Pediatric Nursing NCLEX Practice Questions

1. Clay is an 8-year-old boy diagnosed with heart failure. Which of the following shows that he is strictly following the directed therapeutic regimen?

Daily use of an antibiotic

Pulse rate less than 50 beats/minute

Normal weight for age

Elevation in red blood cell (RBC) count

Adequate weight for height demonstrates adequate nutritional intake and lack of edema.Option A: Daily use of antibiotic is not indicated in heart failure.Option B. A pulse rate less than 50 beats/minute. bradycardia. probably indicates digoxin toxicity.Option D: An elevated RBC count demonstrates polycythemia.

Explanation

Adequate weight for height demonstrates adequate nutritional intake and lack of edema.Option A: Daily use of antibiotic is not indicated in heart failure.Option B. A pulse rate less than 50 beats/minute. bradycardia. probably indicates digoxin toxicity.Option D: An elevated RBC count demonstrates polycythemia.

2. The Foley Family is caring for their youngest child. Justin. who is suffering from tetralogy of Fallot. Which of the following are defects associated with this congenital heart condition?

Aorta exits from the right ventricle. pulmonary artery exits from the left ventricle. and two noncommunicating circulations

Ventricular septal defect. overriding aorta. pulmonic stenosis (PS). and right ventricular hypertrophy

Coarctation of aorta. aortic valve stenosis. mitral valve stenosis. and patent ductus arteriosus

Tricuspid valve atresia. atrial septal defect. ventricular septal defect. and hypoplastic right ventricle

The defects associated with tetralogy of Fallot include ventricular septal defect. overriding aorta. pulmonic stenosis (PS). and right ventricular hypertrophy.Option A: The aorta exiting from the right ventricle with no communication between the systemic and pulmonic circulation describes the defects associated with transposition of the great vessels.Option C: Coarctation of aorta and aortic and mitral valve stenosis are defects associated with tricuspid atresia. Severe coarctation of aorta. severe aortic valvular stenosis or atresia. and severe mitral valve stenosis or atresia are defects associated with hypoplastic left heart syndrome.Option D: Also. the left ventricle. aortic valve. mitral valve. and ascending aorta usually are small or hypoplastic.

Explanation

The defects associated with tetralogy of Fallot include ventricular septal defect. overriding aorta. pulmonic stenosis (PS). and right ventricular hypertrophy.Option A: The aorta exiting from the right ventricle with no communication between the systemic and pulmonic circulation describes the defects associated with transposition of the great vessels.Option C: Coarctation of aorta and aortic and mitral valve stenosis are defects associated with tricuspid atresia. Severe coarctation of aorta. severe aortic valvular stenosis or atresia. and severe mitral valve stenosis or atresia are defects associated with hypoplastic left heart syndrome.Option D: Also. the left ventricle. aortic valve. mitral valve. and ascending aorta usually are small or hypoplastic.

3. Which of the following would Nurse Tony suppose to regard as a cardinal manifestation or symptom of digoxin toxicity to his patient Clay diagnosed with heart failure?

Headache

Respiratory distress

Extreme bradycardia

Constipation

Extreme bradycardia is a cardinal sign of digoxin toxicity.Option A. B. D: Headache. respiratory distress. and constipation are not related to digoxin toxicity.

Explanation

Extreme bradycardia is a cardinal sign of digoxin toxicity.Option A. B. D: Headache. respiratory distress. and constipation are not related to digoxin toxicity.

4. Which of the following instructions would Nurse Courtney include in a teaching plan that focuses on initial prevention for Sheri who is diagnosed with rheumatic fever?

Treating streptococcal throat infections with an antibiotic

Giving penicillin to patients with rheumatic fever

Using corticosteroid to reduce inflammation

Providing an antibiotic before dental work

This instruction is crucial because rheumatic fever often develops as a complication of untreated or inadequately treated streptococcal throat infections (such as strep throat). Prompt treatment with antibiotics (such as penicillin or amoxicillin) can prevent the bacteria from triggering an immune response that leads to rheumatic fever. The other options (giving penicillin to patients with rheumatic fever, using corticosteroids to reduce inflammation, and providing an antibiotic before dental work) are more focused on management or specific treatments rather than initial prevention of rheumatic fever.

Explanation

This instruction is crucial because rheumatic fever often develops as a complication of untreated or inadequately treated streptococcal throat infections (such as strep throat). Prompt treatment with antibiotics (such as penicillin or amoxicillin) can prevent the bacteria from triggering an immune response that leads to rheumatic fever. The other options (giving penicillin to patients with rheumatic fever, using corticosteroids to reduce inflammation, and providing an antibiotic before dental work) are more focused on management or specific treatments rather than initial prevention of rheumatic fever.

5. Appropriate intervention is vital for many children with heart disease in order to go on to live active. full lives. Which of the following outlines an effective nursing intervention to decrease cardiac demands and minimize cardiac workload?

