Pediatric Cardiac Test Questions and Correct
Answers
Question 1
The nurse should recognize that congestive heart failure (CHF) is which of the
following?
a. Disease related to cardiac defects
b. Consequence of an underlying cardiac defect
c. Inherited disorder associated with a variety of defects
d. Result of diminished workload imposed on an abnormal myocardium
Correct Answer
ANS: B
CHF is the inability of the heart to pump an adequate amount of blood to the
systemic circulation at normal filling pressures to meet the body's metabolic
demands. CHF is not a disease but rather a result of the inability of the heart to
pump efficiently. CHF is not inherited. CHF occurs most frequently secondary to
congenital heart defects in which structural abnormalities result in increased volume
load or increased pressures on the ventricles.
Question 2
The primary nursing intervention to prevent bacterial endocarditis is which of the
following?
a. Counsel parents of high-risk children.
b. Institute measures to prevent dental procedures.
c. Encourage restricted mobility in susceptible children.
d. Observe children for complications, such as embolism and heart failure.
Correct Answer
ANS: A
The objective of nursing care is to counsel the parents of high-risk children about
the need for both prophylactic antibiotics for dental procedures and maintaining
excellent oral health. The child's dentist should be aware of the child's cardiac
condition. Dental procedures should be done to maintain a high level of oral health.
Restricted mobility in susceptible children is not indicated. Parents are taught to
observe for unexplained fever, weight loss, or change in behavior.
Page 1 of 17
,Question 3
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during
sleep. The nurse should do which of the following?
a. Administer oxygen.
b. Record data on nurses' notes.
c. Report data to the practitioner.
d. Place child in high Fowler position.
Correct Answer
ANS: C
One of the earliest signs of CHF is tachycardia (sleeping heart rate >160 beats/min)
as a direct result of sympathetic stimulation. The practitioner needs to be notified
for evaluation of possible CHF. Although oxygen or a semiupright position may be
indicated, the first action is to report the data to the practitioner.
Question 4
Which of the following defects results in obstruction to blood flow?
a. Aortic stenosis
b. Tricuspid atresia
c. Atrial septal defect
d. Transposition of the great arteries
Correct Answer
ANS: A
Aortic stenosis is a narrowing or stricture of the aortic valve, causing resistance to
blood flow in the left ventricle, decreased cardiac output, left ventricular
hypertrophy, and pulmonary vascular congestion. Tricuspid atresia results in
decreased pulmonary blood flow. The atrial septal defect results in increased
pulmonary blood flow. Transposition of the great arteries results in mixed blood
flow.
Page 2 of 17
, Question 5
The mother of a child with tetralogy of Fallot asks the nurse why her child has clubbed
fingers. The nurse bases the response on the understanding that clubbing is due to
which of the following?
a) Anemia.
b) Peripheral hypoxia.
c) Delayed physical growth.
d) Destruction of bone marrow.
Correct Answer
Answer: B
Clubbing of the fingers is one common finding in the child with persistent hypoxia
leading to tissue changes in the body because of the low oxygen content of the
blood (hypoxemia). It apparently results from tissue fibrosis and hypertrophy from
the hypoxemia and from an increase in capillaries in the area, which occur as the
body attempts to improve blood supply. Clubbing of the fingers is associated with
polycythemia, not anemia. Polycythemia results from the body's attempt to increase
oxygen levels in the tissues. The child may be small for his or her chronological age,
but clubbing does not result from slow physical growth. Destruction of the bone
marrow is not related to this congenital heart malformation. Instead, bone marrow
is actively producing erythrocytes to compensate for the chronic hypoxia.
Question 6
The nurse is caring for a child with Kawasaki disease in the acute phase. Which of the
following clinical manifestations would the nurse expect to observe?
a. Osler nodes
b. Cervical lymphadenopathy
c. Strawberry tongue
d. Chorea
e. Erythematous palms
f. Polyarthritis
Correct Answer
ANS: B, C, E
Clinical manifestations of Kawasaki disease in the acute phase include cervical
lymphadenopathy, a strawberry tongue, and erythematous palms. Osler nodes are a
clinical manifestation of endocarditis. Chorea and polyarthritis are seen in rheumatic
fever.
Page 3 of 17
Answers
Question 1
The nurse should recognize that congestive heart failure (CHF) is which of the
following?
a. Disease related to cardiac defects
b. Consequence of an underlying cardiac defect
c. Inherited disorder associated with a variety of defects
d. Result of diminished workload imposed on an abnormal myocardium
Correct Answer
ANS: B
CHF is the inability of the heart to pump an adequate amount of blood to the
systemic circulation at normal filling pressures to meet the body's metabolic
demands. CHF is not a disease but rather a result of the inability of the heart to
pump efficiently. CHF is not inherited. CHF occurs most frequently secondary to
congenital heart defects in which structural abnormalities result in increased volume
load or increased pressures on the ventricles.
Question 2
The primary nursing intervention to prevent bacterial endocarditis is which of the
following?
a. Counsel parents of high-risk children.
b. Institute measures to prevent dental procedures.
c. Encourage restricted mobility in susceptible children.
d. Observe children for complications, such as embolism and heart failure.
Correct Answer
ANS: A
The objective of nursing care is to counsel the parents of high-risk children about
the need for both prophylactic antibiotics for dental procedures and maintaining
excellent oral health. The child's dentist should be aware of the child's cardiac
condition. Dental procedures should be done to maintain a high level of oral health.
Restricted mobility in susceptible children is not indicated. Parents are taught to
observe for unexplained fever, weight loss, or change in behavior.
Page 1 of 17
,Question 3
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during
sleep. The nurse should do which of the following?
a. Administer oxygen.
b. Record data on nurses' notes.
c. Report data to the practitioner.
d. Place child in high Fowler position.
Correct Answer
ANS: C
One of the earliest signs of CHF is tachycardia (sleeping heart rate >160 beats/min)
as a direct result of sympathetic stimulation. The practitioner needs to be notified
for evaluation of possible CHF. Although oxygen or a semiupright position may be
indicated, the first action is to report the data to the practitioner.
Question 4
Which of the following defects results in obstruction to blood flow?
a. Aortic stenosis
b. Tricuspid atresia
c. Atrial septal defect
d. Transposition of the great arteries
Correct Answer
ANS: A
Aortic stenosis is a narrowing or stricture of the aortic valve, causing resistance to
blood flow in the left ventricle, decreased cardiac output, left ventricular
hypertrophy, and pulmonary vascular congestion. Tricuspid atresia results in
decreased pulmonary blood flow. The atrial septal defect results in increased
pulmonary blood flow. Transposition of the great arteries results in mixed blood
flow.
Page 2 of 17
, Question 5
The mother of a child with tetralogy of Fallot asks the nurse why her child has clubbed
fingers. The nurse bases the response on the understanding that clubbing is due to
which of the following?
a) Anemia.
b) Peripheral hypoxia.
c) Delayed physical growth.
d) Destruction of bone marrow.
Correct Answer
Answer: B
Clubbing of the fingers is one common finding in the child with persistent hypoxia
leading to tissue changes in the body because of the low oxygen content of the
blood (hypoxemia). It apparently results from tissue fibrosis and hypertrophy from
the hypoxemia and from an increase in capillaries in the area, which occur as the
body attempts to improve blood supply. Clubbing of the fingers is associated with
polycythemia, not anemia. Polycythemia results from the body's attempt to increase
oxygen levels in the tissues. The child may be small for his or her chronological age,
but clubbing does not result from slow physical growth. Destruction of the bone
marrow is not related to this congenital heart malformation. Instead, bone marrow
is actively producing erythrocytes to compensate for the chronic hypoxia.
Question 6
The nurse is caring for a child with Kawasaki disease in the acute phase. Which of the
following clinical manifestations would the nurse expect to observe?
a. Osler nodes
b. Cervical lymphadenopathy
c. Strawberry tongue
d. Chorea
e. Erythematous palms
f. Polyarthritis
Correct Answer
ANS: B, C, E
Clinical manifestations of Kawasaki disease in the acute phase include cervical
lymphadenopathy, a strawberry tongue, and erythematous palms. Osler nodes are a
clinical manifestation of endocarditis. Chorea and polyarthritis are seen in rheumatic
fever.
Page 3 of 17
