Peds Cardiology Study
What information would be included in the care plan of an infant in heart failure? A. Begin formulas with increased calories. B. Maintain child in the supine position. C. Encourage larger, less frequent feedings. D. Administer digoxin even if the infant is vomiting.
A. Begin formulas with increased calories.
The nurse is caring for a newborn who is scheduled for cardiac surgery to correct a diagnosed defect. Which statements by the mother demonstrate understanding of the situation? Select all that apply. A. "I'm sure it is likely that my baby will be in intensive care after surgery. I believe I can pump so he can still receive my milk." B. "Since having the surgery my baby sometimes nurses for almost an hour." C. "I know my child uses up a lot of energy feeding but it doesn't seem to cause distress when I breastfeed." D. "I hope my baby doesn't have to have feeding through a feeding tube after surgery, but I know that is a possibility." E. "I have read that human milk fortifier can be added to my breast milk for additional calorie needs if necessary."
A. "I'm sure it is likely that my baby will be in intensive care after surgery. I believe I can pump so he can still receive my milk." C. "I know my child uses up a lot of energy feeding but it doesn't seem to cause distress when I breastfeed." D. "I hope my baby doesn't have to have feeding through a feeding tube after surgery, but I know that is a possibility." E. "I have read that human milk fortifier can be added to my breast milk for additional calorie needs if necessary."
A 5-year-old child has undergone a cardiac catheterization and is being prepared for discharge home with the parents. The nurse is teaching the parents how to care for the child at home. The nurse determines that the teaching is successful based on which statement(s) by the parents? Select all that apply. A. "If our child has pain, we can give acetaminophen or ibuprofen." B. "If we notice any drainage or bleeding at the site, we will call the health care provider." C. "Our child should not shower for about a week after the procedure." D. "Once our child is home, we do not need to check the temperature anymore." E. "After several days, we do not need to keep any dressing on the site."
A. "If our child has pain, we can give acetaminophen or ibuprofen." B. "If we notice any drainage or bleeding at the site, we will call the health care provider." E. "After several days, we do not need to keep any dressing on the site."
A 4-year-old child is scheduled for an echocardiogram. The nurse is explaining this procedure to the child's parents. Which information would the nurse likely include? Select all that apply. A. "This test uses sound waves to check the heart structures." B. "This test checks the electrical conduction of your child's heart." C. "This test exposes your child to radiation so we need to be careful." D. "This test should not cause your child any pain." E. "This test will require us to give your child a small amount of anesthesia."
A. "This test uses sound waves to check the heart structures." D. "This test should not cause your child any pain."
The nurse takes an infant's apical pulse before administering digoxin. What is the usually accepted level of pulse rate considered safe for administering digoxin to an 8-month-old infant? A. 100 beats per minute B. 60 beats per minute C. 80 beats per minute D. 150 beats per minute
A. 100 beats per minute
The pediatric nurse has digoxin ordered for each of five children. The nurse should withhold digoxin for which children? Select all that apply. A. 16-year-old child with a heart rate of 54 beats per minute B. 2-year-old child whose digoxin level was 2.4 ng/ml from a blood draw this morning C. 4-month-old child with an apical heart rate of 102 beats per minute D. 12-year-old child whose digoxin level was 0.9 ng/ml on a blood draw this morning E. 5-year-old child who developed vomiting and diarrhea, and is difficult to arouse
A. 16-year-old child with a heart rate of 54 beats per minute B. 2-year-old child whose digoxin level was 2.4 ng/ml from a blood draw this morning E. 5-year-old child who developed vomiting and diarrhea, and is difficult to arouse
Coarctation of the aorta demonstrates few symptoms in newborns. What is an important assessment to make on all newborns to help reveal this condition? A. Assessing for the presence of femoral pulses B. Recording an upper extremity blood pressure C. Auscultating for a cardiac murmur D. Observing for excessive crying
A. Assessing for the presence of femoral pulses
The nurse is caring for a 1-day-old newborn with patent ductus arteriosus with the following vital signs: pulse 160, respirations 80, oxygen saturation 92%, retractions, and crackles noted in bilateral lungs. Which nursing actions are appropriate at this time? Select all that apply. A. Begin indomethacin infusion. B. Feed a high-calorie formula. C. Initiate intravenous access. D. Administer furosemide. E. Apply oxygen via oxyhood.
