Question 1

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. C, F

Question 2

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 D

Question 3

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 the procedure.
D)   Expect bright red drainage for several hours after removal. C

Question 4

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 5

Seventy-two hours after cardiac surgery, a young child has a temperature of 101° F. Which action should the nurse take?

Accepted Answer

A)   Keep child warm with blankets.
B)   Apply a hypothermia blanket.
C)   Record temperature on nurses' notes.
D)   Report findings to physician.

Question 6

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.

Question 7

When discussing hyperlipidemia with a group of adolescents, which high level labs should the nurse explain can prevent cardiovascular disease?

Accepted Answer

A)   Cholesterol
B)   Triglycerides
C)   Low-density lipoproteins (LDLs) 
D)   High-density lipoproteins (HDLs)

Question 8

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 9

The nurse is caring for an infant with congestive heart disease (CHD). The nurse should plan which intervention to decrease cardiac demands?

Accepted Answer

A)   Organize nursing activities to allow for uninterrupted sleep.
B)   Allow the infant to sleep through feedings during the night.
C)   Wait for the infant to cry to show definite signs of hunger.
D)   Discourage parents from rocking the infant

Question 10

The nurse is assessing a child after a cardiac catheterization. Which complication should the nurse be assessing for?

Accepted Answer

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

Question 11

What is the primary nursing intervention to prevent bacterial endocarditis?

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 12

Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?

Accepted Answer

A)   Osler nodes
B)   Janeway lesions
C)   Subcutaneous nodules
D)   Aschoff nodes

Question 13

The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?

Accepted Answer

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

Question 14

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 15

José is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?

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 16

Which type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?

Accepted Answer

A)   Neurogenic
B)   Cardiogenic
C)   Hypovolemic
D)   Anaphylactic

Question 17

The nurse is teaching parents about signs of digoxin (Lanoxin) toxicity. Which is a common sign of digoxin toxicity?

Accepted Answer

A)   Seizures
B)   Vomiting
C)   Bradypnea
D)   Tachycardia

Question 18

Which is the most common causative agent of bacterial endocarditis?

Accepted Answer

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

Question 19

An 8-year-old child 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
D)   100

Question 20

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."

Exam 23: The Child with Cardiovascular Dysfunction