Chapter 29: The Child with Cardiovascular Dysfunction

Chapter 29: The Child with Cardiovascular Dysfunction

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. What term is defined as the volume of blood ejected by the heart in 1 minute?

ANS:  D

Cardiac output is defined as the volume of blood ejected by the heart in 1 minute. Cardiac output = Heart rate x Stroke volume. Afterload is the resistance against which the ventricles must pump when ejecting blood (ventricular ejection). A cardiac cycle is the sequential contraction and relaxation of both the atria and ventricles. Stroke volume is the amount of blood ejected by the heart in any one contraction.

DIF:    Cognitive Level: Understanding       REF:   p. 1254           TOP:   Nursing Process: Diagnosis

MSC:  Client Needs: Physiological Integrity

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

ANS:  D

Chest radiographs provide information on the size of the heart and pulmonary blood flow patterns. The bones of the chest are visible on chest radiographs, but the heart and blood vessels are also seen. Magnetic resonance imaging is a noninvasive technique that allows for evaluation of vascular anatomy outside of the heart. A graphic measure of electrical activity of the heart is provided by electrocardiography.

DIF:    Cognitive Level: Understanding       REF:   p. 1256

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

3. A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching?

ANS:  B

Preoperative teaching should always be directed to the child’s stage of development. The caregivers also benefit from these explanations. The parents may ask additional questions, which should be answered, but the child needs to receive the information based on developmental level. This age group will not understand in-depth descriptions. School-age children should be prepared close to the time of the cardiac catheterization.

DIF:    Cognitive Level: Applying               REF:   p. 1259

TOP:   Integrated Process: Teaching/Learning

MSC:  Client Needs: Physiological Integrity

4. After returning from cardiac catheterization, the nurse monitors the child’s vital signs. The heart rate should be counted for how many seconds?

ANS:  C

The heart rate is counted for a full minute to determine whether arrhythmias or bradycardia is present. Fifteen to 30 seconds are too short for accurate assessment. Sixty seconds is sufficient to assess heart rate and rhythm.

DIF:    Cognitive Level: Applying               REF:   p. 1260

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

5. After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond?

ANS:  C

The pulse distal to the catheterization site may be weaker for the first few hours after catheterization but should gradually increase in strength. Documentation of the finding provides a baseline. The extremity is maintained straight for 4 to 6 hours. This is an expected change. The pulse is monitored. If there are neurovascular changes in the extremity, the practitioner is notified. The site is kept dry. Warm compresses are not indicated.

DIF:    Cognitive Level: Applying               REF:   p. 1260

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity