PEDS (APEA) STUDY GUIDE 2026 QUESTIONS
WITH CORRECT ANSWERS GRADED A+
◉ 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. Answer: 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. Answer: 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). Answer: 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. Answer: 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. Answer: 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:
WITH CORRECT ANSWERS GRADED A+
◉ 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. Answer: 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. Answer: 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). Answer: 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. Answer: 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. Answer: 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:
