APEA PEDS CARDIOLOGY WITH QUESTIONS AND WELL VERIFIED
ANSWERS ALREADY GRADED A+ REAL EXAM !!! REAL EXAM !!
A 13-year-old patient has experienced frequent episodes of chest pain over the past few weeks. The
pain exacerbates after heavy lifting. The patient denies nausea, vomiting and dizziness. The patient's
heart rate is 100 beats per minute. Elicited heart sounds identify regular rate and rhythm without an
audible murmur. The remainder of the vital signs and physical examination are unremarkable. The most
appropriate next step is to:
prescribe acetaminophen with codeine as needed for pain.
order a 12-lead electrocardiogram.
recommend he continue with activities as usual and stop the activity if the pain occurs.
refer to a cardiologist for work-up. ----ANS---order a 12-lead electrocardiogram.
A child with a heart murmur audible at the lower left sternal border would be suggestive of:
a normal finding.
aortic valve stenosis.
ventricular septal defect.
pulmonary valve stenosis. ----ANS---ventricular septal defect.
murmur at midsternal or upper right sternal border and is associated with a click could be suggestive of
aortic valve stenosis
murmur at the upper left sternal border with prominent ejection click in early systole could be
suggestive of pulmonary valve stenosis
A 3-month-old patient has a history of poor weight gain, dyspnea during feedings, and cyanosis with
crying. Examination identifies tachycardia with a loud murmur at the left upper sternal border with a
single second heart sound. These findings are most consistent with:
congestive heart failure.
,an atrial septal defect (ASD).
tetralogy of Fallot (TOF).
patent ductus arteriosus (PDA). ----ANS---tetralogy of Fallot (TOF)
A 15-year-old patient is diagnosed with primary hypertension. The patient receives a prescription for
benazepril (Lotensin). Which of the following most common side effects should be included when
teaching the patient about benazepril?
Headache, dizziness, and cough
Headache, cough, and hypokalemia
Dizziness, cough, and hypouricemia
Headache, dizziness, and hypokalemia ----ANS---Headache, dizziness, and cough
A 10-month-old infant presents with pallor, poor feeding, and irritability. The pulse rate is found to be
195, it lasts for 1-2 minutes and decreases to 160. The NP suspects:
tachycardia
supraventricular tachycardia
sinus arrhythmia
ventricular premature beats. ----ANS---supraventricular tachycardia
infant may or may not have cyanotic episodes
Episodes of rapid heart rate occur and range from 180 up to 300 bpm; it may stop and start quickly or
lasts for hours.
Wolf-Parkinson White syndrome may be a potential cause of SVT and patient should be referred to
cardiology
A 5-year-old presents for re-evaluation of a Grade IV/VI systolic ejection murmur that was first
documented 1 month ago. On examination, the murmur is audible while the patient is sitting and
supine. The remainder of the exam is unremarkable. Based on these findings, the nurse practitioner
concludes that:
today's findings are characteristic of an innocent murmur.
, an electrocardiogram (EKG) is warranted.
this is a normal finding.
this patient should be referred to a pediatric cardiologist. ----ANS---this patient should be referred to a
pediatric cardiologist.
The most common congenital heart defect in children is:
an atrial septal defect (ASD).
a ventricular septal defect (VSD).
tetralogy of Fallot (TOF).
hypoplastic left heart syndrome (HLHS). ----ANS---a ventricular septal defect (VSD).
20-30% of all CHDs
majority of VSDs close by age 4 without intervention
When assessing the heart, the best area to auscultate aortic valve sounds would be:
2nd left intercostal space (ICS), left sternal border (LSB).
2nd right intercostal space (ICS), right sternal border (RSB).
3rd or 4th left intercostal space (ICS), left sternal border (LSB).
5th left intercostal space (ICS), left midclavicular line (MCL). ----ANS---2nd right intercostal space (ICS),
right sternal border (RSB).
Elevated blood pressure in children less than 13 years old is classified as persistent blood pressure
readings:
in the 75th percentile for a normotensive child of the same age, sex, and height.
in the 80th percentile for a normotensive child of the same age, sex, and height.
equal to or exceeding the 90th percentile for a normotensive child of the same age, sex, and height.
equal to or exceeding the 95th percentile for a normotensive child of the same age, sex, and height. ----
ANS---equal to or exceeding the 90th percentile for a normotensive child of the same age, sex, and
height.
