EAQ Cardiac
An early sign of congestive heart failure that the nurse should recognize is: tachypnea. bradycardia. inability to sweat. increased urine output.
a
The parent of a child with rheumatic fever (RF) tells the nurse that the child appears clumsy, inattentive, and nervous. Which condition does the nurse suspect in the child? Hypertension Dyslipidemia Chorea Anaphylaxis
c
A young child with tetralogy of Fallot may assume a posturing position as a compensatory mechanism. The position automatically assumed by the child is: low-Fowler's. prone. supine. squatting.
d
The nurse is instructing the mother about feeding habits for an infant with heart failure. Which precaution related to breast feeding should the nurse include in the teaching? Increase volume of feeding if fed every 4 hours. Withhold breast feeding and provide gavage feeding. Breast feed the child every 2 hours. Alternate breast milk with high-calorie formulas.
d
The nurse is providing care for a child who has a congenital heart defect. The nurse suspects dysrhythmia in the child. What action does the nurse take? Monitor the child's blood pressure. Assess the neck veins for pulsations. Assess the child for chest deformities. Count the apical rate for 1 full minute.
d
The primary therapy for secondary hypertension in children is: weight reduction. low-salt diet. increased exercise and fitness. treatment of underlying cause.
d
The school nurse is called to the cafeteria because a child "has eaten something he is allergic to." The child is in severe respiratory distress. First, the nurse should: determine what the child has eaten. administer diphenhydramine (Benadryl). move the child to the nurse's office or hallway. have someone call for an ambulance/paramedic rescue squad.
d
What should the nurse recognize as an early clinical sign of compensated shock in a child? Confusion Sleepiness Hypotension Apprehension
d
Which is considered a mixed cardiac defect? Pulmonic stenosis Atrial septal defect Patent ductus arteriosus Transposition of the great arteries
d
An infant with cyanosis is prescribed a hyperoxia test. What is the purpose of this test? To determine the underlying cause of the cyanosis To determine the oxygen level found in the blood To confirm streptococcal antibodies in the blood To identify the presence of congenital defects
a
The child with hypercholesterolemia is prescribed a thyroid-stimulating hormone blood test. What is the purpose of this test? To assess: If hypothyroidism has resulted in hypercholesterolemia for the presence of preexisting coronary artery disease If the patient's cholesterol levels in the blood are elevated For risk factors associated with metabolic syndrome
a
The nurse is asked to administer captopril (Capoten) for afterload reduction in a child with heart failure. Which action does the nurse take before administering the drug? Monitors blood pressure Takes apical pulse rate Obtains blood glucose Monitors temperature
a
The nurse is assessing a child with cyanosis. The nurse observes that there is clubbing of the fingers in the child. Which condition does the nurse suspect in the child? Heart disease Pneumonia Renal failure Dehydration
a
The nurse is assessing the chest tube drainage in a child after cardiac surgery. Which condition indicates postoperative hemorrhage in the child? The drainage: output is 5 mL/kg an hour. is serous after 24 hours. is bright red the first hour. output is 1 mL/kg per hour.
a
The nurse is caring for a child with heart disease. Which precaution does the nurse take during cardiac monitoring with electrocardiogram? Ensures that the electrodes are placed correctly Ensures that the electrodes are changed every hour Uses bedside monitors to auscultate heart sounds Ensures that the child drinks coldwater before the test
a
The nurse is preparing to give digoxin to a 9-month-old infant. The nurse checks the dose and draws up 4 mL of the drug. The most appropriate nursing action is to: not give the dose; suspect dosage error. mix the dose with juice to disguise its taste. check heart rate; administer the dose by placing it to the back and side of the mouth. check heart rate; administer the dose by letting the infant suck it through a nipple.
a
The nurse is providing care for a child who is being treated for acute rheumatic fever (RF). The child is at risk for a recurrence of RF. What does the nurse expect the primary health care provider to prescribe? Monthly Penicillin G injections Intravenous (IV) antibiotics Prostaglandin E 1 (Alprostadil) Diphenhydramine (Benadryl)
a
The nurse is providing care for a child with pulmonary artery hypertension (PAH). The child showed no response to vasodilator therapy. What does the nurse expect the primary health care provider to prescribe? Bosentan (Tracleer) Digoxin (Lanoxin) Salicylate therapy IV gamma globulin (IVGG)
a
The nurse is providing care to an infant with heart failure (HF). The nurse observes that the child is stressed and fatigued as evidenced by continued fussiness and crying. Which intervention does the nurse implement to feed the child? Provide a gavage feeding. Use a soft preemie nipple. Hold in a semiupright position. Use a gastrostomy tube.
