Question 1

Which laboratory test does the nurse anticipate for a child who is admitted to the hospital with suspected rheumatic fever?
A) Erythrocyte sedimentation rate
B) Throat culture
C) C-reactive protein
D) Antistreptolysin-O (ASO) titer

Accepted Answer

A diagnosis of rheumatic fever is confirmed by a positive antistreptolysin-O (ASO) titer test. A high titer indicates recent streptococcal infection.

Question 2

A toddler is prescribed digoxin (Lanoxin) for cardiac failure. Which should the nurse instruct the toddler's parents to monitor for as a manifestation associated with digoxin toxicity?
A) Bradycardia
B) Tinnitus
C) Ataxia
D) Hypotension

Accepted Answer

Bradycardia is a common sign of digoxin toxicity, especially in children. Parents should be instructed to monitor the child's heart rate and report any significant decrease.

Question 3

The nurse is teaching a pregnant client about fetal circulation. Which is the correct sequence of blood flow that indicates the pregnant client understands the information presented?
A) Ductus arteriosus
B) Ductus venosus
C) Foramen ovale

Accepted Answer

C,A,B

Question 4

Which teaching point should the nurse include in the discharge instructions for a pediatric client who has undergone cardiac surgery?
A) Should not receive routine immunizations.
B) Should be restricted from most play activities.
C) Fever is expected for several weeks following the surgery.
D) Prophylactic antibiotics are required for any dental, oral, or upper respiratory tract procedures.

Accepted Answer

Prophylactic antibiotics are necessary to prevent infective endocarditis after cardiac surgery. Routine immunizations should be given unless specifically contraindicated by the healthcare provider. The child may participate in modified play activities as approved by the healthcare provider. Fever should not be expected for several weeks following surgery and could indicate an infection.

Question 5

Which assessment data would cause the nurse to suspect that a pediatric client is experiencing hypovolemic shock? Select all that apply.
A) Dyspnea
B) Bradycardia
C) Tachycardia
D) Capillary refill time greater than 3 seconds.
E) Blood pressure 72/42 mmHg

Accepted Answer

The answer of Which assessment data would cause the nurse...

Question 6

Which clinical manifestation does the nurse anticipate for a pediatric client who is admitted with congestive heart failure (CHF)?
A) Tachycardia
B) Weight loss
C) Hypertension
D) Bradycardia

Accepted Answer

Tachycardia is a common clinical manifestation in pediatric clients with congestive heart failure as the heart tries to compensate for decreased cardiac output. Weight gain or fluid retention, rather than weight loss, is typically seen in CHF. Hypertension is not a typical finding in pediatric CHF, and bradycardia is unlikely given the compensatory tachycardia.

Question 7

The nurse admits a child with a ventricular septal defect (VSD) to the pediatric unit. Which is the priority nursing diagnosis for this child?
A) Hypothermia related to decreased metabolic state
B) Acute Pain related to the effects of a congenital heart defect
C) Ineffective Tissue Perfusion (peripheral) related to cyanosis secondary to congenital heart defect
D) Impaired Gas Exchange related to pulmonary congestion secondary to the increased pulmonary blood flow

Accepted Answer

Impaired Gas Exchange related to pulmonary congestion secondary to the increased pulmonary blood flow is the priority nursing diagnosis because VSD results in increased blood flow to the lungs, leading to pulmonary congestion and eventually impaired gas exchange. Hypothermia, acute pain, and ineffective tissue perfusion are potential concerns but are not as immediate or directly related to the VSD as impaired gas exchange.

Question 8

Which initial laboratory data does the nurse anticipate for a child who is admitted to the hospital with a cyanotic heart defect?
A) A low platelet count
B) A high white blood cell count
C) A high hemoglobin
D) A low hematocrit

Accepted Answer

A high hemoglobin level is expected in a child with a cyanotic heart defect due to chronic hypoxia stimulating erythropoietin production to increase hemoglobin levels in an attempt to compensate for low oxygen levels.

Answer: D
 A low hematocrit level may also be expected in a child with a cyanotic heart defect due to chronic hypoxia causing plasma expansion and dilution of red blood cells.

Therefore, both options C and D are correct.

Question 9

Which is the priority nursing action when providing care to a pediatric client who is diagnosed with hypovolemic shock?
A) Assessing the cause of bleeding
B) Establishing an open airway and administering oxygen
C) Administering analgesics for pain control
D) Providing replacement of volume

Accepted Answer

Establishing an open airway and administering oxygen is the priority nursing action when providing care to a pediatric client who is diagnosed with hypovolemic shock. This is because hypovolemic shock is a life-threatening condition that occurs when there is a loss of blood or fluid from the body, which can lead to decreased oxygen delivery to the tissues and organs. Establishing an open airway and administering oxygen helps to improve oxygenation and prevent further tissue damage.

