Nokea
What statement best identifies the cause of heart failure (HF)?
- A. Disease related to cardiac defects
- B. Consequence of an underlying cardiac defect
- C. Inherited disorder associated with a variety of defects
- D. Result of diminished workload imposed on an abnormal myocardium
Correct Answer: B
Rationale: Heart failure results from the heart?s inability to pump sufficient blood, often due to congenital defects causing increased volume or pressure. It?s not a primary disease, not typically inherited, and involves increased, not diminished, myocardial workload.
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The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurses response should be based on which knowledge?
- A. It is a safe, frequently used drug.
- B. Parents lack the expertise necessary to administer digoxin.
- C. It is difficult to either overmedicate or undermedicate with digoxin.
- D. Parents need to learn specific, important guidelines for administration of digoxin.
Correct Answer: D
Rationale: Digoxin?s narrow therapeutic range requires parents to learn specific guidelines for safe administration and monitoring to prevent toxicity. It?s not inherently safe, parents can be taught, and over- or undermedication is a risk without proper guidance.
A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?
- A. 60 beats/min
- B. 90 beats/min
- C. 100 beats/min
- D. 120 beats/min
Correct Answer: B
Rationale: For infants and young children, digoxin is withheld if the 1-minute apical pulse is below 90 beats/min to prevent toxicity. A rate of 60 is the adult threshold, and 100-120 beats/min are acceptable for administration.
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.
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.
A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition?
- A. Cyanosis
- B. Heart failure
- C. Decreased pulmonary blood flow
- D. Bounding pulses in upper extremities
Correct Answer: B
Rationale: Left-to-right shunting increases pulmonary blood flow, overloading the right heart and leading to heart failure. Cyanosis and decreased pulmonary flow occur with right-to-left shunts, and bounding pulses are specific to coarctation of the aorta.