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FINAL
100

What procedure uses high-frequency sound waves obtained by a transducer to produce an image of cardiac structures?

A. Echocardiography 

B. Electrocardiography

C. Cardiac catheterization

D. Electrophysiology

A. Echocardiography

100

What is an early sign of congestive heart failure that the nurse should recognize?

A. Tachypnea 

B. Bradycardia

C. Inability to sweat

D. Increased urinary output

A. Tachypnea

100

What is an important nursing responsibility when a dysrhythmia is suspected?

A. Order an immediate electrocardiogram.

B. Count the radial pulse every 1 minute for five times.

C. Count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate.

D. Have someone else take the radial pulse simultaneously with the apical pulse.

C. Count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate.

100

The goals of therapeutic management for congestive heart failure is to

A. increase afterload and perfusion to tissues.

B. decrease preload and increase afterload.

C. decrease preload, afterload and increase contractility. 

D. decrease contractility and increase preload and afterload.

C. decrease preload, afterload and increase contractility.

200

After a patient returns from cardiac catheterization, the nurse notes that the pulse distal to the catheter insertion site is weaker (+1). The most appropriate nursing intervention is to

A. elevate the affected extremity.

B. document the findings and continue to monitor. 

C. notify the health care provider of the finding.

D. apply warm compresses to the insertion site.

B. document the findings and continue to monitor.

200

The nurse should explain to the parents that their child is receiving furosemide (Lasix) for severe congestive heart failure because of its effects as

A. a diuretic. 

B. a beta-blocker.

C. a form of digitalis.

D. an ACE inhibitor.

A. a diuretic.

200

The primary therapy for secondary hypertension in children is

A. weight reduction.

B. low-salt diet.

C. increased exercise and fitness.

D. treatment of underlying cause. 

D. treatment of underlying cause.

200

If a child is being treated with ACE inhibitors as part of the therapeutic regimen for heart failure, which observation if noted would alert the nurse to a potential interaction?

A. Diuretic therapy with Aldactone 

B. Child complains of being slightly dizzy at times

C. Maintaining normal urine output

D. Blood pressure monitoring at lower end of normal range

A. Diuretic therapy with Aldactone

300

Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. Based on the nurse’s knowledge of congenital heart defects, this system in clinical practice is

A. helpful, because it explains the hemodynamics involved.

B. helpful, because children with cyanotic defects are easily identified.

C. problematic, because cyanosis is rarely present in children.

D. problematic, because children with acyanotic heart defects may develop cyanosis.

D. problematic, because children with acyanotic heart defects may develop cyanosis.

300

The nurse is preparing to give digoxin (Lanoxin) to a 9-month-old infant. The nurse checks the dose; 4 ml of the drug is to be drawn up. Based on the nurse’s knowledge of this medication and safe pediatric dosages, the most appropriate action by the nurse is

A. do not draw-up dose; suspect dosage error. 

B. mix dose with juice to disguise its taste.

C. check heart rate; administer dose by placing it to the back and side of mouth.

D. check heart rate; administer dose by letting infant suck it through a nipple.

A. do not draw-up dose; suspect dosage error.

300

What should the nurse recognize as an early clinical sign of compensated shock in a child?

A. Confusion

B. Sleepiness

C. Hypotension

D. Apprehensiveness 

D. Apprehensiveness

300

An adolescent is being treated for new-onset hypertension with medication. First line therapy previously tried was with dietary management but the decision has now been made to start oral medications. Which complaint if provided by the patient would indicate a potential concern?

A. Patient states that he is no longer losing weight after being on the medication for one week’s time.

B. Patient states he is maintaining his oral intake of 8 glasses of water a day.

C. He is taking the medication in the evening rather than taking the medication in the morning as prescribed as he thinks that he feels better and has less side effects.

D. He reports that he occasionally feels “lightheaded” when getting out of a chair during the course of the school day in some of his classes. 

D. He reports that he occasionally feels “lightheaded” when getting out of a chair during the course of the school day in some of his classes.

400

Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of

 A. pulmonary infection.

 B. right-to-left shunt of blood.

 C. decreased workload on left side of heart.

 D. increased pulmonary vascular congestion. 

 D. increased pulmonary vascular congestion.

400

Nursing care of the infant and child with congestive heart failure includes

A. force fluids appropriate to age.

B. monitor respirations during active periods.

C. organize activities to allow for uninterrupted sleep. 

D. give larger feedings less often to conserve energy.

C. organize activities to allow for uninterrupted sleep.

400

A cardiac assessment is required to determine if a child’s physical symptoms are related to possible heart disease. The nurse is proceeding to auscultation techniques. When observing the nursing student perform this assessment, which action would indicate that additional training was required?

A. Documentation of heart sounds in reference to anatomical location.

B. Determination that there is no evidence of carotid bruits.

C. Calculation of heart rate.

D. Ascertaining whether there is evidence of splenic enlargement. 

D. Ascertaining whether there is evidence of splenic enlargement.

500

What is considered a mixed cardiac defect?

A. Pulmonic stenosis

B. Atrial septal defect

C. Patent ductus arteriosus

D. Transposition of the great arteries 

D. Transposition of the great arteries

500

What should nurses stress when counseling parents regarding the home care of the child with a cardiac defect before corrective surgery?

A. The importance of reducing caloric intake to decrease cardiac demands

B. The importance of relaxing discipline and limit setting to prevent crying

C. The need to be extremely concerned about cyanotic spells

D. The desirability of promoting normalcy within the limits of the child’s condition 

D. The desirability of promoting normalcy within the limits of the child’s condition

500

A physician suspects that a child may have congenital cardiac disease. Which noninvasive diagnostic procedure would help to confirm the possibility of heart disease?

A. EKG

B. Echocardiogram 

C. Chest x-ray

D. Pulse oximetry

B. Echocardiogram

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