NUR 439 FINAL EXAM QUESTION AND VERIFIED ANSWERS

NUR 439 FINAL EXAM QUESTION AND VERIFIED ANSWERS1. The most common congenital heart defect in children is a. tricuspid atresia b. ventricular septal defect c. aortic stenosis d. pulmonary atresia b 2. the mother of a 4 month old infant reports that he turned "blue" and seemed to have fast labored breathing after vigorous crying soon after awakening. He settled down and his color and breathing seemed to improve. On physical examination, the mucous membranes of the lips and mouth appear mildly cyanotic. A systolic murmur is heard best at the upper and left sternal border. Vital signs are normal with normal peripheral pulses. There is no hepatomegaly. A likely diagnosis is a. congestive heart failure b. apnea c. coarctation of the aorta d. cyanotic spells related to TET d 3. management of an infant with suspected heart disease and a reported cyanotic spell should include a. prompt referral to cardiology b. an apnea monitor c. instructing the parents to keep a diary of these events d. continuous administration of oxygen a 4. Chest pain in young children is usually a. a symptom of congenital heart disease b. non cardiac in origin c. a sign of hypercholesterolemia d. a symptom of congestive heart failure b 5. a common cause of congestive heart failure the first year of life is a. pulmonary stenosis b. ventricular septal defect c. rheumatic fever d. complete heart block b 6. the least likely physical finding in a 2 month old with congestive heart failure is a. tachypnea b. tachycardia c. hepatomegaly d. pedal edema d 7. a vibratory systolic ejection murmur is heard at the lower left sternal border in a healthy 4 year old at her preschool physical. The cardiovascular exam is otherwise normal. A likely diagnosis is a. venous hum b. stills murmur c. transposition of the great arteries d. rheumatic heart disease b 8. characteristics of a venous hum include a. a systolic murmur b. radiation over the precordium c. a marked decrease or disappearance of the murmur when the child is supine d. heard best at the lower left sternal border c 9. which of the following is true regarding innocent murmurs a. the murmur is often holosytolic b. prompt referral to cardiologist is indicated c. a precordial thrill is present d. the murmur is low intensity, grade 1 -3 d 10. SBE prophylaxis is recommended for a. all children with congenital heart disease on a daily basis b. all children with congenital heart disease before dental, GI, and GU procedures c. children with repaired congenital heart disease with a residual defect at the repair site d. five years after repair of all congenital heart disease c 11. a 12 year old girl seen at a routine visit has a blood pressure of 138/90. This blood pressure is in the 99th percentile for a height at the 95th percentile. She denies any symptoms such as headache or blurred vision. there is no family history of hypertension. The initial management would include a. intravenous pyelogram b. return for two repeat blood pressure measurements c. no follow up needed - blood pressure likely related to anxiety d. a diuretic therapy b