Q.1 Which of the following is the most common congenital heart defect in children?
Tetralogy of Fallot
Ventricular Septal Defect
Atrial Septal Defect
Coarctation of the Aorta
Explanation - Ventricular Septal Defect (VSD) is the most common congenital heart defect, characterized by an abnormal opening between the ventricles.
Correct answer is: Ventricular Septal Defect
Q.2 A child with cyanotic heart disease is likely to exhibit which of the following?
Blue lips and nails
Pale skin
High blood pressure
Bradycardia
Explanation - Cyanotic heart disease results in reduced oxygenation of the blood, leading to cyanosis, noticeable as blue lips and nail beds.
Correct answer is: Blue lips and nails
Q.3 Which nursing intervention is priority for a child with congestive heart failure (CHF)?
Encourage fluid intake
Administer diuretics as prescribed
Limit activity completely
Provide high-calorie diet
Explanation - Diuretics reduce fluid overload, decrease pulmonary congestion, and improve cardiac function in children with CHF.
Correct answer is: Administer diuretics as prescribed
Q.4 Which diagnostic test is most definitive for detecting structural heart defects in children?
Electrocardiogram (ECG)
Chest X-ray
Echocardiogram
Pulse oximetry
Explanation - Echocardiography provides real-time imaging of the heart’s structure and function, making it the definitive test for congenital heart defects.
Correct answer is: Echocardiogram
Q.5 Which sign indicates increased work of breathing in infants with respiratory distress?
Nasal flaring
Bradycardia
Hypothermia
Cyanosis only on extremities
Explanation - Nasal flaring is a compensatory mechanism in infants to reduce airway resistance and indicates respiratory distress.
Correct answer is: Nasal flaring
Q.6 What is the primary cause of clubbing in children with chronic hypoxemia?
Pulmonary hypertension
Chronic oxygen deprivation
Heart murmurs
Frequent infections
Explanation - Clubbing occurs due to long-term low oxygen levels in the blood, commonly seen in cyanotic heart and chronic respiratory conditions.
Correct answer is: Chronic oxygen deprivation
Q.7 Which position helps improve breathing in a child with severe respiratory distress?
Supine
Prone
Tripod position
Side-lying
Explanation - Sitting upright and leaning forward (tripod position) maximizes chest expansion and eases breathing in distressed children.
Correct answer is: Tripod position
Q.8 A child with Kawasaki disease is at risk for which cardiovascular complication?
Myocardial infarction
Coronary artery aneurysm
Aortic stenosis
Mitral valve prolapse
Explanation - Kawasaki disease causes inflammation of blood vessels, leading to potential coronary artery aneurysms if untreated.
Correct answer is: Coronary artery aneurysm
Q.9 Which symptom is most indicative of left-sided heart failure in children?
Peripheral edema
Pulmonary congestion and dyspnea
Hepatomegaly
Ascites
Explanation - Left-sided heart failure leads to fluid backup in the lungs, causing pulmonary congestion and difficulty breathing.
Correct answer is: Pulmonary congestion and dyspnea
Q.10 Which nursing measure is important for a child with asthma during an acute attack?
Encourage deep coughing exercises
Administer short-acting bronchodilator
Place child in supine position
Restrict oxygen therapy
Explanation - Short-acting bronchodilators relieve bronchospasm quickly and are the first-line treatment during acute asthma attacks.
Correct answer is: Administer short-acting bronchodilator
Q.11 Which finding is characteristic of a child with coarctation of the aorta?
High blood pressure in upper extremities and weak pulses in lower extremities
Cyanosis of lips
Clubbing of fingers
Edema in lower limbs
Explanation - Coarctation of the aorta results in obstruction of blood flow to lower extremities, causing hypertension in arms and weak femoral pulses.
Correct answer is: High blood pressure in upper extremities and weak pulses in lower extremities
Q.12 Which electrolyte imbalance is most concerning in a child receiving diuretics for heart failure?
Hypernatremia
Hypokalemia
Hypercalcemia
Hypomagnesemia
Explanation - Loop and thiazide diuretics increase potassium excretion, making hypokalemia a significant risk in children with heart failure.
Correct answer is: Hypokalemia
Q.13 Which of the following is the hallmark of respiratory syncytial virus (RSV) infection in infants?
