Question 1

The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot.Which signs and symptoms should the nurse include? (Select all that apply.)

Accepted Answer

A)  Warm flushed extremities 
B)  Weight loss 
C)  Decreased urinary output 
D)  Sweating (inappropriate) 
E)  Anorexia

Question 2

Which complication should the nurse asses for when caring for a child post cardiac catheterization?

Accepted Answer

A)  Cardiac arrhythmia 
B)  Hypostatic pneumonia 
C)  Congestive heart failure 
D)  Rapidly increasing blood pressure

Question 3

Which term is used to describe a clinical manifestation of the systemic venous congestion that can occur with congestive heart failure?

Accepted Answer

A)  Tachypnea 
B)  Tachycardia 
C)  Peripheral edema 
D)  Pale, cool extremities

Question 4

What is a major clinical manifestation of rheumatic fever?

Accepted Answer

A)  Polyarthritis 
B)  Osler's nodes 
C)  Janeway spots 
D)  Splinter hemorrhages of distal third of nails

Question 5

Nursing interventions for the child after a cardiac catheterization include which of the following? (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 6

Which 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 as ordered by the physician.

Question 7

Surgical closure of the ductus arteriosus would bring about what desired effect?

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 8

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 9

Which is the acceptable mg/dL level,or below this level,low-density lipoprotein (LDL)cholesterol level for a child from a family with heart disease? _____ Record your answer as a whole number.

Accepted Answer

The answer of Which is the acceptable mg/dL level,or below...

Question 10

Which structural defects constitute 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

The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur.This finding is associated with which congenital heart defect?

Accepted Answer

A)  Pulmonary stenosis 
B)  Patent ductus arteriosus 
C)  Ventricular septal defect 
D)  Coarctation of the aorta

Question 12

What is the nurse's first action when planning to teach the parents of an infant with a congenital heart defect (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

Question 13

The nurse is admitting a child with rheumatic fever.Which therapeutic management should the nurse expect to implement?

Accepted Answer

A)  Administering penicillin 
B)  Avoiding salicylates (aspirin) 
C)  Imposing strict bed rest for 4 to 6 weeks 
D)  Administering corticosteroids if chorea develops

Question 14

Parents of a 3-year-old child diagnosed 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 what knowledge?

Accepted Answer

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

Question 15

MATCHING
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention.

-Fourth priority

Accepted Answer

A) Administer 100% oxygen by blow-by 
B) Place infant in knee-chest position 
C) Remain calm 
D) Give morphine subcutaneously or by an existing intravenous line

Question 16

What is a common,serious complication of rheumatic fever?

Accepted Answer

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

Question 17

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

Accepted Answer

A)  Not showing unfamiliar equipment 
B)  Letting child hear the sounds of an electrocardiograph monitor 
C)  Avoiding mentioning postoperative discomfort and interventions 
D)  Explaining that an endotracheal tube will not be needed if the surgery goes well

Question 18

Which clinical changes occur as a result of septic shock?

Accepted Answer

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

Exam 42: The Child With Cardiovascular Dysfunction