A. Begin indomethacin infusion. C. Initiate intravenous access. D. Administer furosemide. E. Apply oxygen via oxyhood.
The nurse is caring for an infant suspected of having tricuspid atresia. What essential assessment(s) will the nurse complete for this infant? Select all that apply. A. Determine ability to suck. B. Auscultate heart rate. C. Auscultate lung fields for crackles. D. Inspect for peripheral cyanosis. E. Measure respiratory rate.
A. Determine ability to suck. B. Auscultate heart rate. C. Auscultate lung fields for crackles. E. Measure respiratory rate.
The nurse is educating an adolescent female at risk for hypertension. Which interventions will the nurse recommend? Select all that apply. A. Increase hours of sleep. B. Begin a beta-blocker. C. Exercise on a daily basis. D. Avoid any smoking. E. Maintain a healthy weight.
A. Increase hours of sleep. C. Exercise on a daily basis. D. Avoid any smoking. E. Maintain a healthy weight.
The primary health care provider has prescribed intravenous furosemide for a child diagnosed with congestive heart failure (CHF). Which action will the nurse take when administering this medication? A. Infuse no more than 4 mg per minute. B. Assess glucose levels. C. Monitor respirations during administration. D. Administer with 10% dextrose solution.
A. Infuse no more than 4 mg per minute.
Which collaborative actions will the nurse perform when caring for an infant with transposition of the great arteries scheduled for surgical repair of the defect? Select all that apply. A. Keep oxygen saturation above 75%. B. Apply a continuous pulse oximeter. C. Auscultate lung sounds frequently. D. Administer indomethacin intravenously. E. Provide education to the parents.
A. Keep oxygen saturation above 75%. B. Apply a continuous pulse oximeter. C. Auscultate lung sounds frequently. E. Provide education to the parents.
The nurse is assessing a child with suspected rheumatic fever. What assessment findings are consistent with the disease process? Select all that apply. A. Macular rash on trunk B. Involuntary limb movement C. Nonpalpable subcutaneous nodules D. Tender swollen joints E. Diastolic murmur
A. Macular rash on trunk B. Involuntary limb movement D. Tender swollen joints
A nurse is administering digoxin to a 3-year-old child. What would be a reason to hold the dose of digoxin? A. Nausea and vomiting B. Ataxia C. Hypertension D. Fever and tinnitus
A. Nausea and vomiting
The nurse is caring for a child who has been experiencing hypercyanotic episodes. Which treatments will be effective in managing them? Select all that apply. A. Provide supplemental oxygen. B. Apply a cool cloth the child's forehead. C. Administer meperidine as prescribed. D. Reduce intravenous fluids. E. Assist the child to a knee-chest position.
A. Provide supplemental oxygen E. Assist the child to a knee-chest position.
The nurse is caring for a child who is preparing to undergo an exercise stress test. Which interventions will be included in the care? Select all that apply. A. Remind the child to verbalize any feelings of discomfort during the test. B. Complete ECG one hour after test is completed. C. Monitor vital signs prior to the start of the test. D. Monitor vital signs at completion of the test. E. Assess blood glucose level prior to the start of the test and one hour after.
A. Remind the child to verbalize any feelings of discomfort during the test. C. Monitor vital signs prior to the start of the test. D. Monitor vital signs at completion of the test.
When caring for a child with a congenital heart defect, which assessment finding may be a sign the child is experiencing heart failure? A. Tachycardia B. Inability to sweat C. Bradycardia D. Splenomegaly
A. Tachycardia
The child has returned to the nurse's unit following a cardiac catheterization. The insertion site is located at the right groin. Peripheral pulses were easily palpated in bilateral lower extremities prior to the procedure. Which finding should be reported to the child's physician? Select all that apply. A. The child's right foot is cool with a pulse assessed only with the use of a Doppler. B. The right groin is soft without edema. C. The child is reporting nausea. D. The child has a runny nose. E. The child has a temperature of 102.4° F (39.1° C).
