NUR 307 EXAM: Nursing Care of the
Child With an Alteration in
Perfusion/Cardiovascular
Disorder||Questions and
answers||already graded A+||latest
update||
A parent asks if the reason her infant has a congenital heart defect is because of
something she did while she was pregnant. What is the best response by the nurse? -
CORRECT ANSWER There are several reasons a baby can have a heart defect, let's
talk about those causes.
Focus on the therapeutic communication in this situation, while still obtaining more
information. This will help the nurse explore various options for the cause of the defect
with the parent.
A nurse is caring for a child with Kawasaki disease. Which assessment finding would
the nurse expect to see? -CORRECT ANSWER Peeling hands and feet and fever
One of the signs of Kawasaki disease is the peeling hands and feet. The other
symptoms are not necessarily characteristic of Kawasaki disease.
A parent brings an infant in for poor feeding. Which assessment data would most likely
indicate a coarctation of the aorta? -CORRECT ANSWER Pulses weaker in lower
extremities compared to upper extremities
An infant with coarctation of the aorta has decreased systemic circulation, causing this
problem. The cyanosis would be associated with tetralogy of Fallot.
A nurse is reviewing blood work for a child with a cyanotic heart defect. What result
would most likely be seen in a client experiencing polycythemia? -CORRECT ANSWER
Increased RBC
Polycythemia can occur in clients with a cyanotic heart defect. The body tries to
compensate for having low oxygen levels and produces more red blood cells (RBCs).
This would cause an increased result on the lab tests. This problem does not affect the
white blood cells (WBCs).
,An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be
the first priority? -CORRECT ANSWER Place the infant in the knee-chest position.
Placing the infant in the knee-chest position is the first priority when caring for an infant
with tetralogy of Fallot. Starting IV fluids and preparing the child for surgery would not
be necessary since it is known that the infant has a cyanotic birth defect. Raising the
head of the bed would not be a priority since the infant needs to be placed in the knee-
chest position.
A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What
would be the priority nursing intervention? -CORRECT ANSWER Notify the doctor
immediately.
The nurse would notify the doctor immediately. Cardiac tamponade is a medical
emergency and should be addressed. The child can die if intervention is postponed. It
would not be appropriate to perform any interventions until confirming that this is the
actual diagnosis.
A parent is asking for more information about their infant's patent ductus arteriosus
(PDA). What would be included in the education? -CORRECT ANSWER This is caused
by an opening that usually closes by 1 week of age.
A PDA is caused by an opening that usually closes by 1 week of age called the ductus
arteriosus. The defect is usually fixed by a single surgery or during a cardiac
catheterization procedure. IV fluids are not a routine intervention for the PDA. Most of
the time a PDA occurs in premature infants.
A nurse is taking the history of a 4-year-old boy who will undergo a cardiac
catheterization. Which statement by his mother may necessitate rescheduling of the
procedure? -CORRECT ANSWER "He seems listless and slightly warm."
Fever and other signs and symptoms of infection may necessitate rescheduling the
procedure. Although information about allergies is important, not all contrast media
contain iodine as a base. The nurse should address the child's fears in a
developmentally appropriate way, but fear of the procedure does not warrant
rescheduling. Not using any medication would not be a reason for rescheduling the
procedure.
The nurse has administered oral penicillin as ordered for prophylaxis of endocarditis.
The nurse instructs the parents to immediately report which reaction? -CORRECT
ANSWER Wheezing
The nurse must report any hypersensitivity reactions such as wheezing and pruritus, as
these could be a sign of anaphylaxis. Stomach upset is common with oral antibiotics
and is not something that needs to be reported immediately. Nausea with diarrhea is
, common with oral antibiotics and does not need to be reported immediately. Abdominal
distress is common with oral antibiotics and does not need to be reported immediately.
The nurse is caring for a 14-year-old girl with atrial fibrillation. Which medication would
the nurse expect to be prescribed? -CORRECT ANSWER Digoxin
Digoxin is indicated for atrial fibrillation. It increases the contractility of the heart muscle
by decreasing conduction and increasing force. Alprostadil is indicated for temporary
maintenance of ductus arteriosus patency in infants with ductal-dependent congenital
heart defects. Furosemide is used for the management of edema associated with heart
failure. Indomethacin is used to close a patent ductus arteriosus.
