Question 1

Which compensatory position will the nurse observe in a child with tetralogy of Fallot (TOF)  who is experiencing a hypercyanotic spell?

Accepted Answer

A)   In a high-Fowler position
B)   Supine with the legs elevated
C)   With knees pulled up to chest
D)   On the left sideE) All of the above
F) A) and B)

Question 2

The nurse is explaining the goals of the Congenital Heart Disease Genetic Network Study (CHD GENES)  to a couple considering genetic screening for congenital defects. Which statement by a parent indicates that more teaching is needed?

Accepted Answer

A)   "There is a strong genetic role in the development of congenital heart disease."
B)   "A goal of this study is to identify how genetics affects clinical outcomes."
C)   "This study will help develop new therapies."
D)   "This study has positively identified ways to prevent congenital heart disease."E) B) and C)
F) B) and D)

Question 3

When assessing a newborn immediately after birth, which concept should the nurse keep in mind?

Accepted Answer

A)   Pulmonary pressures rise.
B)   Left atrial pressure rises.
C)   Right atrial pressure rises.
D)   Systemic vascular resistance falls.E) A) and B)
F) All of the above

Question 4

When assessing a patient with Ebstein anomaly, the nurse should assess for an anomaly of which heart valve?

Accepted Answer

A)   Pulmonic valve
B)   Mitral valve
C)   Aortic valve
D)   Tricuspid valveE) B) and C)
F) A) and D)

Question 5

What response should the nurse give, while teaching a prenatal class, when asked when cardiac defects occur?

Accepted Answer

A)   "They may occur any time during gestation."
B)   "They occur by the end of the ninth week."
C)   "They occur before implantation has occurred."
D)   "They occur shortly before birth."E) A) and C)
F) All of the above

Question 6

To improve ventricular contractility in a child with a ventricular septal defect, the nurse would expect to administer:

Accepted Answer

A)   a diuretic.
B)   a cardiac glycoside.
C)   an ACE inhibitor.
D)   an aldosterone receptor blocker.E) C) and D)
F) A) and B) B

Question 7

Which finding would the nurse expect to auscultate in a patient with rheumatic heart disease causing mitral stenosis?

Accepted Answer

A)   Loud S1, split S2
B)   S3 and S4 heart sounds
C)   Loud high-pitched rumbling murmur
D)   Murmur on diastoleE) A) and B)
F) A) and C)

Question 8

When performing a screening for critical congenital heart disease (CCHD) , where should the nurse obtain the preductal pulse oximeter reading?

Accepted Answer

A)   From the right hand
B)   From the left hand
C)   From the right foot
D)   From the left footE) A) and B)
F) A) and C)

Question 9

What is the best response by the nurse when the mother of a 24-hour-old newborn asks why her baby is being screened for congenital heart disease?

Accepted Answer

A)   "We don't trust you to notice possible heart problems in your baby."
B)   "This is a routine mandatory newborn screening."
C)   "Your baby's skin color is a little red."
D)   "The doctor heard a heart murmur which is not normal at this stage after delivery."E) A) and C)
F) C) and D)

Question 10

An experienced labor and delivery nurse is orienting nurses new to labor and delivery. Which of the following does the experienced nurse teach about fetal circulation?

Accepted Answer

A)   Oxygenated blood is carried to the fetus via the umbilical artery.
B)   Oxygenated blood enters the right atrium.
C)   Most of the blood in the right atrium crosses the foramen ovale into the left atrium.
D)   Blood entering the right ventricle is pumped to the lungs.E) All of the above
F) C) and D)

Question 11

Which intervention should the nurse anticipate performing first after the birth of an infant with hypoplastic left heart syndrome?

Accepted Answer

A)   Preparing the infant for surgery
B)   Administering a prostaglandin infusion
C)   Placing the infant on the transplant list
D)   Preparing the parents for the death of the infantE) A) and C)
F) A) and D)

Question 12

The nurse is performing a cardiac assessment on a newborn. Which findings would the nurse expect in a grade 4 murmur?

Accepted Answer

A)   Murmur is barely audible.
B)   Murmur is loud, but without a thrill.
C)   Murmur is loud with a palpable thrill.
D)   Murmur is audible without a stethoscope.E) All of the above
F) B) and C)

Question 13

Which medication would the nurse give to prevent renal reabsorption of sodium and chloride in the infant with pulmonary congestion secondary to congenital heart disease?

Accepted Answer

A)   Prostaglandin
B)   Loop diuretic
C)   Inotropes
D)   ACE inhibitorsE) B) and D)
F) A) and B)

Question 14

The nurse, assessing a patient with endocarditis, notes small red painful growths on the fingers and toe pads. The nurse documents these findings as:

Accepted Answer

A)   Osler nodes.
B)   Janeway lesions.
C)   Roth spots.
D)   Ebstein anomaly.E) C) and D)
F) A) and D) A

Question 15

Which finding would alert the nurse to a potential problem in a newborn undergoing critical congenital heart disease testing?

