Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. A 3-month-old infant is diagnosed with pulmonary stenosis. Which parent teaching does
the nurse provide?
a. Options for treatment include a repair of the artery or the valve.
b. Balloon angioplasty is performed as an outpatient procedure.
c. Pulmonary stenosis repair can be delayed until 1 year of age.
d. After repair, the child is no longer at risk for cardiac problems.
ANS: A
Chapter: Chapter 13 Cardiovascular Disorders
Chapter Learning Objective: 4. Identify the nursing interventions necessary to educate
the caregiver to care for a child with cardiovascular disease.
Page: 271
Heading: Congenital Heart Disease With Obstructive Disorders > Pulmonary Stenosis
> Caregiver Education
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Synthesis [Creating]
Concept: Caring
Difficulty: Difficult
Feedback
A. This is correct. Options are to repair the pulmonary artery and/or pulmonic valve
as soon as possible to avoid worsening side effects of the condition.
B. This is incorrect. Side effects of pulmonary stenosis include increased workload
of the right ventricle, congestive heart failure, hepatomegaly, development of
murmurs, shortness of breath, and cyanosis. Delaying corrective surgery will
worsen effects of the condition.
C. This is incorrect. The infant with pulmonary stenosis will be hospitalized for
assessment and treatment.
D. This is incorrect. The child must return to the cardiologist frequently for follow-
up, and caregivers should be provided information on the recurrence of
symptoms that may occur due to restenosis.
PTS: 1 CON: Caring
2. The parents are preparing to take their newborn, who was diagnosed with tetralogy of
Fallot with pulmonary atresia, home. The nurse is developing a teaching sheet regarding
, care of the newborn for the parents. Which information does the nurse need to include in
the teaching plan?
a. There is no need to limit activities.
b. It is important to maintain caloric intake.
c. No secondary complications are expected.
d. The neonate has natural immunity to infections.
ANS: B
Chapter: Chapter 13 Cardiovascular Disorders
Chapter Learning Objective: 4. Identify the nursing interventions necessary to educate
the caregiver to care for a child with cardiovascular disease.
Page: 272
Heading: Congenital Heart Disease With Obstructive Disorders > Tetralogy of Fallot
With Pulmonary Atresia > Caregiver Education
Integrated Processes: Communication and Documentation
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Synthesis [Creating]
Concept: Teaching and Learning
Difficulty: Difficult
Feedback
A. This is incorrect. The parents will be taught to calm the infant by holding the
infant over the caregiver’s shoulders with the infant’s knees drawn up toward the
chest. This will increase the blood flow to the lungs. The parents will limit
cardiac stress by keeping the infant calm.
B. This is correct. Due to a clinical finding of failure to gain weight, the parents are
instructed on the importance of maintaining caloric intake. Frequent small
feedings are necessary to meet this need and not increase cardiac stress.
C. This is incorrect. Parents need to monitor for signs and symptoms of heart
failure.
D. This is incorrect. Educate parents on the increased risk of bacterial endocarditis
and the prescribed medication regimen.
PTS: 1 CON: Teaching and Learning
3. The nurse is providing information to the parents of a toddler who is scheduled for
surgery for the replacement of the pulmonic valve. The parents have many questions
about the function of the valve. Which information from the nurse is correct?
a. The valve must work correctly to get oxygen from the lungs to the body.
b. If the valve does not work correctly, blood is kept from entering the heart.
c. When the valve is defective, the blood leaving the heart is decreased.
d. A defect in the valve causes less blood to get to the lungs for oxygenation.
ANS: D
, Chapter: Chapter 13 Cardiovascular Disorders
Chapter Learning Objective: 1. Identify the normal assessment of the anatomy and
physiology of the pediatric cardiovascular system.
Page: 251
Heading: Heart Anatomy and Physiology > Heart Valves
Integrated Process: Teaching and Learning
Client Need: Physiological Integrity > Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Teaching and Learning
Difficulty: Difficult
Feedback
A. This is incorrect. The aortic valve must work correctly for oxygenated blood to
be carried from the left side of the heart to the rest of the body.
B. This is incorrect. Blood must enter the right side of the heart from the body to be
reoxygenated. The unoxygenated blood enters the right atrium through the
tricuspid valve into the right ventricle.
C. This is incorrect. A defect in the aortic valve would cause problems with
oxygenated blood leaving the left ventricle.
D. This is correct. When there is a defect in the right pulmonic valve, the blood has
difficulty leaving the right ventricle and getting to the lungs for reoxygenation.
This explanation by the nurse correctly describes the function of the valve and
the purpose of the surgery.
PTS: 1 CON: Teaching and Learning
4. The nurse caring for a child who is exhibiting supraventricular tachycardia as revealed on
the cardiac monitor. Which nursing intervention would the nurse attempt first?
a. Administer adenosine.
b. Perform nasal suctioning.
c. Apply ice to the forehead.
d. Ask the child to bear down.
ANS: D
Chapter: Chapter 13 Cardiovascular Disorders
Chapter Learning Objective: 4. Identify the nursing intervention necessary to educate
the caregiver to care for a child with cardiovascular disease.
Page: 283
Heading: Cardiac Dysrhythmias > Tachycardia > Supraventricular Tachycardia
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Clinical Judgment
Difficulty: Difficult
Identify the choice that best completes the statement or answers the question.
