Question 1

In addition to closing the atrial and septal defect, the goal of surgery for atrioventricular septal defect is to:

Accepted Answer

The goal of surgery for atrioventricular septal defect includes reconstructing new mitral and tricuspid valves from the common atrioventricular (A-V) valve, addressing the issue of the valves being part of the defect.

Question 2

The nurse is caring for a 2-week-old infant with a diagnosis of truncus arteriosus. The nurse is aware that surgical repair for truncus arteriosus is done at which of the following times?

Accepted Answer

Surgical repair for truncus arteriosus is typically performed within the first few weeks of life to correct the defect and prevent complications such as heart failure or pulmonary hypertension. Waiting beyond this period increases the risk of irreversible damage to the pulmonary vasculature.

Question 3

Children with defects with decreased pulmonary blood flow frequently have which of the following symptoms?

Accepted Answer

Children with defects leading to decreased pulmonary blood flow often exhibit symptoms related to inadequate oxygenation and compensatory mechanisms. These include hypoxia (low oxygen levels in the blood), cyanosis (a bluish coloration of the skin due to low oxygen levels), polycythemia (an increase in the number of red blood cells to compensate for hypoxia), and erythrocytosis (a similar condition to polycythemia, focusing on the increased concentration of red blood cells). These symptoms arise because the heart is unable to pump sufficient oxygenated blood through the body, including to the lungs for oxygenation.

Question 4

The nurse is working with an infant who has a diagnosis of severe valvular pulmonary stenosis (PS). Although infants who have mild PS are asymptomatic, this infant with severe PS will most likely demonstrate which of the following signs and symptoms on assessment?

Accepted Answer

Severe valvular pulmonary stenosis leads to an increase in right ventricular pressure due to the heart working harder to pump blood through the narrowed valve. This can result in no symptoms at rest due to compensatory mechanisms, but intolerance of activity and cyanosis with activity as the demand on the heart increases.

Question 5

Which of the following is the treatment for moderate to severe valvular pulmonary stenosis?

Accepted Answer

Balloon valvuloplasty is the preferred treatment for moderate to severe valvular pulmonary stenosis, as it can effectively dilate the stenotic pulmonary valve without the need for open-heart surgery.

Question 6

An infant with tetralogy of Fallot who has multiple hypercyanotic spells will likely have a procedure to ensure pulmonary blood flow until surgical repair is performed. Which of the following is this procedure?

Accepted Answer

The Blalock-Taussig (BT) shunt or modified BT shunt is a procedure used to increase pulmonary blood flow in children with congenital heart defects like tetralogy of Fallot, especially in those experiencing hypercyanotic spells. This procedure temporarily augments blood flow to the lungs, allowing for better oxygenation until a more definitive surgical repair can be performed.

Question 7

When a newborn has a transposition of the great arteries (TGA), the only chance for survival is:

Accepted Answer

In transposition of the great arteries (TGA), the aorta and the pulmonary artery are switched from their normal positions. This means that oxygen-poor blood circulates through the body without going through the lungs, and oxygen-rich blood circulates through the lungs without going out to the body. A connection that allows mixing of oxygenated and deoxygenated blood, such as a patent ductus arteriosus or through an atrial septal defect, is crucial for survival until corrective surgery can be performed. This mixing is necessary for the newborn to receive some oxygenated blood circulation.

Question 8

When the nurse assesses a newborn that has transposition of the great arteries (TGA), the nurse will most likely find which of the following signs or symptoms?

Accepted Answer

Transposition of the great arteries (TGA) is a congenital heart defect where the two main arteries leaving the heart are reversed. This condition leads to poor oxygenation of the blood, which is why infants with TGA often appear normal in size and weight but present with acute cyanosis that does not improve with oxygen administration.

Question 9

Which of the following is the treatment of choice for the neonate with transposition of the great arteries (TGA)?

