Question 1

Basically there are three areas of congenital heart disease that the nurse must be concerned with. One of these causes central cyanosis. Which of these would it be?

Accepted Answer

Central cyanosis is caused by Cyanotic lesions. Obstructive lesions cause pressure overload, and left-to-right lesions cause volume overload.

Question 2

When a child is suspected of having a cardiac problem there are three common symptoms they could present with. One is a murmur the other is cyanosis, so what would be the third most common presentation?

Accepted Answer

Respiratory problem are the third most common presentation of cardiac problems other than murmur and cyanosis. The nurse must be on the watch for potential pulmonary infection when observing clinical presentation.

Question 3

A nurse is in the process of accessing a 6 week old infant who has been brought into the emergency room for assessment. The nurse is not sure if the patient is presenting cardiac or respiratory symptoms and decides to do a palpation of the heart. If the problem is cardiac related then as a result of the palpitation the nurse may discover that the heart is enlarged and is identified by what signs?

Accepted Answer

A distinct force of movement is felt while the fingertips are on the right ventricle. If the palpation is done correctly then an unmistakable detection of forceful movement will be evident. However, slight impulses are not abnormal.

Question 4

Many nurses find it difficult in a nurse to get accurate information when making their assessment using the stethoscope and it can near impossible with a crying or irritable baby. What can the nurse do in order to make her job a little easier?

Accepted Answer

Give the baby a pacifier or bottle as a temporary aid to stop the crying. The auscultation should not be delayed in the event there is something abnormal that may be occurring, especially if the baby is crying for what may seem like no apparent reason.

Question 5

A neonatal nurse is doing a routine exam of a 2 week old premature infant. She detects a systolic murmur which can be heard maximally in the Axillae. It has a high pitch long sound to it almost like a blowing sound. This finding most likely means:

Accepted Answer

At this age it is not a cause for concern. This particular murmur is coming from the peripheral pulmonary arteries and is common in premature babies and on occasion in full term babies.

Question 6

A concerned parent has just been told that her infant has congestive heart failure. They of course very upset and the supervisory neonatal nurse is trying to give them some encouragement. The nurse should tell them:

Accepted Answer

The nurse should tell them "There are medications that can be use to help relieve the symptoms." It's important the nurse fully understand what the diagnosis is that has been made, what the physician has told the parents and to be most positive without being misleading.

Question 7

A neonatal nurse who has just recently graduated and is serving her first shift in the neonatal unit is asked by the attending physician to order a BUN test for a 4 week old infant. The child has been diagnosed with Congestive Heart Failure (CHF). What with the results of the BUN test tell him?

Accepted Answer

It will tell him there is a decreased blood flow to the kidneys. Increased BUN levels can indicate several conditions such as acute or chronic kidney disease and many other conditions as well as also indicate a recent heart attack. In the case of congestive heart failure this can cause decreased blood flow to the kidneys which could support the diagnosis of the CHF.

Question 8

A 4-month old has been admitted into the hospital suffering from Myocarditis. Which one of the following is the test used to give a specific positive diagnosis of this condition?

Accepted Answer

There is no positive test. There are no specific tests to help make the diagnosis therefore the diagnosis is made from the clinical assessment with various tests used to verify the diagnosis.

Question 9

A neonatal nurse has a 2 month old patient and she must ensure monitoring of Hemodynamic monitoring, pulmonary pressure, and right, left venous pressure included in the monitoring will be the heart rate, any contractibility and arrhythmias. Along with there will be other various presentations to watch for as well. What is the most likely reason for this intensive type of monitoring from the following choices?

Accepted Answer

The patient is post surgical from a cardiac procedure. Post operation monitoring is critical after any type of neonatal surgery but is extremely important following cardiac surgery.

Question 10

A family has been brought into emergency following a head on automobile collision. An 8-month old baby was thrust forward and received blunt force to the thoracic area. Which of the following is most likely to give the nurse indications that there may be injury to the heart?

Accepted Answer

Arrhythmias is likely to indicate the nurse of the injury to the heart. There can be many types of injuries sustained in an accident such as this and one of the primary concerns is if there has been any damage incurred to the heart. An Electrocardiogram (EKG) will rule out any potential cardiac injury in most cases.

Question 11

Which of the following heart defects is the most common congenital heart defect?

Accepted Answer

Ventricular Septal Defect is the most common type of heart malformation (congenital heart disease). At least 1 baby in every 500 is born with a VSD.

Question 12

A nurse is making a room assignment for a 12-month-old with bacterial meningitis. The nurse plans to place the infant in which of the following rooms?

Accepted Answer

A child with bacterial meningitis should be placed in an isolation room until the child receives antibiotics, given through the IV route, for 24 hours. The room must be near the nurse's station for close monitoring and easier access. Bacterial meningitis is transmitted through respiratory secretions; it is not an airborne disease. An isolation room with negative pressure is recommended for a client with tuberculosis.

Question 13

Which of the following infants should the nurse see first?

Accepted Answer

The normal apical rate for newborns is between 120 to 160 beats per minute when sleeping and around 180 beats per minute when crying. A bulging fontanel caused by crying is a common finding in infants. It becomes a concern if the fontanel does not return to normal when the infant is already calm. Parchment-like skin is usually seen in babies born after 42 weeks of gestation. Brief episodes of apnea during sleep, lasting no more than 20 seconds, are usually observed in newborns. The respiratory pattern in newborns is caused by immaturity of the part of the brain that controls breathing.

Question 14

A pregnant woman at 28 weeks gestation finds out that she is infected with human immunodeficiency virus. The nurse informs the mother that which of the following does not put the baby at risk for HIV infection?

Accepted Answer

HIV is transmitted by direct contact to contaminated bodily fluids, including vaginal secretions, blood, IV substance abuse, and breast milk. Changing diapers does not transmit the virus.

Quiz 2: Neonatal