A. The child's right foot is cool with a pulse assessed only with the use of a Doppler. C. The child is reporting nausea. E. The child has a temperature of 102.4° F (39.1° C).
Parents are told their infant has a hypoplastic left heart. How would the nurse explain this condition to the family? A. This is a problem where the left side of the heart did not develop properly. B. The infant will have immediate surgery to completely correct the heart defect. C. There are no surgeries that can help the child live with this heart defect. D. This is a problem where the right side of the heart did not develop properly.
A. This is a problem where the left side of the heart did not develop properly.
The nurse is caring for a newborn in the hospital. Which assessment finding is most concerning? A. a fixed split-S2 heart sound B. respiratory rate 62 breaths per minute C. cool and bluish tint to hands D. high-pitched systolic murmur
A. a fixed split-S2 heart sound
The nurse is collecting data on a child being evaluated for rheumatic fever. The caregiver reports that over the past several weeks the child seems to have lack of coordination, facial grimaces and repetitive involuntary movements. Based on these symptoms the nurse would suspect what condition? A. chorea B. arthralgia C. polyarthritis D. carditis
A. chorea
A 3-year-old child is postoperative from a cardiac surgery. Which assessment finding(s) by the nurse warrants immediate action? Select all the apply. A. heart rate increase from 88 to 136 beats/min B. apical heart rate strong and easily auscultated C. report of pain with movement of 6 out of 10 on numeric scale D. drainage on the chest dressing E. cessation of chest tube drainage
A. heart rate increase from 88 to 136 beats/min E. cessation of chest tube drainage
When caring for a child with Kawasaki disease, the nurse would know that: A. management includes administration of aspirin and IVIG. B. steroid creams are used for the hand peeling. C. joint pain is a permanent problem. D. antibiotics should be administered every 8 hours by IV.
A. management includes administration of aspirin and IVIG.
A child has been prescribed spironolactone. Which laboratory values should be reviewed when following up on this medication? Select all that apply. A. serum potassium levels B. serum calcium levels C. serum chloride levels D. serum magnesium levels E. serum sodium levels
A. serum potassium levels E. serum sodium levels
After a cardiac catheterization, the nurse monitors the child's fluid balance closely based on the understanding that: A. the contrast material used has a diuretic effect. B. the prolonged preprocedure fasting state places the child at risk for dehydration. C. blood loss during the procedure can be significant. D. the insertion of the catheter into the heart stimulates a diuretic response.
A. the contrast material used has a diuretic effect.
The nurse is reviewing nutritional recommendations with the parents of a teen diagnosed with hyperlipidemia. Which statements indicate an understanding of the recommended diet for this condition? Select all that apply. A. "I need to limit fat intake in meals to 40%." B. "Adding fresh fruits to my child's lunch is a good idea." C. "My child loves chicken and I can still serve it but I need to remove the skin." D. "Cooking with palm oil will be helpful." E. "I should plan to have vegetables with each evening meal served."
B. "Adding fresh fruits to my child's lunch is a good idea." C. "My child loves chicken and I can still serve it but I need to remove the skin." E. "I should plan to have vegetables with each evening meal served."
A group of nurses is reviewing the cardiovascular system and its function. Which statement by one of the nurses demonstrates an understanding of a child's cardiovascular system? A. "The child's heart doesn't mature and function like an adult's until between 8 and 10 years of age." B. "At birth, the infant's right and left ventricle are about the same size." C. "The heart rate of the child decreases whenever the child experiences a fever." D. "Between the ages of 5 and 6, the child's left ventricle grows to about two times the size of the right."
B. "At birth, the infant's right and left ventricle are about the same size."
The nurse is teaching the parents of a child with congenital heart disease about clubbing. Which statement by the parents demonstrates a need for further teaching? A. "Clubbing may result due to our child having chronically low oxygen levels." B. "If clubbing is noted, we should administer oxygen to our child immediately." C. "We may notice a rounding then thickening of the nail beds." D. "One of the first signs of clubbing we will see is the nail beds becoming softer."