Question 10

Which parental statement regarding the use of cyclosporin A after a heart transplant indicate correct understanding of the information presented by the nurse?
A) "This medication is used to treat hypertension."
B) "This medication is used to reduce serum cholesterol level."
C) "This medication is used to prevent rejection."
D) "This medication is used to treat infections."

Accepted Answer

Cyclosporin A is an immunosuppressant medication that is used to prevent rejection of the transplanted heart by suppressing the immune system. It is not used to treat hypertension, reduce serum cholesterol levels, or treat infections.

Question 11

Which heart defect should the nurse suspect for an infant whose upper extremities have stronger pulses than the lower extremities and blood pressure is higher in the arms than in the legs?
A) Transposition of the great vessels
B) Patent ductus arteriosus
C) Coarctation of the aorta
D) Atrial septal defect

Accepted Answer

Coarctation of the aorta is a narrowing of the aortic arch or descending aorta that can result in weaker pulses and lower blood pressure in the lower extremities. This can cause the upper extremities to have stronger pulses and higher blood pressure in the arms than in the legs. Transposition of the great vessels and atrial septal defect would not cause this specific symptom, and while patent ductus arteriosus can cause differences in blood pressure, it would not cause differences in pulse strength.

Question 12

Which feeding techniques should the nurse include in the teaching session for the parents of an infant who is being discharged in order to gain weight for the corrective surgery needed for a congenital heart defect? Select all that apply.
A) Breastfeed if possible.
B) Complete each feeding within 30 minutes.
C) Position the infant flat to promote swallowing.
D) Dilute the formula with extra water to ensure adequate fluid intake.
E) Burp the infant frequently.

Accepted Answer

Breastfeeding is encouraged for its nutritional benefits and ease of digestion. Completing feedings within 30 minutes helps prevent the infant from expending too much energy on eating, which is crucial for those with congenital heart defects. Frequent burping reduces the risk of gas and discomfort, which can be particularly problematic for infants with heart issues. Positioning the infant flat does not promote safe swallowing and can increase the risk of aspiration. Diluting formula is not recommended as it can lead to inadequate nutrient intake and potentially worsen the infant's condition.

Question 13

A 2-month-old infant with a congenital heart defect is admitted to the pediatric intensive care unit with congestive heart failure. Which intervention should the nurse include in the infant's plan of care?
A) Monitor respirations during active periods.
B) Give larger feedings less often to conserve energy.
C) Organize activities to allow for uninterrupted sleep.
D) Force fluids appropriate for age.

Accepted Answer

Organizing activities to allow for uninterrupted sleep helps conserve the infant's energy, which is crucial in managing congestive heart failure.

Question 14

An infant who is diagnosed with a mild heart defect will not have surgical correction for at least 2 years. Which information should the nurse include in the discharge teaching regarding management in the home environment?
A) "Your child will have a low-grade fever until the defect is repaired."
B) "It is important for your child to maintain normal activity."
C) "Your child is not at risk for congestive heart failure."
D) "It is important to avoid antipyretics for the treatment of fever."

Accepted Answer

The infant with a mild heart defect is not at risk for congestive heart failure and can maintain normal activity at home. The other options are not relevant or accurate in this situation.

Question 15

An infant with tetralogy of Fallot (TOF) is having a hypercyanotic episode ("tet" spell). Which nursing interventions are appropriate? Select all that apply.
A) Administer oxygen.
B) Place the child in knee-chest position.
C) Administer morphine and propranolol intravenously as ordered.
D) Draw blood for a serum hemoglobin.
E) Administer diphenhydramine (Benadryl) as ordered.

Accepted Answer

During a hypercyanotic episode in a child with TOF, the priority nursing interventions are to increase oxygenation and decrease systemic vascular resistance. Administering oxygen and placing the child in a knee-chest position can increase oxygen supply and decrease venous return, respectively. Medications such as morphine and propranolol can decrease systemic vascular resistance and relieve the cyanotic episode. Drawing blood for serum hemoglobin or administering diphenhydramine are not appropriate interventions for a hypercyanotic episode in a child with TOF.

Question 16

Which parental statement indicates correct understanding for the reason a cardiac catheterization is needed for a child who is diagnosed with a congenital heart defect?
A) "This procedure will keep the ductus arteriosus open and oxygenated and unoxygenated blood mixed."
B) "This procedure is used to close the ductus arteriosus to prevent mixing of arterial and venous blood."
C) "This procedure will redirect the blood so that blood bypasses the right ventricle."
D) "This procedure connects the ventricle to the atrium."

Accepted Answer

The answer of Which parental statement indicates correct understanding for...

