Question 1

The primary nursing intervention to prevent bacterial endocarditis is to:

Accepted Answer

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 2

Which is a common,serious complication of rheumatic fever?

Accepted Answer

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

Question 3

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 statement?

Accepted Answer

A) Child needs opportunities to play with peers. 
B) Child needs to understand that peers' activities are too strenuous. 
C) Parents can meet all of the child's needs. 
D) Constant parental supervision is needed to avoid overexertion.

Question 4

Surgical closure of the ductus arteriosus would:

Accepted Answer

A) stop the loss of unoxygenated blood to the systemic circulation. 
B) decrease the edema in legs and feet. 
C) increase the oxygenation of blood. 
D) prevent the return of oxygenated blood to the lungs.

Question 5

A chest radiograph 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 show:

Accepted Answer

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

Question 6

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

Accepted Answer

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 7

The nurse is admitting a child with coarctation of the aorta.Which figure depicts this congenital heart defect?

Accepted Answer

A)  
 
B)  
 
C)  
 
D)

Question 8

A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting.While an airway is being established,the nurse should prepare which medication for immediate administration?

Accepted Answer

A) Diphenhydramine (Benadryl) 
B) Dobutamine (Dobutarex) 
C) Epinephrine (Adrenalin) 
D) Calcium chloride (calcium chloride)

Question 9

A 6-month-old infant is receiving digoxin (Lanoxin).The nurse should notify the practitioner and withhold the medication if the apical pulse is less than _____ beats/min.

Accepted Answer

A) 60 
B) 70 
C) 90 to 110 
D) 110 to 120

Question 10

The nurse is conducting a staff in-service on congenital heart defects.Which structural defect constitutes tetralogy of Fallot?

Accepted Answer

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

Which occurs in septic shock?

Accepted Answer

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

Question 12

A preschool child is scheduled for an echocardiogram.Parents ask the nurse whether they can hold the child during the procedure.The nurse should answer with which response?

Accepted Answer

A) "You will be able to hold your child during the procedure." 
B) "Your child can be active during the procedure, but can't sit in your lap." 
C) "Your child must lie quietly; sometimes a mild sedative is administered before the procedure." 
D) "The procedure is invasive so your child will be restrained during the echocardiogram."

Question 13

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

Accepted Answer

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 14

Nursing interventions for the child after a cardiac catheterization should include which actions? (Select all that apply.)

Accepted Answer

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 15

The nurse is teaching nursing students about shock that occurs in children.One of the most frequent causes of hypovolemic shock in children is:

Accepted Answer

A) sepsis. 
B) blood loss. 
C) anaphylaxis. 
D) congenital heart disease.

Question 16

The nurse is preparing an adolescent for discharge after a cardiac catheterization.Which statement by the adolescent would indicate a need for further teaching?

Accepted Answer

A) "I should avoid tub baths but may shower." 
B) "I have to stay on strict bed rest for 3 days." 
C) "I should remove the pressure dressing the day after the procedure." 
D) "I may attend school but should avoid exercise for several days."

Question 17

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

Accepted Answer

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

Question 18

When discussing hyperlipidemia with a group of adolescents,the nurse should explain that cardiovascular disease can be prevented by high levels of:

Accepted Answer

A) cholesterol. 
B) triglycerides. 
C) low-density lipoproteins (LDLs). 
D) high-density lipoproteins (HDLs).

Question 19

Which clinical manifestation should the nurse expect to see as shock progresses in a child and becomes decompensated shock?

Accepted Answer

A) Thirst 
B) Irritability 
C) Apprehension 
D) Confusion and somnolence

Question 20

Which explanation regarding cardiac catheterization is appropriate for a preschool child?

Accepted Answer

A) Postural drainage will be performed every 4 to 6 hours after the test. 
B) It is necessary to be completely "asleep" during the test. 
C) The test is short, usually taking less than 1 hour. 
D) When the procedure is done, you will have to keep your leg straight for at least 4 hours.

Exam 25: The Child with Cardiovascular Dysfunction