Deck 47: Cardiovascular Dysfunction
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Deck 47: Cardiovascular Dysfunction
1
An 8-month-old infant has a hypercyanotic spell while blood is being drawn.What is the nurse's initial action?
A) Assess for neurological defects.
B) Place the child in the knee-chest position.
C) Begin cardiopulmonary resuscitation.
D) Prepare the family for imminent death.
A) Assess for neurological defects.
B) Place the child in the knee-chest position.
C) Begin cardiopulmonary resuscitation.
D) Prepare the family for imminent death.
Place the child in the knee-chest position.
2
What should the nurse do when suctioning a young child who has had heart surgery?
A) Perform suctioning at least every hour.
B) Suction for no longer than 30 seconds at a time.
C) Administer supplemental oxygen before and after suctioning.
D) Expect symptoms of respiratory distress when suctioning.
A) Perform suctioning at least every hour.
B) Suction for no longer than 30 seconds at a time.
C) Administer supplemental oxygen before and after suctioning.
D) Expect symptoms of respiratory distress when suctioning.
Administer supplemental oxygen before and after suctioning.
3
Which drug is an angiotensin-converting enzyme (ACE)inhibitor?
A) Captopril (Capoten)
B) Furosemide (Lasix)
C) Spironolactone (Aldactone)
D) Chlorothiazide (Diuril)
A) Captopril (Capoten)
B) Furosemide (Lasix)
C) Spironolactone (Aldactone)
D) Chlorothiazide (Diuril)
Captopril (Capoten)
4
When preparing a school-age child and the family for heart surgery,what should the nurse consider?
A) Don't show the child unfamiliar equipment.
B) Let the child hear the sounds of an electrocardiograph monitor.
C) Avoid mentioning postoperative discomfort and interventions.
D) Explain that an endotracheal tube will not be needed if the surgery goes well.
A) Don't show the child unfamiliar equipment.
B) Let the child hear the sounds of an electrocardiograph monitor.
C) Avoid mentioning postoperative discomfort and interventions.
D) Explain that an endotracheal tube will not be needed if the surgery goes well.
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5
A chest x-ray is ordered for a child with suspected cardiac problems.The child's parent asks the nurse,"What will the radiograph show about the heart?" What knowledge about the x-ray film should the nurse base her response on?
A) It will show the bones of the chest but not the heart.
B) It will measure electrical potential generated by the heart muscle.
C) It will provide a permanent record of heart size and configuration.
D) It will provide a computerized image of heart vessels and tissues.
A) It will show the bones of the chest but not the heart.
B) It will measure electrical potential generated by the heart muscle.
C) It will provide a permanent record of heart size and configuration.
D) It will provide a computerized image of heart vessels and tissues.
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6
What is a beneficial effect of administering digoxin (Lanoxin)?
A) It decreases edema.
B) It decreases cardiac output.
C) It increases heart size.
D) It increases venous pressure.
A) It decreases edema.
B) It decreases cardiac output.
C) It increases heart size.
D) It increases venous pressure.
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7
Seventy-two hours after cardiac surgery,a young child has a temperature of 37.7°C.What should the nurse do?
A) Keep the child warm with blankets.
B) Apply a hypothermia blanket.
C) Record the temperature on the nurses' notes.
D) Report these findings to the physician.
A) Keep the child warm with blankets.
B) Apply a hypothermia blanket.
C) Record the temperature on the nurses' notes.
D) Report these findings to the physician.
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8
Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion.What knowledge should inform the nurse's reply?
A) The child needs opportunities to play with peers.
B) The child needs to understand that peers' activities are too strenuous.
C) Parents can meet all the child's needs.
D) Constant parental supervision is needed to avoid overexertion.
A) The child needs opportunities to play with peers.
B) The child needs to understand that peers' activities are too strenuous.
C) Parents can meet all the child's needs.
D) Constant parental supervision is needed to avoid overexertion.
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9
As part of the treatment for heart failure,the child takes the diuretic furosemide.When teaching home care,the nurse encourages the family to give the child foods such as bananas,oranges,and leafy vegetables.What are these foods high in?
A) Chlorides
B) Potassium
C) Sodium
D) Vitamins
A) Chlorides
B) Potassium
C) Sodium
D) Vitamins
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10
What is a clinical manifestation of the systemic venous congestion that can occur with heart failure?
A) Tachypnea
B) Tachycardia
C) Peripheral edema
D) Pale,cool extremities
A) Tachypnea
B) Tachycardia
C) Peripheral edema
D) Pale,cool extremities
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11
Which is best described as the heart's inability to pump an adequate amount of blood to the systemic circulation at normal filling pressures?
A) Pulmonary congestion
B) Congenital heart defect
C) Heart failure
D) Systemic venous congestion
A) Pulmonary congestion
B) Congenital heart defect
C) Heart failure
D) Systemic venous congestion
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12
The parents of a young child with heart failure tell the nurse that they are "nervous" about giving digoxin.What knowledge should the nurse include in her response?
A) It is a safe,frequently used drug.
B) It is difficult to either overmedicate or undermedicate with digoxin.
C) Parents lack the expertise necessary to administer digoxin.
D) Parents must learn specific,important guidelines for administration of digoxin.
A) It is a safe,frequently used drug.
B) It is difficult to either overmedicate or undermedicate with digoxin.
C) Parents lack the expertise necessary to administer digoxin.
D) Parents must learn specific,important guidelines for administration of digoxin.
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13
Which is a common sign of digoxin toxicity?
A) Seizures
B) Vomiting
C) Bradypnea
D) Tachycardia
A) Seizures
B) Vomiting
C) Bradypnea
D) Tachycardia
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14
The nurse is caring for a child after heart surgery.What should be done if there is evidence of cardiac tamponade?
A) Increase analgesia.
B) Apply warming blankets.
C) Immediately report this to the physician.
D) Encourage the child to cough,turn,and breathe deeply.
A) Increase analgesia.
B) Apply warming blankets.
C) Immediately report this to the physician.
D) Encourage the child to cough,turn,and breathe deeply.
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15
A 4-year-old child is scheduled for a cardiac catheterization.Which statement reflects the correct way for the nurse to provide preoperative teaching?
A) It should be given to his parents because he is too young to understand.
B) It should be detailed in regard to the actual procedures so he will know what to expect.
C) It should be done several days before the procedure so that he will be prepared.
D) It should be adapted to his level of development so that he can understand.
A) It should be given to his parents because he is too young to understand.
B) It should be detailed in regard to the actual procedures so he will know what to expect.
C) It should be done several days before the procedure so that he will be prepared.
D) It should be adapted to his level of development so that he can understand.
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16
Which structural defects constitute tetralogy of Fallot?
A) Pulmonic stenosis,ventricular septal defect,overriding aorta,right ventricular hypertrophy
B) Aortic stenosis,ventricular septal defect,overriding aorta,right ventricular hypertrophy
C) Aortic stenosis,atrial septal defect,overriding aorta,left ventricular hypertrophy
D) Pulmonic stenosis,ventricular septal defect,aortic hypertrophy,left ventricular hypertrophy
A) Pulmonic stenosis,ventricular septal defect,overriding aorta,right ventricular hypertrophy
B) Aortic stenosis,ventricular septal defect,overriding aorta,right ventricular hypertrophy
C) Aortic stenosis,atrial septal defect,overriding aorta,left ventricular hypertrophy
D) Pulmonic stenosis,ventricular septal defect,aortic hypertrophy,left ventricular hypertrophy
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17
The nurse is caring for a school-age girl who has had a cardiac catheterization.The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood.What is the priority nursing action?
A) Notify the physician.
B) Apply a new bandage with more pressure.
C) Place the girl in the Trendelenburg position.
D) Apply direct pressure above the catheterization site.
A) Notify the physician.
B) Apply a new bandage with more pressure.
C) Place the girl in the Trendelenburg position.
D) Apply direct pressure above the catheterization site.
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18
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect.The nurse recognizes that a risk of cerebrovascular accidents (strokes)exists.What is an important objective to decrease this risk?
A) Minimize seizures.
B) Prevent dehydration.
C) Promote cardiac output.
D) Reduce energy expenditure.
A) Minimize seizures.
B) Prevent dehydration.
C) Promote cardiac output.
D) Reduce energy expenditure.
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19
Which defect results in increased pulmonary blood flow?
A) Pulmonic stenosis
B) Tricuspid atresia
C) Atrial septal defect
D) Transposition of the great arteries
A) Pulmonic stenosis
B) Tricuspid atresia
C) Atrial septal defect
D) Transposition of the great arteries
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20
Which complication may occur after a cardiac catheterization?
A) Transient dysrhythmias
B) Hypostatic pneumonia
C) Heart failure
D) Rapidly increasing blood pressure
A) Transient dysrhythmias
B) Hypostatic pneumonia
C) Heart failure
D) Rapidly increasing blood pressure
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21
Which occurs in septic shock?
A) Hypothermia
B) Increased cardiac output
C) Vasoconstriction
D) Angioneurotic edema
A) Hypothermia
B) Increased cardiac output
C) Vasoconstriction
D) Angioneurotic edema
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22
Which is one of the most frequent causes of hypovolemic shock in children?
A) Sepsis
B) Blood loss
C) Anaphylaxis
D) Congenital heart disease
A) Sepsis
B) Blood loss
C) Anaphylaxis
D) Congenital heart disease
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23
Which clinical manifestation does the nurse expect to see as shock progresses and becomes decompensated shock in a child?