B. "If clubbing is noted, we should administer oxygen to our child immediately."
A child will be undergoing a Holter monitor test. Which statement by the parent indicates the need for further instruction? A. "Wearing a snug shirt the day of the test will be helpful." B. "My child cannot have any thing to eat or drink after midnight the day of the test." C. "This test will monitor my child for about 24 hours." D. "We do not need to alter our activities during the testing period."
B. "My child cannot have any thing to eat or drink after midnight the day of the test."
A nurse is taking the history of a 4-year-old child who will undergo a cardiac catheterization. Which statement by the parent may necessitate rescheduling of the procedure? A. "My child tells me about headaches because of being scared and nervous about the procedure." B. "My child seems listless and slightly warm." C. "My child kept scratching the chest, so I applied hydrocortisone cream to stop the itching." D. "My child is allergic to iodine and shellfish."
B. "My child seems listless and slightly warm."
The nurse is assessing the blood pressure of a toddler. Which finding would the nurse document as a normal finding? A. 100/60 mm Hg B. 90/64 mm Hg C. 110/60 mm Hg D. 80/40 mm Hg
B. 90/64 mm Hg
The nurse is caring for a child admitted to the hospital for a cardiac catheterization. Upon return from the cardiac catheterization, which nursing action is priority? A. Palpate for pulses in bilateral extremities. B. Assess the dressing at the insertion site. C. Maintain patency of intravenous access. D. Apply blood pressure monitor.
B. Assess the dressing at the insertion site.
A 5-year-old is being prepared for diagnostic cardiac catheterization, in which the catheter will be inserted in the right femoral vein. What intervention should the nurse take to prevent infection? A. Record pedal pulses B. Avoid drawing a blood specimen from the right femoral vein before the procedure C. Keep the child NPO for 2 to 4 hours before the procedure D. Apply EMLA cream to the catheter insertion site
B. Avoid drawing a blood specimen from the right femoral vein before the procedure
A school nurse is caring for a child with a severe sore throat and fever. What is the nurse's best recommendation to the parent? A. Have the child go to the emergency room. B. Have the child be seen by the primary care provider. C. Give acetaminophen for the fever and pain, and have the child rest. D. Have the child drink fluids that contain electrolytes.
B. Have the child be seen by the primary care provider.
The nurse is caring for child who present to the emergency department with reports of a fever for 5 days. The nurse notes a diffuse maculopapular rash, reddened cracked lips, erythema of hands, and bilateral conjunctivitis and suspects Kawasaki disease. Which nursing action is priority? A. Place the child on a soft diet. B. Initiate intravenous access. C. Assess cervical lymph nodes. D. Administer acetaminophen.
B. Initiate intravenous access.
When educating the family of an ill infant with an atrioventricular canal defect/septal defect, what information would be included in the education if the doctor is planning on performing palliative care until the infant is healthier? A. The medication indomethacin is used to try to close the hole. B. Palliative pulmonary artery banding should help the infant grow. C. Most infants do not need surgical repair for this if palliative procedures are performed. D. VSD patching surgery should be performed immediately.
B. Palliative pulmonary artery banding should help the infant grow.
A child with a congenital heart defect is getting an echocardiogram. How would the nurse describe this test to the parent? A. This test will only determine the size of the heart. B. This test will check how blood is flowing through the heart. C. This noninvasive test will check the electrical impulses in the heart. D. This invasive test will measure the blockage in the heart.
B. This test will check how blood is flowing through the heart.
Parents are told that their infant has a heart defect with a left-to-right shunt. What is the best way for the nurse to explain this type of shunting to the parents? A. This type of shunting causes an increase of blood to the systemic circulation. B. This type of shunting causes an increase of blood to the lungs. C. This type of shunting causes a decrease of blood to the brain. D. This type of shunting causes a decrease of blood to the lungs.
