INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 238
Chapter 26: The Child with a Cardiovascular Disorder
MULTIPLE CHOICE
1. What does the nurse explain that a ventricular septal defect will allow?
a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
b. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis
c. No shunting because of high pressure in the left ventricle
d. Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume
ANS: A
Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts from left to right
because of the higher pressure in the left ventricle. This particular shift does not cause cyanosis.
DIF: Cognitive Level: Comprehension REF: Page 626
TOP: Congenital Heart Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?
a. A loud, harsh murmur with a systolic thrill
b. Cyanosis when crying
c. Blood pressure higher in the arms than in the legs
d. A machinery-like murmur
ANS: A
A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.
DIF: Cognitive Level: Comprehension REF: Page 626
TOP: Congenital Heart Disease KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
NURSINGTB.COM
3. What finding would the nurse expect when measuring blood pressure on all four extremities of a child with
coarctation of the aorta?
a. Blood pressure higher on the right side
b. Blood pressure higher on the left side
c. Blood pressure lower in the arms than in the legs
d. Blood pressure lower in the legs than in the arms
ANS: D
The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses
between the upper and lower extremities. Pressure is increased proximal to the defect and decreased distal to
the coarctation.
DIF: Cognitive Level: Comprehension REF: Page 627
TOP: Congenital Heart Disease KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurses
best response?
a. Squatting increases the return of venous blood back to the heart.
b. Squatting decreases arterial blood flow away from the heart.
c. Squatting is a common resting position when a child is tachycardic.
d. Squatting increases the workload of the heart.
ANS: A
The squatting position allows the child to breathe more easily because systemic venous return is increased.
DIF: Cognitive Level: Comprehension REF: Page 627
TOP: Congenital Heart Disease KEY: Nursing Process Step: Implementation
This study source was downloaded by 100000840946462 from CourseHero.com on 04-16-2022 10:06:08 GMT -05:00
https://www.coursehero.com/file/63488788/TB-Chapter-26-The-Child-with-a-Cardiovascular-Disorderpdf/
NURSINGTB.COM
, INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 239
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
5. An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand
regarding why dyspnea occurs?
a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
b. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
c. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
d. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the
heart.
ANS: A
When PDA is present, oxygenated blood recycles through the lungs, overburdening the pulmonary circulation.
DIF: Cognitive Level: Comprehension REF: Page 626
OBJ: 4 TOP: Congenital Heart Disease
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant?
a. Counting the apical rate for 30 seconds before administering the medication
b. Withholding a dose if the apical heart rate is less than 100 beats/min
c. Repeating a dose if the child vomits within 30 minutes of the previous dose
d. Checking respiratory rate and blood pressure before each dose
ANS: B
As a rule, if the pulse rate of an infant is below 100 beats/min, the medication is withheld and the physician is
notified.
DIF: Cognitive Level: Application REF: Page 630
TOP: Congestive Heart Failure KEY: NursingNURSINGTB.COM
Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
7. A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis?
a. Coronary arteries
b. Heart muscle and the mitral valve
c. Aortic and pulmonic valves
d. Contractility of the ventricles
ANS: B
The tissues that cover the heart and heart valves are affected. The heart muscle may be involved and the mitral
valve is frequently involved.
DIF: Cognitive Level: Knowledge REF: Page 632
TOP: Rheumatic Fever KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
8. Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital
heart defect?
a. He is always hungry.
b. He tires out during feedings.
c. He is fussy for several hours every day.
d. He sleeps all the time.
ANS: B
Fatigue during feeding or activity is common to most infants with congenital cardiac problems.
DIF: Cognitive Level: Application REF: Page 629
OBJ: 3 TOP: Congenital Heart Disease
KEY: Nursing Process Step: Data Collection
This study source was downloaded by 100000840946462 from CourseHero.com on 04-16-2022 10:06:08 GMT -05:00
https://www.coursehero.com/file/63488788/TB-Chapter-26-The-Child-with-a-Cardiovascular-Disorderpdf/
NURSINGTB.COM
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 238
Chapter 26: The Child with a Cardiovascular Disorder
MULTIPLE CHOICE
1. What does the nurse explain that a ventricular septal defect will allow?
a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
b. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis
c. No shunting because of high pressure in the left ventricle
d. Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume
ANS: A
Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts from left to right
because of the higher pressure in the left ventricle. This particular shift does not cause cyanosis.
