CCRN PEDIATRICS EXAM LATEST 2023-2024
ACTUAL EXAM 150 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
3 causes for Fetal shunt closure - ANSWER 1. increase in aterial oxygen tension
2. decreased prostaglandins
3. decreased adenosine levels
When does the Ductus Arteriosus close? - ANSWER within 10-24 hours of birth
When does the Foramen Ovale Close? - ANSWER When LA pressure exceeds RA pressure (can stay open
for 6mo to a year)
What does Cardiac Output measure? - ANSWER Efficiency of the heart
Cardiac Output is the measure of what? - ANSWER Volume of blood pumped by the heart in one minute
How is cardiac output calculated? - ANSWER Stroke volume x heart rate
Define Preload - ANSWER Elasticity of the heart when the ventricles are at max fill
Two factors contributing to DECREASE in preload - ANSWER 1. dehydration
2. vasodilation
,Define Afterload - ANSWER Resistant force that the ventricles must pump against. Work that the
ventricles must do to push blood through the aorta into the periphery of the body
Define Contractility - ANSWER The amount of force exerted by the heart with each contraction
Name one factor that decreases contractility in the heart - ANSWER hypoxemia
How does dopamine affect heart function - ANSWER increases contractility and stroke volume
Describe the conduction pathway of the heart - ANSWER SA node - Atrium - AV node - Bundle of His -
Ventricle - Purkinje Fibers
Define Chronic Heart Failure - ANSWER The hearts inability to pump oxygenated blood to the body due
to abnormalities in the heart and other areas of the body. Contributing to edema, resp. distress, activity
intolerance, and growth failure
Name 2 compensatory mechanisms of Chronic Heart Failure - ANSWER 1. Activation of the Sympathetic
Nervous System
2. Cardiac reserve; i.e. hypertrophy and dilation of cardiac muscle
Describe Right Sided Heart Failure - ANSWER RV is unable to pump blood efficiently into the Pulmonary
artery, so blood backs up into veins and periphery of body
Describe Left Sided Heart Failure - ANSWER LV is unable to effectively pump blood into aorta and out
into body, so blood backs up into pulmonary outlets and increases pressure in LA
Name 3 causes of Chronic Heart Failure in Children - ANSWER 1. Structural Abnormalities
2. Failure of the heart muscle
3. excessive demands on normal heart muscle
List Manifestations of Impaired Myocardial function - ANSWER 1. tachycardia
,2. Sweating
2. Decreased UOP
3. fatigue
4. anorexia
5. decrease interest in activities
6. cardiomegaly
7. pale/cool extremities
8. decreased BP
List manifestations of Right Sided Heart Failure - ANSWER 1. weight gain
2. edema
3. hepatomegaly
4. ascites
5. distended neck veins
List manifestations of Left Sided Heart Failure - ANSWER 1. Tachycardia
2. dyspnia
3. Activity intolerance
4. persistent cough
5. cyanosis
6. wheezing/grunting
7. orthopnea
What are treatment goals for heart failure - ANSWER 1. remove excess fluid
2. improve cardiac function
3. reduce respiratory distress
4. decrease cardiac demand
, What is the difference between Hypoxemia and hypoxia - ANSWER Hypoxemia is a measurable lab value
in which the arterial oxygen tension is below normal and can be measured by arterial O2 sats or Pa02,
while hypoxia is the decrease in tissue oxygenation resulting from low saturation levels
Clinical manifestations of hypoxemia - ANSWER -clubbing
-polycythemia
-fatigue w/ feeding
-poor weight gain
-squatting
-dyspnea
-tachypnea
What are measures to manage Hypoxemia? - ANSWER -O2
-prevent dehydration and monitor fluid status
-daily weights
-assess resp. status closely
-prevent infection
List the 4 main manifestations of Shock - ANSWER 1. circulatory failure
2. Metabolic acidosis
3. hypotension
4. hypoxemia
Describe the picture of Compensated Shock - ANSWER 1. Shunting occurs due to sympathetic activation
2. BP is normal initially
3. cool clammy skin/poor perfusion to periphery
4. decreased bowel sounds
5. decreased urine output
6. lactic acid build-up
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller wilmug. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $18.49. You're not tied to anything after your purchase.
