Success Peds - Cardiovascular

A 3-month-old has been diagnosed with a VSD. The flow of blood through the heart with this type of defect is: 1. Right to left. 2. Equal between the two chambers. 3. Left to right. 4. Bypassing the defect.

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The parent of an infant newly diagnosed with TOF is asking the nurse which defects are involved. Select all that apply. 1. VSD. 2. Right ventricular hypertrophy. 3. Left ventricular hypertrophy. 4. PS. 5. Pulmonic atresia. 6. Overriding aorta. 7. PDA.

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During play, a toddler with a history of TOF might assume which of the following positions? 1. Sitting. 2. Supine. 3. Squatting. 4. Left lateral recumbent.

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Gamma globulin is being given to a 1-year-old being treated for KD. Which of the following vaccines must be delayed for 11 months after the administration of gamma globulin? 1. Diphtheria, tetanus, and pertussis. 2. Hepatitis B. 3. Inactivated polio virus. 4. Measles, mumps, and rubella.

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A nursing action that promotes ideal nutrition in an infant with CHF is: 1. Feeding formula that is supplemented with additional calories. 2. Allowing the infant to nurse at each breast for 20 minutes. 3. Providing large feedings every 5 hours. 4. Using firm nipples with small openings to slow feedings.

1

The nurse is caring for a school-aged boy with KD. 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: 1. Immunoglobulin G and aspirin. 2. Immunoglobulin G and ACE inhibitors. 3. Immunoglobulin E and heparin. 4. Immunoglobulin E and ibuprofen.

1

What two physiological changes occur as a result of hypoxemia in CHF? 1. Polycythemia and clubbing. 2. Anemia and barrel chest. 3. Increased white blood cells and low platelets. 4. Elevated erythrocyte sedimentation rate and peripheral edema.

1

Hypoxic spells in the infant with CHD can cause which of the following? Select all that apply. 1. Polycythemia. 2. Blood clots. 3. CVA. 4. Developmental delays. 5. Viral pericarditis. 6. Brain damage. 7. Alkalosis.

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A 1-year-old child is being prepared for a cardiac catheterization procedure. Which of the following findings about the child might delay the procedure? 1. 30th percentile for weight. 2. Severe diaper rash. 3. Allergy to soy. 4. Oxygen saturation of 91% on room air.

2

A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess: 1. Pain. 2. Pulses. 3. Hemoglobin and hematocrit levels. 4. Catheterization report.

2

An infant with CHF is receiving digoxin to enhance myocardial function. What should the nurse assess prior to administering the medication? 1. Yellow sclera. 2. Apical pulse rate. 3. Cough. 4. Liver function test.

2

Aspirin has been ordered for the child with RF in order to: 1. Keep the PDA open. 2. Reduce joint inflammation. 3. Decrease swelling of strawberry tongue. 4. Treat ventricular hypertrophy of endocarditis.

2

Parents report that their 6-year-old has been seen by the school nurse for dizziness that occurred when standing in line for recess and homeroom since the start of the school term. 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 the child if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has: 1. VSD. 2. AS. 3. Mitral valve prolapse. 4. Tricuspid atresia.

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The nurse is caring for a 3-month-old with a VSD. The physicians have decided not to repair it surgically. The parents express concern that this is not best for their child and ask why their daughter will not have an operation. The nurse's best response to the parents is: 1. "It is always helpful to get a second opinion about any serious condition like this." 2. "Your daughter's defect is small and will likely close on its own by the time she is 2 years old." 3. "It is common for the physicians to wait until an infant develops respiratory distress before they do the surgery because of the danger." 4. "With a small defect like this, we will wait until the child is 10 years old to do the surgery."

2

The nurse is caring for a 4-year-old female with a Glasgow Coma Scale of 3, HR of 88 beats per minute and regular, respiratory rate of 22, BP of 78/52, and blood sugar of 35 mg/dL. The nurse asks the caregiver about accidental ingestion of what drug? 1. Calcium channel blocker. 2. Beta blocker. 3. ACE inhibiter. 4. ARB.

2

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 disturbances. They state it seems worse when she is anxious and does not occur when she is sleeping. The nurse questions the parents about what recent illness? 1. KD. 2. RF. 3. Malignant hypertension. 4. Atrial fibrillation.

2

The school nurse has been following an 8-year-old female who comes to the office frequently. She has come mainly for vague complaints of dizziness and headache. Today, she is brought after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. Calling for the ambulance, the nurse suspect she has: 1. Transposition of the great vessels. 2. COA. 3. AS. 4. PS.

