Question 1

The nurse is caring for a child who has just been diagnosed with an atrial septal defect (ASD). Which manifestations would the nurse expect upon assessment? Select all that apply. A)Pulmonary artery hypotension B)Midsystolic murmur at lower right sternal border C)Mitral valve regurgitation with cleft on mitral valve D)S₁ heart tone may be split due to forceful left ventricular contraction E)Congestive heart failure

Accepted Answer

A)ASD occurs when there is an opening in the atrial septum, permitting left-to-right shunting of blood. Midsystolic murmur may be auscultated at the lower left sternal border due to increased blood flow across the tricuspid valve. Mitral valve regurgitation may occur with a cleft on the mitral valve. S₁ heart tones may be split due to forceful right ventricular contraction. Finally, pulmonary artery hypertension and congestive heart failure may occur. B)ASD occurs when there is an opening in the atrial septum, permitting left-to-right shunting of blood. Midsystolic murmur may be auscultated at the lower left sternal border due to increased blood flow across the tricuspid valve. Mitral valve regurgitation may occur with a cleft on the mitral valve. S₁ heart tones may be split due to forceful right ventricular contraction. Finally, pulmonary artery hypertension and congestive heart failure may occur. C)ASD occurs when there is an opening in the atrial septum, permitting left-to-right shunting of blood. Midsystolic murmur may be auscultated at the lower left sternal border due to increased blood flow across the tricuspid valve. Mitral valve regurgitation may occur with a cleft on the mitral valve. S₁ heart tones may be split due to forceful right ventricular contraction. Finally, pulmonary artery hypertension and congestive heart failure may occur. D)ASD occurs when there is an opening in the atrial septum, permitting left-to-right shunting of blood. Midsystolic murmur may be auscultated at the lower left sternal border due to increased blood flow across the tricuspid valve. Mitral valve regurgitation may occur with a cleft on the mitral valve. S₁ heart tones may be split due to forceful right ventricular contraction. Finally, pulmonary artery hypertension and congestive heart failure may occur. E)ASD occurs when there is an opening in the atrial septum, permitting left-to-right shunting of blood. Midsystolic murmur may be auscultated at the lower left sternal border due to increased blood flow across the tricuspid valve. Mitral valve regurgitation may occur with a cleft on the mitral valve. S₁ heart tones may be split due to forceful right ventricular contraction. Finally, pulmonary artery hypertension and congestive heart failure may occur.

Question 2

The nurse is analyzing data collected after assessing a child with a congenital heart defect that decreases pulmonary blood flow. Which nursing diagnosis would be applicable for this client?
A)Acute Pain
B)Ineffective Breathing Pattern
C)Decreased Cardiac Output
D)Excess Fluid Volume

Accepted Answer

A)Nursing diagnoses for clients with congenital heart defects that decrease pulmonary blood flow include Decreased Cardiac Output, Risk for Infection, Caregiver Role Strain, and Activity Intolerance. Acute Pain and Ineffective Breathing Pattern are appropriate nursing diagnoses for a child following cardiac surgery. Excess Fluid Volume is a nursing diagnosis seen in the care of a client with a congenital heart defect that increases pulmonary blood flow.
B)Nursing diagnoses for clients with congenital heart defects that decrease pulmonary blood flow include Decreased Cardiac Output, Risk for Infection, Caregiver Role Strain, and Activity Intolerance. Acute Pain and Ineffective Breathing Pattern are appropriate nursing diagnoses for a child following cardiac surgery. Excess Fluid Volume is a nursing diagnosis seen in the care of a client with a congenital heart defect that increases pulmonary blood flow.
C)Nursing diagnoses for clients with congenital heart defects that decrease pulmonary blood flow include Decreased Cardiac Output, Risk for Infection, Caregiver Role Strain, and Activity Intolerance. Acute Pain and Ineffective Breathing Pattern are appropriate nursing diagnoses for a child following cardiac surgery. Excess Fluid Volume is a nursing diagnosis seen in the care of a client with a congenital heart defect that increases pulmonary blood flow.
D)Nursing diagnoses for clients with congenital heart defects that decrease pulmonary blood flow include Decreased Cardiac Output, Risk for Infection, Caregiver Role Strain, and Activity Intolerance. Acute Pain and Ineffective Breathing Pattern are appropriate nursing diagnoses for a child following cardiac surgery. Excess Fluid Volume is a nursing diagnosis seen in the care of a client with a congenital heart defect that increases pulmonary blood flow.

Question 3

The mother of a baby born with a congenital heart defect is upset, as no one else in the family has been born with this condition. To determine the cause of the defect, which question is appropriate for the nurse to ask the mother?
A)"Did you consume any alcohol before you knew you were pregnant?"
B)"Is there a history of diabetes in your family?"
C)"Was the baby's father exposed to any toxins in the work environment?"
D)"Do you have a history of hypertension?"

Accepted Answer

A)Most congenital heart defects occur during the first 8 weeks of pregnancy and are a combination of environmental and genetic factors. Fetal exposure to alcohol is one of the greatest factors for the development of these defects. Asking the mother if she consumed alcohol before she was aware that she was pregnant is an appropriate question when determining the cause of the heart defect. A history of hypertension will not cause a fetus to develop a congenital heart defect. The father's exposure to toxins in the work environment is not known to cause congenital heart defects of children. Maternal diabetes can impair fetal heart development, but a family history of diabetes is not known to cause congenital heart defects.
B)Most congenital heart defects occur during the first 8 weeks of pregnancy and are a combination of environmental and genetic factors. Fetal exposure to alcohol is one of the greatest factors for the development of these defects. Asking the mother if she consumed alcohol before she was aware that she was pregnant is an appropriate question when determining the cause of the heart defect. A history of hypertension will not cause a fetus to develop a congenital heart defect. The father's exposure to toxins in the work environment is not known to cause congenital heart defects of children. Maternal diabetes can impair fetal heart development, but a family history of diabetes is not known to cause congenital heart defects.
C)Most congenital heart defects occur during the first 8 weeks of pregnancy and are a combination of environmental and genetic factors. Fetal exposure to alcohol is one of the greatest factors for the development of these defects. Asking the mother if she consumed alcohol before she was aware that she was pregnant is an appropriate question when determining the cause of the heart defect. A history of hypertension will not cause a fetus to develop a congenital heart defect. The father's exposure to toxins in the work environment is not known to cause congenital heart defects of children. Maternal diabetes can impair fetal heart development, but a family history of diabetes is not known to cause congenital heart defects.
D)Most congenital heart defects occur during the first 8 weeks of pregnancy and are a combination of environmental and genetic factors. Fetal exposure to alcohol is one of the greatest factors for the development of these defects. Asking the mother if she consumed alcohol before she was aware that she was pregnant is an appropriate question when determining the cause of the heart defect. A history of hypertension will not cause a fetus to develop a congenital heart defect. The father's exposure to toxins in the work environment is not known to cause congenital heart defects of children. Maternal diabetes can impair fetal heart development, but a family history of diabetes is not known to cause congenital heart defects.

Question 4

A baby will be having surgery to correct a congenital heart defect. On which topic should the parents be instructed regarding the care of the child before surgery?
A)Restricting immunizations until after the surgery
B)Preventing exposure to infection
C)Implementing no particular precautions
D)Restricting fluids for a week before the surgery

Accepted Answer

A)Preoperative care of a baby having surgery to correct a congenital heart defect should include prevention from infection with good hand washing. There are precautions that the parents should take to ensure the child is in optimal health prior to the surgery. Immunizations should be continued. The parents may be instructed to withhold food and fluids several hours before the surgery. Fluids would not be restricted for a week before surgery.
B)Preoperative care of a baby having surgery to correct a congenital heart defect should include prevention from infection with good hand washing. There are precautions that the parents should take to ensure the child is in optimal health prior to the surgery. Immunizations should be continued. The parents may be instructed to withhold food and fluids several hours before the surgery. Fluids would not be restricted for a week before surgery.
C)Preoperative care of a baby having surgery to correct a congenital heart defect should include prevention from infection with good hand washing. There are precautions that the parents should take to ensure the child is in optimal health prior to the surgery. Immunizations should be continued. The parents may be instructed to withhold food and fluids several hours before the surgery. Fluids would not be restricted for a week before surgery.
D)Preoperative care of a baby having surgery to correct a congenital heart defect should include prevention from infection with good hand washing. There are precautions that the parents should take to ensure the child is in optimal health prior to the surgery. Immunizations should be continued. The parents may be instructed to withhold food and fluids several hours before the surgery. Fluids would not be restricted for a week before surgery.

