NUR 102 EXAM 5_PERFUSION ,ALL ANSWERS.

NUR 102 EXAM 5_PERFUSION ,ALL vv vv vv vv




ANSWERS
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Hyperactivity and Gastrointestinal disturbances are not associated with aortic stenosis. Pallor is a sign,
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but not specific to AS. - ANSWER-✔✔The clinic nurse reviews the record of a child just seen by HCP and
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diagnosed with suspected aortic stenosis. The nurse expect to note documentation of which clincial
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manifestation specifically found in this disorder?
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A. Pallor
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B. hyperactivity
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C. Exercise intolerence
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D. Gastrointestinal disturbances
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C



Visitors are still allowed as long as there is no infection in the person visiting. However, the child should
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be kept away from large crowds for 1 week at least. The rest of the statements are true. - ANSWER-✔✔A
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child is being discharged following cardiac surgery. Prior to discharge there are instructions given to the
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mother. Which statement indicates A NEED FOR FURTHER TEACHING?
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A. "Quiet activities are allowed"
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B. "The child should play inside for now"
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C. "No visitors for 1 month"
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D. "Regular naps will continue as scheduled"
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,D



Tachypnea and Tachycardia are CHD findings, but they are acute hypoxia. Sucking indicates
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hunger/irritability, but is not associated with CHD. - ANSWER-✔✔The nurse is caring for an infant with a
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diagnosis of Congenital Heart Disease. Which finding, on physical asssessment, does the nurse attribute
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to chronic hypoxia?
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A. tachypnea
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B. Tachycardia
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C. Sucking of the fingers
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D. Clubbing of the fingers.
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C



severe bradycardia is not a finding, only asymptomatic if there is a Left to Right shunt. The weight would
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be below normal, not above. - ANSWER-✔✔The nurse is caring for a child with a diagnosis of Right to left
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heart shunting. On review of the child's record, the nurse should expect to note documentation of which
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MOST common finding?
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A. severe bradycardia
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B. asymptomatic after feeding.
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C. Bluish discoloration of the skin
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D. higher than normal body weight.
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C



Paleness is not early sign, but it is an indications of HF. Strong sucking is not associated with HF. -
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ANSWER-✔✔The nurse is caring for an infant with Congential Heart Disease. Which, if noted in the
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infant, should alert the nurse to the EARLY development of Heart Failure?
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, A. paleness
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B. strong sucking reflex
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C. Diaphoresis during feeding
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D. show/shallow breathing
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D



Nursing supervisors and the Respiratory Therapist contact are things that need to happen, but not the
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first thing a nurse should do, as the infant is unstable during a hypercyanotic episode. We need to
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stabilize the infant first. Prone position does not allow to proper perfusion; it makes matters worse. -
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ANSWER-✔✔The nurse is assigned to care for an infant with Tetralogy of Fallot. The mother of the infant
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calls the nurse to the room because the infant suddenly seems to be having difficulty breathing. The
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nurse enters and notes the infant is experiencing a hypercyanotic episode. What is the nurses PRIORITY
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action?
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A. Notify nurse supervisor
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B. Contact Respiratory Therapist
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C. place infant in prone position
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D. Place infant in knee-chest position
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A



Apical pulse is lower than the normal range.
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Normal range is 90-130 beats/min for an infant. - ANSWER-✔✔The nurse is preparing to administer
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Digoxin to an infant with HF. Before administering the medication, the nurse double-checks the dose and
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counts the apical rate of 80 beats/min. Based on this finding, what is the nurses MOST APPROPRIATE
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action?
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