The Child with a Cardiovascular Disorder (Nclex questions)

the child with a cardiovascular disorder (nclex questions) 4.8 (15 reviews) Terms in this set (26) Keiser University-Ft LauderdaleNUR 1140 Save

• The nurse explains that a

ventricular septal defect will allow:

• blood to shunt left to right,

causing increased pulmonary flow and no cyanosis.

• blood to shunt right to left,

causing decreased pulmonary flow and cyanosis.

• no shunting because of high

pressure in the left ventricle.

• 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.

• The assessment that would lead

the nurse to suspect that a newborn infant has a ventricular septal defect

is:

• a loud, harsh murmur with a

systolic tremor.

• cyanosis when crying.
• blood pressure higher in the arms

than in the legs.

• a machinery-like murmur.

ANS: A

A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.

• The finding the nurse would

expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta is

blood pressure that is:

• higher on the right side.
• higher on the left side.
• lower in the arms than in the legs.
• 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.

• When a father asks why his child

with tetralogy of Fallot seems to favor a squatting position, the nurse

would explain that squatting:

• increases the return of venous

blood back to the heart.

• decreases arterial blood flow

away from the heart.

• is a common resting position when

a child is tachycardic.

• increases the workload of the

heart.

ANS: A

The squatting position allows the child to breathe more easily because systemic venous return is increased.

• An infant is experiencing dyspnea

related to patent ductus arteriosus (PDA). The nurse understands

dyspnea occurs because blood is:

• circulated through the lungs again,

causing pulmonary circulatory congestion.

• shunted past the pulmonary

circulation, causing pulmonary hypoxia.

• shunted past cardiac arteries,

causing myocardial hypoxia.

• 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.

• An appropriate nursing action

related to the administration of digoxin (Lanoxin) to an infant would

be:

• counting the apical rate for 30

seconds before administering the medication.

• withholding a dose if the apical

heart rate is less than 100 beats/min.

• repeating a dose if the child vomits

within 30 minutes of the previous dose.

• 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.

• A child develops carditis from

rheumatic fever. The nurse knows that the areas of the heart affected

by carditis are the:

• coronary arteries.
• heart muscle and the mitral valve.
• aortic and pulmonic valves.
• 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.