Chapter 42:
CardŤovascular
DysfunctŤon NursŤng
School Test Banks
Chapter 42: Cardiovascular Dysfunction
MULTIPLE CHOICE
1. The nurse is assessing a child postcardiac catheterization.
Which complication might the nurse anticipate?
a. Cardiac arrhythmia c. Congestive heart
failure
b. Hypostatic d. Rapidly increasing
pneumonia blood pressure
ANS: A
Because a catheter is introduced into the heart, a risk exists of
catheter-induced arrhythmias occurring during the procedure.
These are usually transient. Hypostatic pneumonia, congestive
heart failure, and rapidly increasing blood pressure are not risks
usually associated with cardiac catheterization.
PTS: 1 DIF: Cognitive Level: Application REF: 1320
1/41
,OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic
Integrity
2. Jos is a 4-year-old child scheduled for a cardiac
catheterization. Preoperative teaching should be:
a. Directed at his parents because he is too young to
understand.
b. Detailed in regard to the actual procedures so he will
know what to expect.
c. Done several days before the procedure so that he
will be prepared.
d. Adapted to his level of development so that he can
understand.
ANS: D
Preoperative teaching should always be directed at the childs
stage of development. The caregivers also benefit from the same
explanations. The parents may ask additional questions, which
should be answered, but the child needs to receive the
information based on developmental level. This age group does
not understand in-depth descriptions. Preschoolers should be
prepared close to the time of the cardiac catheterization.
PTS: 1 DIF: Cognitive Level: Application REF: 1320
OBJ: Nursing Process: Implementation MSC: Client Needs: Health
Promotion and Maintenance
3. The nurse is caring for a school-age girl who has had a cardiac
catheterization. The child tells the nurse that her bandage is too
wet. The nurse finds the bandage and bed soaked with blood.
The most appropriate initial nursing action is to:
a. Notify the physician.
2/41
, b. Apply a new bandage with more pressure.
c. Place the child in the Trendelenburg position.
d. Apply direct pressure above the catheterization site.
ANS: D
If bleeding occurs, direct continuous pressure is applied 2.5 cm
(1 inch) above the percutaneous skin site to localize pressure
over the vessel puncture. Notifying the physician and applying a
new bandage with more pressure can be done after pressure is
applied. The nurse can have someone else notify the physician
while the pressure is being maintained. The Trendelenburg
position would not be helpful; it would increase the drainage
from the lower extremities.
PTS: 1 DIF: Cognitive Level: Analysis REF: 1320
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic
Integrity
4. Which defect results in increased pulmonary blood flow?
a. Pulmonic stenosis c. Atrial septal defect
b. Tricuspid atresia d. Transposition of the
great arteries
ANS: C
Atrial septal defect results in increased pulmonary blood flow.
Blood flows from the left atrium (higher pressure) into the right
atrium (lower pressure) and then to the lungs via the pulmonary
artery. Pulmonic stenosis is an obstruction to blood flowing from
the ventricles. Tricuspid atresia results in decreased pulmonary
blood flow. Transposition of the great arteries results in mixed
blood flow.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1322
OBJ: Nursing Process: Assessment MSC: Client Needs: PhysiologicIntegrity
3/41
, 5. Which structural defects constitute tetralogy of Fallot?
a. Pulmonic stenosis, ventricular septal defect,
overriding aorta, right ventricular hypertrophy
b. Aortic stenosis, ventricular septal defect, overriding
aorta, right ventricular hypertrophy
c. Aortic stenosis, atrial septal defect, overriding aorta,
left ventricular hypertrophy
d. Pulmonic stenosis, ventricular septal defect, aortic
hypertrophy, left ventricular hypertrophy
ANS: A
Tetralogy of Fallot has these four characteristics: pulmonary stenosis, ventricular septal defect,
overriding aorta, and right ventricular hypertrophy. There is pulmonic stenosis but not aorticstenosis in
tetralogy of Fallot. Right ventricular hypertrophy, notleft ventricular hypertrophy, is present in tetralogy
of Fallot.