Question 5

The nurse is planning care for a pediatric client recovering from surgery to repair a congenital heart defect. Which intervention should the nurse include to support the client's fluid status?
A)Encourage oral intake of fluids when permitted.
B)Limit oral and intravenous intake of fluids.
C)Continue normal saline administration even after oral intake is normal.
D)Convert the intravenous line to a saline lock immediately after surgery.

Accepted Answer

A)The child should be encouraged to begin oral fluids and nutrition when permitted. Although oral fluids are rarely limited, intake and output should be carefully assessed. Fluids and antibiotics should be provided as ordered until the child's oral intake is normal. Once normal, the line can be converted to a heparin or saline lock.
B)The child should be encouraged to begin oral fluids and nutrition when permitted. Although oral fluids are rarely limited, intake and output should be carefully assessed. Fluids and antibiotics should be provided as ordered until the child's oral intake is normal. Once normal, the line can be converted to a heparin or saline lock.
C)The child should be encouraged to begin oral fluids and nutrition when permitted. Although oral fluids are rarely limited, intake and output should be carefully assessed. Fluids and antibiotics should be provided as ordered until the child's oral intake is normal. Once normal, the line can be converted to a heparin or saline lock.
D)The child should be encouraged to begin oral fluids and nutrition when permitted. Although oral fluids are rarely limited, intake and output should be carefully assessed. Fluids and antibiotics should be provided as ordered until the child's oral intake is normal. Once normal, the line can be converted to a heparin or saline lock.

Question 6

The nurse is caring for an infant diagnosed with hypoplastic left heart syndrome. The client has recently been scheduled for surgery to repair the defect. Which procedure does the nurse anticipate needing to provide client teaching about to the client's family?
A)Norwood procedure
B)Jatene procedure
C)Rastelli procedure
D)Damus-Kaye-Stansel procedure

Accepted Answer

A)Hypoplastic left heart syndrome is repaired using the Norwood, Glenn, and Fontan procedures, depending on the child's age. The Jatene procedure and the Damus-Kaye-Stansel procedure surgically repair the Transposition of Great Arteries (TGA). The Rastelli procedure is used to repair TGA with ventricular septal defect and pulmonary stenosis.
B)Hypoplastic left heart syndrome is repaired using the Norwood, Glenn, and Fontan procedures, depending on the child's age. The Jatene procedure and the Damus-Kaye-Stansel procedure surgically repair the Transposition of Great Arteries (TGA). The Rastelli procedure is used to repair TGA with ventricular septal defect and pulmonary stenosis.
C)Hypoplastic left heart syndrome is repaired using the Norwood, Glenn, and Fontan procedures, depending on the child's age. The Jatene procedure and the Damus-Kaye-Stansel procedure surgically repair the Transposition of Great Arteries (TGA). The Rastelli procedure is used to repair TGA with ventricular septal defect and pulmonary stenosis.
D)Hypoplastic left heart syndrome is repaired using the Norwood, Glenn, and Fontan procedures, depending on the child's age. The Jatene procedure and the Damus-Kaye-Stansel procedure surgically repair the Transposition of Great Arteries (TGA). The Rastelli procedure is used to repair TGA with ventricular septal defect and pulmonary stenosis.

Question 7

A client diagnosed with cardiomyopathy asks the nurse to explain the different types of the disease. Which is inappropriate for the nurse to include in the teaching session?
A)Dilated cardiomyopathy
B)Restrictive cardiomyopathy
C)Hypotrophic cardiomyopathy
D)Arrythmogenic right ventricular dysplasia

Accepted Answer

A)The types of cardiomyopathy include dilated, restrictive, hypertrophic, arrythmogenic right ventricular dysplasia, and unclassified.
B)The types of cardiomyopathy include dilated, restrictive, hypertrophic, arrythmogenic right ventricular dysplasia, and unclassified.
C)The types of cardiomyopathy include dilated, restrictive, hypertrophic, arrythmogenic right ventricular dysplasia, and unclassified.
D)The types of cardiomyopathy include dilated, restrictive, hypertrophic, arrythmogenic right ventricular dysplasia, and unclassified.