1. A 3-month-old infant is diagnosed with pulmonary stenosis. Which parent teaching does
the nurse provide?
a. Options for treatment include a repair of the artery or the valve.
b. Balloon angioplasty is performed as an outpatient procedure.
c. Pulmonary stenosis repair can be delayed until 1 year of age.
d. After repair, the child is no longer at risk for cardiac problems.
ANS: A
Chapter: Chapter 13 Cardiovascular Disorders
Chapter Learning Objective: 4. Identify the nursing interventions necessary to educate
the caregiver to care for a child with cardiovascular disease.
Page: 271
Heading: Congenital Heart Disease With Obstructive Disorders > Pulmonary Stenosis
> Caregiver Education
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Synthesis [Creating]
Concept: Caring
Difficulty: Difficult
Feedback
A. This is correct. Options are to repair the pulmonary artery and/or pulmonic valve
as soon as possible to avoid worsening side effects of the condition.
B. This is incorrect. Side effects of pulmonary stenosis include increased workload
of the right ventricle, congestive heart failure, hepatomegaly, development of
murmurs, shortness of breath, and cyanosis. Delaying corrective surgery will
worsen effects of the condition.
C. This is incorrect. The infant with pulmonary stenosis will be hospitalized for
assessment and treatment.
D. This is incorrect. The child must return to the cardiologist frequently for follow-
up, and caregivers should be provided information on the recurrence of
symptoms that may occur due to restenosis.
PTS: 1 CON: Caring
2. The parents are preparing to take their newborn, who was diagnosed with tetralogy of
Fallot with pulmonary atresia, home. The nurse is developing a teaching sheet regarding
, care of the newborn for the parents. Which information does the nurse need to include in
the teaching plan?
a. There is no need to limit activities.
b. It is important to maintain caloric intake.
c. No secondary complications are expected.
d. The neonate has natural immunity to infections.
ANS: B
Chapter: Chapter 13 Cardiovascular Disorders
Chapter Learning Objective: 4. Identify the nursing interventions necessary to educate
the caregiver to care for a child with cardiovascular disease.
Page: 272
Heading: Congenital Heart Disease With Obstructive Disorders > Tetralogy of Fallot
With Pulmonary Atresia > Caregiver Education
Integrated Processes: Communication and Documentation
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Synthesis [Creating]
Concept: Teaching and Learning
Difficulty: Difficult
Feedback
A. This is incorrect. The parents will be taught to calm the infant by holding the
infant over the caregiver’s shoulders with the infant’s knees drawn up toward the
chest. This will increase the blood flow to the lungs. The parents will limit
cardiac stress by keeping the infant calm.
B. This is correct. Due to a clinical finding of failure to gain weight, the parents are
instructed on the importance of maintaining caloric intake. Frequent small
feedings are necessary to meet this need and not increase cardiac stress.
C. This is incorrect. Parents need to monitor for signs and symptoms of heart
failure.
D. This is incorrect. Educate parents on the increased risk of bacterial endocarditis
and the prescribed medication regimen.
PTS: 1 CON: Teaching and Learning
3. The nurse is providing information to the parents of a toddler who is scheduled for
surgery for the replacement of the pulmonic valve. The parents have many questions
about the function of the valve. Which information from the nurse is correct?
a. The valve must work correctly to get oxygen from the lungs to the body.
b. If the valve does not work correctly, blood is kept from entering the heart.
c. When the valve is defective, the blood leaving the heart is decreased.
d. A defect in the valve causes less blood to get to the lungs for oxygenation.
ANS: D
, Chapter: Chapter 13 Cardiovascular Disorders
Chapter Learning Objective: 1. Identify the normal assessment of the anatomy and
physiology of the pediatric cardiovascular system.
Page: 251
Heading: Heart Anatomy and Physiology > Heart Valves
Integrated Process: Teaching and Learning
Client Need: Physiological Integrity > Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Teaching and Learning
Difficulty: Difficult
Feedback
A. This is incorrect. The aortic valve must work correctly for oxygenated blood to
be carried from the left side of the heart to the rest of the body.
B. This is incorrect. Blood must enter the right side of the heart from the body to be
reoxygenated. The unoxygenated blood enters the right atrium through the
tricuspid valve into the right ventricle.
C. This is incorrect. A defect in the aortic valve would cause problems with
oxygenated blood leaving the left ventricle.
D. This is correct. When there is a defect in the right pulmonic valve, the blood has
difficulty leaving the right ventricle and getting to the lungs for reoxygenation.
This explanation by the nurse correctly describes the function of the valve and
the purpose of the surgery.
PTS: 1 CON: Teaching and Learning
4. The nurse caring for a child who is exhibiting supraventricular tachycardia as revealed on
the cardiac monitor. Which nursing intervention would the nurse attempt first?
a. Administer adenosine.
b. Perform nasal suctioning.
c. Apply ice to the forehead.
d. Ask the child to bear down.
ANS: D
Chapter: Chapter 13 Cardiovascular Disorders
Chapter Learning Objective: 4. Identify the nursing intervention necessary to educate
the caregiver to care for a child with cardiovascular disease.
Page: 283
Heading: Cardiac Dysrhythmias > Tachycardia > Supraventricular Tachycardia
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Clinical Judgment
Difficulty: Difficult