B. This type of shunting causes an increase of blood to the lungs.
The nurse receives the shift report of multiple pediatric clients. Which pediatric client will the nurse see first? A. a child with history of hypertension and a current blood pressure of 130/90 mm Hg B. a toddler with tetralogy of Fallot squatting quietly in the corner of the room C. an infant whose parents report difficulty feeding with a temperature of 100.1°F (38°C) D. an adolescent with coarctation of the aorta with reports of coughing and coryza
B. a toddler with tetralogy of Fallot squatting quietly in the corner of the room
A group of students are reviewing information about acute rheumatic fever. The students demonstrate a need for additional review when they identify what as a major Jones criterion? A. subcutaneous nodules B. arthralgia C. carditis D. erythema marginatum
B. arthralgia
A nurse is providing care to a child with Kawasaki disease. Which medication(s) would the nurse expect the health care provider to prescribe? Select all that apply. A. abciximab B. aspirin C. ibuprofen D. corticosteroids E. IV immunoglobulin
B. aspirin E. IV immunoglobulin
The nurse is assessing a child with aortic stenosis. Which findings would the nurse most likely assess? Select all that apply. A. moderately loud systolic murmur at the base of the heart B. dizziness with prolonged standing C. thrill palpated at base of heart D. blood pressure in arms significantly higher than in legs E. chest pain with activity
B. dizziness with prolonged standing C. thrill palpated at base of heart E. chest pain with activity
The nurse in a pediatric cardiovascular clinic is talking with the father of a 5-year-old child who underwent cardiac surgery for a heart defect at the age of 3. The father reports that the child has been having increased shortness of breath, tires easily after playing, and has been gaining weight. The nurse is aware that the child is most likely demonstrating symptoms of which acquired cardiovascular disorder? A. infective endocarditis B. heart failure C. cardiomyopathy D. Kawasaki Disease
B. heart failure
The nurse is caring for a child with suspected heart arrhythmia. The child will wear an ambulatory electrocardiograph monitor for 24 hours. What is the most important instruction for the nurse to give the child and parent during monitoring? A. why the child will continue to take any scheduled medications during monitoring B. how and when to use the event button C. importance of keeping the electrodes dry and intact D. the need for rest frequently during monitoring
B. how and when to use the event button
Which finding(s) is a major criterion used to help the health care provider diagnose acute rheumatic fever in a child? Select all that apply. A. temperature of 101.2°F (38.4°C) B. painless nodules located on the wrists C. elevated erythrocyte sedimentation rate D. heart block with a prolonged PR interval E. pericarditis with the presence of a new heart murmur
B. painless nodules located on the wrists E. pericarditis with the presence of a new heart murmur
A newborn has been diagnosed with a congenital heart disease. Which congenital heart disease is associated with cyanosis? A. coarctation of aorta B. tetralogy of Fallot C. pulmonary stenosis D. aortic stenosis
B. tetralogy of Fallot
The nurse is taking a health history of a 6-week-old boy with a suspected cardiovascular disorder. Which response by the mother would lead the nurse to suspect that the child is experiencing heart failure? A. "He seems to have a normal appetite." B. "He does not seem sick." C. "He gets sweaty when he eats." D. "He does not seem short of breath."
C. "He gets sweaty when he eats."
The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching? A. "We need to avoid a tub bath for the next 3 days." B. "Strenuous activity should be limited for the next 3 days." C. "The feeling of the heart skipping a beat is common." D. "We need to watch for changes in skin color or difficulty breathing."
C. "The feeling of the heart skipping a beat is common."
An 8-year-old child is scheduled for an exercise stress test. Which instruction would be most important for the nurse to emphasize? A. "You get some medicine that will make you sleepy." B. "You need to lie very still during this test." C. "You need to report any symptoms you are having during the test." D. "You'll have to wear the monitor for 24 hours."