Accepted Answer

The arterial switch operation is the treatment of choice for neonates with transposition of the great arteries (TGA), as it corrects the anomaly by re-establishing the correct anatomical pathways for blood flow.

Question 10

The nurse takes the right arm and the right leg blood pressure with the correct size cuff and subtracts the leg systolic pressure from the arm systolic pressure. The nurse does this to figure out:

Accepted Answer

DThe nurse measures blood pressure in both the arm and leg and compares the systolic pressures to assess for a pressure gradient, which can indicate a coarctation of the aorta (A) or an impairment in circulation between the arm and leg (D). A significant difference in systolic pressures can suggest these conditions.

Question 11

The nurse is caring for a child after heart surgery. One nursing diagnosis is "Ineffective family coping related to illness and hospitalization as evidenced by verbalization of guilt by parents and lack of involvement in the child's care." Which of the following interventions would be most helpful?

Accepted Answer

Explanation: Option B is the most comprehensive and supportive intervention. It involves educating the parents about the medical aspects of their child's condition, which can reduce fear and anxiety, and it also includes emotional support through listening and involving social workers and clergy. This approach addresses both the informational and emotional needs of the family, which can enhance coping mechanisms.

Question 12

Following congenital heart surgery, the nurse who is preparing caregivers for their child's discharge will begin teaching at which of the following time periods?

Accepted Answer

Teaching should begin in the early postoperative period to ensure caregivers have ample time to learn and practice the care their child will need at home, allowing for questions and clarification well before discharge.

Question 13

The nurse who is providing discharge teaching will advise parents that children usually can return to school within approximately 2 weeks, but the child should be excused from physical education classes for how many weeks?

Accepted Answer

Children are typically advised to refrain from physical education classes for about 6 weeks to ensure proper recovery and avoid any complications.

Question 14

Which of the following conditions is the leading cause of acquired heart disease in children in developing countries?

Accepted Answer

Acute rheumatic fever, a complication of untreated or inadequately treated strep throat infections, is the leading cause of acquired heart disease in children in developing countries, primarily due to its damage to heart valves.

Question 15

Acute rheumatic fever follows which of the following health problems?

Accepted Answer

Acute rheumatic fever is a complication that can follow an untreated or partially treated infection with group A streptococcus, typically manifesting after a case of streptococcal pharyngitis (strep throat).

Question 16

Following the acute inflammatory phase of rheumatic fever, which of the following cardiac pathologies is evident?

Accepted Answer

Rheumatic fever can lead to rheumatic heart disease, where valvulitis is a common pathology, with the mitral valve being the most frequently affected. This is due to the autoimmune response triggered by the infection, leading to inflammation and potential damage to the heart valves.

Question 17

The criteria for diagnosis of acute rheumatic fever are known as:

Accepted Answer

The criteria for diagnosis of acute rheumatic fever are known as the Jones criteria. These criteria include major manifestations such as carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules, as well as minor manifestations and evidence of preceding streptococcal infection.

Question 18

What are the three organ systems primarily affected by acute rheumatic fever?

Accepted Answer

Acute rheumatic fever primarily affects the heart, central nervous system (manifesting as Sydenham's chorea), and joints (manifesting as migratory polyarthritis), making option C correct.

Question 19

Which of the following is the most characteristic finding of Kawasaki disease (KD) upon assessment?

Accepted Answer

Kawasaki disease is characterized by several symptoms, including fever and various signs of inflammation. One of the hallmark features is changes in the extremities, such as swelling and redness of the hands and feet, followed by peeling of the skin in these areas, typically starting around day 10 of the illness. This makes option A the most characteristic finding of Kawasaki disease among the choices provided.

Question 20

Which of the following best describes the pathophysiology of Kawasaki disease?

Accepted Answer

Kawasaki disease is characterized as a multisystem vasculitis, which predominantly affects the coronary arteries, potentially leading to serious complications such as coronary artery aneurysms.

Quiz 25: Cardiovascular Alterations