Deck 12: Cardiovascular Disorders

Question 1

Identify one or more choices that best complete the statement or answer the question.
The nurse works in a pediatric clinic with patients who have heart disease or who have undergone treatment for heart disease. The nurse is frequently asked about the need for prophylactic antibiotics for these patients during invasive dental care. Which patients does the nurse identify as being at risk for endocarditis and being in need of antibiotic therapy? Select all that apply.

A)A child with a prosthetic heart valve
B)A child with a congenital defect scheduled for surgical repair
C)A child who was previously diagnosed with endocarditis
D)A child with a confirmed diagnosis of rheumatic heart disease
E)A child who had a congenital heart defect repaired 9 months ago

Answer 1

A child with a prosthetic heart valve
A child with a congenital defect scheduled for surgical repair
A child who was previously diagnosed with endocarditis
A child with a confirmed diagnosis of rheumatic heart disease

Question 2

A 3-month-old infant is diagnosed with pulmonary stenosis. Which parent teaching does the nurse provide?

A)Options for treatment include a repair of the artery or the valve.
B)Balloon angioplasty is performed as an outpatient procedure.
C)Pulmonary stenosis repair can be delayed until 1 year of age.
D)After repair, the child is no longer at risk for cardiac problems.

Answer 2

Options for treatment include a repair of the artery or the valve.

Question 3

The nurse is providing care for a 12-year-old patient who is hospitalized with generalized weakness and muscle wasting, which began in the hips, pelvic area, thighs, and shoulders. The physician suspects Duchenne muscular dystrophy. Which action by the physician does the nurse expect?

A)Prescribe physical therapy to improve muscle strength.
B)Suggest homeschooling until the acute stage ends.
C)Perform an echocardiogram to evaluate cardiac functioning.
D)Perform muscle biopsies to identify the stage of the disease.

Answer 3

Perform an echocardiogram to evaluate cardiac functioning.

Question 4

The nurse is providing information to the parents of a toddler who is scheduled for surgery for the replacement of the pulmonic valve. The parents have many questions about the function of the valve. Which information from the nurse is correct?

A)The valve must work correctly to get oxygen from the lungs to the body.
B)If the valve does not work correctly, blood is kept from entering the heart.
C)When the valve is defective, the blood leaving the heart is decreased.
D)A defect in the valve causes less blood to get to the lungs for oxygenation.

Question 5

The nurse is performing a physical assessment on a 7-year-old child as a requirement for playing a sport at school. The nurse reports which assessment finding as abnormal and requests a follow-up from a primary care physician?

A)Systolic blood pressure is 84 mm Hg.
B)Systolic blood pressure is 90 mm Hg and diastolic is 20 mm Hg.
C)Pulse oximeter reading is 95% on room air.
D)PMI is at 4th or 5th intercostal space at the midclavicular line.

Question 6

The nurse is providing care for a neonate diagnosed with a cardiovascular disorder immediately after birth. When gathering assessment information from the mother, which comment will the nurse recognize as the most likely contributing factor for the defect?

A)"We live in the country, and we get all our water from a well."
B)"I quit my preschool job when a child was diagnosed with measles."
C)"The baby was born a week early; I hope that is not the cause."
D)"We were in a European country before pregnancy was confirmed."

Question 7

The nurse is aware the neonate's blood circulation is different before birth than after birth. Which circulation pattern does the nurse recognize as occurring prior to birth?

A)Oxygenated blood flows from the right atrium to the left atrium through the foramen ovale.
B)Oxygenated blood flows from the right ventricle to the lungs and then to the left ventricle.
C)For a short time after birth, the neonate continues to depend on the mother for oxygen supply.
D)Once the neonate takes a first breath, the ductus venosus closes and blood goes to the lungs.

Question 8

Identify one or more choices that best complete the statement or answer the question.
The nurse on a pediatric unit is providing care for a 5-year-old child diagnosed with congestive heart failure. The physician prescribes digoxin therapy. Which medication-focused interventions does the nurse include when creating a plan of care for the patient? Select all that apply.

A)Hold medication if an antibiotic is prescribed.
B)Evaluate parent's ability to obtain radial pulse.
C)Administer medication at the same time every day.
D)Administer 1 hour before or 2 hours after meals.
E)Replace medication if a dose is vomited within 1 hour.

Question 9

The parents are preparing to take their newborn, who was diagnosed with tetralogy of Fallot with pulmonary atresia, home. The nurse is developing a teaching sheet regarding care of the newborn for the parents. Which information does the nurse need to include in the teaching plan?

A)There is no need to limit activities.
B)It is important to maintain caloric intake.
C)No secondary complications are expected.
D)The neonate has natural immunity to infections.

Question 10

The nurse is teaching a pediatric electrocardiogram (EKG) class to nurses in a pediatric cardiac unit. Which anatomical structure does the nurse use to describe the initiation of cardiac electrical conduction?

