PEDS cardiac

1. A 10-month-old infant with Tetralogy of Fallot experiences a cyanotic episode or "blue spell". To improve oxygenation during such an episode, the nurse should place the infant in which position? a. Knee to chest b. Fowler's c. Trendelenburg d. Prone

A

1. A mom calls the clinic saying her child missed the digoxin dose by 2 hrs. What do you tell her? a. Give the prescribed dose now and get back on schedule b. Double the dose at the next prescribed time c. Give half the dose now and the full next schedule dose d. I'm calling DCFS

A

19. The nurse is working in a pediatric clinic when Stuart, a 3-year-old with congenital heart anomalies presents. He is diagnosed with Subacute Bacterial Endocarditis (SBE). While assessing Stuart and obtaining his history, the nurse would expect which of the following? a. Weight loss b. Ruddy complexion c. Edema to the extremities d. Restlessness and inability to sleep

A

4. 8-year-old Michael has rheumatic fever. As the nurse caring for Michael, you know that which of the following symptoms of the disease leaves permanent sequelae? a. Carditis b. Polyarthritis c. Gingivitis d. Anemia

A

5. True or false: Closure of VSD can occur spontaneously in the first year of life a. True b. False

A

6. What is NOT a common nursing intervention for Kawasaki disease a. Administer ibuprofen as prescribed b. IV IgG as prescribed c. Provide soft foods d. Use a soft tooth brush

A

7. What is not one of the four structural anomalies associated with Tetralogy of Fallot? a. ASD b. VSD c. Overriding aorta d. Right ventricular hypertrophy

A

13. The child with Tetralogy of Fallot experiences which of the following types of shunting of the blood? a. Left to right b. Right to left c. Upper to lower d. Lower to upper

B

17. The nurse is caring for a 3-week-old Autumn diagnosed with an ASD. Which of the following should be included in Autumn's plan of care? a. Monitor strict I&O, weigh all diapers and weight Autumn weekly b. Cluster all care so that oxygen demands are decreased c. Provide high calorie formula and allow Autumn to feed slowly over an hour d. Allow Autumn to cry to encourage expansion and clearing of lung fields

B

2. A child in the ER has +3 radial and +1 pedal pulses. Which cardiac defect is most likely? a. VSD b. Coarctation of the aorta c. ASD d. Aortic stenosis

B

3. When will a child with Tetralogy of Fallot have all defects surgically corrected? a. By 3 months of age b. By 1 year of age c. By 18 months of age d. By 4 years of age

B

3. Which of the following instructions would the nurse include in a teaching plan that focuses on initial prevention of rheumatic fever? a. Using a corticosteroid to reduce inflammation b. Treating streptococcal throat infection with an antibiotic c. Providing an antibiotic before dental work d. Giving penicillin to clients with rheumatic fever

B

5. 8-year-old Michael has rheumatic fever. You would expect to see which of the following as part of Michael's health history? a. Otitis media b. Sore throat c. Measles d. Varicella zoster

B

7. A 5-year-old child named Amy who has a diagnosis of Tetralogy of Fallot is having cardiac surgery to repair her Tetralogy of Fallot. She has developed polycythemia. What would be the best action because of the development of this condition? a. Allow rest period b. Keep her hydrated c. Keep her in a semi-fowlers position d. Perform passive range of motion

B

9. A child, age 4, is admitted with a tentative diagnosis of congenital heart disease. When assessment reveals a bounding radial pulse and weak femoral pulse, the nurse suspects that the child had: a. Patent ductus arteriosus b. Coarctation of the aorta c. Ventricular septal defect d. Truncus arteriosus

B

11. The nurse is reviewing the anatomy and physiology of the heart. All of the following statements are true except: a. Prior to birth the pressure is highest on the right side of the heart b. The area of highest pressure in the heart of a healthy child is the left ventricle c. A right to left shunt creates increased pulmonary blood flow d. Relaxation of the heart is called diastole

C

15. The nurse is caring for Sam, a 2-year-old with an unrepaired VSD. When reviewing Sam's admission history, the nurse notes that his oxygen saturations were low, and he was found mottled with cyanosis to the mouth and extremities. These findings can be attributed to which of the following? a. A VSD causes a left to right shunt which commonly leads to cyanosis b. Mottling and cyanosis are often seen in a hypothermic child c. The right side of the heart has begun to fail causing a right to left shunt d. The left side of the heart has begun to fail causing a left to right shunt