Question 8

The nurse provides discharge instructions to the parents of a child recovering from surgery to repair a congenital heart defect. What statement indicates that teaching has been effective?
A)"Our child should be restricted in play and activity for at least 6 months."
B)"Our child will need to take antibiotics prior to having dental surgery."
C)"Fluids should be restricted to maximize lung function."
D)"Our child should not return to normal activities for at least 2 years."

Accepted Answer

A)Since the child is at risk for infective endocarditis, prophylactic antibiotics are indicated for invasive procedures. The child should be encouraged to gradually return to normal activities, including play. The child's activity should not be restricted for 6 months to 2 years. The child should not restrict fluids.
B)Since the child is at risk for infective endocarditis, prophylactic antibiotics are indicated for invasive procedures. The child should be encouraged to gradually return to normal activities, including play. The child's activity should not be restricted for 6 months to 2 years. The child should not restrict fluids.
C)Since the child is at risk for infective endocarditis, prophylactic antibiotics are indicated for invasive procedures. The child should be encouraged to gradually return to normal activities, including play. The child's activity should not be restricted for 6 months to 2 years. The child should not restrict fluids.
D)Since the child is at risk for infective endocarditis, prophylactic antibiotics are indicated for invasive procedures. The child should be encouraged to gradually return to normal activities, including play. The child's activity should not be restricted for 6 months to 2 years. The child should not restrict fluids.

Question 9

A 72-year-old client diagnosed with hypertrophic cardiomyopathy (HCM)is speaking to the healthcare team about treatment options. Which treatment option would likely not be recommended for this client, even though it is commonly used to treat younger clients with this condition?
A)Defibrillator implantation
B)Beta-blocker administration
C)Calcium channel blocker administration
D)Physical activity restrictions

Accepted Answer

A)Treatment guidelines for older clients with HCM are not well established, although they may include the use of beta blockers and/or calcium channel blockers. The client will also likely have restrictions on physical activity. However, the low morbidity and mortality rates among older clients do not support the use of the defibrillator devices frequently implanted in younger clients.
B)Treatment guidelines for older clients with HCM are not well established, although they may include the use of beta blockers and/or calcium channel blockers. The client will also likely have restrictions on physical activity. However, the low morbidity and mortality rates among older clients do not support the use of the defibrillator devices frequently implanted in younger clients.
C)Treatment guidelines for older clients with HCM are not well established, although they may include the use of beta blockers and/or calcium channel blockers. The client will also likely have restrictions on physical activity. However, the low morbidity and mortality rates among older clients do not support the use of the defibrillator devices frequently implanted in younger clients.
D)Treatment guidelines for older clients with HCM are not well established, although they may include the use of beta blockers and/or calcium channel blockers. The client will also likely have restrictions on physical activity. However, the low morbidity and mortality rates among older clients do not support the use of the defibrillator devices frequently implanted in younger clients.

Question 10

A 14-year-old child was recently diagnosed with hypertrophic cardiomyopathy. During a follow-up appointment, the mother asks the nurse, "How will this affect my child's ability to play football in the fall?" How should the nurse respond?
A)"This shouldn't affect his ability to play football."
B)"Children with cardiomyopathy should not play football."
C)"He could participate in flag football but not tackle football."
D)"This may actually make him a better, stronger football player."

Accepted Answer

A)Children with cardiomyopathy should not play competitive sports due to the possibility of collapse or increased heart failure. Depending on the child's clinical status, low-impact activities may be appropriate, but this should be discussed with the child's physician.
B)Children with cardiomyopathy should not play competitive sports due to the possibility of collapse or increased heart failure. Depending on the child's clinical status, low-impact activities may be appropriate, but this should be discussed with the child's physician.
C)Children with cardiomyopathy should not play competitive sports due to the possibility of collapse or increased heart failure. Depending on the child's clinical status, low-impact activities may be appropriate, but this should be discussed with the child's physician.
D)Children with cardiomyopathy should not play competitive sports due to the possibility of collapse or increased heart failure. Depending on the child's clinical status, low-impact activities may be appropriate, but this should be discussed with the child's physician.