2

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: 1. Pulmonary hypertension. 2. A PDA. 3. A VSD. 4. Bronchopulmonary dysplasia.

2

While looking through the chart of an infant with a CHD of decreased pulmonary blood flow, the nurse would expect what laboratory finding? 1. Decreased platelet count. 2. Polycythemia. 3. Decreased ferritin level. 4. Shift to the left.

2

A 2-month-old is being treated with furosemide for CHF. Which of the following plans would also be appropriate in helping to control the CHF? 1. Promoting fluid restriction. 2. Feeding a low-salt formula. 3. Feeding in semi-Fowler position. 4. Encouraging breast milk.

3

A 5-month-old has been diagnosed with an ASD. The flow of blood through the heart with this type of defect is: 1. Right to left .2. Equal between the two chambers. 3. Left to right .4. Bypassing the defect.

3

Family discharge teaching has been effective when the parents of a female toddler diagnosed with KD states: 1. "The arthritis in her knees is permanent. She will need knee replacements." 2. "I will give her a pain reliever for her peeling palms and soles of her feet." 3. "I know she will be irritable for 2 months after her symptoms started." 4. "I will continue with high doses of Tylenol for her inflammation."

3

Heart transplant may be indicated for a child with which of the following symptoms? 1. Severe heart failure and PDA. 2. Severe heart failure and VSD. 3. Severe heart failure and hypoplastic left heart syndrome. 4. Severe heart failure and PS.

3

In which of the following CHDs would the nurse need to take upper and lower extremity BPs? 1. Transposition of the great vessels. 2. AS. 3. COA. 4. TOF.

3

Which medication should the nurse give to a patient who is diagnosed with transposition of the great vessels? 1. Ibuprofen. 2. Betamethasone. 3. Prostaglandin E. 4. Indocin.

3

Which of the following assessments indicate that the parents of a 7-year-old are following the prescribed treatment for CHF? 1. HR of 56 beats per minute. 2. Elevated red blood cell count. 3. 50th percentile height and weight for age. 4. Urine output of 0.5 cc/kg/hr.

3

Which patient could require feeding by gavage? 1. A patient with KD in the acute phase. 2. A toddler with repair of transposition of the great vessels. 3. An infant with CHF. 4. A school-ager with RF and chorea.

3

Which statement by the mother of a male toddler with RF shows she has good understanding of the care of her child? 1. "I will apply heat to his swollen joints to promote circulation." 2. "I will have him do gentle stretching exercises to prevent contractures." 3. "I will give him the aspirin that is ordered for pain and inflammation." 4. "I will apply cold packs to his swollen joints to reduce pain."

3

Which statement by the mother of a patient with RF shows she has an understanding of prevention in her other children? 1. "Whenever one of them gets a sore throat, I will give that child an antibiotic." 2. "There is no treatment. It must run its course." 3. "If their culture is positive for group A streptococcus, I will give them their antibiotic." 4. "If their culture is positive for staphylococcus A, I will give them their antibiotic."

3

Congenital Heart Defects are classified by which of the following? Select all that apply. 1. Cyanotic defect. 2. Acyanotic defect. 3. Defects with increased pulmonary blood flow. 4. Defects with decreased pulmonary blood flow. 5. Mixed defects. 6. Obstructive defects. 7. Pansystolic murmurs.

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A 2-month-old with TOF is seen in your clinic for a check-up. During the examination, the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to: 1. Lay the child flat to promote hemostasis. 2. Lay the child flat with legs elevated to increase blood flow to the heart. 3. Sit the child on the parent's lap, with legs dangling, to promote venous pooling. 4. Hold the child in knee-chest position to decrease venous blood return.

4

An infant has been diagnosed with an ASD, or AVC defect. The flow of blood through the heart with this type of defect is: 1. Right to left. 2. Equal between the two chambers. 3. Bypassing the defect. 4. In either direction.

4

The nurse is caring for a child who has undergone cardiac catheterization. During the recovery phase, the nurse notices the dressing is saturated with bright red blood and a 6-inch circle of blood on the crib sheet. The nurse's first action is to: 1. Call the interventional cardiologist. 2. Notify the cardiac catheterization laboratory that the child will be returning. 3. Apply a bulky pressure dressing over the present dressing. 4. Apply direct pressure 1 inch above the puncture site.

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