Procedures
A nurse is monitoring a child who had a cardiac catheterization 4 hours ago. The nurse notes the foot on the affected side is cool to the touch and the pedal pulse is weak. What complication do these signs most likely indicate?
A.Embolism
B.Hemorrhage
C.Anaphylactic reaction
D.Infection
A.Embolism
An infant with heart failure is exhibiting tachypnea, tachycardia, and scalp sweating during feeding. The nurse interprets these signs as indicating what?
A.The infant is being stressed and cardiac demand is high.
B.A normal response to feeding in a healthy infant.
C.The early onset of a respiratory infection.
D.An allergic reaction to the formula.
A.The infant is being stressed and cardiac demand is high.
A nurse is assessing a newborn and notes a significant difference between the blood pressure in the arms and the legs. This finding is most characteristic of which cardiac defect?
A.Ventricular Septal Defect
B.Atrial Septal Defect
C.Coarctation of the aorta
D.Patent Ductus Arteriosus
C.Coarctation of the aorta
A 9-year-old child presents with a low-grade fever, joint pain, and a distinctive rash on the trunk described as macules with clear centers and defined borders. The child had a sore throat about three weeks ago. Which diagnosis do these findings most strongly suggest?
A.Acute Rheumatic Fever (ARF)
B.Kawasaki Disease (KD)
C.Multisystem Inflammatory Syndrome in Children (MIS-C)
D.Infective Endocarditis
A.Acute Rheumatic Fever (ARF)
A new parent asks the nurse why the pediatrician mentioned their baby's heart rate of 140 bpm is normal, while an adult's normal rate is much lower. What is the nurse's best response?
A.The infant's heart is less efficient and must beat faster to pump the same amount of blood.
B.All newborns have an elevated heart rate for the first few months, which is unrelated to size.
C.Heart rate is inversely proportional to body size; smaller bodies have faster heart rates.
D.Infant heart rates are higher to compensate for their much higher blood pressure.
C.Heart rate is inversely proportional to body size; smaller bodies have faster heart rates.
Which diagnostic test provides information about the heart's size, shape, and pattern of blood flow, and is typically the first test ordered for a suspected heart defect?
A.Cardiac Catheterization
B.Electrocardiogram (EKG)
C.Echocardiogram
D.Chest x-ray
D.Chest x-ray
A child with chronic hypoxemia from a heart defect is found to have polycythemia on a routine blood test. This physiological adaptation places the child at an increased risk for what complication?
A.Cerebrovascular accident
B.Anemia
C.Hemorrhage
D.Infection
A.Cerebrovascular accident
A nurse is assessing an infant with a congenital heart defect that causes increased pulmonary blood flow, such as an atrial septal defect. Which set of clinical signs would be most expected?
A.Hypoxemia and cyanosis
B.Signs and symptoms of heart failure
C.Higher blood pressure in the arms than the legs
D.Oxygen saturation consistently in the 80s
B.Signs and symptoms of heart failure
A child is in the subacute phase of Kawasaki Disease. Which clinical finding would the nurse most expect to see?
A.Swollen cervical lymph nodes (lymphadenopathy).
B.Peeling skin on the fingers and toes.
C.A bright red 'strawberry' tongue.
D.A high fever that is unresponsive to antipyretics.
B.Peeling skin on the fingers and toes.
How does the physical structure of an infant's ventricular walls at birth compare to their structure during later development?
A.The right ventricular wall is significantly thicker than the left at birth.
B.The ventricular walls are approximately the same size at birth, with the left side thickening over time.
C.Both ventricular walls are very thin at birth and thicken at the same rate.
D.The left ventricular wall is significantly thicker than the right at birth.
B.The ventricular walls are approximately the same size at birth, with the left side thickening over time.
A cardiologist suspects a child has a patent foramen ovale (PFO) that was not visible on a standard transthoracic echocardiogram (TTE). Which test would be superior for visualizing this specific defect?
A.Exercise Stress Test
B.Transesophageal echocardiogram (TEE)
C.Chest X-ray
D.Cardiac MRI
B.Transesophageal echocardiogram (TEE)
A nurse is administering digoxin to a child with heart failure. The child's latest lab results show a low serum potassium level. The nurse should be particularly alert for which potential complication?
A.Decreased therapeutic effect of the digoxin.
B.An increase in peripheral edema.
C.Increased risk for digoxin toxicity.
D.A sudden increase in urine output.
C.Increased risk for digoxin toxicity.
The primary cause of hypoxemia and cyanosis in defects with decreased pulmonary blood flow, such as Tetralogy of Fallot, is which hemodynamic event?
A.Left-to-right shunting of blood through a septal defect
B.Right-to-left shunting of deoxygenated blood
C.Anatomic narrowing of the aorta
D.Complete separation of the pulmonary and systemic circuits
B.Right-to-left shunting of deoxygenated blood
A nurse is developing a plan of care for a child diagnosed with Kawasaki Disease (KD). What is the primary long-term complication the nurse should monitor for, which is the main concern associated with this condition?