A loud systolic ejection murmur audible at the left upper sternal border and/or a holosystolic murmur at
the left mid sternal border would be consistent with:
ANSWERS ALREADY GRADED A+ REAL EXAM !!! REAL EXAM !!
A 13-year-old patient has experienced frequent episodes of chest pain over the past few weeks. The
pain exacerbates after heavy lifting. The patient denies nausea, vomiting and dizziness. The patient's
heart rate is 100 beats per minute. Elicited heart sounds identify regular rate and rhythm without an
audible murmur. The remainder of the vital signs and physical examination are unremarkable. The most
appropriate next step is to:
prescribe acetaminophen with codeine as needed for pain.
order a 12-lead electrocardiogram.
recommend he continue with activities as usual and stop the activity if the pain occurs.
refer to a cardiologist for work-up. ----ANS---order a 12-lead electrocardiogram.
A child with a heart murmur audible at the lower left sternal border would be suggestive of:
a normal finding.
aortic valve stenosis.
ventricular septal defect.
pulmonary valve stenosis. ----ANS---ventricular septal defect.
murmur at midsternal or upper right sternal border and is associated with a click could be suggestive of
aortic valve stenosis
murmur at the upper left sternal border with prominent ejection click in early systole could be
suggestive of pulmonary valve stenosis
A 3-month-old patient has a history of poor weight gain, dyspnea during feedings, and cyanosis with
crying. Examination identifies tachycardia with a loud murmur at the left upper sternal border with a
single second heart sound. These findings are most consistent with:
congestive heart failure.
,an atrial septal defect (ASD).
tetralogy of Fallot (TOF).
patent ductus arteriosus (PDA). ----ANS---tetralogy of Fallot (TOF)
A 15-year-old patient is diagnosed with primary hypertension. The patient receives a prescription for
benazepril (Lotensin). Which of the following most common side effects should be included when
teaching the patient about benazepril?
Headache, dizziness, and cough
Headache, cough, and hypokalemia
Dizziness, cough, and hypouricemia
Headache, dizziness, and hypokalemia ----ANS---Headache, dizziness, and cough
A 10-month-old infant presents with pallor, poor feeding, and irritability. The pulse rate is found to be
195, it lasts for 1-2 minutes and decreases to 160. The NP suspects:
tachycardia
supraventricular tachycardia
sinus arrhythmia
ventricular premature beats. ----ANS---supraventricular tachycardia
infant may or may not have cyanotic episodes
Episodes of rapid heart rate occur and range from 180 up to 300 bpm; it may stop and start quickly or
lasts for hours.
Wolf-Parkinson White syndrome may be a potential cause of SVT and patient should be referred to
cardiology
A 5-year-old presents for re-evaluation of a Grade IV/VI systolic ejection murmur that was first
documented 1 month ago. On examination, the murmur is audible while the patient is sitting and
supine. The remainder of the exam is unremarkable. Based on these findings, the nurse practitioner
concludes that:
today's findings are characteristic of an innocent murmur.
, an electrocardiogram (EKG) is warranted.
this is a normal finding.
this patient should be referred to a pediatric cardiologist. ----ANS---this patient should be referred to a
pediatric cardiologist.
The most common congenital heart defect in children is:
an atrial septal defect (ASD).
a ventricular septal defect (VSD).
tetralogy of Fallot (TOF).
hypoplastic left heart syndrome (HLHS). ----ANS---a ventricular septal defect (VSD).
20-30% of all CHDs
majority of VSDs close by age 4 without intervention
When assessing the heart, the best area to auscultate aortic valve sounds would be:
2nd left intercostal space (ICS), left sternal border (LSB).
2nd right intercostal space (ICS), right sternal border (RSB).
3rd or 4th left intercostal space (ICS), left sternal border (LSB).
5th left intercostal space (ICS), left midclavicular line (MCL). ----ANS---2nd right intercostal space (ICS),
right sternal border (RSB).
Elevated blood pressure in children less than 13 years old is classified as persistent blood pressure
readings:
in the 75th percentile for a normotensive child of the same age, sex, and height.
in the 80th percentile for a normotensive child of the same age, sex, and height.
equal to or exceeding the 90th percentile for a normotensive child of the same age, sex, and height.
equal to or exceeding the 95th percentile for a normotensive child of the same age, sex, and height. ----
ANS---equal to or exceeding the 90th percentile for a normotensive child of the same age, sex, and
height.
A loud systolic ejection murmur audible at the left upper sternal border and/or a holosystolic murmur at
the left mid sternal border would be consistent with:
