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TB Chapter 26 The Child with a Cardiovascular
Disorder Correct Questions and Answers Uploaded
TB-Chapter 26 The Child with a Cardiovascular Disorder
Chapter 26: The Child with a Cardiovascular Disorder
MULTIPLE CHOICE
- What does the nurse explain that a ventricular septal defect will allow? a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis b. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis c. No shunting because of high pressure in the left ventricle d. Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume
ANS: A
Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts from left to right because of the higher pressure in the left ventricle. This particular shift does not cause cyanosis.
DIF: Cognitive Level: Comprehension REF: Page 626 TOP: Congenital Heart Disease KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect? a. A loud, harsh murmur with a systolic thrill b. Cyanosis when crying c. Blood pressure higher in the arms than in the legs d. A machinery-like murmur
ANS: A
A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.
DIF: Cognitive Level: Comprehension REF: Page 626 TOP: Congenital Heart Disease KEY: Nursing Process Step: Data Collection MSC: NCLEX: Physiological Integrity: PhysiNolUoRgiScIaNl GATdBap.CtaOtiMon
- What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?
TB Chapter 26 The Child with a Cardiovascular
Disorder Correct Questions and Answers Uploaded
TB-Chapter 26 The Child with a Cardiovascular Disorder
a. Blood pressure higher on the right side b. Blood pressure higher on the left side c. Blood pressure lower in the arms than in the legs d. Blood pressure lower in the legs than in the arms
ANS: D The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the defect and decreased distal to the coarctation.
DIF: Cognitive Level: Comprehension REF: Page 627 TOP: Congenital Heart Disease KEY: Nursing Process Step: Data Collection MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurses best response? a. Squatting increases the return of venous blood back to the heart. b. Squatting decreases arterial blood flow away from the heart. c. Squatting is a common resting position when a child is tachycardic. d. Squatting increases the workload of the heart.
ANS: A
The squatting position allows the child to breathe more easily because systemic venous return is increased.
DIF: Cognitive Level: Comprehension REF: Page 627 TOP: Congenital Heart Disease KEY: Nursing Process Step: Implementation
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 241 ANS: B The tissues that cover the heart and heart valves are affected. The heart muscle may be involved and the mitral valve is frequently involved.
DIF: Cognitive Level: Knowledge REF: Page 632 TOP: Rheumatic Fever KEY: Nursing Process Step: Data Collection MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect? a. He is always hungry. b. He tires out during feedings. c. He is fussy for several hours every day. d. He sleeps all the time.
ANS: B Fatigue during feeding or activity is common to most infants with congenital cardiac problems.
DIF: Cognitive Level: Application REF: Page 629 OBJ: 3 TOP: Congenital Heart Disease KEY: Nursing Process Step: Data Collection
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 242
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
- The nurse is caring for a child with a diagnosis of Kawasaki disease. The childs parent asks the nurse, How does Kawasaki disease affect my childs heart and blood vessels? On what understanding is the nurses response based? a. Inflammation weakens blood vessels, leading to aneurysm. b. Increased lipid levels lead to the development of atherosclerosis. c. Untreated disease causes mitral valve stenosis. d. Altered blood flow increases cardiac workload with resulting heart failure.
ANS: A Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.
DIF: Cognitive Level: Comprehension REF: Page 635 TOP: Kawasaki Disease KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. Which statement by the father leads the nurse to determine he understood the instructions? a. If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest. b. If the baby turns blue, I will lay him down on a firm surface with his head lower than the rest of his body. c. If the baby turns blue, I will immediately put the baby upright in an infant seat. d. If the baby turns blue, I will put the baby in supine position with his head elevated.
ANS: A In the event of a paroxysmal hypercyanotic or tet spell, the infant should be placed in a knee-chest position.
DIF: Cognitive Level: Application REF: Page 628 OBJ: 4 TOP: Tetralogy of Fallot KEY: Nursing Process Step: Evaluation
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MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
- The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, Why do my childs fingertips look like that? On what understanding does the nurse
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 244
KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
- An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity? a. Restlessness b. Decreased respiratory rate c. Increased urinary output d. Vomiting
ANS: D Symptoms of digoxin toxicity include: nausea, vomiting, anorexia, irregularity in pulse rate and rhythm, and a sudden change in pulse.
DIF: Cognitive Level: Comprehension REF: Page 630 TOP: Heart Failure KEY: Nursing Process Step: Data Collection MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood? a. The patent ductus arteriosus b. A ventricular septal defect c. The closure of the foramen ovale d. An atrial septal defect
ANS: D Because the right side of the heart must take over pumping blood to both the lungs and systemic circulation, the ductus arteriosus must remain open to shunt the oxygenated blood from the lungs.