Feeding the infant over long periods

Allowing the infant to have her way to avoid conflict

Scheduling care to provide for uninterrupted rest periods

Developing and implementing a consistent care plan

Organizing nursing care to provide for uninterrupted periods of sleep reduces cardiac demand.Option A: Feeding time should be restricted to a maximum of 45 minutes or discontinued sooner if the infant tires.Option B: In an attempt to get her own way. the child may cry. Excessive crying should be limited; however. appropriate limit setting should still be observed.Option D: Developing and implementing a consistent care plan can be important. but it is not related to decreasing cardiac demands or workload.

Explanation

Organizing nursing care to provide for uninterrupted periods of sleep reduces cardiac demand.Option A: Feeding time should be restricted to a maximum of 45 minutes or discontinued sooner if the infant tires.Option B: In an attempt to get her own way. the child may cry. Excessive crying should be limited; however. appropriate limit setting should still be observed.Option D: Developing and implementing a consistent care plan can be important. but it is not related to decreasing cardiac demands or workload.

6. When creating a teaching program for the parents of Jessica who is diagnosed with pulmonic stenosis (PS). Nurse Alex would keep in mind that this disorder involves which of the following?

A single vessel arising from both ventricles

Obstruction of blood flow from the left ventricle

Obstruction of blood flow from the right ventricle

Return of blood to the heart without entry to the left atrium

PS refers to an obstruction of blood flow from the right ventricle.Option A: Truncus arteriosus involves a single vessel arising from both ventricles.Option D: Total anomalous pulmonary venous communications involve the return of blood to the heart without entry into the left atrium and obstruction of blood flow from the left ventricle.

Explanation

PS refers to an obstruction of blood flow from the right ventricle.Option A: Truncus arteriosus involves a single vessel arising from both ventricles.Option D: Total anomalous pulmonary venous communications involve the return of blood to the heart without entry into the left atrium and obstruction of blood flow from the left ventricle.

7. Mr. and Mrs. Baker's only daughter is diagnosed with heart failure. Which of the following interventions would be appropriate to promote optimal nutrition for the infant?

Replacing regular nipples with easy-to-suck ones

Allowing the infant to feed for at least 1 hour

Providing large feedings evenly spaced every 4 hours

Offering formula that is high in sodium and calories

The nurse should replace regular nipples with easy-to-suck-ones because the infant may tire instantly with regular nipples and thus would not be able to suck sufficiently.Option B. C: Also to prevent tiring. small frequent feedings lasting no more than 45 minutes. rather than large evenly spaced feedings or ones lasting longer than 1 hour. should be given.Option D: Typically. the infant receives a low-sodium. high-calorie diet.

Explanation

The nurse should replace regular nipples with easy-to-suck-ones because the infant may tire instantly with regular nipples and thus would not be able to suck sufficiently.Option B. C: Also to prevent tiring. small frequent feedings lasting no more than 45 minutes. rather than large evenly spaced feedings or ones lasting longer than 1 hour. should be given.Option D: Typically. the infant receives a low-sodium. high-calorie diet.

8. A 5-year-old girl Hannah is recently diagnosed with Kawasaki disease. Apart from the identified symptoms of the disease. she may also likely develop which of the following?

Sepsis

Meningitis

Mitral valve disease

Aneurysm formation

Kawasaki disease is a rare childhood illness that affects the blood vessels. 20% to 25% of children can develop aneurysm formation if not intervened. Treatment depends on the degree of the disease. but is often immediate treatment with IV gamma globulin or aspirin. Corticosteroids can sometimes lessen impending complications. Children who experience the disease usually need lifelong follow-up appointments to keep an eye on heart health.

Explanation

Kawasaki disease is a rare childhood illness that affects the blood vessels. 20% to 25% of children can develop aneurysm formation if not intervened. Treatment depends on the degree of the disease. but is often immediate treatment with IV gamma globulin or aspirin. Corticosteroids can sometimes lessen impending complications. Children who experience the disease usually need lifelong follow-up appointments to keep an eye on heart health.

9. Bryce is a child diagnosed with coarctation of aorta. While assessing him. Nurse Zach would expect to find which of the following?

Squatting posture

Absent or diminished femoral pulses

Severe cyanosis at birth

Cyanotic (“tet”) episodes

Absent or diminished femoral pulse is a classic characteristic of coarctation of aorta.Option C: Severe cyanosis at birth is seen in such defects as transposition of the great vessels.Option A. D: Tet episodes and squatting are characteristic of tetralogy of Fallot.

Explanation

Absent or diminished femoral pulse is a classic characteristic of coarctation of aorta.Option C: Severe cyanosis at birth is seen in such defects as transposition of the great vessels.Option A. D: Tet episodes and squatting are characteristic of tetralogy of Fallot.

10. It is considered as the bluntly rounded portion of the heart

Base

Pericardium

Aorta

Apex

The blunt. rounded point of the heart is the apex.Option A: The larger. flat portion at the opposite is the base.Option B: The pericardium is also called the pericardial sac. It has a fibrous outer layer and a thin inner layer that surrounds the heart.Option C: The aorta is the largest artery that carries blood from the left ventricle to the body.

Explanation

The blunt. rounded point of the heart is the apex.Option A: The larger. flat portion at the opposite is the base.Option B: The pericardium is also called the pericardial sac. It has a fibrous outer layer and a thin inner layer that surrounds the heart.Option C: The aorta is the largest artery that carries blood from the left ventricle to the body.