Question 1

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.

Accepted Answer

The answer of A nurse is conducting discharge teaching to...

Question 2

Which defect results in increased pulmonary blood flow?

Accepted Answer

An atrial septal defect (ASD) is a congenital heart defect where there is a hole in the wall (septum) separating the two atria of the heart. Blood can then flow through this hole from the left atrium to the right atrium, causing an increase in pulmonary blood flow.

Question 3

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.

Accepted Answer

Circumoral cyanosis in a newborn can indicate a cyanotic congenital heart defect. Tetralogy of Fallot, Pulmonary atresia, and Transposition of the great arteries are all conditions that can cause cyanosis due to mixing of oxygenated and deoxygenated blood or obstruction of blood flow to the lungs.

Question 4

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.

Accepted Answer

A: Replacing whole milk with lower fat milk options can help lower cholesterol intake.
C: Fish is high in omega-3 fatty acids, which can improve cholesterol levels.
D: Fruit juices can be high in sugar, which can increase triglycerides and ultimately increase cholesterol levels. Limiting intake is recommended. Red meat is not recommended to increase as it is high in cholesterol and saturated fat. Whole grains are recommended as they contain fiber, which can help lower cholesterol levels.

Question 5

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?

Accepted Answer

Calming the crying infant is the first response.An infant with unrepaired tetralogy of Fallot who is crying and agitated may eventually lose consciousness.Placing the infant in a knee-chest position will decrease venous return so that smaller amounts of highly saturated blood reach the heart.This should be done after calming the infant.Administering oxygen is indicated after placing the infant in a knee-chest position.Administering morphine sulfate calms the infant and depresses respirations.It may be indicated sometime after the infant has been calmed.

Question 6

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

Accepted Answer

Acute rheumatic fever can cause migratory arthritis, leading to tender, warm, and inflamed joints.

Question 7

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

Accepted Answer

The infant with congestive heart failure may tire easily,so the feeding should not continue beyond 30 minutes.If inadequate amounts of formula are taken,gavage feedings should be considered.The infant is fed smaller volumes of concentrated formula every 3 hours.

Question 8

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?

Accepted Answer

Resistance in the pulmonary circulation is very high because the lungs are collapsed and filled with fluid.Oxygen and nutrients are carried to the fetus by the umbilical vein.The inferior vena cava empties blood into the right atrium.The direction of blood flow and the pressure in the right atrium propel most of this blood through the foramen ovale into the left atrium.Most of the blood in the pulmonary artery flows though the ductus arteriosus into the descending aorta.

Question 9

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

Accepted Answer

CPR instructions are the highest priority for a child with a cardiac dysrhythmia, as they are at risk for cardiac arrest. It is important for the parents or caregivers to know what to do in case of an emergency. The other options are also important to include in discharge teaching, but not as the highest priority.

Question 10

A common,serious complication of rheumatic fever is

Accepted Answer

Rheumatic fever can cause damage to the heart valves, leading to conditions such as mitral stenosis or regurgitation. This is a common and serious complication of the disease. While seizures, cardiac dysrhythmias, and pulmonary hypertension can also occur in some cases, valve damage is the most common and significant complication.

Question 11

What is the most common causative agent of bacterial endocarditis?

Accepted Answer

Streptococcus viridans is the most common causative agent of bacterial endocarditis, accounting for over 60% of cases. Staphylococcus aureus is also a common cause, but less frequently than Streptococcus viridans. Staphylococcus albus and Staphylococcus albicans are not commonly associated with endocarditis. Streptococcus hemolyticus is a misnomer and is not a recognized species.

Question 12

The primary nursing intervention to prevent bacterial endocarditis is

Accepted Answer

Administration of prophylactic antibiotics before dental procedures or invasive medical procedures is the primary nursing intervention to prevent bacterial endocarditis in high-risk children. The other options may be important in the care of children with bacterial endocarditis, but they are not the primary prevention measures.

Question 13

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

Accepted Answer

The initial treatment of secondary hypertension involves treating the underlying disease or condition causing the hypertension. In this case, the cardiac abnormality should be treated to address the hypertension. Weight control, diet, and medication (such as digoxin or beta-adrenergic receptor blockers) may also be used in addition to treating the underlying condition.

Question 14

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

Accepted Answer

This statement shows an understanding that weight reduction can be a treatment for primary hypertension. A is incorrect because diuretics are not always the first-line treatment for hypertension. B is incorrect because congenital heart defects are not a common cause of primary hypertension. D is incorrect because exercise can help lower blood pressure in someone with primary hypertension.

Question 15

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?

Accepted Answer

The AAP states that breastfeeding should not be precluded for most high-risk neonates and infants,including those with congenital heart disease.The benefits of breastfeeding these infants includes; higher and more stable oxygen saturation measurements,improved weight gain,and shorter hospital stays.

Question 16

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

Accepted Answer

Digoxin is a cardiac glycoside that has positive inotropic effects on the heart. This means that it strengthens and improves the force of contraction of the heart muscle. As a result, it can improve symptoms of heart failure such as edema, because it can help to increase blood flow and reduce fluid build-up in the body. Digoxin does not decrease cardiac output, increase heart size or increase venous pressure.

Question 17

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

Accepted Answer

Captopril (Capoten) is an ACE inhibitor used to treat hypertension, heart failure, and diabetic nephropathy. Furosemide, Spironolactone, and Chlorothiazide are diuretics used to treat hypertension and other conditions.

Question 18

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

Accepted Answer

The answer of Elevated blood pressure in the blood vessels...

Question 19

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?

Accepted Answer

The most serious complication of Kawasaki disease is coronary aneurysm, which can lead to myocardial infarction, congestive heart failure, and even sudden death. Close monitoring of the child's cardiac status and regular echocardiograms are necessary to detect any development of aneurysms. While cardiac valvular disease and cardiomyopathy can occur in Kawasaki disease, they are not as commonly associated or as serious as coronary aneurysm. Rheumatic fever is not a complication of Kawasaki disease.

Quiz 46: The Child With a Cardiovascular Alteration