Right to left shunts include:
- A. Fallot's tetralogy
- B. Tricuspid atresia
- C. Eisenmenger complex
- D. Ductus arteriosus in the fetus
Correct Answer: A
Rationale: Fallot's tetralogy is a congenital heart defect that includes a right-to-left shunt, allowing deoxygenated blood to bypass the lungs.
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A child has been diagnosed with valvular disease following rheumatic fever (RF). During patient teaching, the nurse discusses the child’s long-term prophylactic therapy with antibiotics for dental procedures, surgery, and childbirth. The parents Indicate they understand when they say:
- A. “She will need to take the antibiotics until she turns 18 years old.â€
- B. “She will need to take the antibiotics for 5 years after the last attack.â€
- C. “She will need to take the antibiotics for 10 years after the last attack.â€
- D. “She will need to take the antibiotics for the rest of her life.â€
Correct Answer: D
Rationale: Lifelong antibiotic prophylaxis is recommended for individuals with valvular disease following rheumatic fever to prevent recurrent infections and further cardiac damage.
Side effects of propranolol may include
- A. hypothyroidism
- B. elevated triglycerides
- C. school performance problems
- D. pulmonary fibrosis
Correct Answer: B
Rationale: Propranolol can cause elevated triglycerides and school performance issues due to its beta-blocking effects.
The nurse is caring for a child after heart surgery. What should the nurse do if evidence of cardiac tamponade is found?
- A. Increase analgesia
- B. Apply warming blankets
- C. Immediately report this to physician
- D. Encourage child to cough, turn, and breathe deeply
Correct Answer: C
Rationale: If evidence is noted of cardiac tamponade, which is blood or fluid in the pericardial space constricting the heart, the physician is notified immediately of this life-threatening complication. Increasing analgesia may be done before the physician drains the fluid, but the physician must be notified. Warming blankets are not indicated at this time. Encouraging the child to cough, turn, and breathe deeply should be deferred till after the evaluation by the physician.
A 9-month-old infant has a grade III/VI, harsh, rumbling, continuous murmur in the left infraclavicular fossa and pulmonic area. A chest radiograph reveals cardiac enlargement. The primary care pediatric nurse practitioner will refer the infant to a pediatric cardiologist and prepare the parents for which intervention to repair this defect?
- A. Cardiopulmonary bypass surgery
- B. Coil insertion in the catheterization laboratory
- C. Indomethacin administration
- D. Observation for spontaneous closure
Correct Answer: B
Rationale: This murmur is characteristic of a PDA and, because of cardiac enlargement, represents a larger shunt, requiring repair. Infants older than 8 months may have a coil or plug inserted into the shunt in the cardiac catheterization laboratory.
Patrick, a healthy adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should monitor this client’s fluid intake because fluid overload may cause:
- A. Cerebral edema
- B. Dehydration
- C. Heart failure
- D. Hypovolemic shock
Correct Answer: A
Rationale: Fluid overload in a patient with meningitis can exacerbate cerebral edema, increasing intracranial pressure and worsening the condition.
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