Deck 46: The Child With a Cardiovascular Alteration

Question 1

What is the nurse's first action when planning to teach the parents of an infant with a CHD?

A) Assess the parents' anxiety level and readiness to learn.
B) Gather literature for the parents.
C) Secure a quiet place for teaching.
D) Discuss the plan with the nursing team.

Answer 1

Assess the parents' anxiety level and readiness to learn.

Question 2

A child had an aortic stenosis defect surgically repaired 6 months ago.Which antibiotic prophylaxis is indicated for an upcoming tonsillectomy?

A) No antibiotic prophylaxis is necessary.
B) Amoxicillin is taken orally 1 hour before the procedure.
C) Oral penicillin is given for 7 to 10 days before the procedure.
D) Parenteral antibiotics are administered for 5 to 7 days after the procedure.

Answer 2

Amoxicillin is taken orally 1 hour before the procedure.

Question 3

Which postoperative intervention should be questioned for a child after a cardiac catheterization?

A) Continue intravenous (IV) fluids until the infant is tolerating oral fluids.
B) Check the dressing for bleeding.
C) Assess peripheral circulation on the affected extremity.
D) Keep the affected leg flexed and elevated.

Answer 3

Keep the affected leg flexed and elevated.

Question 4

Before preparing a teaching plan for the parents of an infant with ductus arteriosus,it is important that the nurse understands this condition.Which statement best describes patent ductus arteriosus?

A) Patent ductus arteriosus involves a defect that results in a right-to-left shunting of blood in the heart.
B) Patent ductus arteriosus involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close.
C) Patent ductus arteriosus is a stenotic lesion that must be surgically corrected at birth.
D) Patent ductus arteriosus causes an abnormal opening between the four chambers of the heart.

Question 5

In which situation is there a risk that a newborn infant will have a congenital heart defect (CHD)?

A) Trisomy 21 detected on amniocentesis
B) Family history of myocardial infarction
C) Father has type 1 diabetes mellitus
D) Older sibling born with Turner syndrome

Question 6

For what reason might a newborn infant with a cardiac defect,such as coarctation of the aorta,that results in a right-to-left shunt receive prostaglandin E₁?

A) To decrease inflammation
B) To control pain
C) To decrease respirations
D) To improve oxygenation

Question 7

Nursing care for the child in congestive heart failure includes

A) Counting the number of saturated diapers
B) Putting the infant in the Trendelenburg position
C) Removing oxygen while the infant is crying
D) Organizing care to provide rest periods

Question 8

Before giving a dose of digoxin (Lanoxin),the nurse checked an infant's apical heart rate and it was 114 bpm.What should the nurse do next?

A) Administer the dose as ordered.
B) Hold the medication until the next dose.
C) Wait and recheck the apical heart rate in 30 minutes.
D) Notify the physician about the infant's heart rate.

Question 9

A child with pulmonary atresia exhibits cyanosis with feeding.On reviewing this child's laboratory values,the nurse is not surprised to notice which abnormality?

A) Polycythemia
B) Infection
C) Dehydration
D) Anemia

Question 10

Which CHD results in increased pulmonary blood flow?

A) Ventricular septal defect
B) Coarctation of the aorta
C) Tetralogy of Fallot
D) Pulmonary stenosis

Question 11

The nurse discovers a heart murmur in an infant 1 hour after birth.She is aware that fetal shunts are closed in the neonate at what point?

A) When the umbilical cord is cut
B) Within several days of birth
C) Within a month after birth
D) By the end of the first year of life

Question 12

When assessing a child for possible congenital heart defects (CHDs),where should the nurse measure blood pressure?

A) The right arm
B) The left arm
C) All four extremities
D) Both arms while the child is crying

Question 13

What is the appropriate priority nursing action for the infant with a CHD who has an increased respiratory rate,is sweating,and is not feeding well?

A) Recheck the infant's blood pressure.
B) Alert the physician.
C) Withhold oral feeding.
D) Increase the oxygen rate.

Question 14

What is an expected assessment finding in a child with coarctation of the aorta?

A) Orthostatic hypotension
B) Systolic hypertension in the lower extremities
C) Blood pressure higher on the left side of the body
D) Disparity in blood pressure between the upper and lower extremities

Question 15

The nurse is admitting a child to the hospital for a cardiac workup.What is the first step in a cardiac assessment?

A) Percussion
B) Palpation
C) Auscultation
D) History and inspection

Question 16

The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur.This finding is associated with which congenital heart defect?

A) Pulmonary stenosis
B) Patent ductus arteriosus
C) Ventricular septal defect
D) Coarctation of the aorta

Question 17

Which information should be included in the nurse's discharge instructions for a child who underwent a cardiac catheterization earlier in the day?

A) Pressure dressing is changed daily for the first week.
B) The child may soak in the tub beginning tomorrow.
C) Contact sports can be resumed in 2 days.
D) The child can return to school on the third day after the procedure.

Question 18

What intervention should be included in the plan of care for an infant with the nursing diagnosis of Excess Fluid Volume related to congestive heart failure?

A) Weigh the infant every day on the same scale at the same time.
B) Notify the physician when weight gain exceeds more than 20 g/day.
C) Put the infant in a car seat to minimize movement.
D) Administer digoxin (Lanoxin) as ordered by the physician.

Question 19

Which statement made by a parent indicates understanding of restrictions for a child after cardiac surgery?

