Question 1

Which of the following is a major clinical manifestation of rheumatic fever?

Accepted Answer

Polyarthritis is a major clinical manifestation of rheumatic fever, characterized by inflammation of multiple joints. It is one of the major criteria (Jones criteria) used for the diagnosis of rheumatic fever. Osler nodes, Janeway spots, and splinter hemorrhages are associated with infective endocarditis, not rheumatic fever.

Question 2

Which of the following is an important nursing consideration when suctioning a young child who has had heart surgery?

Accepted Answer

Administering supplemental oxygen before and after suctioning is crucial, especially in children who have had heart surgery, to prevent hypoxia. Suctioning can temporarily reduce oxygen levels, so pre- and post-oxygenation helps maintain adequate oxygen saturation.

Question 3

Seventy-two hours after cardiac surgery, a young child has a temperature of 101° F. The nurse should do which of the following?

Accepted Answer

A fever 72 hours post-surgery could indicate an infection or other complication, so it is important to report this to the physician for further evaluation and management.

Question 4

Which of the following is an important nursing consideration when chest tubes will be removed from a child?

Accepted Answer

Administering analgesics before the procedure is important to manage pain associated with the removal of chest tubes.

Question 5

When discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what are thought to protect against cardiovascular disease?

Accepted Answer

High-density lipoproteins (HDLs) are often referred to as "good" cholesterol because they help remove other forms of cholesterol from the bloodstream, thereby protecting against cardiovascular disease.

Question 6

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 which of the following?

Accepted Answer

Children with congenital heart disease can often participate in play and activities with their peers, adjusted to their level of tolerance. It is important for their social development and mental health to have opportunities to interact with other children. The nurse should encourage safe, moderated play that considers the child's medical condition.

Question 7

Which of the following is a sign of hypokalemia?

Accepted Answer

Muscle weakness is a common sign of hypokalemia, which is a condition characterized by low potassium levels in the blood.

Question 8

Which of the following is a common, serious complication of rheumatic fever?

Accepted Answer

Cardiac valve damage is a common and serious complication of rheumatic fever, often affecting the mitral and aortic valves, leading to valvular heart disease.

Question 9

The nurse is caring for a child after heart surgery. Which of the following should the nurse do if evidence is found of cardiac tamponade?

Accepted Answer

Cardiac tamponade is a life-threatening condition where fluid accumulates in the pericardium (the sac around the heart), leading to decreased heart function. Immediate reporting to a physician is crucial for prompt intervention and management.

Question 10

Which of the following should the nurse consider when preparing a school-age child and the family for heart surgery?

Accepted Answer

Allowing a child to hear the sounds of an ECG monitor can help familiarize them with the equipment and reduce fear of the unknown. It's part of preparing them psychologically for the hospital environment.

Question 11

The primary nursing intervention to prevent bacterial endocarditis is which of the following?

Accepted Answer

Counseling parents of high-risk children about prophylactic antibiotics is the primary nursing intervention to prevent bacterial endocarditis. This involves educating them on the importance of antibiotics before certain medical or dental procedures that could introduce bacteria into the bloodstream, potentially leading to endocarditis in vulnerable individuals.

Question 12

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 for this child because they are high in which of the following?

Accepted Answer

Furosemide is a loop diuretic that can cause significant potassium loss. Foods like bananas, oranges, and leafy vegetables are high in potassium, which can help replace the potassium lost due to the medication.

Question 13

What is the most common causative agent of bacterial endocarditis?

Accepted Answer

Streptococcus viridans is the most common causative agent of bacterial endocarditis, especially in cases not associated with intravenous drug use. It is part of the normal flora of the mouth and can enter the bloodstream during dental procedures or due to poor oral hygiene, leading to endocarditis.

Question 14

Which of the following actions by the school nurse is important in the prevention of rheumatic fever?

Accepted Answer

Rheumatic fever is primarily caused by untreated or improperly treated streptococcal infections, such as strep throat. Referring children with sore throats for throat cultures is crucial for the early detection and appropriate treatment of these infections, thereby preventing the development of rheumatic fever.

Question 15

The infant with congestive heart failure has a need for:

Accepted Answer

Infants with congestive heart failure require increased calories to support their increased metabolic demand due to the heart working harder to pump blood.

Question 16

Which of the following is the leading cause of death after heart transplantation?

Accepted Answer

Rejection is the leading cause of death after heart transplantation, as the recipient's immune system may attack the transplanted heart, leading to organ failure.

Question 17

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which of the following is an important objective to decrease this risk?

Accepted Answer

Preventing dehydration is crucial because dehydration can increase blood viscosity, which raises the risk of thrombus formation and subsequent cerebrovascular accidents in children with cardiac defects.

Question 18

What painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?

Accepted Answer

Osler nodes are painful, tender, pea-sized nodules that may appear on the pads of the fingers or toes in bacterial endocarditis.

Question 19

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be which of the following?

Accepted Answer

Placing the child in the knee-chest position increases venous return to the heart, which can help improve oxygenation during a hypercyanotic spell, often seen in conditions like Tetralogy of Fallot. This position helps by increasing the blood flow to the lungs, where it gets oxygenated.

Question 20

Therapeutic management of the child with rheumatic fever includes:

Accepted Answer

Penicillin is used to eradicate the streptococcal infection that triggers rheumatic fever.

Quiz 25: The Child With Cardiovascular Dysfunction