Question 1

A child develops carditis from rheumatic fever.Which areas of the heart are affected by carditis?

Accepted Answer

The tissues that cover the heart and heart valves are affected.The heart muscle may be involved and the mitral valve is frequently involved.

Question 2

Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin)to an infant?

Accepted Answer

As a rule,if the pulse rate of an infant is below 100 beats/min,the medication is withheld and the physician is notified.

Question 3

What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol?

Accepted Answer

For a child with increased cholesterol a fat reduction of 25-35% of total calories with less than 75 saturated fat and less than 200 mg of cholesterol per day is advised.

Question 4

A child with rheumatic fever begins involuntary,purposeless movements of her limbs.What does the nurse recognize that this indicates?

Accepted Answer

As the effects of rheumatic fever affect the central nervous system,the child may develop Sydenham's chorea,manifested by involuntary,purposeless movements of the limbs.

Question 5

A child has an elevated antistreptolysin O (ASO)titer.Which combination of symptoms,in conjunction with this finding,would confirm a diagnosis of rheumatic fever?

Accepted Answer

The presence of two major Jones criteria would indicate a high probability of rheumatic fever.

Question 6

A father asks why his child with tetralogy of Fallot seems to favor a squatting position.What is the nurse's best response?

Accepted Answer

The squatting position allows the child to breathe more easily because systemic venous return is increased.

Question 7

An infant is experiencing dyspnea related to patent ductus arteriosus (PDA).What does the nurse understand regarding why dyspnea occurs?

Accepted Answer

When PDA is present,oxygenated blood recycles through the lungs,overburdening the pulmonary circulation.

Question 8

The nurse is planning a hypertension-prevention program.What should be the main focus of the nurse when presenting information?

Accepted Answer

The main focus of a hypertension-prevention program is patient education.

Question 9

The parent of a 1-year-old child with tetralogy of Fallot asks the nurse,"Why do my child's fingertips look like that?" On what understanding does the nurse base a response?

Accepted Answer

Clubbing of the fingers develops in response to chronic hypoxia.

Question 10

What is accurate about the characteristics of high-density lipoproteins (HDLs)?

Accepted Answer

HDLs have low amounts of triglycerides,large amounts of proteins,low amount of cholesterol,and are excreted via the liver.They have no role in the production of steroids.

Question 11

Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?

Accepted Answer

Fatigue during feeding or activity is common to most infants with congenital cardiac problems.

Question 12

Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood?

Accepted Answer

Because the right side of the heart must take over pumping blood to both the lungs and systemic circulation,the ductus arteriosus must remain open to shunt the oxygenated blood from the lungs.

Question 13

An infant with congestive heart failure is receiving digoxin (Lanoxin).What does the nurse recognize as a sign of digoxin toxicity?

Accepted Answer

Symptoms of digoxin toxicity include: nausea,vomiting,anorexia,irregularity in pulse rate and rhythm,and a sudden change in pulse.

Question 14

How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G?

Accepted Answer

Children who recover from rheumatic fever should have a chemoprophylaxis protocol of penicillin G injections (about 200,000 units per dose)for a minimum of 5 years or up to the age of 18 to prevent further bouts of rheumatic fever.

Question 15

A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur.What diagnostic test does the nurse anticipate?

Accepted Answer

Echocardiography is a noninvasive procedure that localizes murmurs and determines if theheart is structurally normal.

Question 16

The nurse is caring for a child with a diagnosis of Kawasaki disease.The child's parent asks the nurse,"How does Kawasaki disease affect my child's heart and blood vessels?" On what understanding is the nurse's response based?

Accepted Answer

Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.

Question 17

Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?

Accepted Answer

A loud,harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.

Question 18

The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic.Which statement by the father leads the nurse to determine he understood the instructions?

Accepted Answer

In the event of a paroxysmal hypercyanotic or "tet" spell,the infant should be placed in a knee-chest position.

Question 19

What does the nurse explain that a ventricular septal defect will allow?

Accepted Answer

Pulmonary blood flow is increased when a ventricular septal defect exists.The blood shifts from left to right because of the higher pressure in the left ventricle.This particular shift does not cause cyanosis.

Question 20

What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?

Accepted Answer

The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses between the upper and lower extremities.Pressure is increased proximal to the defect and decreased distal to the coarctation.

Quiz 26: The Child with a Cardiovascular Disorder