Chapter 23 The Child with
Cardiovascular
Dysfunction 2026 | Q&A &
Rationales
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Updated 2026 Questions and Answers
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Rationales
Included
,An infant with an unrepaired tetralogy of Fallot defect is b. Place the infant in knee-chest position.
becoming extremely cyanotic a. Administer 100% oxygen by blow-by.
during a routine blood draw. Which interventions should d. Give morphine subcutaneously or by an existing intravenous line.
the nurse implement? Place in order from c. Remain calm.
the highest-priority intervention to the lowest-priority
intervention. Provide the answer using ANS:
lowercase letters separated by commas (e.g., a, b, c, d). b, a, d, c
Hypercyanotic spells, also referred to as blue spells or tet spells because they are
a. Administer 100% oxygen by blow-by. often seen in infants
with tetralogy of Fallot, may occur in any child whose heart defect includes
b. Place the infant in knee-chest position. obstruction to pulmonary
blood flow and communication between the ventricles. The infant becomes
c. Remain calm. acutely cyanotic and
d. Give morphine subcutaneously or by an existing hyperpneic because sudden infundibular spasm decreases pulmonary blood flow
intravenous line. and increases right-to-
left shunting. Because profound hypoxemia causes cerebral hypoxia,
hypercyanotic spells require prompt
assessment and treatment to prevent brain damage or possibly death. The infant
should first be placed in
the knee-chest position to reduce blood returning to the heart. Next 100% oxygen
is given to alleviate the
hypoxemia. Morphine is next administered to reduce infundibular spasms. Last,
the nurse should remain
calm.
DIF: Cognitive Level: Apply REF: p. 741
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
1. A chest radiograph film is ordered for a child with c. Permanent record of heart size and configuration
suspected cardiac problems. Thechild's parent asks the
nurse, "What will the radiograph show about the heart?" ANS: C
What knowledge A chest radiograph will provide information on the heart size and pulmonary
about the x-ray should the nurse include in the response blood-flow patterns. It will
to the parents? provide a baseline for future comparisons. The heart will be visible, as well as the
sternum and ribs.
a. Bones of chest but not the heart Electrocardiography (ECG) measures the electrical potential generated from
heart muscle.
b. Measurement of electrical potential generated from Echocardiography will produce a computerized image of the heart vessels and
heart muscle tissues by using sound
waves.
c. Permanent record of heart size and configuration DIF: Cognitive Level: Understand REF: p. 738
TOP: Integrated Process: Teaching/Learning
d. Computerized image of heart vessels and tissues MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
, 2. The nurse is assessing a child after a cardiac a. Cardiac arrhythmia
catheterization. Which complication should
the nurse be assessing for? ANS: A
a. Cardiac arrhythmia
Because a catheter is introduced into the heart, a risk exists of catheter-induced
b. Hypostatic pneumonia dysrhythmias occurring
during the procedure. These are usually transient. Hypostatic pneumonia, heart
c. Heart failure failure, and rapidly
increasing blood pressure are not risks usually associated with cardiac
d. Rapidly increasing blood pressure catheterization.
DIF: Cognitive Level: Apply REF: p. 739
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
3. José is a 4-year-old child scheduled for a cardiac ANS: D
catheterization. What should be
included in preoperative teaching?
d. Adapted to his level of development so that he can understand
a. Directed at his parents because he is too young to
understand Preoperative teaching should always be directed at the child's stage of
development. The caregivers also
b. Detailed in regard to the actual procedures so he will benefit from the same explanations. The parents may ask additional questions,
know what to expect which should be answered,
but the child needs to receive the information based on developmental level.
c. Done several days before the procedure so that he will Preschoolers will not
be prepared understand in-depth descriptions and should be prepared close to the time of the
cardiac catheterization.
d. Adapted to his level of development so that he can DIF: Cognitive Level: Apply REF: p. 739
understand TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance
4. Which explanation regarding cardiac catheterization is d. When the procedure is done, you will have to keep your leg straight for at least
appropriate for a preschool 4 hours.
child?
ANS: D
a. Postural drainage will be performed every 4 to 6 hours The child's leg will have to be maintained in a straight position for approximately 4
after the test. hours. Younger
children can be held in the parent's lap with the leg maintained in the correct
b. It is necessary to be completely "asleep" during the position. Postural drainage
test. will not be performed unless the child has corresponding pulmonary problems.
The child should be
c. The test is short, usually taking less than 1 hour. sedated to lie still, but being completely asleep is not necessary. The test will vary
in length of time from
d. When the procedure is done, you will have to keep start to finish.
your leg straight for at least
4 hours.
