Nokea
What cardiovascular defect results in obstruction to blood flow?
- A. Aortic stenosis
- B. Tricuspid atresia
- C. Atrial septal defect
- D. Transposition of the great arteries
Correct Answer: A
Rationale: Aortic stenosis narrows the aortic valve, obstructing blood flow from the left ventricle, causing hypertrophy and congestion. Tricuspid atresia reduces pulmonary flow, atrial septal defect increases it, and transposition involves mixed flow, not obstruction.
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The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication?
- A. Hypoxemia
- B. Right-to-left shunt of blood
- C. Decreased workload on the left side of the heart
- D. Pulmonary vascular congestion
Correct Answer: D
Rationale: PDA causes left-to-right shunting from the aorta to the pulmonary artery, leading to pulmonary vascular congestion. Surgery prevents this complication. Hypoxemia is linked to mixed flow defects, the shunt is left-to-right, and PDA increases left heart workload.
Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infants status, which finding is indicative of achieving this goal?
- A. Irritability when awake
- B. Capillary refill of more than 5 seconds
- C. Appropriate weight gain for age 18
- D. Positioned in high Fowler position to maintain oxygen saturation at 90%
Correct Answer: C
Rationale: Appropriate weight gain indicates successful feeding and reduced caloric loss, reflecting decreased cardiac demand. Irritability and prolonged capillary refill suggest ongoing HF, and high Fowler positioning aids breathing but doesn?t confirm reduced cardiac strain.
What nutritional component should be altered in the infant with heart failure (HF)?
- A. Decrease in fats
- B. Increase in fluids
- C. Decrease in protein
- D. Increase in calories
Correct Answer: D
Rationale: Infants with heart failure need increased calories due to elevated metabolic rates from poor cardiac function. Fats and protein should be increased to meet caloric needs, and fluids are carefully monitored to avoid overload.
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk?
- A. Minimize seizures.
- B. Prevent dehydration.
- C. Promote cardiac output.
- D. Reduce energy expenditure.
Correct Answer: B
Rationale: Preventing dehydration reduces stroke risk in hypoxic children with polycythemia, as dehydration increases blood viscosity. Seizure control, cardiac output, and energy expenditure are important but don?t directly address stroke risk.
After returning from cardiac catheterization, the nurse monitors the childs vital signs. The heart rate should be counted for how many seconds?
- A. 15
- B. 30
- C. 60
- D. 120
Correct Answer: C
Rationale: Counting the heart rate for 60 seconds ensures accurate detection of arrhythmias or bradycardia. Shorter durations (15 or 30 seconds) are insufficient, and 120 seconds is unnecessarily long for routine assessment.