rationale: For an infant, digoxin should typically be held if the apical pulse is below 90-
100 bpm. With a heart rate of 112, the pulse is safe to administer, but digoxin requires a
second nurse to verify the dose due to its narrow therapeutic range .
7. The nurse is educating parents about their baby's upcoming echocardiogram.
Which statement by the parents indicates a need for further teaching?
A) "My baby will need to lie still during the test."
B) "The test uses sound waves to look at the heart."
C) "My baby cannot have a bottle for 4 hours before the test."
D) "The test is painless and non-invasive."
Correct Answer: C) "My baby cannot have a bottle for 4 hours before the test."
, Rationale: An echocardiogram is a non-invasive ultrasound that does not require NPO
status. Preparation typically involves keeping the infant calm or possibly sedating, but
feeding restrictions are not necessary for this test .
8. A child with Kawasaki disease is admitted to the unit. The nurse should prepare
to:
A) Give high-dose aspirin as ordered
B) Administer oral penicillin
C) Initiate strict bed rest
D) Prepare for surgical intervention
Correct Answer: A) Give high-dose aspirin as ordered
Rationale: The standard treatment for Kawasaki disease in the acute phase includes high-
dose aspirin (for its anti-inflammatory effects) and IVIG (to reduce the risk of coronary
artery aneurysms). Aspirin is typically not given to children, but in Kawasaki disease, it is
necessary .
9. A child is diagnosed with acute rheumatic fever following untreated strep
throat. Which cardiac complication is the primary concern?
A) Myocardial infarction
B) Valvular damage (especially mitral)
C) Pericardial effusion
D) Aortic dissection
Correct Answer: B) Valvular damage (especially mitral)
Rationale: Rheumatic fever causes inflammation of all heart layers (pancarditis), but
valvular damage, particularly to the mitral and aortic valves, is the most concerning long-
term complication, leading to rheumatic heart disease .
Questions | Galen College (2025/2026)
QUESTIONS 1–50: Cardiac Defects & Cardiovascular Disorders
1. A nurse is assessing a newborn with a suspected congenital heart defect. Which
finding is most suggestive of a cyanotic defect?
A) Bounding peripheral pulses
B) Oxygen saturation of 85% on room air
C) Hepatomegaly
D) Systolic murmur
Correct Answer: B) Oxygen saturation of 85% on room air
Rationale: Cyanotic defects result in right-to-left shunting, causing deoxygenated blood to
enter systemic circulation, leading to hypoxemia (SpO2 typically <90%). Bounding pulses
suggest PDA (acyanotic). Hepatomegaly suggests heart failure .
2. The nurse is caring for a child with a ventricular septal defect (VSD). Which
pathophysiologic change does the nurse expect?
A) Increased pulmonary blood flow
B) Decreased pulmonary blood flow
C) Mixed blood flow with cyanosis
D) Obstruction of blood flow from the left ventricle
Correct Answer: A) Increased pulmonary blood flow
,Rationale: VSD is an acyanotic defect with left-to-right shunting. Higher pressure in the
left ventricle forces blood through the hole into the right ventricle and pulmonary artery,
increasing pulmonary blood flow .
3. The nurse is performing the cardiac screening on a newborn before discharge.
Which assessment finding would be suggestive of a Coarctation of the Aorta?
A) Higher BP in the right arm than the right leg
B) Higher BP in the right leg than the right arm
C) Equal BP in all four extremities
D) Bounding pulses in the lower extremities
Correct Answer: A) Higher BP in the right arm than the right leg
Rationale: Coarctation of the aorta causes narrowing of the aorta, leading to higher blood
pressure in the upper extremities compared to the lower extremities. Femoral pulses are
weak or absent .
4. The nurse is getting vital signs on a 36-hour-old infant and notes bounding
peripheral pulses and a BP of 96/25. The nurse suspects which diagnosis?
A) Coarctation of the aorta
B) Patent Ductus Arteriosus (PDA)
C) Ventricular Septal Defect (VSD)
D) Tetralogy of Fallot
Correct Answer: B) Patent Ductus Arteriosus (PDA)
Rationale: PDA is characterized by a continuous machinery-like murmur, bounding
peripheral pulses, and a wide pulse pressure. The ductus arteriosus fails to close, allowing
blood to flow from the aorta to the pulmonary artery .
5. Which of the following is NOT a component of Tetralogy of Fallot?
,A) Pulmonary stenosis
B) Ventricular septal defect (VSD)
C) Hypertrophic Left Ventricle
D) Overriding aorta
Correct Answer: C) Hypertrophic Left Ventricle
Rationale: Tetralogy of Fallot consists of four defects: pulmonary stenosis, ventricular
septal defect, overriding aorta, and right ventricular hypertrophy (not left). The right
ventricle becomes hypertrophied due to increased pressure from pulmonary stenosis .
6. A 3-month-old infant has Digoxin scheduled at 2000. The nurse assesses the
infant and notes an apical HR of 112, RR 42, and BP 96/60. What should the nurse
do next?
A) Administer the digoxin as ordered
B) Hold the digoxin and notify the provider
C) Double-check the digoxin dose with another nurse
D) Recheck the heart rate in 30 minutes
Correct Answer: C) Double-check the digoxin dose with another nurse
Rationale: For an infant, digoxin should typically be held if the apical pulse is below 90-
100 bpm. With a heart rate of 112, the pulse is safe to administer, but digoxin requires a
second nurse to verify the dose due to its narrow therapeutic range .
7. The nurse is educating parents about their baby's upcoming echocardiogram.
Which statement by the parents indicates a need for further teaching?
A) "My baby will need to lie still during the test."
B) "The test uses sound waves to look at the heart."
C) "My baby cannot have a bottle for 4 hours before the test."
D) "The test is painless and non-invasive."
Correct Answer: C) "My baby cannot have a bottle for 4 hours before the test."
, Rationale: An echocardiogram is a non-invasive ultrasound that does not require NPO
status. Preparation typically involves keeping the infant calm or possibly sedating, but
feeding restrictions are not necessary for this test .
8. A child with Kawasaki disease is admitted to the unit. The nurse should prepare
to:
A) Give high-dose aspirin as ordered
B) Administer oral penicillin
C) Initiate strict bed rest
D) Prepare for surgical intervention
Correct Answer: A) Give high-dose aspirin as ordered
Rationale: The standard treatment for Kawasaki disease in the acute phase includes high-
dose aspirin (for its anti-inflammatory effects) and IVIG (to reduce the risk of coronary
artery aneurysms). Aspirin is typically not given to children, but in Kawasaki disease, it is
necessary .
9. A child is diagnosed with acute rheumatic fever following untreated strep
throat. Which cardiac complication is the primary concern?
A) Myocardial infarction
B) Valvular damage (especially mitral)
C) Pericardial effusion
D) Aortic dissection
Correct Answer: B) Valvular damage (especially mitral)
Rationale: Rheumatic fever causes inflammation of all heart layers (pancarditis), but
valvular damage, particularly to the mitral and aortic valves, is the most concerning long-
term complication, leading to rheumatic heart disease .
