PEDS Heart and Renal Qs (ATI, PEDS book, PEDS success book)

Which are the most serious complications for a child with Kawasaki disease? (Select all that apply) A). Coronary thrombosis B). Coronary stenosis C). Coronary artery aneurysm D). Hypocoagulability E). Decreased sedimentation rate F). Hypoplastic left heart syndrome

A, B , C

What can an electrocardiogram (ECG) detect? (Select all that apply) A). Ischemia B). Injury C). Cardiac output D). Dysrhythmias E). Systemic Vascular Resistance F). Occlusion Pressure G). Conduction delay

A, B, D, G

A heart transplant may be indicated for a child with severe heart failure and: A). Patent ductus arteriosus B). Ventricular septal defect C). Hypoplastic left heart syndrome D). Pulmonic Stenosis

C

While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has: A). Pulmonary hypertension B). Patent ductus arteriosus C). Ventricular septal defect D). Bronchopulmonary dysplasia

B

The most common cardiac dysfunction in peds is: A). Ventricular tachycardia B). Sinus bradycardia C). Supraventricular tachycardia D). First- degree heart block

C

The flow of blood through the heart with an atrial septal defect is _______________

Left to right

Indomethacin may be given to close which congenital heart defect (CHD) in newborns? _____________________

Patent Ductus arteriosus

The following are examples of acquired heart disease (Select all that apply) A). Infective endocarditis B) Hypoplastic left heart syndrome C). Rheumatic fever D). Cardiomyopathy E). Kawasaki Disease F). Transposition of the great vessels

A, C, D, E

A nurse is caring for a child who is suspected of having rheumatic fever. Which of the following findings should the nurse expect? (Select all that apply) A). Erythema marginatum (rash) B). Continuous joint pain of the digits C). Tender, subcutaneous nodules D). Decreased erythrocyte sedimentation rate E). Elevated, C-Reactive protein

A, E

Which interventions decreased cardiac demands in an infant with congestive heart failure? Select all that apply A). Allow parents to hold and rock their child B). Feed only when the infant is crying C). Keep the child uncovered to promote low body temp D). Make frequent position changes E). Feed the child when sucking the fists F). Change bed linens only when necessary G). Organize nursing activites

A, D, E, F, G

A 3-month-old has been diagnosed with ventricular septal defect. The flow of the blood through the heart is _________

Left to Right

The nurse is caring for a 9-month-old who was born with a congenital heart defect. Assessment reveals a HR of 160, capillary refill of 4 seconds, bilateral crackles, and sweat on the scalp. These are signs of _____________

Congestive Heart Failure

A nurse is providing teaching to the caregiver of an infant who has a prescription for digoxin. Which of the following instructions should the nurse include? A). "Do not give your baby fluids after giving the medication" B). "Digoxin increases your baby's heart rate" C). "Give the correct dose of medication at regularly scheduled times" D). "If your baby vomits a dose, you should repeat the dose to ensure that the correct amount is recieved"

C

A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? A). Gallop and rales B). Blood Pressure discrepancies in the extremities C). Right ventricular hypertrophy on ECG D). Heart Murmur

D

The nurse is caring for an 8-year-old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbance. They state it seems worse when she is anxious and does not occur while sleeping. The nurse questions the parents about what recent illness? A). Kawasaki disease B). Strep throat C). Malignant hypertension D). Atrial fibrillation

B

The parents of a 3-month-old asky why their baby will not have an operation to correct a ventricular septal defect. The nurses best response is: A). "It is always helpful to get a second opinion about any serious condition like this" B). "Your baby's defect is small and will likely close on its own by 1 year of age" C). "It is common for physicians to wait until an infant develops respiratory distress before they do surgery" D). "With a small defect like this, they wait until the child is 10 years old to do the surgery"

B

The school nurse has been following a child who comes to the office frequently for vague complaints of dizziness and headache. Today she is brought in after fainting in the cafe following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has: A). Transposition of the great vessels B). Coarctation of the aorta C). Aortic Stenosis D). Pulmonic stenosis

B

Which finding might delay a cardiac catheterization procedure on a 1-year-old? A). 30th percentile for weight B). Severe diaper rash C). Allergy to soy D). Oxygen saturation of 91% on room air

B

While looking through the chart of an infant with congenital heart defects of decreased pulmonary blood flow, the nurse would expect what laboratory finding? A). Decreased platelet count B). Polycythemia C). Decreased ferritin level D). Shift to the left

B

A nurse is assessing who has heart failure. Which of the following findings should the nurse expect? (Select all that apply) A). Bradycardia B). Cool extremities C). Peripheral edema D). Increased urinary output E). Nasal Flaring

B,C,E

Family discharge teaching has been effective when the parent of a toddler diagnosed with Kawasaki disease (KD) states: A). "The arthritis in her knees is permanent. She will need knee replacements." B). "I will give her diphenhydramine (Benadryl) for her peeling palms and soles of her feet." C). "I know she will be irritable for 2 months after her symptoms started." D). "I will continue with high doses of Tylenol for her inflammation."