There is a ventricular septal defect, not an atrial septal defect,and overriding aorta, not aortic
hypertrophy, is present.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1327
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. What 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 c. Congestive heart
congestion failure
b. Congenital heart d. Systemic venous
4/41
CardŤovascular
DysfunctŤon NursŤng
School Test Banks
Chapter 42: Cardiovascular Dysfunction
MULTIPLE CHOICE
1. The nurse is assessing a child postcardiac catheterization.
Which complication might the nurse anticipate?
a. Cardiac arrhythmia c. Congestive heart
failure
b. Hypostatic d. Rapidly increasing
pneumonia blood pressure
ANS: A
Because a catheter is introduced into the heart, a risk exists of
catheter-induced arrhythmias occurring during the procedure.
These are usually transient. Hypostatic pneumonia, congestive
heart failure, and rapidly increasing blood pressure are not risks
usually associated with cardiac catheterization.
PTS: 1 DIF: Cognitive Level: Application REF: 1320
1/41
,OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic
Integrity
2. Jos is a 4-year-old child scheduled for a cardiac
catheterization. Preoperative teaching should be:
a. Directed at his parents because he is too young to
understand.
b. Detailed in regard to the actual procedures so he will
know what to expect.
c. Done several days before the procedure so that he
will be prepared.
d. Adapted to his level of development so that he can
understand.
ANS: D
Preoperative teaching should always be directed at the childs
stage of development. The caregivers also benefit from the same
explanations. The parents may ask additional questions, which
should be answered, but the child needs to receive the
information based on developmental level. This age group does
not understand in-depth descriptions. Preschoolers should be
prepared close to the time of the cardiac catheterization.
PTS: 1 DIF: Cognitive Level: Application REF: 1320
OBJ: Nursing Process: Implementation MSC: Client Needs: Health
Promotion and Maintenance
3. The nurse is caring for a school-age girl who has had a cardiac
catheterization. The child tells the nurse that her bandage is too
wet. The nurse finds the bandage and bed soaked with blood.
The most appropriate initial nursing action is to:
a. Notify the physician.
2/41
, b. Apply a new bandage with more pressure.
c. Place the child in the Trendelenburg position.
d. Apply direct pressure above the catheterization site.
ANS: D
If bleeding occurs, direct continuous pressure is applied 2.5 cm
(1 inch) above the percutaneous skin site to localize pressure
over the vessel puncture. Notifying the physician and applying a
new bandage with more pressure can be done after pressure is
applied. The nurse can have someone else notify the physician
while the pressure is being maintained. The Trendelenburg
position would not be helpful; it would increase the drainage
from the lower extremities.
PTS: 1 DIF: Cognitive Level: Analysis REF: 1320
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic
Integrity
4. Which defect results in increased pulmonary blood flow?
a. Pulmonic stenosis c. Atrial septal defect
b. Tricuspid atresia d. Transposition of the
great arteries
ANS: C
Atrial septal defect results in increased pulmonary blood flow.
Blood flows from the left atrium (higher pressure) into the right
atrium (lower pressure) and then to the lungs via the pulmonary
artery. Pulmonic stenosis is an obstruction to blood flowing from
the ventricles. Tricuspid atresia results in decreased pulmonary
blood flow. Transposition of the great arteries results in mixed
blood flow.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1322
OBJ: Nursing Process: Assessment MSC: Client Needs: PhysiologicIntegrity
3/41
, 5. Which structural defects constitute tetralogy of Fallot?
a. Pulmonic stenosis, ventricular septal defect,
overriding aorta, right ventricular hypertrophy
b. Aortic stenosis, ventricular septal defect, overriding
aorta, right ventricular hypertrophy
c. Aortic stenosis, atrial septal defect, overriding aorta,
left ventricular hypertrophy
d. Pulmonic stenosis, ventricular septal defect, aortic
hypertrophy, left ventricular hypertrophy
ANS: A
Tetralogy of Fallot has these four characteristics: pulmonary stenosis, ventricular septal defect,
overriding aorta, and right ventricular hypertrophy. There is pulmonic stenosis but not aorticstenosis in
tetralogy of Fallot. Right ventricular hypertrophy, notleft ventricular hypertrophy, is present in tetralogy
of Fallot.
There is a ventricular septal defect, not an atrial septal defect,and overriding aorta, not aortic
hypertrophy, is present.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 1327
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. What 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 c. Congestive heart
congestion failure
b. Congenital heart d. Systemic venous
4/41
