Pillitteri: Maternal and Child Health Nursing, 5th Edition
Chapter 41: Nursing Care of the Child With a Cardiovascular Disorder
1. A parent
... [Show More] brings a 2-month-old who has tetralogy of Fallot for a health maintenance visit. The parent's chief concern is most apt to be that the infant
2. Tetralogy of Fallot is the most frequently occurring type of congenital heart disease in children. The four anomalies associated with this defect are
A) atrial septal defect, pulmonary stenosis, left ventricular hypertrophy, overriding aorta.
B) ventricular septal defect, aortic stenosis, mitral stenosis, right-sided aorta.
C) tricuspid stenosis, right ventricular hypertrophy, pulmonary stenosis, atrial septal defect.
D) ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, overriding aorta.
3. When reviewing the record of a child with tetralogy of Fallot, which of the following would you expect to discover?
A) Leukopenia.
B) Polycythemia.
C) Increased platelet level.
D) Anemia.
Feedback: Children who cannot oxygenate red cells well often produce excess red blood cells or develop polycythemia.
4. To assess for cyanosis in an infant with cardiovascular disease, it would be best to assess
A) the child's toes for color.
B) the child's tongue and buccal membrane.
C) the child's lips and the circumoral area.
D) the child's fingertips for color and blanching.
.
5. You would teach the mother of a boy with tetralogy of Fallot that if he suddenly becomes cyanotic and dyspneic to
A) place him in a semi-Fowler's position in an infant seat.
B) lie him supine with the head turned to one side.
C) lie him prone, being sure he can breathe easily.
D) place him in a knee–chest position.
6. Infants with congenital heart disease should not be allowed to become dehydrated because this makes them prone to
A) seizures.
B) tachycardia.
C) cerebrovascular accident.
D) jaundice.
7. At 3 years of age, a child has a cardiac catheterization. After the procedure, which of the following interventions would be most important?
A) Assuring the child that the procedure is now over.
B) Allowing the child to adapt to the light room gradually.
C) Taking pedal pulses for the first 4 hours.
D) Allowing the child to talk about the procedure.
8. When a child is scheduled for a cardiac catheterization, an important health teaching point for parents is that
A) the procedure is noninvasive and not frightening for children.
B) the child will return with a bulky pressure dressing over the catheter insertion area.
C) the child will require a general anesthetic and needs to be prepared for this.
D) the child will have to remain NPO for 6 to 8 hours after the procedure to prevent vomiting.
9. An 8-month-old has a ventricular septal defect. Which nursing diagnosis below would best apply?
A) Ineffective airway clearance related to altered pulmonary status.
B) Ineffective tissue perfusion related to inefficiency of the heart as a pump.
C) Impaired gas exchange related to a right-to-left shunt.
D) Impaired skin integrity related to poor peripheral circulation.
10. An infant girl is prescribed digoxin. You would teach her parents that the action of this drug is to
A) slow and strengthen her heartbeat.
B) increase her heart rate.
C) thicken the walls of the myocardium.
D) prevent subacute bacterial endocarditis.
11. You take 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) 60 beats/minute.
B) 80 beats/minute.
C) 100 beats/minute.
D) 150 beats/minute.
12. Which of the following would be most important to implement for an infant who develops heart failure?
A) Restricting milk intake daily.
B) Planning ways to reduce salt intake.
C) Placing her in a semi-Fowler's position.
D) Keeping her supine and playing quiet games.
13. After cardiac surgery, a child has chest tubes inserted that are attached to an underwater-seal drainage system. You should be prepared to clamp chest tubes when
A) a clot obstructs the tubing.
B) a tube becomes disconnected.
C) red-stained drainage appears in a tube.
D) you sit the child up to help with coughing.
14. On assessment immediately following cardiac surgery, which of the following conditions would you expect to find in an infant?
A) Hypothermia.
B) Hypovolemia.
C) Hypertension.
D) Hyperexcitability.
15. When evaluating an infant's progress, you should remember that after cardiac surgery, most parents need support to
A) continue limiting their child's activities.
B) learn to feed the child again.
C) learn to change the dressing on the chest tubes.
D) allow the child to perform age-level tasks.
16. You care for a toddler who has a functional heart murmur. You would advise the child's parents that
A) this type of murmur is insignificant.
B) mild activity restrictions are indicated.
C) more frequent health appraisals are indicated.
D) corrective surgery may be required later in life.
17. You see a school-age child in an ambulatory setting because of rheumatic fever. Which of the following would you expect to find revealed by the health history?
A) Knee pain, abdominal rash, subcutaneous nodules.
B) An elevated temperature, back pain, loss of hair.
C) Fatigue, slow pulse, frequent urination.
D) Loss of weight, abdominal pain, chest pain.
18. Which of the following nursing diagnoses would best apply to a child with rheumatic fever?
A) Ineffective breathing pattern related to cardiomegaly.
B) Activity intolerance related to inability of heart to sustain extra workload.
C) Disturbed sleep pattern related to hyperexcitability.
D) Risk for self-directed violence related to development of cerebral anoxia.
19. When taking the pulse of a child with rheumatic fever, which method would be most appropriate?
A) Brachial pulse for 30 seconds.
B) Radial pulse for 60 seconds.
C) Apical pulse for 60 seconds.
D) Dorsalis pedis pulse for 60 seconds.
20. When you are making plans for the discharge of a child following rheumatic fever, you anticipate that you will be giving her parents instructions to
A) administer oral penicillin to the child daily.
B) watch for signs of poor platelet function, such as petechiae.
C) ensure that the child remains inside until surgery is scheduled.
D) test the child's urine daily for protein.
21. When planning the care for a child with Kawasaki disease, which of the following would be most important?
A) Making sure he performs postural drainage daily.
B) Observing him for symptoms of bowel obstruction.
C) Encouraging him to cough and deep-breathe.
D) Teaching him to live with a chronic illness.
22. Coarctation of the aorta demonstrates few symptoms in newborns. Which of the following is an important assessment to make on all newborns to help reveal this condition?
A) Observing for excessive crying.
B) Assessing for the presence of femoral pulses.
C) Recording an upper extremity blood pressure.
D) Auscultating for a cardiac murmur.
23. An 18-year-old with hypertension attends your ambulatory clinic. She currently takes an oral contraceptive and an over-the-counter vitamin pill daily. What health teaching would you initiate with her?
A) Teach her not to take the oral contraceptive in the morning when blood pressure is highest.
B) Suggest she discontinue the vitamin tablet to help reduce her blood pressure.
C) Suggest she speak to her physician about whether she should remain on the oral contraceptive.
D) Nothing. There is no relationship between use of oral contraceptives or vitamins and hypertension.
24. Which of the following criteria is used to define childhood hypertension?
A) A systolic reading over 70.
B) A systolic reading above the 95th percentile for the child's age.
C) Sustained increased systolic and diastolic readings of 20 or more after minimal exercise.
D) An increase in either systolic or diastolic reading after exercise.
25. A child is born with a ventricular septal defect. The opening is large enough to require surgery. The goal of closing this opening is to prevent:
A) Cardiac failure
B) Excessive bleeding
C) Cyanosis
D) Hypovolemic shock
26. A 2-day-old infant has a heart murmur. The ECG was normal. What disorder would most likely be suspected?
A) Ventricular septal defect
B) Coarctation of the aorta
C) Patent ductus arteriosus
D) Tetralogy of Fallot [Show Less]