C. "You need to report any symptoms you are having during the test."
The nurse is assessing the blood pressure of an adolescent. In which range should the nurse expect the blood pressure measurement for a healthy 13-year-old boy? A. 94 to 112/56 to 60 mm Hg B. 80 to 90/40 to 64 mm Hg C. 100 to 120/70 to 80 mm Hg D. 80 to 100/64 to 80 mm Hg
C. 100 to 120/70 to 80 mm Hg
The nurse is caring for a child with aortic stenosis. Which health care provider prescription(s) will the nurse question? Select all that apply. A. Obtain echocardiogram. B. Apply a cardiac monitor. C. Administer indomethacin. D. Give prostaglandin E1 (PGE1). E. Prepare for balloon dilation.
C. Administer indomethacin. D. Give prostaglandin E1 (PGE1).
The nurse is assessing the heart rate of a 6-month-old infant and determines it to be 82 beats/min. What action should the nurse take first? A. Reassess the heart rate in 5 minutes. B. Report the finding to the health care provider. C. Conduct a focused cardiovascular assessment. D. Obtain a health history from the parent.
C. Conduct a focused cardiovascular assessment.
While assessing a neonate with a ventricular septal defect (VSD), the nurse notes crackles and retractions. The nurse obtains the following vital signs: temp 100.2°F (38°C), pulse 134 bpm, respirations 64 breaths/minute, oxygen saturation 97% on room air. What will the nurse do first? A. Advise the mother to bottle feed. B. Administer acetaminophen rectally. C. Give furosemide intravenously. D. Apply oxygen 10 liters/min (LPM) via oxyhood.
C. Give furosemide intravenously.
The nurse is performing echocardiography on a newborn who is suspected of having a congenital heart defect. The child's mother is concerned about the safety of using this on a newborn and wants to know how this technology works. The nurse assures her that this technology is very safe and may be repeated frequently without added risk. What should the nurse mention in explaining how this diagnostic test works? A. X-rays are directed toward the heart B. A radioactive substance is injected intravenously into the bloodstream and is traced and recorded on video C. High-frequency sound waves are directed toward the heart D. A microphone is placed on the child's chest to record heart sounds and translate them into electrical energy
C. High-frequency sound waves are directed toward the heart
A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia? A. Increased WBC B. Decreased WBC C. Increased RBC D. Decreased RBC
C. Increased RBC
A 6-year-old girl is diagnosed with aortic stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother? A. Insertion of Dacron-coated stainless-steel coils by interventional cardiac catheterization B. No treatment is necessary, as the defect will resolve spontaneously C. Insertion of a catheter with an uninflated balloon tip into the affected area followed by inflation of the balloon to open the narrowing D. Surgical closure by ductal ligation
C. Insertion of a catheter with an uninflated balloon tip into the affected area followed by inflation of the balloon to open the narrowing
The nurse is conducting a physical examination of a 7-year-old girl prior to a cardiac catheterization. The nurse knows to pay particular attention to assessing the child's pedal pulses. How can the nurse best facilitate their assessment after the procedure? A. Mark the location of the child's peripheral pulses with an indelible marker. B. Document the location and quality of the child's pedal pulses. C. Mark the child's pedal pulses with an indelible marker, then document. D. Assess the location and quality of the child's peripheral pulses.
C. Mark the child's pedal pulses with an indelible marker, then document.
When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover? A. Anemia B. Increased platelet level C. Polycythemia D. Leukopenia
C. Polycythemia
At 3 years of age, a child has a cardiac catheterization. After the procedure, which interventions would be most important? A. Assuring the child that the procedure is now over B. Allowing the child to adapt to the light in the room gradually C. Taking pedal pulses for the first 4 hours D. Allowing the child to talk about the procedure
C. Taking pedal pulses for the first 4 hours
The nurse is caring for a child with congestive heart failure and is administering the drug digoxin. At the beginning of this drug therapy, the process of digitalization is done for which reason? A. To establish a maintenance dose of the drug B. To decrease the pain to a tolerable level C. To build the blood levels to a therapeutic level D. To increase the heart rate
C. To build the blood levels to a therapeutic level
A health care provider and other health team members are discussing congenital heart disorders that increase pulmonary blood flow. Which disorders are topics for this discussion? Select all that apply. A. Coarctation of the aorta B. Pulmonary stenosis C. Ventricular septal defect D. Atrioventricular canal defect E. Patent ductus arteriosus
C. Ventricular septal defect D. Atrioventricular canal defect E. Patent ductus arteriosus
The nurse is caring for a 3-month-old infant with history of congenital heart disease. The infant is brought to the emergency department with nausea and vomiting for 3 days. Admission laboratory results confirm dehydration. The nurse realizes that the dehydrated infant is at risk for: A. jaundice. B. seizure activity. C. a cerebrovascular accident (stroke). D. tachycardia.