A.Chronic kidney disease from systemic inflammation.
B.Damage and enlargement of the coronary arteries.
C.Permanent neurological damage from chorea.
D.Development of chronic arthritis.
B.Damage and enlargement of the coronary arteries.
A nurse is assessing a 4-week-old infant with a suspected congenital heart defect. Which symptom reported by the parents is a key indicator of cardiac dysfunction?
A.The infant's heart rate is 150 bpm while active.
B.The infant sleeps for 4-hour stretches at night.
C.The infant has 2-3 stools per day.
D.The infant becomes sweaty and breathes rapidly during feedings.
D.The infant becomes sweaty and breathes rapidly during feedings.
A 6-year-old child has returned to the floor after a cardiac catheterization via the right femoral artery. Which of the following nursing interventions is a priority in the immediate post-procedure period?
A.Maintaining the affected extremity in a straight position.
B.Changing the pressure dressing every hour.
C.Administering a regular diet as soon as the child is awake.
D.Encouraging early ambulation to prevent clots.
A.Maintaining the affected extremity in a straight position.
A school-aged child with a cyanotic heart defect is often observed squatting. The nurse explains to the parents that this behavior is a compensatory mechanism that primarily achieves which outcome?
A.Decreases the heart rate by stimulating the vagus nerve.
B.Reduces venous return to the heart to prevent fluid overload.
C.Lowers systemic blood pressure to reduce cardiac workload.
D.Increases blood flow to the lungs to improve oxygenation.
D.Increases blood flow to the lungs to improve oxygenation.
A nursing student is creating a study guide for Tetralogy of Fallot. Which of the following defects should NOT be included in the list of its four characteristic components?
A.Pulmonic stenosis
B.Right ventricular hypertrophy
C.Patent Ductus Arteriosus
D.Overriding aorta
C.Patent Ductus Arteriosus
A school-aged child is diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) approximately 3 weeks after a mild respiratory illness. Which set of symptoms is most characteristic of MIS-C presentation?
A.High persistent fever, 'strawberry' tongue, cracked lips, and peeling skin on the feet.
B.Migratory joint pain, a non-pruritic rash with clear centers, and involuntary muscle movements.
C.Productive cough, high fever, and chest pain that worsens with deep breaths.
D.Prominent abdominal pain and vomiting, infected conjunctiva, and neck pain.
D.Prominent abdominal pain and vomiting, infected conjunctiva, and neck pain.
Cardiac output is a critical measure of heart function. It is calculated by multiplying which two factors?
A.Preload and afterload
B.Stroke volume and contractility
C.Heart rate and stroke volume
D.Blood pressure and heart rate
C.Heart rate and stroke volume
A nurse is providing discharge instructions to the parents of a child who underwent a cardiac catheterization. Which instruction regarding bathing is correct?
A.Showering and tub baths are not permitted for one week.
B.The child can take a tub bath the day after the procedure to keep the site clean.
C.Apply a waterproof dressing so the child can bathe normally immediately.
D.Keep the site clean and dry, avoiding tub baths for 3 days
D.Keep the site clean and dry, avoiding tub baths for 3 days
A pediatric patient with a history of chronic lung disease is admitted with suspected heart failure. Based on the typical progression of this condition, which clinical finding would the nurse most likely expect?
A.Decreased systemic vascular resistance due to peripheral vasodilation.
B.Systemic venous hypertension from increased central venous pressure.
C.Low output demands on the myocardium.
D.Pulmonary edema from left ventricular dysfunction.
B.Systemic venous hypertension from increased central venous pressure.
What is the primary hemodynamic consequence of a Patent Ductus Arteriosus (PDA)?
A.Blood flow is obstructed, increasing pressure in the left ventricle.
B.A large hole between the ventricles allows blood to mix freely.
C.Oxygenated blood from the aorta shunts into the pulmonary artery.
D.Deoxygenated blood from the pulmonary artery shunts into the aorta.
C.Oxygenated blood from the aorta shunts into the pulmonary artery.
A nurse is administering high-dose intravenous immunoglobulin (IVIG) to a child with Kawasaki Disease. The parents ask why this treatment is necessary. What is the nurse's best response?
A.It helps the fever go down and makes your child feel comfortable.
B.It helps reduce the widespread inflammation, especially in the heart's arteries, to prevent future damage.
C.It is a strong antibiotic to fight the unknown infection causing the disease.
D.It replaces the platelets that are being destroyed by the disease process.
B.It helps reduce the widespread inflammation, especially in the heart's arteries, to prevent future damage.
While the ductus arteriosus typically closes within 48-72 hours after birth, when does the foramen ovale functionally close?
A.Immediately at the time of cord clamping.
B.Within the first week of life.
C.At the same time as the ductus arteriosus (48-72 hours).
D.Within the first hour or two after birth.
D.Within the first hour or two after birth.