a
The nurse is teaching the parent of an infant how to treat a hypercyanotic spell in the child after a crying episode. What does the nurse teach the mother? Hold the infant in the knee-chest position. Breast feed the infant after he or she is calm. Place the infant in a semi-Fowler position. Administer oral fluids to prevent dehydration.
a
The nurse should explain to the parents that their child is receiving Lasix for severe congestive heart failure because it is a/an: diuretic. β-blocker. form of digitalis. ACE inhibitor.
a
The nurse should instruct a child to remain completely still during which procedure in which high frequency sound waves are translated into images by a transducer? Echocardiography Electrocardiography Cardiac catheterization Electrophysiology
a
The parent of a child who is at risk for infective endocarditis (IE) asks the nurse how to prevent infection in the child. What instruction does the nurse provide to the parent? "Take prophylactic antibiotics prior to dental work." "Increase daily fluid intake to prevent dehydration." "Read food labels to limit sodium intake in your diet." "Take frequent rest periods and limit physical activity."
a
A child with heart failure is prescribed digoxin (Lanoxin) to improve myocardial function. What precaution does the nurse take after administering the drug? Takes apical pulse rate Observes for signs of toxicity Ensures complete bed rest Provides sodium-restricted diet
b
After a patient returns from cardiac catheterization, the nurse assesses that the pulse distal to the catheter insertion site is weaker. The nurse should: elevate the affected extremity. record the data on the nurse's notes. notify the physician of the observation. apply warm compresses to the insertion site.
b
The nurse is assessing a child who presents with chest pain and syncope. The child also reports shortness of breath during exercise. Which condition does the nurse suspect in the child? Hypertrophic cardiomyopathy Pulmonary artery hypertension Tachydysrhythmias Hypercholesterolemia
b
The nurse is teaching a parent ways to promote maximum chest expansion in the infant to reduce respiratory distress. Which instruction does the nurse provide? "Place the infant in a knee-chest position." "Hold the infant at a 30 to 45 degree angle." "Situate the infant in a supine position." "Do not keep the infant in the infant seat."
b
The parent of a child with a heart disease tells the nurse, "I usually bathe, dress, and feed my child even though I know that my child can do it. I'm worried that my child may come to some harm if I am not present." What is the nurse's best response? "You can continue doing it and be protective of your child." "You can let the child do it and watch from a distance." "You are setting a bad example by behaving in this manner." "You don't need to worry because your child will be fine."
b
An important nursing responsibility when a dysrhythmia is suspected is to: order an immediate electrocardiogram. count the radial rate at 1-minute intervals 5 times in a row. count the apical rate for 1 full minute and compare it with the radial rate. have someone else take the radial rate while the nurse simultaneously checks the apical rate.
c
Nursing care of the infant or child with congestive heart failure includes: forcing fluids appropriate to age. monitoring respirations during active periods. organizing activities to allow for uninterrupted sleep. giving larger feedings less often to conserve energy.
c
Which condition leads to an increase in the pulmonary blood flow? Coarctation of the aorta Aortic stenosis Ventricular septal defect Pulmonic stenosis
c
Which defect is present with tetralogy of Fallot? Patent ductus arteriosus Coarctation of the aorta Hypertrophy of the right ventricle Transportation of the great arteries
c
Which medication does the nurse expect the primary health care provider to prescribe to reduce afterload in a child with heart failure? Chlorothiazide (Diuril) Digoxin (Lanoxin) Captopril (Capoten) Furosemide (Lasix)
c
Congenital heart defects traditionally have been divided into acyanotic or cyanotic defects. The nurse should recognize that in clinical practice this system is: helpful because it explains the hemodynamics involved. helpful because children with cyanotic defects are easily identified. problematic because cyanosis is rarely present in children. problematic because children with acyanotic heart defects may develop cyanosis.
d
Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress the: importance of reducing caloric intake to decrease cardiac demands. importance of relaxing discipline and limit-setting to prevent crying. need to be extremely concerned about cyanotic spells. desirability of promoting normalcy within the limits of the child's condition.
d
The doctor suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent: pulmonary infection. right-to-left shunt of blood. decreased workload on left side of heart. increased pulmonary vascular congestion.
d