Question 11

The nurse is caring for an adult client who was diagnosed with a congenital heart defect as a child, which was later repaired with surgery. Which common complication of a heart defect should the nurse monitor that the client may still be at risk for?
A)Deep vein thrombosis
B)Endocarditis
C)Atherosclerosis
D)Shock

Accepted Answer

A)Common complications of congenital heart defects that develop during adulthood include dysrhythmias, endocarditis, stroke, heart failure, pulmonary hypertension, and heart valve problems. Congenital heart defects do not normally cause deep vein thrombosis, atherosclerosis, or shock.
B)Common complications of congenital heart defects that develop during adulthood include dysrhythmias, endocarditis, stroke, heart failure, pulmonary hypertension, and heart valve problems. Congenital heart defects do not normally cause deep vein thrombosis, atherosclerosis, or shock.
C)Common complications of congenital heart defects that develop during adulthood include dysrhythmias, endocarditis, stroke, heart failure, pulmonary hypertension, and heart valve problems. Congenital heart defects do not normally cause deep vein thrombosis, atherosclerosis, or shock.
D)Common complications of congenital heart defects that develop during adulthood include dysrhythmias, endocarditis, stroke, heart failure, pulmonary hypertension, and heart valve problems. Congenital heart defects do not normally cause deep vein thrombosis, atherosclerosis, or shock.

Question 12

During what period of gestation do congenital heart defects usually develop?
A)First 8 weeks of gestation
B)Second trimester
C)Third trimester
D)Last 4 weeks of gestation

Accepted Answer

A)Most congenital heart defects develop during the first 8 weeks of gestation. They are usually the result of combined genetic and environmental factors.
B)Most congenital heart defects develop during the first 8 weeks of gestation. They are usually the result of combined genetic and environmental factors.
C)Most congenital heart defects develop during the first 8 weeks of gestation. They are usually the result of combined genetic and environmental factors.
D)Most congenital heart defects develop during the first 8 weeks of gestation. They are usually the result of combined genetic and environmental factors.

Question 13

The nurse is caring for a client diagnosed with cardiomyopathy. The client experiences tachycardia. Which medication does the nurse anticipate being prescribed?
A)ACE Inhibitor
B)Angiotensin II receptor blocker
C)Beta blocker
D)Cardiac glycoside

Accepted Answer

A)A client with cardiomyopathy experiencing tachycardia may take a beta blocker to lower the heart rate. ACE inhibitors and angiotensin II receptor blockers are used to decrease blood pressure in a client with cardiomyopathy. Cardiac glycosides are used in congestive heart failure and do not assist in lowering the heart rate in a client with cardiomyopathy.
B)A client with cardiomyopathy experiencing tachycardia may take a beta blocker to lower the heart rate. ACE inhibitors and angiotensin II receptor blockers are used to decrease blood pressure in a client with cardiomyopathy. Cardiac glycosides are used in congestive heart failure and do not assist in lowering the heart rate in a client with cardiomyopathy.
C)A client with cardiomyopathy experiencing tachycardia may take a beta blocker to lower the heart rate. ACE inhibitors and angiotensin II receptor blockers are used to decrease blood pressure in a client with cardiomyopathy. Cardiac glycosides are used in congestive heart failure and do not assist in lowering the heart rate in a client with cardiomyopathy.
D)A client with cardiomyopathy experiencing tachycardia may take a beta blocker to lower the heart rate. ACE inhibitors and angiotensin II receptor blockers are used to decrease blood pressure in a client with cardiomyopathy. Cardiac glycosides are used in congestive heart failure and do not assist in lowering the heart rate in a client with cardiomyopathy.

Question 14

A nurse is educating a client with cardiomyopathy about diet choices that are appropriate for the client's condition. Which statement is inappropriate for the nurse to include in the teaching session?
A)"It is important to monitor your sodium intake."
B)"Increasing your dietary protein helps with cardiac cell repair."
C)"Here is a list of high-fat, high-cholesterol foods to avoid."
D)"I have notified the dietitian regarding your condition in order to provide you with more information."

