Pediatric Primary Care: Chapter 38: Cardiovascular Disorders, Burns Chapt 45
- Endocrine and Metabolic Disorders
1. The primary care pediatric nurse ANS: A
practitioner (PNP) is examining a A wide splitting of S without becoming a single sound on
2-week-old infant and auscultates expiration may indicate increased
a wide splitting of S during expira- pulmonary flow, typical of atrial septal defect. Coarcta-
tion. What condition may this find- tion of the aorta may cause a systolic ejection murmur.
ing A patent ductus arteriosus has a characteristic machin-
represent? ery-like murmur. A ventricular septal defect has a harsh,
a. Atrial septal defect (ASD) high-pitched, grade II to IV/VI holosystolic murmur.
b. Coarctation of the aorta (COA)
c. Patent ductus arteriosis (PDA)
d. Ventricular septal defect (VSD)
2. The primary care pediatric nurse ANS: C
practitioner auscultates a new A Still's murmur is characterized by a vibratory or musi-
grade II vibratory, mid-systolic cal low-grade sound, along the sternal border, which is
murmur at the mid sternal border louder when the child is supine or during inspiration. It
in a 4-year-old child that is loud- is usually heard in children between the ages of 2 and
er when the child is supine. What 6 years old. Pathologic murmurs are usually harsh, not
type of murmur is most likely? vibratory. A pulmonary flow murmur has a soft, blowing
a. Pathologic murmur sound and radiates to the lung fields. A venous hum has
b. Pulmonary flow murmur a soft, high-pitched swishing sound.
c. Still's murmur
d. Venous hum
3. During a well child assessment, ANS: D
the primary care pediatric nurse A harsh, blowing murmur is suspicious for pathology,
practitioner (PNP) auscultates a so a cardiology referral is warranted. The cardiologist
harsh, blowing grade IV/VI mur- will determine which tests and procedures should be
mur in a 6-month-old infant. What performed.
will the nurse practitioner do
next?
,Pediatric Primary Care: Chapter 38: Cardiovascular Disorders, Burns Chapt 45
- Endocrine and Metabolic Disorders
a. Get a complete blood count to
rule out severe anemia.
b. Obtain an electrocardiogram to
assess for arrhythmia.
c. Order a chest radiograph to eval-
uate for cardiomegaly.
d. Refer to a pediatric cardiologist
for further evaluation.
4. The primary care pediatric nurse ANS: B
practitioner provides primary care Infants with heart defects who have congestive heart
for a 4-month-old infant who has failure (CHF) may need modification of formula or breast
a ventricular septal defect (VSD). milk to increase calories. This infant is nursing well, so
The infant has been breastfeed- fortifying the breast milk to increase calories is the first
ing well but in the past month has and best option. Adding solids does not significantly
dropped from the 20th percentile increase caloric intake.
to the 5th for weight. What will the
nurse practitioner recommend?
a. Adding solid foods to the in-
fant's diet to increase caloric in-
take
b. Fortifying breast milk to in-
crease the number of calories per
ounce
c. Stopping breastfeeding and giv-
ing 30 kcal/ounce formula
d. Supplementing breastfeeding
with 24 kcal/ounce formula
5. A 12-month-old infant who had ANS: C
cardiopulmonary bypass with red Live vaccines should be delayed until 6 months after car-
, Pediatric Primary Care: Chapter 38: Cardiovascular Disorders, Burns Chapt 45
- Endocrine and Metabolic Disorders
blood cell (RBC) and plasma infu- diopulmonary bypass and exposure to RBCs and plasma.
sions during surgery at 8 months The PCV-13 is not a live-virus vaccine and the others are.
is seen for a well child examina-
tion. Which vaccine may be admin-
istered at this visit?
a. Measles, mumps, and rubella
(MMR)
b. oral polio vaccine (OPV)
c. Live-viruse (PCV-13)
d. Varivax
6. The primary care pediatric nurse ANS: A
practitioner (PNP) performs a well Children who have had complete repair of congeni-
child examination on a tal heart defect (CHD) should have subacute bacteri-
12-month-old child who had repair al endocarditis (SBE) prophylaxis with amoxicillin for 6
of a congenital heart defect at 8 months after the procedure. Capoten, an antihyperten-
months of age. The child sive, digoxin, an inotropic medication, and furosemide, a
has a normal exam. The parent re- diuretic, are given for specific symptoms as indicated.
ports that the child is not taking
any medications. The nurse
practitioner will contact the child's
cardiologist to discuss whether
the child needs which
medication?