A)The Purkinje fibers in the ventricles
B)The bundle branch in the left atrium
C)The sinoatrial node in the right atrium
D)The bundle of His in the ventricle walls

Question 11

The nurse is preparing an 8-year-old patient for a cardiac catheterization. Which intervention will the nurse initiate immediately postprocedure?

A)Observe for signs and symptoms of infection.
B)Hold food and fluids until gag reflex returns.
C)Keep the involved extremity straight for 4 to 6 hours.
D)Notify physician if green or yellow drainage is noted.

Question 12

Identify one or more choices that best complete the statement or answer the question.
The nurse in a pediatric office is aware that certain factors may be indicators of heart disease in children. Which children does the nurse recognize with manifestations related to heart disease? Select all that apply.

A)The newborn with dysmorphic facial features
B)The school-age patient with slow capillary refill
C)Identification of scoliosis in a new adolescent patient
D)An infant who is unable to meet developmental milestones
E)A toddler with clubbing and erythema of the fingers and toes

Question 13

Identify one or more choices that best complete the statement or answer the question.
The nurse is providing care for a 9-year-old patient who was recently diagnosed with cardiomyopathy after a viral infection. Which teaching does the nurse provide to the patient's parents about the diagnosed condition? Select all that apply.

A)Need for intensive care of the patient
B)Preparation for anticipatory grieving
C)The necessity for physical activity
D)Allowing patient to discuss feelings
E)Reasons for frequent medical visits

Question 14

The nurse is assisting with high school sports physicals. The nurse performs a physical assessment on a male student who is tall and thin, with disproportionately long arms. Which additional finding will prompt the nurse to recommend a cardiac evaluation?

A)Notable laxity of joints
B)Sparsity of body hair
C)Deep tone to the voice
D)Slow, rhythmic gait

Question 15

Identify one or more choices that best complete the statement or answer the question.
The pediatric nurse is providing care for a school-age patient diagnosed with rheumatic heart disease. When developing a plan of care for the patient's hospital stay, which interventions does the nurse include? Select all that apply.

A)Administer inflammatory and antibiotic medications as prescribed.
B)Assess for the presence of strep throat or other throat infections.
C)Include chest pain and heart palpation assessment with vital signs.
D)Begin patient/family teaching about the possibility of surgery.
E)Organize daily care and treatments to provide for joint pain relief.

Question 16

The nurse is reviewing medications for the treatment of a heart rhythm disorder in a patient who is 8 years of age. The parent of the patient states that the physician recently prescribed medication to treat the patient's attention deficit-hyperactivity disorder. Using knowledge of recent professional recommendations, which statement by the nurse is correct?

A)"We need to remind the physician there is a heart condition."
B)"Do not start the medication until I can check for safety warnings."
C)"Children with heart disorders have a higher incidence of ADHD."
D)"Giving the medication can cause death if there is a cardiac issue."

Question 17

Identify one or more choices that best complete the statement or answer the question.
A neonate became dusky and developed respiratory distress at the age of 4 days and is diagnosed with a hypoplastic left heart. The surgeon obtains an informed consent from the parents to perform emergency surgery. Which information will the nurse provide to promote parental understanding? Select all that apply.

A)The left side of the neonate's heart did not develop correctly.
B)The function of left side of the heart is to pump blood to the body.
C)Provide reassurance to the parents that surgery will fix the problem.
D)Share that medical management of the condition is needed for one year.
E)A normally existing hole in the wall of the heart at birth will be enlarged.

Question 18

The nurse is providing care for a neonate diagnosed with tetralogy of Fallot. Prostaglandin E1 therapy is prescribed to keep the foramen ovale and the ductus arteriosus open. Which is the most important intervention for the nurse to include in the neonate's plan of care?

A)Maintain a separate IV access for continuous administration of the medication.
B)Watch for respiratory distress or apnea after adding medication to the breathing tube.
C)Monitor for and document evidence of flushing, bradycardia, and irritability as expected.
D)Monitor weight and adjust the dosage using a scale of 0.05 to 0.1 mcg/kg/min IV infusion.

Question 19

Identify one or more choices that best complete the statement or answer the question.
A new mother brings her 2-week-old neonate to the pediatrician's office, stating, "I think something is wrong with my baby." When the infant is undressed, the nurse notices signs of possible cardiac problems. Which assessment findings support the nurse's suspicions? Select all that apply.

A)Prolonged capillary refill time
B)Bluish tinge to oral structures
C)Peripheral cyanosis of left leg
D)Amount of urinary output
E)Mottled appearance of skin

Question 20

Identify one or more choices that best complete the statement or answer the question.
A parent brings a 2-year-old child with a fever and a rash to the pediatric clinic. The health-care provider suggests the child may have one of several conditions that present with similar symptoms, but wants to rule out Kawasaki disease. Which tests does the nurse expect to be performed? Select all that apply.

A)Chest x-ray
B)White blood cell count
C)Allergy testing
D)Baseline echocardiograms
E)MRI of the chest