DIF: Cognitive Level: Comprehension REF: Page 626
TOP: Congenital Heart Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect?
a. A loud, harsh murmur with a systolic thrill
b. Cyanosis when crying
c. Blood pressure higher in the arms than in the legs
d. A machinery-like murmur
ANS: A
A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.
DIF: Cognitive Level: Comprehension REF: Page 626
TOP: Congenital Heart Disease KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
NURSINGTB.COM
3. What finding would the nurse expect when measuring blood pressure on all four extremities of a child with
coarctation of the aorta?
a. Blood pressure higher on the right side
b. Blood pressure higher on the left side
c. Blood pressure lower in the arms than in the legs
d. Blood pressure lower in the legs than in the arms
ANS: D
The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses
between the upper and lower extremities. Pressure is increased proximal to the defect and decreased distal to
the coarctation.
DIF: Cognitive Level: Comprehension REF: Page 627
TOP: Congenital Heart Disease KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurses
best response?
a. Squatting increases the return of venous blood back to the heart.
b. Squatting decreases arterial blood flow away from the heart.
c. Squatting is a common resting position when a child is tachycardic.
d. Squatting increases the workload of the heart.
ANS: A
The squatting position allows the child to breathe more easily because systemic venous return is increased.
DIF: Cognitive Level: Comprehension REF: Page 627
TOP: Congenital Heart Disease KEY: Nursing Process Step: Implementation
This study source was downloaded by 100000840946462 from CourseHero.com on 04-16-2022 10:06:08 GMT -05:00
https://www.coursehero.com/file/63488788/TB-Chapter-26-The-Child-with-a-Cardiovascular-Disorderpdf/
NURSINGTB.COM
, INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 239
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
5. An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand
regarding why dyspnea occurs?
a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
b. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia.
c. Blood is shunted past cardiac arteries, causing myocardial hypoxia.
d. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the
heart.
ANS: A
When PDA is present, oxygenated blood recycles through the lungs, overburdening the pulmonary circulation.
DIF: Cognitive Level: Comprehension REF: Page 626
OBJ: 4 TOP: Congenital Heart Disease
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant?
a. Counting the apical rate for 30 seconds before administering the medication
b. Withholding a dose if the apical heart rate is less than 100 beats/min
c. Repeating a dose if the child vomits within 30 minutes of the previous dose
d. Checking respiratory rate and blood pressure before each dose
ANS: B
As a rule, if the pulse rate of an infant is below 100 beats/min, the medication is withheld and the physician is
notified.
DIF: Cognitive Level: Application REF: Page 630
TOP: Congestive Heart Failure KEY: NursingNURSINGTB.COM
Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
7. A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis?
a. Coronary arteries
b. Heart muscle and the mitral valve
c. Aortic and pulmonic valves
d. Contractility of the ventricles
ANS: B
The tissues that cover the heart and heart valves are affected. The heart muscle may be involved and the mitral
valve is frequently involved.
DIF: Cognitive Level: Knowledge REF: Page 632
TOP: Rheumatic Fever KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
8. Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital
heart defect?
a. He is always hungry.
b. He tires out during feedings.
c. He is fussy for several hours every day.
d. He sleeps all the time.
ANS: B
Fatigue during feeding or activity is common to most infants with congenital cardiac problems.
DIF: Cognitive Level: Application REF: Page 629
OBJ: 3 TOP: Congenital Heart Disease
KEY: Nursing Process Step: Data Collection
This study source was downloaded by 100000840946462 from CourseHero.com on 04-16-2022 10:06:08 GMT -05:00
https://www.coursehero.com/file/63488788/TB-Chapter-26-The-Child-with-a-Cardiovascular-Disorderpdf/
NURSINGTB.COM