A) "My child needs to get extra rest for a few weeks."
B) "My son is really looking forward to riding his bike next week."
C) "I'm so glad we can attend religious services as a family this coming Sunday."
D) "I am going to keep my child out of daycare for 6 weeks."

Question 20

Which statement suggests that a parent understands how to correctly administer digoxin?

A) "I measure the amount I am supposed to give with a teaspoon."
B) "I put the medicine in the baby's bottle."
C) "When she spits up right after I give the medicine, I give her another dose."
D) "I give the medicine at 8 in the morning and evening every day."

Question 21

A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery.The nurse instructs the parents to notify the physician if what condition occurs? Select all that apply.

A) Respiratory rate of 36 at rest
B) Appetite slowly increasing
C) Temperature above 37.7° C (100° F)
D) New, frequent coughing
E) Turning blue or bluer than normal

Question 22

Which defect results in increased pulmonary blood flow?

A) Pulmonic stenosis
B) Tricuspid atresia
C) Atrial septal defect
D) Transposition of the great arteries

Question 23

As a nurse working in the newborn nursery,you notice an infant who is having circumoral cyanosis.Which CHD do you suspect the child may have? Select all that apply.

A) Patent ductus arteriosus (PDA)
B) Tetralogy of Fallot
C) Pulmonary atresia
D) Transposition of the great arteries
E) Ventricular septal defect

Question 24

A child has a total cholesterol level of 180 mg/dL.What dietary recommendations should the nurse make to the child and the child's parents? Select all that apply.

A) Replace whole milk for 2% or 1% milk.
B) Increase servings of red meat.
C) Increase servings of fish.
D) Avoid excessive intake of fruit juices.
E) Limit servings of whole grain.

Question 25

A nurse is assigned to care for an infant with an unrepaired tetralogy of Fallot.What should the nurse do first when the baby is crying and becomes severely cyanotic?

A) Place the infant in a knee-chest position.
B) Administer oxygen.
C) Administer morphine sulfate.
D) Calm the infant.

Question 26

The nurse caring for a child diagnosed with acute rheumatic fever should assess the child for

A) Sore throat
B) Elevated blood pressure
C) Desquamation of the fingers and toes
D) Tender, warm, inflamed joints

Question 27

Which strategy is appropriate when feeding the infant with congestive heart failure?

A) Continue the feeding until a sufficient amount of formula is taken.
B) Limit feeding time to no more than 30 minutes.
C) Always bottle feed every 4 hours.
D) Feed larger volumes of concentrated formula less frequently.

Question 28

A nurse is conducting a class for nursing students about fetal circulation.Which statement is accurate about fetal circulation and should be included in the teaching session?

A) Oxygen is carried to the fetus by the umbilical arteries.
B) Blood from the inferior vena cava is shunted directly to the right ventricle through the foramen ovale.
C) Pulmonary vascular resistance is high because the lungs are filled with fluid.
D) Blood flows from the ductus arteriosus to the pulmonary artery.

Question 29

What should the nurse include in discharge teaching as the highest priority for the child with a cardiac dysrhythmia?

A) CPR instructions
B) Repeating digoxin if the child vomits
C) Resting if dizziness occurs
D) Checking the child's pulse after digoxin administration

Question 30

A common,serious complication of rheumatic fever is

A) Seizures
B) Cardiac dysrhythmias
C) Pulmonary hypertension
D) Cardiac valve damage

Question 31

What is the most common causative agent of bacterial endocarditis?

A) Staphylococcus albus
B) Streptococcus hemolyticus
C) Staphylococcus albicans
D) Streptococcus viridans

Question 32

The primary nursing intervention to prevent bacterial endocarditis is

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.

Question 33

An adolescent being seen by the nurse practitioner for a sports physical is identified as having hypertension.On further testing,it is discovered the child has a cardiac abnormality.The initial treatment of secondary hypertension initially involves

A) Weight control and diet
B) Treating the underlying disease
C) Administration of digoxin
D) Administration of beta-adrenergic receptor blockers

Question 34

A nurse is teaching an adolescent about primary hypertension.Which statement made by the adolescent indicates an understanding of primary hypertension?

A) Primary hypertension should be treated with diuretics as soon as it is detected.
B) Congenital heart defects are the most common cause of primary hypertension.
C) Primary hypertension may be treated with weight reduction.
D) Primary hypertension is not affected by exercise.

Question 35

The American Academy of Pediatrics (AAP)recommends exclusive breastfeeding,or provision of breast milk by bottle,for the first 4 to 6 months of life,preferably until the child reaches 1 year of age or beyond.This does not include infants with congenital heart disease who have difficulty maintaining breastfeeding due to poor oxygenation and fatigue.Is this statement true or false?

Question 36

A beneficial effect of administering digoxin (Lanoxin)is that it

A) Decreases edema
B) Decreases cardiac output
C) Increases heart size
D) Increases venous pressure

Question 37

Which drug is an angiotensin-converting enzyme (ACE)inhibitor?

A) Captopril (Capoten)
B) Furosemide (Lasix)
C) Spironolactone (Aldactone)
D) Chlorothiazide (Diuril)

Question 38

Elevated blood pressure in the blood vessels of the lungs is a condition known as PAH or _____________________ __________________ .

Question 39

The nurse is admitting a child who has been diagnosed with Kawasaki disease.What is the most serious complication for which the nurse should assess in Kawasaki disease?

A) Cardiac valvular disease
B) Cardiomyopathy
C) Coronary aneurysm
D) Rheumatic fever