Accepted Answer

A)Diet is an important part of long-term management of heart failure. It also contributes to reducing fluid retention. The nurse should instruct the client with cardiomyopathy to monitor sodium intake and to avoid high-fat, high-cholesterol food. Instructing the client to increase protein is not appropriate and is not shown effective in managing cardiomyopathy. Consulting with the dietitian is appropriate with this client.
B)Diet is an important part of long-term management of heart failure. It also contributes to reducing fluid retention. The nurse should instruct the client with cardiomyopathy to monitor sodium intake and to avoid high-fat, high-cholesterol food. Instructing the client to increase protein is not appropriate and is not shown effective in managing cardiomyopathy. Consulting with the dietitian is appropriate with this client.
C)Diet is an important part of long-term management of heart failure. It also contributes to reducing fluid retention. The nurse should instruct the client with cardiomyopathy to monitor sodium intake and to avoid high-fat, high-cholesterol food. Instructing the client to increase protein is not appropriate and is not shown effective in managing cardiomyopathy. Consulting with the dietitian is appropriate with this client.
D)Diet is an important part of long-term management of heart failure. It also contributes to reducing fluid retention. The nurse should instruct the client with cardiomyopathy to monitor sodium intake and to avoid high-fat, high-cholesterol food. Instructing the client to increase protein is not appropriate and is not shown effective in managing cardiomyopathy. Consulting with the dietitian is appropriate with this client.

Question 15

Which best describes how congenital defects are categorized?
A)By the severity of defect
B)By the pathophysiology and hemodynamics of defect
C)By the location of defect
D)By the infant's age when the defect was diagnosed

Accepted Answer

A)Congenital heart defects are categorized by their pathophysiology and hemodynamics. They are not categorized by the severity of the defect, location of the defect, or the infant's age when the defect is diagnosed.
B)Congenital heart defects are categorized by their pathophysiology and hemodynamics. They are not categorized by the severity of the defect, location of the defect, or the infant's age when the defect is diagnosed.
C)Congenital heart defects are categorized by their pathophysiology and hemodynamics. They are not categorized by the severity of the defect, location of the defect, or the infant's age when the defect is diagnosed.
D)Congenital heart defects are categorized by their pathophysiology and hemodynamics. They are not categorized by the severity of the defect, location of the defect, or the infant's age when the defect is diagnosed.

Question 16

A nurse is caring for a client with cardiomyopathy who is experiencing activity intolerance. Which intervention is inappropriate for this nursing diagnosis?
A)Spacing out nursing activities so client fatigue is lessened
B)Assisting with client activities of daily living (ADLs)as necessary
C)Using passive and active range-of-motion (ROM)exercises as tolerated
D)Consulting with a physical therapist on an activity plan

Accepted Answer

A)The client who is experiencing activity intolerance should have nursing interventions implemented that encourage and preserve client energy. Assisting the client with ADLs, utilizing ROM exercises, and consulting with physical therapy are all interventions that support this nursing diagnosis. The nurse should cluster nursing activities, not space them out, in order to conserve client energy. This allows the client to rest between periods of nursing care.
B)The client who is experiencing activity intolerance should have nursing interventions implemented that encourage and preserve client energy. Assisting the client with ADLs, utilizing ROM exercises, and consulting with physical therapy are all interventions that support this nursing diagnosis. The nurse should cluster nursing activities, not space them out, in order to conserve client energy. This allows the client to rest between periods of nursing care.
C)The client who is experiencing activity intolerance should have nursing interventions implemented that encourage and preserve client energy. Assisting the client with ADLs, utilizing ROM exercises, and consulting with physical therapy are all interventions that support this nursing diagnosis. The nurse should cluster nursing activities, not space them out, in order to conserve client energy. This allows the client to rest between periods of nursing care.
D)The client who is experiencing activity intolerance should have nursing interventions implemented that encourage and preserve client energy. Assisting the client with ADLs, utilizing ROM exercises, and consulting with physical therapy are all interventions that support this nursing diagnosis. The nurse should cluster nursing activities, not space them out, in order to conserve client energy. This allows the client to rest between periods of nursing care.

Question 17

The nurse is assessing a toddler diagnosed with tetralogy of Fallot (TOF). Which clinical manifestations does the nurse anticipate during the physical assessment? Select all that apply.
A)Palpable thrill in the pulmonic area
B)Nail clubbing
C)Cough
D)Apneic periods
E)Knee-chest position