DIF: Cognitive Level: Knowledge REF: Page 628 TOP: Hypoplastic Left Heart Syndrome KEYN: NUuRrSsIinNgGPTrBo.cCeOssMStep: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates? a. Seizure activity b. Hypoxia c. Sydenhams chorea d. Decreasing level of consciousness
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 245 ANS: C As the effects of rheumatic fever affect the central nervous system, the child may develop Sydenhams chorea, manifested by involuntary, purposeless movements of the limbs.
DIF: Cognitive Level: Knowledge REF: Page 632 TOP: Sydenhams Chorea KEY: Nursing Process Step: Data Collection MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G? a. 1 year b. 2 years c. 5 years d. 10 years
ANS: C
Children who recover from rheumatic fever should have a chemoprophylaxis protocol of penicillin G injections (about 200,000 units per dose) for a minimum of 5 years or up to the age of 18 to prevent further bouts of rheumatic fever.
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 247 d. Reduction of aerobic exercise
ANS: C The main focus of a hypertension-prevention program is patient education.
DIF: Cognitive Level: Knowledge REF: Page 634 TOP: Hypertension Prevention KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
- A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate? a. Barium swallow b. Chest x-ray c. Electrocardiogram d. Echocardiogram
ANS: D Echocardiography is a noninvasive procedure that localizes murmurs and determines if theheart is structurally normal.
DIF: Cognitive Level: Knowledge REF: Page 625
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 248
OBJ: N/A TOP: Diagnostic Tests KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early
Detection of Disease MULTIPLE RESPONSE
- How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the childs weakness and fatigue? (Select all that apply.) a. Feeding more frequently with smaller feedings b. Using a soft nipple with enlarged holes c. Holding and cuddling the child during feeding d. Substituting glucose water for formula e. Offering high-caloric formula
ANS: A, B, C, E Infants with CHF fatigue easily. Feeding can be given more frequently in smaller amounts through a soft, large-holed nipple. Formulas with a denser caloric content can be offered. The child may be encouraged to nurse if he or she is held.
DIF: Cognitive Level: Application REF: Page 630 TOP: Feeding Infant with CHF KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
- What are the four structural heart anomalies that make up the tetralogy of Fallot? (Select the four that apply.) a. Hypertrophied right ventricle b. Patent ductus arteriosus c. Ventral septal defect d. Narrowing of pulmonary artery e. Dextroposition of aorta
ANS: A, B, D, E
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The four anomalies that comprise tetralogy of Fallot are hypertrophied right ventricle, patent ductus arteriosus, stenosis of pulmonary artery, and dextroposition of the aorta.
DIF: Cognitive Level: Knowledge REF: Page 627 TOP: Tetralogy of Fallot KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 250
d. Patent ductus arteriosus e. Ventricular septal defects (VSDs)
ANS: A, D, E
The congenital heart defects that cause increased pulmonary blood flow are ASDs, VSDs, and patent ductus arteriosus.
DIF: Cognitive Level: Comprehension REF: Page 628 TOP: Congenital Heart Defects KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- A 16-year-old patient is diagnosed with primary hypertension. What risk factors does the nurse mention when providing education on this diagnosis to the patient and his family? (Select all that apply.) a. Heredity b. Stress c. Congenital defect d. Obesity e. Poor diet
ANS: A, B, D, E Primary, or essential, hypertension implies that no known underlying disease is present. Nevertheless, heredity, obesity, stress, and a poor diet and exercise pattern can contribute to any type of hypertension.
DIF: Cognitive Level: Comprehension REF: Page 625 TOP: Primary Hypertension KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation
COMPLETION
- The nurse takes into consideration that theNmUoRsSt IcNoGmTmBo.CnOcoMngenital heart defect is the defect.
ANS: ventricular septal
VSDs are the most common congenital heart defect.
DIF: Cognitive Level: Knowledge REF: Page 633 TOP: VSD KEY:
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 251 Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- The nurse explains that the difference between the systolic blood pressure reading and the diastolic blood pressure reading is called the.
ANS:
pulse pressure The pulse pressure is the difference between the diastolic pressure and the systolic pressure. DIF: Cognitive Level: Knowledge REF: Page 626 TOP: Pulse Pressure KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- Because the diagnosis of rheumatic fever is difficult, an aid used to identify the presence of rheumatic feve is the.
ANS:
Jones criteria
The Jones criteria identify a cluster of symptoms and divide them into major criteria and minor criteria. The
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 253
Rheumatic fever (RF) is a systemic disease involving the joints, heart, central nervous system (CNS), skin, and subcutaneous tissues. It belongs to a group of disorders known as collagen diseases
DIF: Cognitive Level: Knowledge REF: Page 631 TOP: Rheumatic Fever KEY: Nursing Process Step: Data Collection MSC: NCLEX: Physiological Integrity: Physiological Adaptation