C

In which congenital heart defect would the nurse need to take upper and lower extremity BPs? A). Transposition of the great vessels B). Aortic Stenosis C). Coarctation of the aorta D). Tetralogy of fallot

C

The nurse is caring for a child after a cardiac catheterization. What is the nursing priority? A). Allow early ambulation to encourage activity participation. B). Check pulses above the catheter insertion site for strength and quality. C). Assess extremity distal to the insertion site for temperature and color. D). Change the dressing to evaluate the site for infection.

C

Which plan would be appropriate in helping to control congestive heart failure (CHF) in an infant? A). Promoting fluid restriction. B). Feeding a low-salt formula. C). Feeding in semi-Fowler position. D). Encouraging breast milk.

C

Which statement by the mother of a child with rheumatic fever shows she has good understanding of the care of her child? A). "I will apply heat to his swollen joints to promote circulation" B). "I will have him do gentle stretching exercises to prevent contractures" C). "I will give him the aspirin that is ordered for pain and inflammation" D). "I will apply cold packs to his swollen joints to reduce pain"

C

The nurse is caring for a child who has undergone cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurses first action is to: A). Call the interventional cardiologist B). Notify the cardiac catheterization lab that the child will be returning C). Apply a bulky pressure dressing over the present dressing D). Apply direct pressure 1 inch above the puncture site

D

While assessing a 4-month-old infant, the nurse notes that the baby experiences a hypercyanotic spell. What is the priority nursing action? A). Provide supplemental oxygen by face mask. B). Administer a dose of IV morphine sulfate. C). Begin cardiopulmonary resuscitation. D). Place the infant in a knee-to-chest position.

D

For the child with hypoplastic left heart syndrome, which drug may be given to allow the patent ductus arteriosus to remain open until surgery?

Prostaglandin E

A nursing action that promotes ideal nutrition in an infant with congestive heart failure is: A). Feeding formula that is supplemented with additional calories B). Allowing the infant to nurse at each breast for 20 minutes C). Providing large feedings every 5 hours D). Using firm niopples with small openings to slow feedings

A

Sam, age 11, has a diagnosis of rheumatic fever and has missed school for a week. What is the most likely cause of this problem? A). Previous streptococcal throat infection. B). History of open heart surgery at 5 years of age. C). Playing too much soccer and not getting enough rest. D). Exposure to a sibling with pneumonia.

A

The nurse is caring for a 5-year-old child with a congenital heart anomaly causing chronic cyanosis. When performing the history and physical examination, what is the nurse least likely to assess? A). Obesity from overeating B). Clubbing of the nail beds C). Squatting during play activities D). Exercise intolerance

A

The nurse is caring for a child with kawasaki disease. A student nurse who is on the unit asks if there are medications to treat this disease. The nurse's response to the student nurse is: A). Immunoglobulin G and aspirin B). Immunoglobin G and ACE inhibitors C). Immunoglobulin E and heparin D). Immunoglobulin E and ibuprofen

A

Which physiological change occurs as a result of hypoxemia in congestive heart failure? A). Polycythemia and clubbing B). Anemia and barrel chest C). Increased WBC and low platelets D). Elevated erythrocyte sedimentation rate and peripheral edema

A

Hypoxic spells in the infant with congenital heart defects can cause which of the following? (Select all that apply) A). Polycythemia B). Blood clots C). Cerebrovascular accident D). Developmental delays E). Viral pericarditis F). Brain damage G). Alkalosis

A, B, C, D, F

A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (Select all that apply) A). Weak femoral pulses B). Cool skin of lower extremities C). Severe cyanosis D). Clubbing of the fingers E). Low blood pressure

A, B, E

A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess: A). Pain B). Pulses C). Hemoglobin and hematocrit levels D). Catheterization report

B

A child has been seen by the school nurse for dizziness since the start of the school term. It happens when standing in line for recess and homeroom. The child now reports that she would rather sit and watch her friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has: A). Ventricular septal defect B). Aortic stenosis C). Mitral valve prolapse D). Tricuspid atresia

B

A nurse is caring for a 2-year-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A). Place on NPO status for 12hr prior to the procedure B). Check for iodine or shellfish allergies prior to the procedure C). Elevate the affected extremity following the procedure D). Limit fluid intake following the procedure

B

Aspirin has been ordered for the child with rheumatic fever (RF) in order to: A). Keep the patent ductus arteriosus (PDA) open. B). Reduce joint inflammation. C). Decrease swelling of strawberry tongue. D). Treat ventricular hypertrophy of endocarditis.

B