Cardiovascular
Dysfunction 2026 | Q&A &
Rationales
|Graded A+ | Guaranteed
success|
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales
Included
,An infant with an unrepaired tetralogy of Fallot defect is b. Place the infant in knee-chest position.
becoming extremely cyanotic a. Administer 100% oxygen by blow-by.
during a routine blood draw. Which interventions should d. Give morphine subcutaneously or by an existing intravenous line.
the nurse implement? Place in order from c. Remain calm.
the highest-priority intervention to the lowest-priority
intervention. Provide the answer using ANS:
lowercase letters separated by commas (e.g., a, b, c, d). b, a, d, c
Hypercyanotic spells, also referred to as blue spells or tet spells because they are
a. Administer 100% oxygen by blow-by. often seen in infants
with tetralogy of Fallot, may occur in any child whose heart defect includes
b. Place the infant in knee-chest position. obstruction to pulmonary
blood flow and communication between the ventricles. The infant becomes
c. Remain calm. acutely cyanotic and
d. Give morphine subcutaneously or by an existing hyperpneic because sudden infundibular spasm decreases pulmonary blood flow
intravenous line. and increases right-to-
left shunting. Because profound hypoxemia causes cerebral hypoxia,
hypercyanotic spells require prompt
assessment and treatment to prevent brain damage or possibly death. The infant
should first be placed in
the knee-chest position to reduce blood returning to the heart. Next 100% oxygen
is given to alleviate the
hypoxemia. Morphine is next administered to reduce infundibular spasms. Last,
the nurse should remain
calm.
DIF: Cognitive Level: Apply REF: p. 741
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
1. A chest radiograph film is ordered for a child with c. Permanent record of heart size and configuration
suspected cardiac problems. Thechild's parent asks the
nurse, "What will the radiograph show about the heart?" ANS: C
What knowledge A chest radiograph will provide information on the heart size and pulmonary
about the x-ray should the nurse include in the response blood-flow patterns. It will
to the parents? provide a baseline for future comparisons. The heart will be visible, as well as the
sternum and ribs.
a. Bones of chest but not the heart Electrocardiography (ECG) measures the electrical potential generated from
heart muscle.
b. Measurement of electrical potential generated from Echocardiography will produce a computerized image of the heart vessels and
heart muscle tissues by using sound
waves.
c. Permanent record of heart size and configuration DIF: Cognitive Level: Understand REF: p. 738
TOP: Integrated Process: Teaching/Learning
d. Computerized image of heart vessels and tissues MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
, 2. The nurse is assessing a child after a cardiac a. Cardiac arrhythmia
catheterization. Which complication should
the nurse be assessing for? ANS: A
a. Cardiac arrhythmia
Because a catheter is introduced into the heart, a risk exists of catheter-induced
b. Hypostatic pneumonia dysrhythmias occurring
during the procedure. These are usually transient. Hypostatic pneumonia, heart
c. Heart failure failure, and rapidly
increasing blood pressure are not risks usually associated with cardiac
d. Rapidly increasing blood pressure catheterization.
DIF: Cognitive Level: Apply REF: p. 739
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
3. José is a 4-year-old child scheduled for a cardiac ANS: D
catheterization. What should be
included in preoperative teaching?
d. Adapted to his level of development so that he can understand
a. Directed at his parents because he is too young to
understand Preoperative teaching should always be directed at the child's stage of
development. The caregivers also
b. Detailed in regard to the actual procedures so he will benefit from the same explanations. The parents may ask additional questions,
know what to expect which should be answered,
but the child needs to receive the information based on developmental level.
c. Done several days before the procedure so that he will Preschoolers will not
be prepared understand in-depth descriptions and should be prepared close to the time of the
cardiac catheterization.
d. Adapted to his level of development so that he can DIF: Cognitive Level: Apply REF: p. 739
understand TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance
4. Which explanation regarding cardiac catheterization is d. When the procedure is done, you will have to keep your leg straight for at least
appropriate for a preschool 4 hours.
child?
ANS: D
a. Postural drainage will be performed every 4 to 6 hours The child's leg will have to be maintained in a straight position for approximately 4
after the test. hours. Younger
children can be held in the parent's lap with the leg maintained in the correct
b. It is necessary to be completely "asleep" during the position. Postural drainage
test. will not be performed unless the child has corresponding pulmonary problems.
The child should be
c. The test is short, usually taking less than 1 hour. sedated to lie still, but being completely asleep is not necessary. The test will vary
in length of time from
d. When the procedure is done, you will have to keep start to finish.
your leg straight for at least
4 hours.
