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Cardiovascular
Respiratory
Neurologic
Multi-system
Endocrine
100
Which of the following is not present during a hypercyanotic spell? a. Hypoxia b. Acidosis c. Decreased pulmonary vascular resistance d. Decreased pulmonary blood flow
c. Decreased pulmonary vascular resistance
100
The nurse caring for Emily a child who has been diagnosed with pulmonary hypertension. Nitric Oxide is ordered. Which of the following is an effect of nitric oxide? a. It dilates the systemic vasculature b. It causes systemic hypotension c. Decreases intrapulmonary shunting and improves VQ matching d. It has no effect on pulmonary vascular resistance
c. Decreases intrapulmonary shunting and improves VQ matching
100
Which of the following is a false statement? a. Open fontanels in infants typically lead to increased mortality associated with head injuries b. If an infant is not restrained and is propelled during an MVA, the head usually leads, resulting in critical injury. c. The infant has less myelinated nerves that are easily injured. d. The cranial bones are thin and offer inadequate protection.
a. Open fontanels in infants typically lead to increased mortality associated with head injuries
100
Which of the following is not how the body responds to sympathetic nervous system activation? a. Constriction of blood vessels in kidney b. Dilation of blood vessels in skeletal muscles c. Dilation of coronary arteries d. Constriction of pupils
d. Constriction of pupils
100
Which of the following is true concerning osmolality? a. A normal blood osmolality is 300 b. A normal urine osmolality is 280 c. Urine osmolality should be slightly higher than blood d. Blood osmolality should be slightly higher than urine
b. A normal urine osmolality is 280
200
Which of the following children would not have a decrease in preload? a. A three year old who just received a dose of furosemide. b. A four year old near drowning with 15 cm PEEP to manage worsening ARDS c. An infant with SVT d. An 8 year old with gastroenteritis who just received a bolus of isotonic fluids.
d. An 8 year old with gastroenteritis who just received a bolus of isotonic fluids.
200
Ashley is a 7 year old with asthma. She has been readmitted to the PICU after being discharged 4 weeks ago. Her last 2 admissions were also for status asthmaticus. She is currently very short of breath with severe retractions noted throughout. Her PCO2 has risen from 50 to 58 in the last hour. Her respiratory rate is 64 breaths/minute and her O2 sats are 84 on room air. Which of the following is a priority? a. Administer continuous albuterol by nebulizer b. Provide 100% O2 by non rebreather mask c. Prepare to intubate and provide ventilator assistance d. Prepare to administer an injectable beta 2 agonist
c. Prepare to intubate and provide ventilator assistance
200
Which of the following is not correct? a. PaCO2<35 leads to an increase in pH b. Hypercarbia leads to constriction of cerebral arterioles c. Hypoxemia causes vasodilation of cerebral arterioles d. Hypoxemia leads to a decrease in blood volume
d. Hypoxemia leads to a decrease in blood volume
200
Which of the following is true of distributive shock? a. It is a shock where excessive fluid is trapped in the vascular bed b. The pumping function of the heart is abnormal c. There is a massive constriction of the blood vessels d. Inadequate intravascular volume leads to a relative hypovolemia
d. Inadequate intravascular volume leads to a relative hypovolemia
200
Which of the following is not true concerning ADH? a. It is stored in the posterior pituitary b. It allows the renal collecting ducts to become less permeable to water c. Its net effect is a more concentrated urine d. In its absence, more fluid is excreted in the urine
b. It allows the renal collecting ducts to become less permeable to water
300
Pulmonary overcirculation is least likely to occur in which of the following circumstances? a. Norwood procedure b. BT Shunt c. PA Band d. Arterial Switch procedure
d. Arterial Switch procedure
300
Emily is a newborn with a diagnosis of tracheoesophageal fistula (TEF). Emily has the most common type of TEF. When reviewing her history, the nurse would expect to find all of the following except: a. Coughing, choking, and cyanosis with first feeding b. Distended firm abdomen c. Flat smooth abdomen d. History of maternal polyhydramnios
b. Distended firm abdomen
300
Which of the following is a true statement concerning traumatic brain injuries? a. Concussions always involve a loss of consciousness b. Diffuse cerebral swelling is due to decreased blood volume c. Cerebral lacerations are often associated with skull fractures d. Skull fractures are examples of secondary injuries
c. Cerebral lacerations are often associated with skull fractures
300
Christy is a 6 year old being cared for in the PICU after experiencing a severe burn. She has now developed SIRS. Which of the following would the nurse not expect to see? a. Increased SVR b. Ascites c. Generalized edema d. Excessive clot formation
a. Increased SVR
300
Which of the following is not an accurate depiction of the body's response to hyperglycemia in ketoacidosis? a. Excess hydrogen ions cause potassium to enter the cells b. Accumulation of ketones is a result of fat metabolism c. Kussmaul breathing is an attempt to elimiate excess carbonic acid d. Excess glucose results in water leaving the vascuar spaces
a. Excess hydrogen ions cause potassium to enter the cells
400
Which of the following is not true of hypoplastic left heart syndrome. a. Most blood flows from the left atrium to the right atrium. b. Blood flows from the ductus arteriosus to the aorta. c. The mitral valve is small and underdeveloped. d. Symptoms are minimized when the ductus arteriosus closes.
