Deck 48: The Child With Alterations in Cardiovascular Function

Question 1

The nurse is checking peripheral perfusion to a child's extremity following a cardiac catheterization. If there is adequate peripheral circulation, the nurse would find that the extremity:

A)Has a capillary refill of greater than three seconds.
B)Is warm, with a capillary refill of less than three seconds.
C)Has decreased sensation with a weakened dorsalis pedis pulse.
D)Has a palpable dorsalis pedis pulse but a weak posterior tibial pulse.

Answer 1

Is warm, with a capillary refill of less than three seconds.

Question 2

The nurse is teaching the parents of a group of cardiac patients. The nurse includes in the information that any child who has undergone cardiac surgery:

A)Should not receive routine immunizations.
B)Should be restricted from most play activities.
C)Can be expected to have a fever for several weeks following the surgery.
D)Should receive prophylactic antibiotics for any dental, oral, or upper respiratory tract procedures.

Answer 2

Should receive prophylactic antibiotics for any dental, oral, or upper respiratory tract procedures.

Question 3

A child diagnosed with congestive heart failure is started on digoxin (Lanoxin) and spironolactone (Aldactone). The mother questions why the child was placed on spironolactone (Aldactone) instead of furosemide (Lasix), which her elderly grandmother uses. The nurse explains that spironolactone (Aldactone) is a diuretic that:

A)Produces rapid diuresis.
B)Blocks reabsorption of sodium and water in renal tubules.
C)Spares potassium.
D)Promotes vascular relaxation.

Answer 3

Spares potassium.

Question 4

A child has had a heart transplant. In preparation for discharge, the nurse provides teaching about home medications. The nurse recognizes that postoperative teaching has been successful when the parents state that the child is on cyclosporin A to:

A)Treat hypertension.
B)Reduce serum cholesterol level.
C)Prevent rejection.
D)Treat infections.

Question 5

A 10-month-old infant is seen in the emergency department for a heart rate of 226 beats per minute. Supraventricular tachycardia is diagnosed. The emergency department nurse will prepare to assist with which possible treatments?

A)Administration of intravenous adenosine (Adenocard)
B)Administration of intravenous amiodarone (Cardarone)
C)Preparation for cardioversion
D)Application of ice to the face
E)Having the child perform a Valsalva maneuver

Question 6

A diagnosis of rheumatic fever is being ruled out for a child. The parents cannot remember the child having a recent streptococcal infection. Which lab test would confirm a recent streptococcal infection?

A)Erythrocyte sedimentation rate
B)Throat culture
C)C-reactive protein
D)Antistreptolysin-O (ASO) titer

Question 7

A two-month-old infant with a congenital heart defect has been admitted to the pediatric intensive care unit with congestive heart failure. Nursing care for this child should include which intervention?

A)Monitor respirations during active periods.
B)Give larger feedings less often to conserve energy.
C)Organize activities to allow for uninterrupted sleep.
D)Force fluids appropriate for age.

Question 8

A child has been admitted to the hospital unit in congestive heart failure (CHF). Symptoms related to this admission diagnosis would include:

A)Tachycardia.
B)Weight loss.
C)Increased blood pressure.
D)Bradycardia.

Question 9

A toddler has been started on digoxin (Lanoxin) for cardiac failure. The nurse will teach the parents to monitor the child for signs of digoxin (Lanoxin) toxicity including:

A)Bradycardia.
B)Tinnitus.
C)Ataxia.
D)Lowered blood pressure.

Question 10

An infant has been diagnosed with a mild heart defect. Surgery to correct the defect will not be performed for at least two years. The nurse teaches the parents that a child with a mild heart defect should:

A)Have a low-grade fever until the defect is repaired.
B)Maintain normal activity.
C)Not develop congestive heart failure.
D)Not be given antipyretics.

Question 11

A term infant is found to have a congenital heart defect. During a cardiac catheterization, a stent is inserted to maintain the ductus arteriosus. The parents ask the nurse to explain the purpose of this procedure. The nurse's response would include the information that the stent:

A)Will keep the ductus arteriosus open and oxygenated and unoxygenated blood mixed.
B)Is used to close the ductus arteriosus to prevent mixing of arterial and venous blood.
C)Will redirect the blood so that blood bypasses the right ventricle.
D)Connects the ventricle to the atrium.