After assessing a child, the nurse suspects coarctation of the aorta based on a finding
of: -CORRECT ANSWER femoral pulse weaker than brachial pulse.
A femoral pulse that is weak or absent in comparison to the brachial pulse is associated
with coarctation of the aorta. Bounding pulse is characteristic of patent ductus arteriosus
or aortic regurgitation. A narrow or thread pulse is associated with heart failure or
severe aortic stenosis. Hepatomegaly is a sign of right-sided heart failure.
A child with heart disease is receiving digoxin and a diuretic. Which laboratory test
result would be most important for the nurse to monitor? -CORRECT ANSWER Serum
potassium level
Children receiving diuretics should have serum potassium levels obtained because
diuretics tend to deplete the body of potassium. This is even more important if the child
is also receiving digoxin because low serum potassium levels potentiate or increase the
effect of the drug. Serum sodium levels may be obtained in children with heart failure to
ensure that an increased sodium level is not causing edema. The erythrocyte
sedimentation rate identifies inflammation and is unrelated to the use of diuretics and
digoxin. Oxygen saturation levels may be done to evaluate for hypoxemia, but these
results would be unrelated to the use of digoxin and diuretics.
A nurse is teaching the parents of a child diagnosed with rheumatic fever about
prescribed drug therapy. Which statement would indicate to the nurse that additional
teaching is needed? -CORRECT ANSWER "We can stop the penicillin when her
symptoms disappear."
For a child with rheumatic fever, drug therapy must be given for the full 10 to 14 days to
ensure complete eradication of the infection. The drug must not be stopped when the
signs and symptoms disappear. To prevent recurrent attacks, prophylactic antibiotic
therapy is prescribed for at least 5 years or until the child is 18 years old. Additional
prophylactic therapy should be instituted when dental or tonsillar surgery is planned.
Child With an Alteration in
Perfusion/Cardiovascular
Disorder||Questions and
answers||already graded A+||latest
update||
A parent asks if the reason her infant has a congenital heart defect is because of
something she did while she was pregnant. What is the best response by the nurse? -
CORRECT ANSWER There are several reasons a baby can have a heart defect, let's
talk about those causes.
Focus on the therapeutic communication in this situation, while still obtaining more
information. This will help the nurse explore various options for the cause of the defect
with the parent.
A nurse is caring for a child with Kawasaki disease. Which assessment finding would
the nurse expect to see? -CORRECT ANSWER Peeling hands and feet and fever
One of the signs of Kawasaki disease is the peeling hands and feet. The other
symptoms are not necessarily characteristic of Kawasaki disease.
A parent brings an infant in for poor feeding. Which assessment data would most likely
indicate a coarctation of the aorta? -CORRECT ANSWER Pulses weaker in lower
extremities compared to upper extremities
An infant with coarctation of the aorta has decreased systemic circulation, causing this
problem. The cyanosis would be associated with tetralogy of Fallot.
A nurse is reviewing blood work for a child with a cyanotic heart defect. What result
would most likely be seen in a client experiencing polycythemia? -CORRECT ANSWER
Increased RBC
Polycythemia can occur in clients with a cyanotic heart defect. The body tries to
compensate for having low oxygen levels and produces more red blood cells (RBCs).
This would cause an increased result on the lab tests. This problem does not affect the
white blood cells (WBCs).
,An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be
the first priority? -CORRECT ANSWER Place the infant in the knee-chest position.
Placing the infant in the knee-chest position is the first priority when caring for an infant
with tetralogy of Fallot. Starting IV fluids and preparing the child for surgery would not
be necessary since it is known that the infant has a cyanotic birth defect. Raising the
head of the bed would not be a priority since the infant needs to be placed in the knee-
chest position.
A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What
would be the priority nursing intervention? -CORRECT ANSWER Notify the doctor
immediately.