Wheezing and bronchiolitis
High fever only
Severe cough without wheezing
Peripheral edema
Explanation - RSV commonly causes bronchiolitis with wheezing in infants due to airway inflammation and obstruction.
Correct answer is: Wheezing and bronchiolitis
Q.14 Which clinical sign suggests right-sided heart failure in a child?
Pulmonary edema
Peripheral edema and hepatomegaly
Dyspnea
Cyanosis only on lips
Explanation - Right-sided heart failure leads to systemic venous congestion, causing peripheral edema and liver enlargement.
Correct answer is: Peripheral edema and hepatomegaly
Q.15 Which oxygen delivery device is most appropriate for a child with mild hypoxemia requiring low-flow oxygen?
Non-rebreather mask
Nasal cannula
Venturi mask
Bag-valve mask
Explanation - A nasal cannula provides low-flow oxygen efficiently and comfortably for children with mild hypoxemia.
Correct answer is: Nasal cannula
Q.16 Which nursing intervention is essential for a child with cystic fibrosis?
Encourage high-fat diet
Promote airway clearance and chest physiotherapy
Restrict fluids
Avoid physical activity
Explanation - Airway clearance techniques help remove thick mucus from lungs, reducing infections in children with cystic fibrosis.
Correct answer is: Promote airway clearance and chest physiotherapy
Q.17 Which is a classic sign of tetralogy of Fallot during an episode of cyanosis?
Knee-chest position
Supine rest
High-pitched cry
Peripheral edema
Explanation - Children with tetralogy of Fallot instinctively squat during cyanotic episodes to increase systemic vascular resistance and improve oxygenation.
Correct answer is: Knee-chest position
Q.18 Which laboratory finding is expected in a child with iron-deficiency anemia secondary to chronic heart failure?
High hemoglobin
Low hematocrit
Elevated platelets
Hyperkalemia
Explanation - Chronic heart failure can lead to poor nutrition and iron deficiency, resulting in low hematocrit and hemoglobin levels.
Correct answer is: Low hematocrit
Q.19 Which sign indicates impending respiratory failure in a child with severe asthma?
Silent chest with absent breath sounds
Mild wheezing
Coughing at night
Slight tachypnea
Explanation - A silent chest indicates very severe airway obstruction and impending respiratory failure; it is a medical emergency.
Correct answer is: Silent chest with absent breath sounds
Q.20 Which is the most appropriate nursing action for a child after cardiac catheterization?
Monitor the insertion site for bleeding and hematoma
Encourage vigorous activity immediately
Administer anticoagulants without monitoring
Avoid checking pulses in extremities
Explanation - After cardiac catheterization, careful monitoring of the puncture site prevents complications such as bleeding or hematoma formation.
Correct answer is: Monitor the insertion site for bleeding and hematoma
Q.21 Which medication is commonly prescribed to improve cardiac output in children with heart failure?
Digoxin
Furosemide
Prednisone
Amoxicillin
Explanation - Digoxin increases myocardial contractility and improves cardiac output in children with heart failure.
Correct answer is: Digoxin
Q.22 Which environmental measure helps prevent respiratory infections in children with chronic lung disease?
Maintaining smoke-free environment
Exposure to crowded places
Keeping windows closed always
Limiting hydration
Explanation - Smoke-free environments reduce irritation and risk of infections in children with chronic respiratory conditions.
Correct answer is: Maintaining smoke-free environment
Q.23 Which finding suggests a child with pneumonia may be deteriorating?
Increased respiratory rate and decreased oxygen saturation
Decreased temperature
Improved breath sounds
Stable heart rate
Explanation - Worsening respiratory distress is indicated by tachypnea and hypoxemia, signaling deterioration in pneumonia.
Correct answer is: Increased respiratory rate and decreased oxygen saturation
Q.24 Which is the primary nursing goal for a child with acute epiglottitis?
Maintain airway patency and prevent obstruction
Encourage oral fluids freely
Perform throat culture immediately
Administer nebulized steroids
Explanation - Epiglottitis can rapidly cause airway obstruction; maintaining airway patency is the priority intervention.
Correct answer is: Maintain airway patency and prevent obstruction