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Which comment made by a parent of a 1-month-old infant would alert the nurse about the presence of a congenital heart defect?
- A. “He is always hungry.â€
- B. “He tires out during feedings.â€
- C. “He is fussy for several hours every day.â€
- D. “He sleeps all the time.â€
Correct Answer: B
Rationale: Fatigue during feeding or activity is common to most infants with congenital cardiac problems.
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A 12-month-old child who had repair of a congenital heart defect at 8 months of age has a normal exam and is not taking any medications. The nurse practitioner will contact the child's cardiologist to discuss whether the child needs which medication?
- A. Amoxicillin
- B. Capoten
- C. Digoxin
- D. Furosemide
Correct Answer: A
Rationale: Children who have had complete repair of congenital heart defect (CHD) should have subacute bacterial endocarditis (SBE) prophylaxis with amoxicillin for 6 months after the procedure.
What are FIVE indications for pacemaker insertion in a child with congenital heart block?
- A. Symptomatic bradycardia
- B. Ventricular dysfunction or low cardiac output
- C. Wide QRS escape
- D. Complex ventricular ectopy
Correct Answer: A
Rationale: Symptomatic bradycardia is the most common indication for pacemaker insertion in children with congenital heart block, to ensure adequate heart rate and perfusion.
A client who was discharged 8 months ago with cirrhosis and ascites is admitted with anorexia and recent hemoptysis. The client is drowsy but responds to verbal stimuli. The nurse programs a blood pressure monitor to take readings every 15 minutes,. Which assessment should the nurse implement first?
- A. Evaluate distal capillary refill for delayed perfusion
- B. Check the extremities for bruising and petechiae
- C. Examine the pretibial regions for pitting edema
- D. Palpate the abdomen for tenderness and rigidity
Correct Answer: D
Rationale: Palpating the abdomen helps assess for complications such as peritonitis or worsening ascites.
A nurse assesses a client who is recovering from a myocardial infarction. The client’s pulmonary artery pressure reading is 25/12 mm Hg. Which action should the nurse take first?
- A. Compare the results with previous pulmonary artery pressure readings.
- B. Increase the intravenous fluid rate because these readings are low.
- C. Immediately notify the health care provider of the elevated pressures.
- D. Document the finding in the client’s chart as the only action.
Correct Answer: A
Rationale: Comparing the current pulmonary artery pressure readings with previous ones helps determine if the values are stable or changing, which guides further intervention.
Pro-BNP can be increased in all, except
- A. Coronary artery disease
- B. Sepsis
- C. Pulmonary hypertension
- D. Obesity
Correct Answer: D
Rationale: Obesity is not typically associated with increased Pro-BNP levels.