A) Thirst and diminished urinary output
B) Irritability and apprehension
C) Tachypnea and poor capillary refill time
D) Normal blood pressure and narrowing pulse pressure
A) Thirst and diminished urinary output
B) Irritability and apprehension
C) Tachypnea and poor capillary refill time
D) Normal blood pressure and narrowing pulse pressure
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24
Which are characteristics of hypovolemic shock? Select all that apply.Express answer in small letters followed by a comma and a space-e.g. ,a,b,c
A) Reduction in peripheral vascular resistance
B) Falling blood pressure
C) Poor capillary filling
D) Increased venous capacity and pooling
E) Decreased cardiac output
F) Low central venous pressure
A) Reduction in peripheral vascular resistance
B) Falling blood pressure
C) Poor capillary filling
D) Increased venous capacity and pooling
E) Decreased cardiac output
F) Low central venous pressure
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25
What is the most common causative agent of bacterial endocarditis?
A) Staphylococcus albus
B) Streptococcus hemolyticus
C) Staphylococcus albicans
D) Streptococcus viridans
A) Staphylococcus albus
B) Streptococcus hemolyticus
C) Staphylococcus albicans
D) Streptococcus viridans
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26
What is the most important thing for the nurse to know when caring for a child with Kawasaki disease?
A) The child's fever is usually responsive to antibiotics within 48 hours.
B) The principal area of involvement is the joints.
C) Aspirin is contraindicated.
D) Therapeutic management includes administration of gamma globulin and aspirin.
A) The child's fever is usually responsive to antibiotics within 48 hours.
B) The principal area of involvement is the joints.
C) Aspirin is contraindicated.
D) Therapeutic management includes administration of gamma globulin and aspirin.
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27
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting.While an airway is being established,what medication should the nurse prepare for immediate administration?
A) Diphenhydramine (Benadryl)
B) Dopamine
C) Epinephrine
D) Calcium chloride
A) Diphenhydramine (Benadryl)
B) Dopamine
C) Epinephrine
D) Calcium chloride
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28
Which is an appropriate nursing intervention for a child after a cardiac catheterization?
A) Allow ambulation as tolerated.
B) Monitor vital signs every 2 hours.
C) Assess the affected extremity for temperature and colour.
D) Check pulses above the catheterization site for equality and symmetry.
A) Allow ambulation as tolerated.
B) Monitor vital signs every 2 hours.
C) Assess the affected extremity for temperature and colour.
D) Check pulses above the catheterization site for equality and symmetry.
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29
When discussing hyperlipidemia with a group of adolescents,the nurse should explain that high levels of what substance are thought to protect against cardiovascular disease?
A) Cholesterol
B) Triglycerides
C) Low-density lipoproteins (LDLs)
D) High-density lipoproteins (HDLs)
A) Cholesterol
B) Triglycerides
C) Low-density lipoproteins (LDLs)
D) High-density lipoproteins (HDLs)
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30
What is a common,serious complication of rheumatic fever?
A) Seizures
B) Cardiac arrhythmias
C) Pulmonary hypertension
D) Cardiac valve damage
A) Seizures
B) Cardiac arrhythmias
C) Pulmonary hypertension
D) Cardiac valve damage
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31
What is the name of the painful,pea-sized nodules that may appear on the pads of the fingers or toes in bacterial endocarditis?
A) Osler nodes
B) Janeway lesions
C) Subcutaneous nodules
D) Aschoff nodes
A) Osler nodes
B) Janeway lesions
C) Subcutaneous nodules
D) Aschoff nodes
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32
What is the leading cause of death after heart transplantation?
A) Infection
B) Rejection
C) Cardiomyopathy
D) Congestive heart failure
A) Infection
B) Rejection
C) Cardiomyopathy
D) Congestive heart failure
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33
What is one important thing the nurse should do when removing chest tubes from a child?
A) Explain that it is not painful.
B) Explain that only a Band-Aid will be needed.
C) Administer analgesics before the procedure.
D) Expect bright red drainage for several hours after removal.
A) Explain that it is not painful.
B) Explain that only a Band-Aid will be needed.
C) Administer analgesics before the procedure.
D) Expect bright red drainage for several hours after removal.
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34
What type of shock is characterized by a hypersensitive reaction causing massive vasodilation and capillary leaks that may occur with a drug or latex allergy?
A) Neurogenic shock
B) Cardiogenic shock
C) Hypovolemic shock
D) Anaphylactic shock
A) Neurogenic shock
B) Cardiogenic shock
C) Hypovolemic shock
D) Anaphylactic shock
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35
What is a major clinical manifestation of rheumatic fever?
A) Chorea
B) Osler nodes
C) Janeway spots
D) Splinter hemorrhages of the distal third of nails
A) Chorea
B) Osler nodes
C) Janeway spots
D) Splinter hemorrhages of the distal third of nails
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36
What is the primary nursing intervention for preventing bacterial endocarditis?
A) Institute measures to prevent dental procedures.
B) Counsel parents of high-risk children about prophylactic antibiotics.
C) Observe children for complications such as embolism and heart failure.
D) Encourage restricted mobility in susceptible children.
A) Institute measures to prevent dental procedures.
B) Counsel parents of high-risk children about prophylactic antibiotics.
C) Observe children for complications such as embolism and heart failure.
D) Encourage restricted mobility in susceptible children.
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