C

18. The nurse is evaluating Taylor, a 10-year-old with a history of streptococcal infection. Taylor has just been diagnosed with Rheumatic Fever and the nurse needs to provide instructions to the parents. Which of the following would not be included in Taylor's care? a. Explain that Taylor will be taking penicillin for the next 10 years b. Encourage Taylor to sue a spoon for meals while avoiding the use of knives and forks c. Encourage activity such has walking and weight lifting d. Encourage Taylor to use anti-inflammatory medications for discomfort

C

2. A child with suspected rheumatic fever is admitted to the pediatric unit. When obtaining the child's history, the nurse considers which information to be most important? a. A fever that started 3 days ago b. Lack of interest in food c. A recent episode of pharyngitis d. Vomiting for 2 days

C

21. The nurse is caring for 3-year-old Noah diagnosed with Kawasaki's disease. While assessing Noah and reviewing his results, the nursed would expect to find which of the following? a. Swelling of the conjunctiva with purulence b. A very distinctive rash to extremities c. Inflammation of the mouth, lips, and tongue d. Lab results showing a positive ASO titer

C

6. A 5-year-old named Amy has a diagnosis of Tetralogy of Fallot and is being admitted for cardiac surgery. During the course of your care for Amy, you correctly identify that the abnormal changes in the heart structure in Tetralogy of Fallot are: a. Stenosis of the pulmonary vein, hypertrophy of the right ventricle, dextroposition of the aorta, and a ventricular septal defect b. Hypertrophy of the left ventricle, stenosis of the pulmonary vein, ventricular septal defect, dextroposition of the aorta c. Stenosis of the pulmonary artery, hypertrophy of the right ventricle, ventricular septal defect, dextroposition of the aorta d. Stenosis of the pulmonary artery, hypertrophy of the left ventricle, a patent ductus arteriosus, dextroposition of the aorta

C

8. Amy has been diagnosed with T of F and is being admitted for cardiac surgery. While playing in the playroom Amy stoops and squats down to the floor. The nurse should: a. Give oxygen b. Pick her up immediately and put her in Fowler's position in bed c. Support the child in the position she assumes and observe d. Call the doctor

C

10. Children with congenital heart conditions are extremely susceptible to: a. Gastrointestinal disorders b. Skin infections c. Allergic conditions d. Upper respiratory infections

D

12. The nurse is caring for a child who is at risk for congestive heart failure secondary to a congenital heart defect that increases pulmonary blood flow except: a. Patent ductus arteriosus (PDA) b. Atrial septal defect (ASD) c. Ventricular septal defect (VSD) d. Pulmonary stenosis

D

14. The nurse is caring for 18-month-old Aniya who has been adopted from Haiti. Aniya has been diagnosed with Tetralogy of Fallot and will be undergoing corrective surgery. The nurse observes Aniya squatting while playing in her room. How should the nurse respond to this situation? a. Immediately administer oxygen and prepare to administer morphine to decrease infundibular spasm b. Place Aniya in her crib in side lying position while obtaining vital signs and oxygen saturation c. Immediately call for extra support d. Continue to watch and assess Aniya without changing her position

D

16. The nurse is caring for Ben, a 4-year-old with an unrepaired VSD. The nurse would expect to find all of the following in Ben's history EXCEPT: a. Tachypnea with congested cough b. Tachycardia c. Height for age at 5th percentile d. Small liver that is difficult to assess

D

20. The nurse is reviewing information regarding Kawasaki's disease. Which of the following is correct? a. Without treatment 50% of all children diagnosed with Kawasaki's disease will have permanent cardiac sequelae b. It is second only to Rheumatic Fever as the leading cause of acquired pediatric heart disease c. It generally affects children over 10 years old d. It is treated with salicylate (aspirin) therapy

D

4. What is NOT a characteristic of rheumatic fever? a. Occurs 2-6 weeks after group A beta-hemolytic strep exposure b. Afternoon low grade fevers c. Chorea and joint inflammation d. Pruritis

D