Chapter 25: The Child With Cardiovascular Dysfunction

Hockenberry & Wilson: Wong’s Essentials of Pediatric Nursing,

8th Edition

Test Bank

Chapter 25: The Child with Cardiovascular Dysfunction

MULTIPLE CHOICE

1. A chest radiograph film is ordered for a child with suspected cardiac problems. The child’s parent asks the nurse, “What will the radiograph show about the heart?” The nurse’s response should be based on knowledge that the x-ray film will do which of the following?

a. Show bones of chest but not the heart.

b. Measure electrical potential generated from heart muscle.

c. Provide permanent record of heart size and configuration.

d. Provide computerized image of heart vessels and tissues.

ANS: C

A chest radiograph will provide information on the heart size and pulmonary blood-flow patterns. It will provide a baseline for future comparisons.

DIF: Cognitive Level: Comprehension REF: Page 869

TOP: Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

2. Which of the following is a complication that may occur after a cardiac catheterization?

a. Cardiac arrhythmia

b. Hypostatic pneumonia

c. Congestive heart failure

d. Rapidly increasing blood pressure

ANS: A

Because a catheter is introduced into the heart, a risk exists of catheter-induced dysrhythmias occurring during the procedure. These are usually transient.

DIF: Cognitive Level: Comprehension REF: Page 864

TOP: Integrated Process: Nursing Process: Problem Identification

MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

3. José 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 child’s stage of development. The caregivers also benefit from the same explanations.

DIF: Cognitive Level: Application REF: Page 864

TOP: Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

4. Which of the following explanations regarding cardiac catheterization is appropriate for a preschool child?

a. Postural drainage will be performed every 4 to 6 hours after the test.

b. It is necessary to be completely “asleep” during the test.

c. The test is short, usually taking less than 1 hour.

d. When the procedure is done, you will have to keep your leg straight for at least 4 hours.

ANS: D

The child’s leg will have to be maintained in a straight position for approximately 4 hours. Younger children can be held in the parent’s lap with the leg maintained in the correct position.

DIF: Cognitive Level: Application REF: Page 865

TOP: Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

5. 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 which of the following?

a. Notify physician.

b. Apply new bandage with more pressure.

c. Place in Trendelenburg position.

d. Apply direct pressure above 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.

DIF: Cognitive Level: Analysis REF: Page 865

TOP: Integrated Process: Nursing Process: Implementation

MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

6. The nurse is preparing an active adolescent for discharge after a cardiac catheterization. Which of the following statements by the adolescent would indicate a need for further teaching?

a. “I should avoid tub baths but may shower.”

b. “I have to stay on strict bed rest for 3 days.”

c. “I should remove the pressure dressing the day after the procedure.”

d. “I may attend school but should avoid exercise for several days.”

ANS: B

The child does not need to be on strict bed rest for 3 days.

DIF: Cognitive Level: Analysis REF: Page 865

TOP: Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

7. Surgical closure of the ductus arteriosus would do which of the following?

a. Stop the loss of unoxygenated blood to the systemic circulation.

b. Decrease the edema in legs and feet.

c. Increase the oxygenation of blood.

d. Prevent the return of oxygenated blood to the lungs.

ANS: D

The ductus arteriosus allows blood to flow from the higher-pressure aorta to the lower-pressure pulmonary artery, causing a right-to-left shunt. If this is surgically closed, no additional oxygenated blood (from the aorta) will return to the lungs through the pulmonary artery.

DIF: Cognitive Level: Analysis REF: Page 869

TOP: Integrated Process: Nursing Process: Planning

MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

8. Which of the following defects results in increased pulmonary blood flow?

a. Pulmonic stenosis

b. Tricuspid atresia

c. Atrial septal defect

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.

DIF: Cognitive Level: Comprehension REF: Page 868

TOP: Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

9. Which of the following structural defects constitute tetralogy of Fallot?

a. Pulmonic stenosis, ventricular

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