Chapter 22: The Child with a Cardiovascular Alteration

Chapter 22: The Child with a Cardiovascular Alteration

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. Which of the following statements about fetal circulation is correct?

a.	Oxygen is carried to the fetus by the umbilical arteries.
b.	Blood from the inferior vena cava is shunted directly to the right ventricle through the foramen ovale.
c.	Pulmonary vascular resistance is high because the lungs are filled with fluid.
d.	Blood flows from the ductus arteriosus to the pulmonary artery.

 

 

ANS:   C

 

	Feedback
A	Oxygen and nutrients are carried to the fetus by the umbilical vein.
B	The inferior vena cava empties blood into the right atrium. The direction of blood flow and the pressure in the right atrium propels most of this blood through the foramen ovale into the left atrium.
C	Resistance in the pulmonary circulation is very high because the lungs are collapsed and filled with fluid.
D	Most of the blood in the pulmonary artery flows though the ductus arteriosus into the descending aorta.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 666

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

2. Which of the following postoperative interventions would be questioned for a child after a cardiac catheterization?

a.	Continue intravenous (IV) fluids until the infant is tolerating oral fluids.
b.	Check the dressing for bleeding.
c.	Assess peripheral circulation on the affected extremity.
d.	Keep the affected leg flexed and elevated.

 

 

ANS:   D

 

	Feedback
A	IV fluid administration continues until the child is taking and retaining adequate amounts of oral fluids.
B	The insertion site dressing should be observed frequently for bleeding. The nurse should also look under the child to check for pooled blood.
C	Peripheral perfusion is monitored after catheterization. Distal pulses should be palpable, although they may be weaker than in the contralateral extremity.
D	The child should be positioned with the affected leg straight for 4 to 6 hours after the procedure.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Text Reference: pg 672

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

3. Which of the following information would be included in the nurse’s discharge instructions for a child who underwent a cardiac catheterization earlier in the day?

a.	Pressure dressing is changed daily for the first week.
b.	The child may soak in the tub beginning tomorrow.
c.	Contact sports can be resumed in 2 days.
d.	The child can return to school on the third day after the procedure.

 

 

ANS:   D

 

	Feedback
A	The day after the cardiac catheterization the pressure dressing is removed and replaced with a Band-Aid. The catheter insertion site is assessed daily for healing. Any bleeding or sign of infection, such as drainage, must be reported to the cardiologist.
B	Bathing is limited to a shower, sponge bath, or a brief tub bath (no soaking) for the first 1 to 3 days after the procedure.
C	Strenuous exercise such as contact sports, swimming, or climbing trees is avoided for up to 1 week after the procedure.
D	The child can return to school on the third day after the procedure. It is important to emphasize follow-up with the cardiologist.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 673

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

4. Which of the following is done first in a cardiac assessment?

a.	Percussion
b.	Palpation
c.	Auscultation
d.	History and inspection

 

 

ANS:   D

 

	Feedback
A	Percussion of the chest is usually deferred.
B	Palpation can be threatening to the child because it requires a significant amount of physical contact. For this reason it is not the initial step in a cardiac assessment.
C	Auscultation requires touching the child and is not the initial step in a cardiac assessment.
D	The assessment should begin with the least threatening interventions—the history and inspection. Assessment progression includes inspection, auscultation, and palpation because each step includes more touching.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 672

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance