COLEGIO DE DAGUPAN

Arellano St. Dagupan City

COLLEGE OF NURSING

PRELIMINARY EXAMINATIONS

PEDIATRIC NURSING (NCM 102)

I. MULTIPLE CHOICE:

GENERAL DIRECTION:
Read and understand each question carefully. Select the best answer. Shade the answer of
your choice on the answer sheet provided for. Please use your black or blue pen only.

1. This is one of the most common acyanotic heart disease there is. This involves the
abnormal opening between the left and right ventricles causing a left-to-right shunting of
blood.

A. Atrial septal defect

B. Coarcation of the aorta
C. Bicuspid stenosis
D. Ventricular septal defect

2. The person with a congenital heart failure develops right-sided heart failure. Which of
the following is NOT a sign or symptom of right-sided heart failure?

A. Difficulty of breathing due to pulmonary congestion

B. Splenomegaly
C. Hepatomegaly
D. Jugular vein distention

3. What would be the characteristic of the shunting of blood for a child with ventricular
septal defect?

A. Left-to-right shunting
B. Aorta to pulmonic trunk shunting
C. Right-to-left shunting
D. Ventriculoperitoneal shunting

4. This would indicate that the person is already having poor oxygen perfusion especially
to the extremities

A. Clubbing of the fingers and toes

B. Pallor
C. Pulmonary congestion
D. Skin flaking

5. Which of the following factors indicating a cardiac defect might be found when
assessing a 1-month-old infant?

A. Weight gain
B. Hyperactivity
C. Poor nutritional intake
D. Pink mucus membranes
6. This is the action digoxin which will help in patients with cardiac failures.

A. Increases blood pressure

B. Decreases cardiac output
C. Increases cardiac muscle contractility
D. Increases sodium reabsorption in the kidneys

7. When giving the patient furosemide (Lasix) you are going to monitor for which of the
following symptoms of furosemide toxicity?

A. Cardiac arrhythmia
B. Hypertension
C. Hyperkalemia
D. Decreased urine output

8. What type of diet is generally allowed for a child who has developed heart failure
brought about by atrial septal defect?

A. Low caloric diet

B. High caloric diet
C. High sodium diet
D. Low sodium diet

9. Which of the following phrases best defines the term stroke volume?

A. Volume of blood returning to the heart

B. Ability of the cardiac muscle to act as an efficient pump
C. Resistance the ventricles pump against when ejecting blood
D. Amount of blood ejected by the heart in any single contraction

10. Which of the following evaluation of cardiovascular status is noninvasive?

A. Cardiac catheterization
B. Echocardiogram
C. Cardiac enzyme levels
D. Transesophageal pacing

11. These are some complications that will arise when the child has ventricular septal
defect EXCEPT
A. Infective endocarditis
B. Increased pulmonary trunk resistance
C. Lung infection
D. Liver failure
12. What would be the characteristic heart sound for a child with ventricular septal
defect?

A. S3 sound
B. Split sound of S1 and S2
C. A widely split pulmonic component of S2
D. Prominent S4

13. Which of the following statements about cardiac catheterization is correct?

A. It’s a noninvasive procedure

B. General anesthesia is required
C. High frequency sound waves produce an image of the heart in motion
 D. It provide visualization of the heart and great vessels with radiopaque dye

14. In getting the health history of the child before cardiac catheterization. Which of the
following findings would be most significant?

A. Allergy to seafoods
B. History of seizures
C. Recent infection
D. Incomplete vaccination

15. Parents ask a nurse about a child’s activity level after cardiac surgery. Which of the
following responses would be best?

A. There are no exercise limitations

B. The child may resume school in three days
C. Encourage a balance in rest and exercise
D. Climbing and contact sports are restricted for one week

16. A teenage client with heart failure is prescribed with digoxin. To which of the
following classifications does this drug belong?

A. Angiotensin-converting enzyme (ACE) inhibitor

B. Cardiac glycoside
C. Diuretic
D. Vasodilator

17. Which of the following symptoms is seen with pulmonary congestion or left sided
heart failure?

A. Weight gain
B. Peripheral edema
C. Neck vein distention
D. Tachypnea and dyspnea

18. Which of the following statements about patent ductus arteriosus is correct?

A. Heart failure is uncommon

B. The ductus normally closes completely by 6 weeks of age
C. An open ductus arteriosus causes decreased blood flow to the lungs
D. It represents a cyanotic defect with decreased pulmonary blood flow

19. Which of the following interventions or drugs is recommended for preterm infants to
close a patent ductus arteriosus?

A. Indomethacin
B. Prostaglandin E
C. Surgical ligation
D. Cardiac catheterization

20. Which of the following findings is expected in a child with a patent ductus arteriosus?

A. Peripheral pulses are weak

B. Machine-like murmur or Gibson murmur
C. Narrowed pulse pressure
D. Right ventricular hypertrophy
21. Which of the following cardiovascular disorders is considered acyanotic?

A. Patent ductus arteriosus

B. Tetralogy of fallot
C. Transposition of the great vessels
D. Truncus arteriosus

22. Which of the following conditions best describe ventricular septal defect?

A. Narrowing of the aortic arch

B. Failure of a septum to develop completely between the atria
C. Narrowing of the valves at the entrance of the pulmonary artery
D. Failure of a septum to develop completely between the ventricles

23. Which of the following surgical interventions is recommended for a child wit
ventricular septal defect?

A. Surgery with pulmonary artery banding

B. Defect repair through cardiac catheterization
C. Surgery with purse-string suture or Dacron patch repair
D. Surgery when severe pulmonary hypertension is noted

24. Which of the following anomalies produces a left-to-right shunt?

A. Atrial septal defect

B. Pulmonic stenosis
C. Tetralogy of fallot
D. Total anomalous pulmonary venous return

25. A child with an atrial septal repair is entering postoperative day 3. which of the
following interventions would be most appropriate?

A. Give the child nothing by mouth

B. Maintain strict bed rest
C. Take vital signs every 8 hours
D. Administer analgesic as ordered PRN

26. Which of the following conditions best describes coarctation of the aorta?

A. Absent tricuspid valve

B. Narrowing in the area of the aortic valve
C. Localized constriction or narrowing of the aortic wall
D. Narrowing at some location along the right ventricular outflow tract

27. A client is diagnosed with coarctation of the aorta. Which of the following findings
would the nurse expect during an assessment?

A. Normal blood pressure

B. Increased blood pressure in the upper extremities
C. Decreased blood pressure in the upper extremities
D. Decreased or absent pulses in the upper extremities

28. Which of the following procedures is recommended to treat coarctation of the aorta?

A. Drug therapy
 B. Balloon angioplasty
C. No surgical intervention required
D. Surgery with cardiopulmonary bypass

29. Which of the following assessments is expected when assessing a child with tetralogy
of Fallot?

A. Machine-like murmur
B. Eisenmenger’s complex
C. Increasing cyanosis with crying or activity
D. Higher pressure in the upper extremities than with the lower extremities

30. A child with tetralogy of Fallot has clubbing of the fingers and toes, a finding related
to which of the following conditions?

A. Polycythemia
B. Chronic hypoxia
C. Pansystolic murmur
D. Abnormal growth and development

31. Which of the following statements is correct for a child with tetralogy of Fallot?

A. The condition is commonly referred to as “blue tets.”

B. They experience hypercyanotic, or “tet spells.”
C. They experience frequent respiratory infections
D. They experience decreased or absent pulses in the lower extremities

32. Which if the following tests would show the direction and amount of shunting in a
child with tetralogy of Fallot?

A. Chest radiography
B. Echocardiography
C. Electrocardiography
D. Cardiac catheterization

33. Which of the following statements best describes transposition of the great vessels?

A. The body receives only saturated blood.

B. It’s classified as an acyanotic defect with increased pulmonary blood flow.
C. The pulmonary artery leaves the left ventricle, an the aorta exits from the
right ventricle.
D. It’s a condition in which the right atrium and the left atrium empty into
one ventricular chamber.

34. Which of the following statements about transposition of the great arteries is correct?

A. Diagnosis is made at birth

B. Diagnosis can be made in utero
C. Chest x-ray can show an accurate view of the defect
D. Heart failure isn’t a related complication
35. Which of the following associated defects is most common with transposition of the
great arteries?

A. Mitral atresia
B. Atrial septal defect
C. Patent foramen ovale
D. Hypoplasia of the left ventricle

36. Administration of which of the following drugs would be the most important in
treating transposition the great vessels?

A. Digoxin
B. Diuretics
C. Antibiotics
D. Prostaglandin E1

37. This surgery generally involves making incisions into the heart muscle, relieving the
right ventricular outflow tract stenosis by careful resection of muscle, and repairing the
VSD using a Gore-Tex patch or a homograft. Additional reparative or reconstructive
work may be done on patients as required by their particular anatomy.

A. Fontan procedure
B. Blalock-Thomas-Taussig procedure
C. Blalock-Thomas procedure
D. Dacron patching

38. This is a response of the body when the body detects constant hypoxia the red
marrow of the bones will be stimulated to increase red blood cells.

