Blood Flow
During fetal life, oxygenated blood travels into the left atrium through a structure known as the:
a. Truncus arteriosus.
b. Foramen ovale.
c. Sinus venosus.
d. Ductus venosus.
b. Foramen ovale.
No communication between the systemic and pulmonary circulations.
A. Patent ductus arteriosus
B. Coarctation of the aorta
C. Ventricular septal defect
D. Transposition of the great vessels
Transposition of the great vessels
A 2-year-old with a known cardiac defect is presenting in congestive heart failure. Which assessment finding would indicate to the nurse possible digoxin toxicity?
a. Tachycardia
b. Bradypnea
c. Bradycardia
d. Tachypnea
c. Bradycardia
Nursing care of the child with Kawasaki disease is challenging because of which occurrence?
a. The child’s irritability
b. Predictable disease course
c. Complex aspirin therapy
d. The child’s ongoing requests for food
a. The child’s irritability
The nurse is teaching a mother how to administer digoxin (Lanoxin) at home to her 4-year-old child. The nurse tells the mother that as a general rule, digoxin should not be administered to the older child whose pulse is:
a. 108.
b. 98.
c. 78.
d. 58.
d. 58.
Which of the following fetal structures is a conduit in which blood is shunted from the pulmonary artery to the descending aorta.
a. Superior vena cava.
b. Ductus arteriosus.
c. Foramen ovale.
d. Ductus venosus.
b. Ductus arteriosus.
Localized narrowing near the insertion of the ductus arteriosus. Increased pressure proximal to the defect and decreased pressure distal to the obstruction
A. Patent ductus arteriosus
B. Coarctation of the aorta
C. Ventricular septal defect
D. Aortic stenosis
Coarctation of the aorta
The nurse is assessing a 6-month-old with congestive heart failure. Which of the following is a clinical manifestation of systemic congestion which can occur with CHF?
a. Tachypnea
b. Bradycardia
c. Systemic venous hypertension
d. Intercostal retractions
c. Systemic venous hypertension
Discharge teaching for a child with Kawasaki dis-ease who received IVIG should include:
a. Temperature should be taken daily; occurrence of fever should be reported immediately.
b. Arthritis, especially in the weight-bearing joints, although temporary, may persist for about a week after the initial infusion was completed.
c. Administer live vaccines such as measles, mumps, and rubella (MMR) vaccine after at least six months from the IVIG infusion.
d. No special instructions are needed except for cardiology follow-up.
a. Temperature should be taken daily; occurrence of fever should be reported immediately.
An infant is receiving Lanoxin elixir 0.028 mg once daily. Lanoxin is available in an elixir concentration of 50 mcg/mL. The correct dose to draw up and administer is:
a. 0.56 mL.
b. 0.28 mL.
c. 0.84 mL.
d. 1.12 mL.
a. 0.56 mL.
When an abnormal connection exists between the heart chambers (e.g., a septal defect), blood will nec-essarily flow from an area of higher pressure (left side) to one of lower pressure (right side). This is called a:
a. Left-to-right shunt.
b. Right-to-left shunt.
a. Left-to-right shunt.
Usually a right-to-left shunt depends on the size of VSD and degree of pulmonary stenosis. Includes four defects
A. Aortic stenosis
B. Coarctation of the aorta
C. Ventricular septal defect
D Tetralogy of Fallot
Tetralogy of Fallot
A nurse is providing care to a 7-month-old infant diagnosed with a ventricular septal defect who has developed congestive heart failure. The nurse has identified fluid volume excess as a key problem with the goal of attaining fluid balance. Which intervention is most applicable to the key problem and goal?
a. Administer digoxin as prescribed.
b. Administer furosemide as prescribed.
c. Cluster the infant’s care to promote adequate rest.
d. Auscultate the infant’s lungs to monitor for pulmonary edema.
b. Administer furosemide as prescribed.
Dehydration must be prevented in children who are hypoxemic because dehydration places the child at risk for:
a. Infection.
b. Cerebral vascular accident.
c. Fever.
d. Air embolism.
b. Cerebral vascular accident.
A 12-month-old infant in heart failure is taking enalapril (ACE inhibitor) and spironolactone. The nurse should be especially alert for:
a. Sodium 142 mEq/L.
b. Potassium 5.5 mEq/L.
c. Potassium 3.1 mEq/L.
d. Sodium 132 mEq/L.
b. Potassium 5.5 mEq/L.
Which of the following is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?
a. Pulmonary venous congestion
b. Congenital heart defect
c. Congestive heart failure
d. Systemic venous congestion
c. Congestive heart failure
Continued patency of this vessel allows blood to flow from the higher-pressure aorta to the lower pressure pulmonary artery, which causes a left-to-right shunt.
A. Patent ductus arteriosus
B. Coarctation of the aorta
C. Transposition of the great vessel
D Tetralogy of Fallot
Patent ductus arteriosus (PDA)
An infant who weighs 7 kg has just returned to the intensive care unit following cardiac surgery. The urine output has been 5 mL in the past hour. In this situation, what is the first action the nurse should take?
a. Notify the surgeon.
b. Identify any other signs of hypervolemia.
c. Suction the patient.
d. Identify any other signs of renal failure.
d. Identify any other signs of renal failure.
An infant who weighs 7 kg has just returned to the intensive care unit following cardiac surgery. The chest tube has drained 40 mL in the past hour. In this situation, what is the first action for the nurse to take?
a. Notify the surgeon.
b. Identify any other signs of hemorrhage.
c. Suction the patient.
d. Identify any other signs of renal failure
a. Notify the surgeon.
Elevated cholesterol:
a. Can predict the long-term risk of heart disease for the individual.
b. Can predict the risk of hypertension in adulthood.
c. Plays an important role in causing atherosclerosis.
d. Plays an important role in causing congestive heart failure.
c. Plays an important role in causing atherosclerosis.
List five of the most significant complications following a cardiac catheterization in an infant or young child.
Stroke, seizures, tamponade, and death.
Loss of circulation to the affected extremity, dysrhythmias, hemorrhage, cardiac perforation, hematoma, hypovolemia and dehydration, hypoglycemia in infants, and changes in the temperature and color of the affected extremity.
Which of the following sets of assessment findings are the most frequent clinical manifestations of an ventricular septal defect in an infant or child?
a. Decreased cardiac output and low blood pressure
b. Heart failure and a characteristic murmur
c. Increased blood pressure and pulse
d. Dyspnea and bradycardia
b. Heart failure and a characteristic murmur
Meeting the nutritional needs of an infant with con-gestive heart failure is challenging due to the poor cardiac function, increased respiratory rate and heart rate of the infant. Which of the following measures would most likely ensure the nutritional needs of the infant with congestive heart failure are being met?
a. The infant should be fed about 30 minutes before napping.
b. The infant should be fed every 2 hours to promote adequate caloric intake
c. The infant should be fed every 3 hours to promote adequate rest periods between feedings.
d. The infant should be given about 45 minutes to complete feeding.
c. The infant should be fed every 3 hours to promote adequate rest periods between feedings.
If bleeding occurs at the insertion site after a cardiac catheterization, the nurse should apply:
a. Warmth to the unaffected extremity.
b. Pressure below the insertion site.
c. Warmth to the affected extremity.
d. Pressure above the insertion site.
d. Pressure above the insertion site.
The most reliable test to provide evidence of recent streptococcal infection in the patient with suspected acute rheumatic fever is the:
a. Throat culture.
b. Mantoux test.
c. Liver enzymes test.
d. Antistreptolysin O test.
d. Antistreptolysin O test.