d. Symptoms are minimized when the ductus arteriosus closes.
400
Carlie is a 4 year old with ARDS. Which of the following is not associated with the effects of the disease process? a. Increased PVR b. Pulmonary hypertension worsens with hypoxia c. Blood is shunted away from the non ventilated areas d. Mediators are released that result in decreased capillary permiability
d. Mediators are released that result in decreased capillary permiability
400
Brian has sustained an epidural hematoma. Which of the following is true regarding epidural hematomas? a. A lateral displacement of cerebral tissue usually results b. Venous tears usually result in a slow bleed that requires ongoing monitoring c. It is often associated with child abuse d. Bleeding occurs between the dura and the skull
d. Bleeding occurs between the dura and the skull
400
Rebecca is a 16 year old who was involved in a motor vehicle crash when her SUV rolled over. Rebecca who was driving was also found to be intoxicated. Rebecca's injuries include a fractured pelvis, a traumatic brain injury, and a tension pneumothorax. Which of the following has the most potential to be immediately life threatening? a. Traumatic brain injury b. Pelvic and femur fracture c. Tension pneumothorax d. Elevated blood alcohol levels
c. Tension pneumothorax
400
Which of the following is true concerning diabetes insipidus (DI)? a. There is a lack of ADH that allows water to be excreted instead of being reabsorbed b. There is an excess ADH that allows water to be excreted instead of being reabsorbed c. There is a lack of ADH leading to volume overload d. There is an excess of ADH leading to volume overload
a. There is a lack of ADH that allows water to be excreted instead of being reabsorbed
500
Sasha has a cardiac defect where the blood flows from the right atrium through an ASD into the left atrium and then through a VSD to the right ventricle and out to the lungs. What kind of defect does Sasha have? a. Aortic stenosis b. Tricuspid atresia c. Truncus arteriosus d. Hypoplastic left heart
b. Tricuspid atresia
500
Which of the following hemodynamic changes are seen in pulmonary hypertension? a. Decreased cardiac output, increased RAP, increased PVR, no change in SVR b. Decreased cardiac output, decreased RAP, increased PVR, increased SVR c. Decreased cardiac output, increased RAP, decreased, PVR, no increased SVR d. Decreased cardiac output, increased RAP, decreased PVR, decreased SVR
a. Decreased cardiac output, increased RAP, increased PVR, no change in SVR
500
Anna is a 3 year old who is admitted to the PICU with traumatic brain injury secondary to child abuse. She is unrepsonsive and intubated. The nurse inititates end tidal CO2 monitoring. Which of the following statements is false? a. Increased ICP can be caused from decreased CO2 levels which promote cerebral vasodilation b. Cerebral perfusion is optimal in the presence of normal to mildly reduced CO2 c. Markedly decreased CO2 levels can lead to ischemia d. Decreased CO2 levels promotecerebral vasoconstriction
a. Increased ICP can be caused from decreased CO2 levels which promote cerebral vasodilation
500
The nurse is caring for Chad, a 3 year old who swallowed one of his mother's tricyclic antidepressants. The nurse would expect Chad's plan of care to include any of the following except: a. Administration of Lidocaine b. Administration of NaHCO3 in the IV fluids c. Administration of Phenobarbital d. Administration of glucose and insulin
d. Administration of glucose and insulin
500
Which of the following is true of SIADH a. There is decreased secreation of ADH with excessive reabsorption of water by the renal tubules b. There is decreased secretion of ADH with excessive excretion of water by the renal tubules c. There is increased secretion of ADH with excessive excretion of water by the renal tubules d. There is increased secretion of ADH with excessive reabsorption of water by the renal tubules
d. There is increased secretion of ADH with excessive reabsorption of water by the renal