A. Polycythemia
B. Thrombocytopenia
C. Pancytopenia
D. Anemia

39. What should be the position of the child when experiencing cyanotic spells?

A. High-Fowler’s position
B. Semi-Fowler’s position
C. Knee-chest position
D. Prone position

40. This allows total correction of transposition of the great vessels the procedure
employs a baffle to direct oxygenated pulmonary venous return into the right atrium and
thence into the right ventricle which is the pumping ventricle for the aorta and the
systemic circulation.

A. Fontan procedure
B. Blalock-Taussig procedure
C. Mustard procedure
D. Jatene operation

41. What would be the best treatment for a newborn that has hypoglycemia?

A. Sugar water
B. Breast milk
C. Formula milk
D. IV fluid of 5% Dextrose
42. Johnny Riley is an infant born with a birth weight of 1,200 g. Which of the following
will Johnny be categorized with?

A. Low-birth-weight
B. Very-low-birth-weight
C. Large-for-gestational-age
D. Extremely-low-birth-weight

43. Which of the following infections would predispose the infant to be small-for-
gestational-age (SGA)?

A. Chickenpox
B. Toxoplasmosis
C. Histoplasmosis
D. Rubeola

44. This kind of procedure is done to infants who have a high hematocrit and high red
blood cell levels to avoid the occurrence of thrombus formation and for the blood vessels
to be blocked?

A. Blood transfusion
B. IV fluid administration
C. Phlebotomy
D. Exchange transfusion

45. Why are small-for-gestational age newborns at risk for difficulty maintaining body
temperature?

A. They are preterm so are born relatively small in size.

B. They are more active than usual to throw off covers.
C. They do not have as many fat stores as other infants.
D. Their skin is more susceptible to conduction of cold.

46. This is the special structure found underneath the skin of the newborn that would help
them regulate their body temperature.

A. Brown fat
B. Subcutaneous tissue
C. Baby fat
D. Adipose tissue

47. Which of the following definitions best describes the etiology of sudden infant
death syndrome (SIDS)?

a. Cardiac arrhythmias
b. Apnea of prematurity
c. Unexplained death of infant
d. Apparent life-threatening event

48. Which of the following children has an increased risk of sudden infant death
syndrome?

a. Premature infant with low birth weight

 b. A healthy 2-year old
c. Infant hospitalized for fever
d. Firstborn child

49. A 6-week-old infant is brought to the emergency department no breathing; a

preliminary finding of sudden infant death syndrome (SIDS) is made to the
parents. Which of the following interventions should the nurse take initially?

a. Call the spiritual advisor

b. Explain the etiology of SIDS
c. Allow them to see their infant
d. Collect the infant’s belongings and give them to the parents

50. Which of the following risk factors is related to sudden infant death syndrome
(SIDS)?

a. Feeding habits
b. gestational age of 42 weeks
c. Immunizations
d. Low birth weight

51. An infant is brought to the emergency department and pronounced dead with the
preliminary finding of sudden infant death syndrome (SIDS). Which of the
following questions to the parents is appropriate?

a. Did you hear the infant cry out?

b. Was the infant’s head buried in a blanket?
c. Were any of the siblings jealous of the new baby
d. How did the infant look when you found him?

52. Which of the following reactions are usually exhibited by the family of an infant
who has died from sudden infant death syndrome (SIDS)?

a. Feelings of blame or guilt

b. Acceptance of the diagnosis
c. Requests for the infant’s belongings
d. Questions regarding the etiology of the diagnosis

53. Sudden infant death syndrome (SIDS) is confirmed by which of the following
procedures?

a. Autopsy
b. Chest X-ray
c. Skeletal survey
d. Laboratory analysis

54. Which of the following positions is recommended for placing an infant to sleep?

a. Prone position
b. Supine position
c. Side-lying position
d. With head of bed elevated 30 degrees

55. Which of the following women are prone to deliver large-for-gestational-age

infants?

a. Multiparous women
 b. Primi mothers
c. A mother with abruptio placenta
d. A mother who smokes

56. Which of the following congenital heart disorders is associated to a child that is
large-for-gestational-age?

a. Tetralogy of fallot
b. Truncus arteriosus
c. Transposition of great vessels
d. Coarctation of the aorta

57. Which of the following would cause an Erb-Duchenne paralysis to an infant?

a. Trauma to the cranial nerves

b. Trauma to the lumbar nerves
c. Trauma to the thoracic nerves
d. Trauma to the cervical nerves

58. A preterm infant can be defined if the infant is

59. Born before the end of 37 weeks

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ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ
ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿ
ÿÿÿÿbilirubin levels are not resolved through therapy this complication may result
a. Liver injury
b. Kidney damage
c. Kernicterus
d. Mental retardation

Prepared by: Jayvee V. De Guzman RN