N396 Exam 3 Practice

A nurse is assessing an infant with suspected cardiovascular compromise. Which physiological mechanism do infants primarily use to maintain cardiac output?

• Increased stroke volume

• Vasodilation

• Increased heart rate

• Enhanced contractility

The nurse is teaching a group of nursing students about differences in pediatric cardiac and respiratory physiology. Which of the following are accurate statements? Select all that apply.

• Children have a larger heart size relative to their chest, which reduces pulmonary reserve.

• Bradycardia in pediatric patients is often caused by hypoxia.

• Stroke volume increases significantly in infants under stress.

• Infants have higher oxygen demands due to their metabolic rate.

• A lower heart rate in infants is an expected sign of adaptation.

Which of the following would the nurse recognize as a late sign of shock in a child?

• Tachycardia

• Cool extremities

• Delayed capillary refill

• Hypotension

The nurse is caring for a 3-month-old infant. Which assessment finding requires immediate intervention?

• Heart rate of 168 bpm during crying

• Respiratory rate of 52 while sleeping

• Oxygen saturation of 89% with bradycardia

• Capillary refill of 3 seconds after feeding

The nurse is preparing to measure an infant's vital signs. The nurse should use which of the following sites to assess a heart rate?

• Carotid artery

• Apex of the heart

• Brachial artery

• Radial artery

A nurse is performing a cardiovascular assessment on a pediatric patient. Which of the following techniques and considerations are appropriate during this assessment? Select all that apply.

• Warm the stethoscope before placing it on the child's skin.

• Use only the diaphragm of the stethoscope for heart sounds.

• Assess the heart sounds when the child is quiet or asleep.

• Use the bell to assess high-pitched heart sounds.

• Have older children sit upright for the assessment.

A nurse is caring for a pediatric patient after a cardiac catheterization procedure. Which post-procedure nursing interventions are essential? Select all that apply.

• Monitor vital signs and assess for signs of bleeding at the catheter insertion site.

• Encourage increased oral fluid intake if not contraindicated.

• Assess distal pulses in the affected extremity and compare bilaterally.

• Keep the affected extremity straight for the prescribed period.

• Monitor for signs of contrast material reaction, such as rash or difficulty breathing.

A nurse is assessing a child after cardiac catheterization via the femoral vein. Which of the following findings would require immediate intervention?

• Mild discomfort at the catheter insertion site

• Capillary refill of 2 seconds in the affected extremity

• Pallor and coolness in the affected extremity

• Slight bruising at the catheter insertion site

A nurse is caring for a child recovering from a cardiac catheterization via the femoral artery. Which positioning instruction is most appropriate immediately post-procedure?

• High Fowler's position with knees flexed

• Supine with affected leg straight for 2-3 hours

• Supine with affected leg straight for 6-8 hours

• Semi-Fowler's with the head of bed at 45 degrees

A nurse is providing discharge teaching to the parents of a child who just underwent cardiac catheterization. Which instructions are appropriate? Select all that apply.

• Keep the site clean and dry.

• Limit physical activity for at least 72 hours.

• Avoid tub baths for at least 3 days.

• Call the provider if your child has a fever or the site is red or swollen.

• Change the bandage daily for 2 days.