A nurse is assessing in infant who has coarctation of the aorta. Which of the following findings should the nurse expect? Select all that apply
A. Weak femoral pulses
B. Cool skin of lower extremities
C. Severe cyanosis
D. Clubbing of the fingers
E. Low blood pressure correct answers A. Wea...
A nurse is assessing in infant who has coarctation of the aorta. Which of the following
findings should the nurse expect? Select all that apply
A. Weak femoral pulses
B. Cool skin of lower extremities
C. Severe cyanosis
D. Clubbing of the fingers
E. Low blood pressure correct answers A. Weak femoral pulses
B. Cool skin of lower extremities
E. Low blood pressure
A nurse is assessing an infant who has heart failure. Which of the following findings
should the nurse expect? Select all that apply
A. Bradycardia
B. Cool extremities
C. Peripheral edema
D. Increased urinary output
E. Nasal flaring correct answers B. Cool extremities
C. Peripheral edema
E. Nasal flaring
A nurse is providing teaching to the caregiver of an infant who has a prescription for
digoxin. Which of the following instructions should the nurse include?
A. Do not offer your baby fluids after giving the medication
B. Digoxin increases your babies heart rate
C. Give the correct dose of medication at regularly scheduled times
D. If your baby vomits a dose, you should repeat the dose to ensure that the correct
amount is received correct answers C. Give the correct dose of medication at regularly
scheduled times
A nurse is caring for a two-year-old child who has a heart defect and is scheduled for a
cardiac catherization. Which of the following actions should the nurse take?
A. Place on NPO status for 12 hours prior to the procedure
B. Check for iodine or shellfish allergies prior to the procedure
C. Elevate the affected extremity following the procedure
D. Limit fluid intake following the procedure correct answers B. Check for iodine or
shellfish allergies prior to the procedure
,A nurse is caring for a child who is suspected of having rheumatic fever. Which of the
following findings should the nurse expect? Select all that apply
A. Erythema marginatum
B. Continuous joint pain of the digits
C. Tender, subcutaneous nodules
D. Decreased ESR
E. Elevated C reactive protein correct answers A. Erythema marginatum
E. Elevated C reactive protein
A nurse is caring for a child after a cardiac catherization. What is the nursing priority?
A. Allow early ambulation to encourage activity participation
B. Check pulses above the catheter insertion site for strength and quality
C. Assess extremity distal to the insertion site for temperature and color
D. Change the dressing to evaluate the site for infection correct answers C. Assess
extremity distal to the insertion side for strength and quality
Sam, age 11, has a diagnosis of rheumatic fever and has missed school for a week.
What is the most likely cause of this problem?
1. Previous streptococcal throat infection.
2. History of open heart surgery at 5 years of age.
3. Playing too much soccer and not getting enough rest.
4. Exposure to a sibling with pneumonia. correct answers Previous streptococcal throat
infection.
While assessing a four-month-old infant, the nurse notes that the baby experiences a
hyper cyanotic spell. What is the priority nursing action?
A. Provide supplemental oxygen by face mask
B. Administer a dose of IV morphine sulfate
C. Begin cardio pulmonary resuscitation
D. Place the infant in a knee to chest position correct answers D. Place the infant in a
knee to chest position
A nurse is teaching an adolescent to self administer a corticosteroid medication using a
meter dose inhaler. Which of the following instructions should the nurse include? Select
all that apply
A. Shake the device prior to use
B. Rinse and expectorate after administration
C. Inhale slowly with medication administration
D. Exhale quickly after medication administration
E. Wait 30 seconds between puffs correct answers A. Shake the device prior to use
B. Rinse and expectorate after administration
,C. Inhale slowly with medication administration
A nurse is caring for a child who is receiving oxygen therapy and is on a continuous
oxygen saturation monitor that is reading 89%. Which of the following actions should the
nurse take first?
A. Increase the oxygen flow rate
B. Encourage the child to take deep breaths
C. Ensure proper placement of the sensor probe
D. Please the child in the Fowler's position correct answers C. Ensure proper
placement of the sensor probe
A nurse in the emergency department is assessing a newly admitted infant. Which of
the following findings is an early indication of hypoxemia?
A. Nonproductive cough
B. Hypoventilation
C. Tachypnea
D. Nasal stuffiness correct answers C. tachypnea
A nurse is caring for a child who is receiving oxygen. Which of the following findings
indicates oxygen toxicity?
A. Increase blood pressure
B. Hyperventilation
C. Decreased PaCO2
D. Unconsciousness correct answers D. Unconsciousness
A nurse is caring for a child who is receiving a broncodilator medication by nebulized
aerosol therapy. Which of the following actions should the nurse take? Select all that
apply
A. Instruct the child that the treatment will last 30 minutes
B. Obtain vital signs prior to the procedure
C. Tell the child to take slow deep breaths
D. Determine if the child should use a mask
E. Attach the device to an air source correct answers B. Obtain vital signs prior to the
procedure
C. Tell the child to take slow deep breaths
D. Determine if the child should use a mask
E. Attach the device to an air source
What is the definition of a congenital heart disease? correct answers Structural
anomalies present at birth, half are diagnosed within the first week of life, 28% occur
along with a syndrome or chromosome defect
, What is the definition of an acquired heart disease? correct answers Disorders that
occur after birth, many of her as a complication of congenital heart disease or an
infectious disease
When does heartbeat begin in a fetus and what causes heartbeat? correct answers 2
to 3 weeks gestation, it occurs due to electrical activity in the developing heart cells
When is heart development complete in a fetus? correct answers 8 to 10 weeks, but it
is passively working and the fetus is still relying on the mother's circulation for support
Although most congenital heart disease has no cause, what are some risk factors
associated with its occurrence? correct answers Maternal substance use, maternal
exposure to infections, family history of CHD
What 3 fetal structures are present in the heart to allow blood to bypass the lungs?
correct answers Ductus arteriosus, foreman ovale, ductus venosus
Where is the Apex of the heart and children less than seven years old? correct answers
4th intercostal space
Where is the Apex of the heart and children greater than seven years old? And what
causes this shift? correct answers 5th intercostal space, as the lungs grow the heart is
displaced downward
What may result from the rapid growth spurt seen in adolescence? correct answers An
innocent murmur may form, this murmur is due to leaking valves or a temporary
reversal of blood flow
Heart rate decreases from an average of 120 in infants to an average of 60 in teens,
what causes this decrease? correct answers Blood volume increases and the heart
becomes stronger, so it no longer needs to beat rapidly in order to maintain cardiac
output
Why do infants have a high heart rate? correct answers Infants have less compliance
of the heart muscle, the only way to increase cardiac output in infants is to increase the
rate
Where do we check a pulse in infants? correct answers We can use the radial,
brachial, dorsalis pedis, posterior tibial, and femoral
Always compare the pulses of the upper extremities to the lower extremities
What three things must we know about a murmur? correct answers Location, quality,
intensity (grade 1-6)
If a murmur improves or subsides with a change in position, what type of murmur is
this? correct answers Innocent murmur
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