Nokea
Which congenital cardiac defect(s) cause(s) increased pulmonary blood flow?
- A. Atrial septal defects (ASDs)
- B. Tetralogy of Fallot
- C. Dextroposition of aorta
- D. Patent ductus arteriosus
- E. Ventricular septal defects (VSDs)
Correct Answer: A,D,E
Rationale: ASDs, patent ductus arteriosus, and VSDs cause increased pulmonary blood flow due to left-to-right shunting.
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What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta?
- A. Blood pressure higher on the right side
- B. Blood pressure higher on the left side
- C. Blood pressure lower in the arms than in the legs
- D. Blood pressure lower in the legs than in the arms
Correct Answer: D
Rationale: Coarctation of the aorta causes higher blood pressure in the arms due to obstruction distal to the defect, resulting in lower pressure in the legs.
What is the nurse's best response?
- A. Squatting increases the return of venous blood back to the heart.
- B. Squatting decreases arterial blood flow away from the heart.
- C. Squatting is a common resting position when a child is tachycardic.
- D. Squatting increases the workload of the heart.
Correct Answer: A
Rationale: Squatting in tetralogy of Fallot increases venous return, improving systemic circulation and reducing cyanosis.
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.'
- B. He tires out during feedings.'
- C. He is fussy for several hours every day.'
- D. He sleeps all the time.'
Correct Answer: B
Rationale: Fatigue during feedings is a common sign of congenital heart defects due to increased cardiac workload.
What does the nurse recognize that this indicates?
- A. Seizure activity
- B. Hypoxia
- C. Sydenham's chorea
- D. Decreasing level of consciousness
Correct Answer: C
Rationale: Sydenham's chorea, characterized by involuntary limb movements, is a neurological manifestation of rheumatic fever.
On what understanding does the nurse base a response?
- A. Clubbing occurs as a result of untreated congestive heart failure.
- B. Clubbing occurs as a result of a left-to-right shunting of blood.
- C. Clubbing occurs as a result of decreased cardiac output.
- D. Clubbing occurs as a result of chronic hypoxia.
Correct Answer: D
Rationale: Chronic hypoxia in tetralogy of Fallot leads to clubbing of the fingertips due to prolonged low oxygen levels.