Deck 48: Cardiovascular Dysfunction

Question 1

A complication that may occur after a cardiac catheterization is:

A)Cardiac arrhythmia.
B)Hypostatic pneumonia.
C)Congestive heart failure.
D)Rapidly increasing blood pressure.

Answer 1

Cardiac arrhythmia.

Question 2

Seventy-two hours after cardiac surgery,a young child has a temperature of 37.7° C (101° F). The nurse should:

A)Keep the child warm with blankets.
B)Apply a hypothermia blanket.
C)Record the temperature on nurses' notes.
D)Report findings to physician.

Answer 2

Report findings to physician.

Question 3

What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?

A)Pulmonary congestion
B)Congenital heart defect
C)Congestive heart failure
D)Systemic venous congestion

Answer 3

Congestive heart failure

Question 4

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. The nurse's reply should be based on knowing that:

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.

Question 5

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 6

The parents of a young child with congestive heart failure tell the nurse that they are "nervous" about giving digoxin. The nurse's response should be based on knowing that:

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.

Question 7

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. The most appropriate initial nursing action is to:

A)Notify the physician.
B)Apply a new bandage with more pressure.
C)Place in the Trendelenburg position.
D)Apply direct pressure above the catheterization site.

Question 8

José is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:

A)Directed at his parents because he is too young to understand.
B)Detailed in regard to the actual procedures so he will know what to expect.
C)Done several days before the procedure so that he will be prepared.
D)Adapted to his level of development so that he can understand.

Question 9

A chest x-ray film is ordered for a child with suspected cardiac problems. The child's parent asks the nurse,"What will the radiograph show about the heart?" The nurse's response should be based on knowledge that the x-ray film will:

A)Show bones of the chest but not the heart.
B)Measure electrical potential generated from heart muscle.
C)Provide a permanent record of heart size and configuration.
D)Provide a computerized image of heart vessels and tissues.

Question 10

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

Question 11

A clinical manifestation of the systemic venous congestion that can occur with congestive heart failure is:

A)Tachypnea.
B)Tachycardia.
C)Peripheral edema.
D)Pale,cool extremities.

Question 12

An important nursing consideration when suctioning a young child who has had heart surgery is to:

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.

Question 13

As part of the treatment for congestive heart failure,the child takes the diuretic furosemide. As part of teaching home care,the nurse encourages the family to give the child foods such as bananas,oranges,and leafy vegetables. These foods are recommended because they are high in:

A)Chlorides.
B)Potassium.
C)Sodium.
D)Vitamins.

Question 14

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be to:

A)Assess for neurologic defects.
B)Place the child in the knee-chest position.
C)Begin cardiopulmonary resuscitation.
D)Prepare the family for imminent death.

Question 15

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 16

A common sign of digoxin toxicity is:

A)Seizures.
B)Vomiting.
C)Bradypnea.
D)Tachycardia.

Question 17

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. An important objective to decrease this risk is to:

A)Minimize seizures.
B)Prevent dehydration.
C)Promote cardiac output.
D)Reduce energy expenditure.

Question 18

When preparing a school-age child and the family for heart surgery,the nurse should consider:

A)Not showing unfamiliar equipment.
B)Letting child hear the sounds of an electrocardiograph monitor.
C)Avoiding mentioning postoperative discomfort and interventions.
D)Explaining that an endotracheal tube will not be needed if the surgery goes well.

Question 19

The nurse is caring for a child after heart surgery. What should he or she do if evidence is found 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.

Question 20

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

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

Question 21

Nursing interventions for the child after a cardiac catheterization include (choose all that apply):

A)Allow ambulation as tolerated.
B)Monitor vital signs every 2 hours.
C)Assess the affected extremity for temperature and color.
D)Check pulses above the catheterization site for equality and symmetry.
E)Remove pressure dressing after 4 hours.
F)Maintain a patent peripheral intravenous catheter until discharge.

Question 22

What painful,tender,pea-sized nodules 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

Question 23

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

Question 24

A major clinical manifestation of rheumatic fever is:

A)Polyarthritis.
B)Osler nodes.
C)Janeway spots.
D)Splinter hemorrhages of distal third of nails.

Question 25

What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks,which may occur with drug or latex allergy?

A)Neurogenic shock
B)Cardiogenic shock
C)Hypovolemic shock
D)Anaphylactic shock

Question 26

One of the most frequent causes of hypovolemic shock in children is:

A)Sepsis.
B)Blood loss.
C)Anaphylaxis.
D)Congenital heart disease.

Question 27

The leading cause of death after heart transplantation is:

A)Infection.
B)Rejection.
C)Cardiomyopathy.
D)Congestive heart failure.

Question 28

MATCHING
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. Place in correct sequence what the nurse should do after the airway has been established. Place in correct order.
Obtain vascular access.

A) Administer epinephrine.
B) Keep child warm and calm.
C) Obtain vascular access.

Question 29

A common,serious complication of rheumatic fever is:

A)Seizures.
B)Cardiac arrhythmias.
C)Pulmonary hypertension.
D)Cardiac valve damage.

Question 30

The most common causative agent of bacterial endocarditis is:

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

Question 31

When caring for the child with Kawasaki disease,the nurse should know that:

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.

Question 32

Which clinical manifestations would the nurse expect to see as shock progresses in a child and becomes decompensated shock? Choose all that apply.

A)Thirst and diminished urinary output
B)Irritability and apprehension
C)Cool extremities and decreased skin turgor
D)Confusion and somnolence
E)Normal blood pressure and narrowing pulse pressure
F) Tachypnea and poor capillary refill time

Question 33

An important nursing consideration when chest tubes will be removed from a child is to:

A)Explain that it is not painful.
B)Explain that only a Band-Aid will be needed.
C)Administer analgesics before procedure.
D)Expect bright red drainage for several hours after removal.

Question 34

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).

Question 35

The primary nursing intervention to prevent bacterial endocarditis is to:

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 36

MATCHING
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. Place in correct sequence what the nurse should do after the airway has been established. Place in correct order.
Administer epinephrine.

A) Administer epinephrine.
B) Keep child warm and calm.
C) Obtain vascular access.

Question 37

MATCHING
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. Place in correct sequence what the nurse should do after the airway has been established. Place in correct order.
Keep child warm and calm.

A) Administer epinephrine.
B) Keep child warm and calm.
C) Obtain vascular access.

Question 38

What occurs in septic shock?

A)Hypothermia
B)Increased cardiac output
C)Vasoconstriction
D)Angioneurotic edema.