The nurse would notify the doctor immediately. Cardiac tamponade is a medical
emergency and should be addressed. The child can die if intervention is postponed. It
would not be appropriate to perform any interventions until confirming that this is the
actual diagnosis.
A parent is asking for more information about their infant's patent ductus arteriosus
(PDA). What would be included in the education? -CORRECT ANSWER This is caused
by an opening that usually closes by 1 week of age.
A PDA is caused by an opening that usually closes by 1 week of age called the ductus
arteriosus. The defect is usually fixed by a single surgery or during a cardiac
catheterization procedure. IV fluids are not a routine intervention for the PDA. Most of
the time a PDA occurs in premature infants.
A nurse is taking the history of a 4-year-old boy who will undergo a cardiac
catheterization. Which statement by his mother may necessitate rescheduling of the
procedure? -CORRECT ANSWER "He seems listless and slightly warm."
Fever and other signs and symptoms of infection may necessitate rescheduling the
procedure. Although information about allergies is important, not all contrast media
contain iodine as a base. The nurse should address the child's fears in a
developmentally appropriate way, but fear of the procedure does not warrant
rescheduling. Not using any medication would not be a reason for rescheduling the
procedure.
The nurse has administered oral penicillin as ordered for prophylaxis of endocarditis.
The nurse instructs the parents to immediately report which reaction? -CORRECT
ANSWER Wheezing
The nurse must report any hypersensitivity reactions such as wheezing and pruritus, as
these could be a sign of anaphylaxis. Stomach upset is common with oral antibiotics
and is not something that needs to be reported immediately. Nausea with diarrhea is
, common with oral antibiotics and does not need to be reported immediately. Abdominal
distress is common with oral antibiotics and does not need to be reported immediately.
The nurse is caring for a 14-year-old girl with atrial fibrillation. Which medication would
the nurse expect to be prescribed? -CORRECT ANSWER Digoxin
Digoxin is indicated for atrial fibrillation. It increases the contractility of the heart muscle
by decreasing conduction and increasing force. Alprostadil is indicated for temporary
maintenance of ductus arteriosus patency in infants with ductal-dependent congenital
heart defects. Furosemide is used for the management of edema associated with heart
failure. Indomethacin is used to close a patent ductus arteriosus.
After assessing a child, the nurse suspects coarctation of the aorta based on a finding
of: -CORRECT ANSWER femoral pulse weaker than brachial pulse.
A femoral pulse that is weak or absent in comparison to the brachial pulse is associated
with coarctation of the aorta. Bounding pulse is characteristic of patent ductus arteriosus
or aortic regurgitation. A narrow or thread pulse is associated with heart failure or
severe aortic stenosis. Hepatomegaly is a sign of right-sided heart failure.
A child with heart disease is receiving digoxin and a diuretic. Which laboratory test
result would be most important for the nurse to monitor? -CORRECT ANSWER Serum
potassium level
Children receiving diuretics should have serum potassium levels obtained because
diuretics tend to deplete the body of potassium. This is even more important if the child
is also receiving digoxin because low serum potassium levels potentiate or increase the
effect of the drug. Serum sodium levels may be obtained in children with heart failure to
ensure that an increased sodium level is not causing edema. The erythrocyte
sedimentation rate identifies inflammation and is unrelated to the use of diuretics and
digoxin. Oxygen saturation levels may be done to evaluate for hypoxemia, but these
results would be unrelated to the use of digoxin and diuretics.
A nurse is teaching the parents of a child diagnosed with rheumatic fever about
prescribed drug therapy. Which statement would indicate to the nurse that additional
teaching is needed? -CORRECT ANSWER "We can stop the penicillin when her
symptoms disappear."
For a child with rheumatic fever, drug therapy must be given for the full 10 to 14 days to
ensure complete eradication of the infection. The drug must not be stopped when the
signs and symptoms disappear. To prevent recurrent attacks, prophylactic antibiotic
therapy is prescribed for at least 5 years or until the child is 18 years old. Additional
prophylactic therapy should be instituted when dental or tonsillar surgery is planned.