a. Amoxicillin
b. Capoten
c. Digoxin
d. Furosemide
7. During a well baby examination ANS: D
of a 6-week-old infant, the pri- Infants with oxygen saturation less than 95% and those
- Endocrine and Metabolic Disorders
1. The primary care pediatric nurse ANS: A
practitioner (PNP) is examining a A wide splitting of S without becoming a single sound on
2-week-old infant and auscultates expiration may indicate increased
a wide splitting of S during expira- pulmonary flow, typical of atrial septal defect. Coarcta-
tion. What condition may this find- tion of the aorta may cause a systolic ejection murmur.
ing A patent ductus arteriosus has a characteristic machin-
represent? ery-like murmur. A ventricular septal defect has a harsh,
a. Atrial septal defect (ASD) high-pitched, grade II to IV/VI holosystolic murmur.
b. Coarctation of the aorta (COA)
c. Patent ductus arteriosis (PDA)
d. Ventricular septal defect (VSD)
2. The primary care pediatric nurse ANS: C
practitioner auscultates a new A Still's murmur is characterized by a vibratory or musi-
grade II vibratory, mid-systolic cal low-grade sound, along the sternal border, which is
murmur at the mid sternal border louder when the child is supine or during inspiration. It
in a 4-year-old child that is loud- is usually heard in children between the ages of 2 and
er when the child is supine. What 6 years old. Pathologic murmurs are usually harsh, not
type of murmur is most likely? vibratory. A pulmonary flow murmur has a soft, blowing
a. Pathologic murmur sound and radiates to the lung fields. A venous hum has
b. Pulmonary flow murmur a soft, high-pitched swishing sound.
c. Still's murmur
d. Venous hum
3. During a well child assessment, ANS: D
the primary care pediatric nurse A harsh, blowing murmur is suspicious for pathology,
practitioner (PNP) auscultates a so a cardiology referral is warranted. The cardiologist
harsh, blowing grade IV/VI mur- will determine which tests and procedures should be
mur in a 6-month-old infant. What performed.
will the nurse practitioner do
next?
,Pediatric Primary Care: Chapter 38: Cardiovascular Disorders, Burns Chapt 45
- Endocrine and Metabolic Disorders
a. Get a complete blood count to
rule out severe anemia.
b. Obtain an electrocardiogram to
assess for arrhythmia.
c. Order a chest radiograph to eval-
uate for cardiomegaly.
d. Refer to a pediatric cardiologist
for further evaluation.
4. The primary care pediatric nurse ANS: B
practitioner provides primary care Infants with heart defects who have congestive heart
for a 4-month-old infant who has failure (CHF) may need modification of formula or breast
a ventricular septal defect (VSD). milk to increase calories. This infant is nursing well, so
The infant has been breastfeed- fortifying the breast milk to increase calories is the first
ing well but in the past month has and best option. Adding solids does not significantly
dropped from the 20th percentile increase caloric intake.
to the 5th for weight. What will the
nurse practitioner recommend?
a. Adding solid foods to the in-
fant's diet to increase caloric in-
take
b. Fortifying breast milk to in-
crease the number of calories per
ounce
c. Stopping breastfeeding and giv-
ing 30 kcal/ounce formula
d. Supplementing breastfeeding
with 24 kcal/ounce formula
5. A 12-month-old infant who had ANS: C
cardiopulmonary bypass with red Live vaccines should be delayed until 6 months after car-
, Pediatric Primary Care: Chapter 38: Cardiovascular Disorders, Burns Chapt 45
- Endocrine and Metabolic Disorders
blood cell (RBC) and plasma infu- diopulmonary bypass and exposure to RBCs and plasma.
sions during surgery at 8 months The PCV-13 is not a live-virus vaccine and the others are.
is seen for a well child examina-
tion. Which vaccine may be admin-
istered at this visit?
a. Measles, mumps, and rubella
(MMR)
b. oral polio vaccine (OPV)
c. Live-viruse (PCV-13)
d. Varivax
6. The primary care pediatric nurse ANS: A
practitioner (PNP) performs a well Children who have had complete repair of congeni-
child examination on a tal heart defect (CHD) should have subacute bacteri-
12-month-old child who had repair al endocarditis (SBE) prophylaxis with amoxicillin for 6
of a congenital heart defect at 8 months after the procedure. Capoten, an antihyperten-
months of age. The child sive, digoxin, an inotropic medication, and furosemide, a
has a normal exam. The parent re- diuretic, are given for specific symptoms as indicated.
ports that the child is not taking
any medications. The nurse
practitioner will contact the child's
cardiologist to discuss whether
the child needs which
medication?
a. Amoxicillin
b. Capoten
c. Digoxin
d. Furosemide
7. During a well baby examination ANS: D
of a 6-week-old infant, the pri- Infants with oxygen saturation less than 95% and those