Question 17

Which is the rationale the nurse provides to the parents of an infant diagnosed with congestive heart failure (CHF) for the prescribed spironolactone?
A) Produces rapid diuresis
B) Blocks reabsorption of sodium and water in renal tubules
C) Spares potassium
D) Promotes vascular relaxation

Accepted Answer

Spironolactone is a potassium-sparing diuretic, which means it helps the body get rid of excess fluid without causing the loss of potassium, unlike other diuretics. This is important in managing congestive heart failure (CHF) where maintaining electrolyte balance is crucial.

Question 18

Which athletic activity should the nurse recommend for a school-age child who is diagnosed with pulmonary artery hypertension?
A) Golf
B) Basketball
C) Cross-country running
D) Soccer

Accepted Answer

Golf involves low-intensity physical activity with minimal exertion and does not increase blood pressure or heart rate significantly. Therefore, it is a good choice for a child with pulmonary artery hypertension who should avoid activities that cause excessive exertion or shortness of breath.

Question 19

Which assessment finding indicates adequate peripheral perfusion for a child after a cardiac catheterization?
A) Capillary refill is greater than 3 seconds.
B) Lower extremities are warm, with a capillary refill of less than 3 seconds.
C) Sensation is decreased with a weakened dorsalis pedis pulse.
D) Dorsalis pedis pulse is palpable but posterior tibial pulse is weak.

Accepted Answer

Warm lower extremities with a capillary refill of less than 3 seconds indicate adequate peripheral perfusion. The other options indicate poor perfusion.

Question 20

Which treatment options should the nurse anticipate for a 10-month-old infant admitted to the emergency department with supraventricular tachycardia? Select all that apply.
A) Administering intravenous adenosine (Adenocard)
B) Administering intravenous amiodarone (Cardarone)
C) Preparing for cardioversion
D) Applying ice to the face
E) Having the child perform a Valsalva maneuver

Accepted Answer

The answer of Which treatment options should the nurse anticipate...

Quiz 47: The Child With Alterations in Cardiovascular Function

Which laboratory test does the nurse anticipate for a child who is admitted to the hospital with suspected rheumatic fever?

A toddler is prescribed digoxin (Lanoxin) for cardiac failure. Which should the nurse instruct the toddler's parents to monitor for as a manifestation associated with digoxin toxicity?

The nurse is teaching a pregnant client about fetal circulation. Which is the correct sequence of blood flow that indicates the pregnant client understands the information presented? A) Ductus arteriosus B) Ductus venosus C) Foramen ovale

Which teaching point should the nurse include in the discharge instructions for a pediatric client who has undergone cardiac surgery?

Which assessment data would cause the nurse to suspect that a pediatric client is experiencing hypovolemic shock? Select all that apply.

Which clinical manifestation does the nurse anticipate for a pediatric client who is admitted with congestive heart failure (CHF) ?

The nurse admits a child with a ventricular septal defect (VSD) to the pediatric unit. Which is the priority nursing diagnosis for this child?

Which initial laboratory data does the nurse anticipate for a child who is admitted to the hospital with a cyanotic heart defect?

Which is the priority nursing action when providing care to a pediatric client who is diagnosed with hypovolemic shock?

Which parental statement regarding the use of cyclosporin A after a heart transplant indicate correct understanding of the information presented by the nurse?

Which heart defect should the nurse suspect for an infant whose upper extremities have stronger pulses than the lower extremities and blood pressure is higher in the arms than in the legs?

Which feeding techniques should the nurse include in the teaching session for the parents of an infant who is being discharged in order to gain weight for the corrective surgery needed for a congenital heart defect? Select all that apply.

A 2-month-old infant with a congenital heart defect is admitted to the pediatric intensive care unit with congestive heart failure. Which intervention should the nurse include in the infant's plan of care?

An infant who is diagnosed with a mild heart defect will not have surgical correction for at least 2 years. Which information should the nurse include in the discharge teaching regarding management in the home environment?

An infant with tetralogy of Fallot (TOF) is having a hypercyanotic episode ("tet" spell) . Which nursing interventions are appropriate? Select all that apply.

Which parental statement indicates correct understanding for the reason a cardiac catheterization is needed for a child who is diagnosed with a congenital heart defect?

Which is the rationale the nurse provides to the parents of an infant diagnosed with congestive heart failure (CHF) for the prescribed spironolactone?

Which athletic activity should the nurse recommend for a school-age child who is diagnosed with pulmonary artery hypertension?

Which assessment finding indicates adequate peripheral perfusion for a child after a cardiac catheterization?

Which treatment options should the nurse anticipate for a 10-month-old infant admitted to the emergency department with supraventricular tachycardia? Select all that apply.