Accepted Answer

A)Manifestations of TOF include a palpable thrill in the pulmonic area, clubbing of the fingers due to reduce oxygenation, and the knee-chest position, which the child will perform to decrease the return of systemic venous blood to the heart. A cough and apneic periods are not manifestations of this congenital heart defect.
B)Manifestations of TOF include a palpable thrill in the pulmonic area, clubbing of the fingers due to reduce oxygenation, and the knee-chest position, which the child will perform to decrease the return of systemic venous blood to the heart. A cough and apneic periods are not manifestations of this congenital heart defect.
C)Manifestations of TOF include a palpable thrill in the pulmonic area, clubbing of the fingers due to reduce oxygenation, and the knee-chest position, which the child will perform to decrease the return of systemic venous blood to the heart. A cough and apneic periods are not manifestations of this congenital heart defect.
D)Manifestations of TOF include a palpable thrill in the pulmonic area, clubbing of the fingers due to reduce oxygenation, and the knee-chest position, which the child will perform to decrease the return of systemic venous blood to the heart. A cough and apneic periods are not manifestations of this congenital heart defect.
E)Manifestations of TOF include a palpable thrill in the pulmonic area, clubbing of the fingers due to reduce oxygenation, and the knee-chest position, which the child will perform to decrease the return of systemic venous blood to the heart. A cough and apneic periods are not manifestations of this congenital heart defect.

Question 18

The nurse is providing teaching to the parents of a child born with tetralogy of Fallot (TOF). Which statement should the nurse include in her teaching regarding this defect?
A)"Increased pulmonary blood flow causes symptoms with this disease."
B)"This disease consists of pulmonic stenosis, left ventricular hypertrophy, ventricular septal defect, and an overriding aorta."
C)"Your child has a decreased amount of red blood cells because of this disease."
D)"This disease consists of pulmonic stenosis, right ventricular hypertrophy, ventricular septal defect, and an overriding aorta."

Accepted Answer

A)TOF consists of four defects-pulmonic stenosis, right ventricular hypertrophy, ventricular septal defect, and an overriding aorta. This disease is also characterized by decreased pulmonary blood flow and polycythemia (increased red blood cells due to hypoxia).
B)TOF consists of four defects-pulmonic stenosis, right ventricular hypertrophy, ventricular septal defect, and an overriding aorta. This disease is also characterized by decreased pulmonary blood flow and polycythemia (increased red blood cells due to hypoxia).
C)TOF consists of four defects-pulmonic stenosis, right ventricular hypertrophy, ventricular septal defect, and an overriding aorta. This disease is also characterized by decreased pulmonary blood flow and polycythemia (increased red blood cells due to hypoxia).
D)TOF consists of four defects-pulmonic stenosis, right ventricular hypertrophy, ventricular septal defect, and an overriding aorta. This disease is also characterized by decreased pulmonary blood flow and polycythemia (increased red blood cells due to hypoxia).

Question 19

The nurse is caring for a pregnant woman with congenital heart disease. The woman asks if she will be able to have a vaginal delivery. Which answer by the nurse is correct?
A)A Cesarean section is preferred because you will lose less blood than with a vaginal birth.
B)A Cesarean section is preferred because there is a lower risk of infection than with a vaginal birth.
C)A vaginal birth is preferred over a Cesarean section for women who have aortic stenosis.
D)A vaginal birth is preferred because there is a lower risk of thrombophlebitis than with a Cesarean section.

Accepted Answer

A)Vaginal delivery is preferable to Cesarean section for most clients with congenital heart defects because they will likely lose less blood with vaginal birth. Risk of wound infection and thrombophlebitis are also concerns with Cesarean birth. Dilated aorta, pulmonary hypertension, and aortic stenosis are contraindications for vaginal delivery.
B)Vaginal delivery is preferable to Cesarean section for most clients with congenital heart defects because they will likely lose less blood with vaginal birth. Risk of wound infection and thrombophlebitis are also concerns with Cesarean birth. Dilated aorta, pulmonary hypertension, and aortic stenosis are contraindications for vaginal delivery.
C)Vaginal delivery is preferable to Cesarean section for most clients with congenital heart defects because they will likely lose less blood with vaginal birth. Risk of wound infection and thrombophlebitis are also concerns with Cesarean birth. Dilated aorta, pulmonary hypertension, and aortic stenosis are contraindications for vaginal delivery.
D)Vaginal delivery is preferable to Cesarean section for most clients with congenital heart defects because they will likely lose less blood with vaginal birth. Risk of wound infection and thrombophlebitis are also concerns with Cesarean birth. Dilated aorta, pulmonary hypertension, and aortic stenosis are contraindications for vaginal delivery.

