Nokea
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.
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A 3-month-old infant has a hypercyanotic spell. What should be the nurses first action?
- A. Assess for neurologic defects.
- B. Prepare the family for imminent death.
- C. Begin cardiopulmonary resuscitation.
- D. Place the child in the kneechest position.
Correct Answer: D
Rationale: Placing the infant in the knee-chest position increases systemic vascular resistance, reducing the hypercyanotic spell. Oxygen and morphine may follow, but this is the first action. Neurologic defects, CPR, or preparing for death are inappropriate initial responses.
After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond?
- A. Elevate the affected extremity.
- B. Notify the practitioner of the observation.
- C. Record data on the assessment flow record.
- D. Apply warm compresses to the insertion site.
Correct Answer: C
Rationale: A weaker pulse post-catheterization is expected initially and should be documented as a baseline for monitoring. The pulse should strengthen over hours. Elevation, warm compresses, or immediate notification are unnecessary unless neurovascular changes occur.
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time?
- A. Administer oxygen.
- B. Record data on the nurses notes.
- C. Report data to the practitioner.
- D. Place the child in the high Fowler position.
Correct Answer: C
Rationale: A sleeping pulse over 160 beats/min suggests tachycardia, an early sign of heart failure due to sympathetic stimulation, requiring practitioner evaluation. Oxygen or positioning may be needed later, but reporting is the priority. Recording alone delays intervention.
A chest radiography examination is ordered for a child with suspected cardiac problems. The childs parent asks the nurse, What will the x-ray show about the heart? The nurses response should be based on knowledge that the radiograph provides which information?
- A. Shows bones of the chest but not the heart
- B. Evaluates the vascular anatomy outside of the heart
- C. Shows a graphic measure of electrical activity of the heart
- D. Supplies information on heart size and pulmonary blood flow patterns
Correct Answer: D
Rationale: Chest radiographs reveal heart size and pulmonary blood flow patterns, aiding in cardiac assessment. They also show chest bones, but the heart is visible. Vascular anatomy is evaluated via MRI, and electrical activity is measured by electrocardiography, not radiographs.
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. What nursing action is most appropriate to institute initially?
- A. Notify the physician.
- B. Place the child in Trendelenburg position.
- C. Apply a new bandage with more pressure.
- D. Apply direct pressure above the catheterization site.
Correct Answer: D
Rationale: Applying direct pressure 2.5 cm above the catheter site controls bleeding by compressing the vessel. Notification and rebandaging follow, but pressure is the priority. Trendelenburg position may increase bleeding and is not indicated.