Accepted Answer

A)   An SpO2 of 94% on room air on the right hand and right foot
B)   An SpO2 of 98% on room air on the right hand and right foot
C)   An SpO2 of 96% on room air on the right hand with less than a 3% difference on the left foot
D)   An SpO2 of 98% on room air on the right hand and left footE) A) and C)
F) B) and C)

Question 16

Which information should the nurse include in the teaching plan for a patient receiving a biologic valve replacement?

Accepted Answer

A)   Anticoagulation will be necessary.
B)   An audible click may be heard.
C)   There is a low risk of thromboemboli.
D)   The valve may need to be replaced in the future.E) None of the above
F) B) and C)

Question 17

When assessing a baby for a murmur caused by an atrial septal defect, where should the nurse place the stethoscope?

Accepted Answer

A)   Upper left sternal border
B)   Upper right sternal border
C)   Lower left sternal border
D)   ApexE) B) and C)
F) A) and D)

Question 18

When teaching a prenatal class, the nurse tells the class that the first fetal heart beat occurs:

Accepted Answer

A)   on day 12.
B)   on day 22.
C)   on day 32.
D)   at the end of the first trimester.E) C) and D)
F) All of the above

Question 19

Which finding should the nurse anticipate in an infant with coarctation of the aorta?

Accepted Answer

A)   Higher right ventricular pressure than left ventricular pressure
B)   Lower blood pressure in the lower extremities than the upper extremities
C)   Higher blood pressure in the upper extremities than the lower extremities
D)   Higher blood pressure in the left arm tan the right armE) A) and C)
F) B) and D) B

Question 20

What is the best response for the nurse to make when the parents of an infant, born with a congenital heart defect, ask the cause of the condition?

Accepted Answer

A)   "It is caused by a genetic defect."
B)   "It is caused by environmental factors."
C)   "The cause is multifactorial."
D)   "The cause is not known."E) None of the above
F) A) and B)

Exam 25: Cardiac Structural Disorders

Which compensatory position will the nurse observe in a child with tetralogy of Fallot (TOF) who is experiencing a hypercyanotic spell?

Correct AnswerverifiedShow Answer

The nurse is explaining the goals of the Congenital Heart Disease Genetic Network Study (CHD GENES) to a couple considering genetic screening for congenital defects. Which statement by a parent indicates that more teaching is needed?

Correct AnswerverifiedShow Answer

When assessing a newborn immediately after birth, which concept should the nurse keep in mind?

Correct AnswerverifiedShow Answer

When assessing a patient with Ebstein anomaly, the nurse should assess for an anomaly of which heart valve?

Correct AnswerverifiedShow Answer

What response should the nurse give, while teaching a prenatal class, when asked when cardiac defects occur?

Correct AnswerverifiedShow Answer

To improve ventricular contractility in a child with a ventricular septal defect, the nurse would expect to administer:

Correct AnswerverifiedB

Which finding would the nurse expect to auscultate in a patient with rheumatic heart disease causing mitral stenosis?

Correct AnswerverifiedShow Answer

When performing a screening for critical congenital heart disease (CCHD) , where should the nurse obtain the preductal pulse oximeter reading?

Correct AnswerverifiedShow Answer

What is the best response by the nurse when the mother of a 24-hour-old newborn asks why her baby is being screened for congenital heart disease?

Correct AnswerverifiedShow Answer

An experienced labor and delivery nurse is orienting nurses new to labor and delivery. Which of the following does the experienced nurse teach about fetal circulation?

Correct AnswerverifiedShow Answer

Which intervention should the nurse anticipate performing first after the birth of an infant with hypoplastic left heart syndrome?

Correct AnswerverifiedShow Answer

The nurse is performing a cardiac assessment on a newborn. Which findings would the nurse expect in a grade 4 murmur?

Correct AnswerverifiedShow Answer

Which medication would the nurse give to prevent renal reabsorption of sodium and chloride in the infant with pulmonary congestion secondary to congenital heart disease?

Correct AnswerverifiedShow Answer

The nurse, assessing a patient with endocarditis, notes small red painful growths on the fingers and toe pads. The nurse documents these findings as:

Correct AnswerverifiedA

Which finding would alert the nurse to a potential problem in a newborn undergoing critical congenital heart disease testing?

Correct AnswerverifiedShow Answer

Which information should the nurse include in the teaching plan for a patient receiving a biologic valve replacement?

Correct AnswerverifiedShow Answer

When assessing a baby for a murmur caused by an atrial septal defect, where should the nurse place the stethoscope?

Correct AnswerverifiedShow Answer

When teaching a prenatal class, the nurse tells the class that the first fetal heart beat occurs:

Correct AnswerverifiedShow Answer

Which finding should the nurse anticipate in an infant with coarctation of the aorta?

Correct AnswerverifiedB

What is the best response for the nurse to make when the parents of an infant, born with a congenital heart defect, ask the cause of the condition?

Correct AnswerverifiedShow Answer

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B

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A

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B

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