Question 12

Following an automobile accident, an eight-year-old child is admitted to the emergency department with injuries that lead to hemorrhaging. The nurse would recognize the early signs of hypovolemic shock would include:

A)Increased work of breathing.
B)Pulse rate of 56.
C)Heart rate 130.
D)Capillary refill time greater than three seconds.
E)Blood pressure 72/42.

Question 13

An infant with a congenital heart defect is being discharged home until the infant reaches an appropriate weight for the corrective surgery. The nurse would teach the parents infant feeding techniques including:

A)Breastfeed if possible.
B)Complete each feeding within 30 minutes.
C)Position the infant flat to promote swallowing.
D)Dilute the formula with extra water to ensure adequate fluid intake.
E)Burp the infant frequently.

Question 14

Which athletic activity could the nurse recommend for a school-age child with pulmonary-artery hypertension?

A)Golf
B)Basketball
C)Cross-country running
D)Soccer

Question 15

A four-year-old child is being emotionally prepared for open heart surgery. The nurse will want to provide the child with which information?

A)Who will be performing the surgery
B)What the surgical procedure will entail
C)The purpose of the heart-lung machine
D)What the ICU will look and sound like when the child wakes up

Question 16

An infant with tetralogy of Fallot (TOF) is having a hypercyanotic episode ("tet" spell). Which nursing interventions should the nurse implement?

A)Administer oxygen.
B)Place the child in knee-chest position.
C)Administer morphine and propranolol intravenously as ordered.
D)Draw blood for a serum hemoglobin.
E)Administer Benadryl as ordered.

Question 17

The nurse has admitted a child with a cyanotic heart defect. Which initial lab result will the nurse anticipate?

A)A low platelet count
B)A high white blood cell count
C)A high hemoglobin
D)A low hematocrit

Question 18

The nurse finds that an infant has stronger pulses in the upper extremities than in the lower extremities and higher blood pressure readings in the arms than in the legs. This could be indicative of what heart defect?

A)Transposition of the great vessels
B)Patent ductus arteriosus
C)Coarctation of the aorta
D)Atrial septal defect

Question 19

The nurse has admitted a child with a ventricular septal defect (VSD) to the unit. Which nursing diagnosis is appropriate for this child?

A)Hypothermia related to decreased metabolic state
B)Acute pain related to the effects of a congenital heart defect
C)Ineffective tissue perfusion (peripheral) related to cyanosis secondary to congenital heart defect
D)Impaired gas exchange related to pulmonary congestion secondary to the increased pulmonary blood flow

Question 20

Following an injury that led to hypovolemic shock, a child is being treated in the emergency department. Which treatment measures would be given the highest priority for this child with hypovolemic shock?

A)Assess the cause of bleeding.
B)Establish an open airway and administer oxygen.
C)Administer analgesics for control of pain.
D)Provide replacement of volume.

Question 21

A child is admitted to the hospital unit with a diagnosis of Kawasaki disease. The physician writes the following orders. Which order would the nurse question?

A)Contact isolation
B)Oral aspirin (dose appropriate for weight) every eight hours
C)Echocardiogram
D)Vital signs every four hours

Question 22

A seven-year-old girl has been diagnosed with rheumatic fever. The physician has talked with the parents and child and explained the disease and the planned medical treatment. Which statement by the parents needs further clarification?

A)"I understand rheumatic fever is a strep infection of the heart."
B)"My child will be on bed rest for several weeks."
C)"My child will be treated with aspirin and/or corticosteroids."
D)"Once my child has recovered, she will still need to be monitored for sequelae to the disease."

Question 23

The nurse is teaching parents about caring for their child after cardiac surgery. Which of the following should be included in the instructions?

A)The child will have a fever for several weeks following the surgery.
B)The child will be restricted from most play activities.
C)The child will not receive routine immunizations.
D)The child will receive prophylactic antibiotics for any dental, oral, or upper respiratory tract procedures.

Question 24

The nurse is off-duty and watching a youth baseball game when one of the players gets hit in the chest with a ball. The child immediately drops to the ground and is unresponsive. What is the priority action for the nurse to initiate?

A)Initiate CPR.
B)Call 911.
C)Find the parents and offer them comfort.
D)Check the child for hemorrhage.