Question 1

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?

Accepted Answer

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. 
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. B

Question 2

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

Accepted Answer

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. 
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. B

Question 3

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

Accepted Answer

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

Question 4

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

Accepted Answer

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. 
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.

Question 5

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?

Accepted Answer

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

Question 6

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?

Accepted Answer

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. 
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 7

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

Accepted Answer

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

Question 8

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?

Accepted Answer

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

Question 9

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

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

Question 10

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

Accepted Answer

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

Question 11

A common,serious complication of rheumatic fever is

Accepted Answer

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

Question 12

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

Accepted Answer

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. 
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.

Question 13

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

Accepted Answer

A)  CPR instructions 
B)  Repeating digoxin if the child vomits 
C)  Resting if dizziness occurs 
D)  Checking the child's pulse after digoxin administration 
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 14

What is the most common causative agent of bacterial endocarditis?

Accepted Answer

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

Question 15

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

Accepted Answer

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

Question 16

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

Accepted Answer

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." 
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 17

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?

Accepted Answer

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. 
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 18

Which CHD results in increased pulmonary blood flow?

Accepted Answer

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

Question 19

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

Accepted Answer

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 
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 20

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

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

Exam 46: The Child With a Cardiovascular Alteration

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?

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

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

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

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?

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?

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

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?

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.

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

A common,serious complication of rheumatic fever is

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

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

What is the most common causative agent of bacterial endocarditis?

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

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

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?

Which CHD results in increased pulmonary blood flow?

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

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

Foundations of Maternity, Women’s Health, and Child Health Nursing

The Nurse’s Role in Maternity, Women’s Health, and Pediatric Nursing

The Childbearing and Child-Rearing Family

Communicating With Children and Families

Health Promotion for the Developing Child

Health Promotion for the Infant

Health Promotion during Early Childhood

Health Promotion for the School-Age Child

Health Promotion for the Adolescent

Hereditary and Environmental Influences on Development

Reproductive Anatomy and Physiology

Conception and Prenatal Development

Adaptations to Pregnancy

Nutrition for Childbearing

Prenatal Diagnostic Tests

Giving Birth

Intrapartum Fetal Surveillance

Pain Management for Childbirth

Nursing Care during Obstetric Procedures

Postpartum Adaptations

The Normal Newborn: Adaptation and Assessment

The Normal Newborn: Nursing Care

Newborn Feeding

The Childbearing Family With Special Needs

Pregnancy-Related Complications

Concurrent Disorders During Pregnancy

The Woman With an Intrapartum Complication

The Woman With a Postpartum Complication

The High-Risk Newborn: Problems Related to Gestational Age and Development

The High Risk Newborn: Acquired and Congenital Conditions

Management of Fertility and Infertility

Women’s Health Care

Physical Assessment of Children

Emergency Care of the Child

The Ill Child in the Hospital and Other Care Settings

The Child With a Chronic Condition or Terminal Illness

Principles and Procedures for Nursing Care of Children

Medication Administration and Safety for Infants and Children

Pain Management for Children

The Child With a Fluid and Electrolyte Alteration

The Child With an Infectious Disease

The Child With an Immunologic Alteration

The Child With a Gastrointestinal Alteration

The Child With a Genitourinary Alteration

The Child With a Respiratory Alteration

The Child With a Hematologic Alteration

The Child With Cancer

The Child With an Alteration in Tissue Integrity

The Child With a Musculoskeletal Alteration

The Child With an Endocrine or Metabolic Alteration

The Child With a Neurologic Alteration

Psychosocial Problems in Children and Families

The Child With a Developmental Disability

The Child With a Sensory Alteration

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