Question 20

The nurse is caring for a premature infant diagnosed with patent ductus arteriosus (PDA). Which medication should the nurse anticipate administering to this client? A)Indomethacin B)Propranolol C)Antibiotics D)Prostaglandin E₁

Accepted Answer

A)Intravenous indomethacin often stimulates the closure of the PDA in premature infants. Prophylactic antibiotics are used in some clients with a congenital heart defect, but this is not common for infants with PDA. Propranolol is used to treat tetralogy of Fallot. Prostaglandin E? is used with some congenital heart defects to maintain a PDA, not help close the PDA. B)Intravenous indomethacin often stimulates the closure of the PDA in premature infants. Prophylactic antibiotics are used in some clients with a congenital heart defect, but this is not common for infants with PDA. Propranolol is used to treat tetralogy of Fallot. Prostaglandin E₁ is used with some congenital heart defects to maintain a PDA, not help close the PDA. C)Intravenous indomethacin often stimulates the closure of the PDA in premature infants. Prophylactic antibiotics are used in some clients with a congenital heart defect, but this is not common for infants with PDA. Propranolol is used to treat tetralogy of Fallot. Prostaglandin E? is used with some congenital heart defects to maintain a PDA, not help close the PDA. D)Intravenous indomethacin often stimulates the closure of the PDA in premature infants. Prophylactic antibiotics are used in some clients with a congenital heart defect, but this is not common for infants with PDA. Propranolol is used to treat tetralogy of Fallot. Prostaglandin E₁ is used with some congenital heart defects to maintain a PDA, not help close the PDA.

Quiz 16: Perfusion

The nurse is caring for a child who has just been diagnosed with an atrial septal defect (ASD) . Which manifestations would the nurse expect upon assessment? Select all that apply.

The nurse is analyzing data collected after assessing a child with a congenital heart defect that decreases pulmonary blood flow. Which nursing diagnosis would be applicable for this client?

The mother of a baby born with a congenital heart defect is upset, as no one else in the family has been born with this condition. To determine the cause of the defect, which question is appropriate for the nurse to ask the mother?

A baby will be having surgery to correct a congenital heart defect. On which topic should the parents be instructed regarding the care of the child before surgery?

The nurse is planning care for a pediatric client recovering from surgery to repair a congenital heart defect. Which intervention should the nurse include to support the client's fluid status?

The nurse is caring for an infant diagnosed with hypoplastic left heart syndrome. The client has recently been scheduled for surgery to repair the defect. Which procedure does the nurse anticipate needing to provide client teaching about to the client's family?

A client diagnosed with cardiomyopathy asks the nurse to explain the different types of the disease. Which is inappropriate for the nurse to include in the teaching session?

The nurse provides discharge instructions to the parents of a child recovering from surgery to repair a congenital heart defect. What statement indicates that teaching has been effective?

A 72-year-old client diagnosed with hypertrophic cardiomyopathy (HCM) is speaking to the healthcare team about treatment options. Which treatment option would likely not be recommended for this client, even though it is commonly used to treat younger clients with this condition?

A 14-year-old child was recently diagnosed with hypertrophic cardiomyopathy. During a follow-up appointment, the mother asks the nurse, "How will this affect my child's ability to play football in the fall?" How should the nurse respond?

The nurse is caring for an adult client who was diagnosed with a congenital heart defect as a child, which was later repaired with surgery. Which common complication of a heart defect should the nurse monitor that the client may still be at risk for?

During what period of gestation do congenital heart defects usually develop?

The nurse is caring for a client diagnosed with cardiomyopathy. The client experiences tachycardia. Which medication does the nurse anticipate being prescribed?

A nurse is educating a client with cardiomyopathy about diet choices that are appropriate for the client's condition. Which statement is inappropriate for the nurse to include in the teaching session?

Which best describes how congenital defects are categorized?

A nurse is caring for a client with cardiomyopathy who is experiencing activity intolerance. Which intervention is inappropriate for this nursing diagnosis?

The nurse is assessing a toddler diagnosed with tetralogy of Fallot (TOF) . Which clinical manifestations does the nurse anticipate during the physical assessment? Select all that apply.

The nurse is providing teaching to the parents of a child born with tetralogy of Fallot (TOF) . Which statement should the nurse include in her teaching regarding this defect?

The nurse is caring for a pregnant woman with congenital heart disease. The woman asks if she will be able to have a vaginal delivery. Which answer by the nurse is correct?

The nurse is caring for a premature infant diagnosed with patent ductus arteriosus (PDA) . Which medication should the nurse anticipate administering to this client?