C. a cerebrovascular accident (stroke).
A nurse is palpating the pulse of a child with suspected aortic regurgitation. Which assessment finding should the nurse expect to note? A. preference to resting on the right side B. pitting periorbital edema C. bounding pulse D. appropriate mastery of developmental milestones
C. bounding pulse
When caring for a child who has just had a cardiac catheterization, what is a sign of hypotension? A. decreased heart rate and dizziness B. diaphoresis and tachycardia C. cold, clammy skin and increased heart rate D. syncope and tachypnea
C. cold, clammy skin and increased heart rate
A newborn is diagnosed with tetralogy of Fallot. When explaining this condition to the mother, which defect would the nurse's description include? A. left ventricular hypertrophy B. stenosis of the aorta C. overriding of the aorta D. atrial septal defect
C. overriding of the aorta
A nurse is reading a journal article about congenital heart conditions that are associated with decreased pulmonary blood flow. The nurse demonstrates understanding of the information when she identifies which anomalies as being associated with tetralogy of Fallot? Select all that apply. A. patent ductus arteriosus B. atrial septal defect C. right ventricular hypertrophy D. overriding aorta E. pulmonary stenosis
C. right ventricular hypertrophy D. overriding aorta E. pulmonary stenosis
The nurse is caring for an 8-month-old infant with a suspected congenital heart defect. The nurse examines the child and documents which expected finding? A. steady weight gain since birth B. appropriate mastery of developmental milestones C. softening of the nail beds D. intact rooting reflex
C. softening of the nail beds
A pregnant client tells her nurse that a friend of hers recently gave birth to an infant who was found to have congenital heart disease. She asks the nurse whether there is anything she can do to reduce the risk of this type of condition occurring in her baby. What information should the nurse mention to this client? A. "Make sure that you encourage your child to exercise as he grows up." B. "There is really nothing you can do." C. "Make sure you encourage a low-sodium diet in your child as he grows up." D. "Make sure you are fully immunized."
D. "Make sure you are fully immunized."
When educating the family of an infant with a small, asymptomatic atrial septal defect (ASD), what information would be included in the education? A. "The medication prostaglandin E1 is used to try to close the hole." B. "The medication indomethacin is used to try to close the hole." C. "Surgery is usually performed in the first two months of life for this." D. "Most infants do not need surgical repair for this."
D. "Most infants do not need surgical repair for this."
A nurse is examining a 10-year-old girl who has a heart murmur. On auscultation, the nurse finds that the murmur occurs only during systole, is short, and sounds soft and musical. When she has the girl stand, she can no longer hear the murmur on auscultation. Which statement should the nurse make to the girl's mother in response to these findings? A. "Your daughter has an organic heart murmur, which indicates that she has some degree of heart disease. The doctor will provide a referral to a good cardiologist." B. "Your daughter has a functional heart murmur; I recommend that you limit her physical activity so that her heart rate is not elevated for long periods of time." C. Not say anything, as the girl has an insignificant heart murmur and there is no reason to alarm the mother or her. D. "Your daughter has an innocent heart murmur, which is nothing to worry about."
D. "Your daughter has an innocent heart murmur, which is nothing to worry about."
A nurse is preparing to administer a prescribed dose of digoxin to an 6-month-old infant. After assessing the infant's apical pulse, the nurse decides to withhold the dose and notify the health care provider. The nurse bases this decision on which apical pulse rate? A. 118 beats/min B. 102 beats/min C. 94 beats/min D. 80 beats/min
D. 80 beats/min
Which nursing diagnosis would best apply to a child with rheumatic fever? A. Risk for self-directed violence related to development of cerebral anoxia B. Ineffective breathing pattern related to cardiomegaly C. Disturbed sleep pattern related to hyperexcitability D. Activity intolerance related to inability of heart to sustain extra workload
D. Activity intolerance related to inability of heart to sustain extra workload
The nurse is caring for a 10-year-old boy following a cardiac catheterization. Four hours after the procedure, the nurse notes some minor bleeding at the site. Which action would be most appropriate? A. Contact the physician. B. Change the dressing. C. Ensure that the child's leg is kept straight. D. Apply pressure 1 inch above the site.
D. Apply pressure 1 inch above the site.
The nurse is assessing an infant and notes brachial pulses of 2+ and femoral pulses of 1+. Which action will the nurse perform first? A. Contact the health care provider. B. Prepare for balloon angioplasty. C. Apply appropriate oxygen device. D. Assess blood pressure in all extremities.
D. Assess blood pressure in all extremities.
The nurse is reviewing the laboratory test results of several children who have come to the clinic for evaluation. Which child would the nurse identify as having the least risk for hyperlipidemia? A. Child D with a total cholesterol level of 220 mg/dl and LDL of 138 mg/dl. B. Child B with a total cholesterol level of 175 mg/dl and LDL of 105 mg/dl. C. Child C with a total cholesterol level of 190 mg/dl and LDL of 125 mg/dl. D. Child A with a total cholesterol of 150 mg/dl and low-density lipoprotein (LDL) of 80 mg/dl.
D. Child A with a total cholesterol of 150 mg/dl and low-density lipoprotein (LDL) of 80 mg/dl.
The nurse is administering medications to the child with congestive heart failure (CHF). Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level? A. Spironolactone B. Ferrous sulfate C. Albuterol sulfate D. Digoxin
D. Digoxin
A nurse admits an infant with a possible diagnosis of congestive heart failure. Which signs or symptoms would the infant most likely be exhibiting? A. Bradypnea B. Bradycardia C. Yellowish color D. Feeding problems
D. Feeding problems
On assessment immediately following cardiac surgery, which condition would the nurse expect to find in an infant? A. Hypovolemia B. Hypertension C. Hyperexcitability D. Hypothermia
D. Hypothermia
An 8-month-old infant has a ventricular septal defect. Which nursing diagnosis would best apply? A. Impaired skin integrity related to poor peripheral circulation B. Ineffective airway clearance related to altered pulmonary status C. Impaired gas exchange related to a right-to-left shunt D. Ineffective tissue perfusion related to inefficiency of the heart as a pump
D. Ineffective tissue perfusion related to inefficiency of the heart as a pump
The nurse is caring for a school-age child with reports of generalized joint pain and a pharyngitis. During assessment, the nurse notes a cardiac murmur. Which action by the nurse is priority? A. Evaluate C-reactive protein. B. Administer penicillin. C. Assess skin for a rash. D. Swab throat for culture.
D. Swab throat for culture.
A nursing instructor is preparing for a class about the structural and functional differences in the cardiovascular system of infants and children as compared to adults. What would the instructor include in the class discussion? A. The heart is about four times the birth size between the ages of 6 and 12 years. B. Blood pressure is initially high at birth but gradually decreases to adult levels. C. Left ventricular function predominates immediately after birth. D. The heart's apex is higher in the chest in children younger than the age of 7 years.
D. The heart's apex is higher in the chest in children younger than the age of 7 years.
The nurse is providing education to parents of a child with a blood pressure in the 90th percentile. What would be included in the intervention strategies? A. Beta-blocker education should be given to the parents. B. The child should not be allowed to participate in sports. C. Blood pressures should be measured daily. D. The nurse would review the child's 24-hour diet recall.
D. The nurse would review the child's 24-hour diet recall.
The nurse is auscultating heart sounds of a child with a mitral valve prolapse. The nurse should expect which assessment finding? A. clicks on the upper left sternal border B. abnormal splitting of S2 sounds C. intensifying of S2 sounds D. mild-to-late ejection click at the apex
D. mild-to-late ejection click at the apex