C HAPTER 26: T HE C HILD WITH A
C ARDIOVASCULAR D ISORDER
Introduction to Maternity and Pediatric Nursing , 8th Edition ; Leifer
MULTIPLE CHOICE
1. The parent of a 1-year-old child with tetralogy of Fallot asks the nurse,
Why do m y childs fingertips look like that? 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.
ANS: D
Clubbing of the fingers develops in response to chronic hypoxia.
DIF: Cognitive Level: Comprehension REF: Page 627
OBJ: 4 TOP: Tetralogy of Fallot KEY: Nursing
Process Step: Implementation MSC: NC LEX:
Physiological Integrity: Physiological Adaptation
2. A child has an elevated antistreptol ysin O (ASO) titer. Which combination
of s ymptoms, in conjunction with this finding, would confirm a diagnosis
of rheumatic fever?
a. Subcutaneous nodules and fever
, b. Painful, tender joints and carditis
c. Erythema marginatum and arthralgia
d. Chorea and elevated sedimentation rate
ANS: B
The presence of two major Jones criteria would indicate a high
probabilit y of rheumatic feve r.
DIF: Cognitive Level: Application REF: Page 632 OBJ: 6
TOP: Rheumatic Fever KEY: Nursing Process Step:
Data Collection MSC: NC LEX: Health Promotion and
Maintenance: Prevention and Earl y Detection of Disease
3. An infant with congestive heart failur e is receiving digoxin (Lanoxin).
What does the nurse recognize as a sign of digoxin toxicit y?
a. Restlessness
b. Decreased respiratory rate
c. Increased urinary output
d. Vomiting
ANS: D
Symptoms of digoxin toxicit y include: nausea, vomiting, anorexia,
irregularit y in pulse rate and rhythm, and a sudden change in pulse.
DIF: Cognitive Level: Comprehension REF: Page 630
TOP: Heart Failure KEY: Nursing Process Step:
, Data Collection MSC: NC LEX: Physiological Integrit y:
Pharmacological Therapies
4. Through what does the infant born with hypoplastic left heart syndrome
acquire ox ygenated blood?
a. The patent ductus arteriosus
b. A ventricular septal defect
c. The closure of the foramen ovale
d. An atrial septal defect
ANS: D
Because the right side of the heart must take over p umping blood to
both the lungs and systemic circulation, the ductus arteriosus must
remain open to shunt the ox ygenated blood from the lungs.
DIF: Cognitive Level: Knowledge REF: Page 628 TOP:
Hypoplastic Left Heart S yndrome KEY: Nursing Process
Step: Planning MSC: NC LEX: Physiological Integrit y:
Physiological Adaptation
5. A child with rheumatic fever begins involuntary, purposeless movements
of her limbs. What does the nurse recognize that this indicates?
a. Seizure activit y
b. Hypoxia
c. Sydenhams chorea
d. Decreasing level of consciousness
ANS: C
C ARDIOVASCULAR D ISORDER
Introduction to Maternity and Pediatric Nursing , 8th Edition ; Leifer
MULTIPLE CHOICE
1. The parent of a 1-year-old child with tetralogy of Fallot asks the nurse,
Why do m y childs fingertips look like that? 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.
ANS: D
Clubbing of the fingers develops in response to chronic hypoxia.
DIF: Cognitive Level: Comprehension REF: Page 627
OBJ: 4 TOP: Tetralogy of Fallot KEY: Nursing
Process Step: Implementation MSC: NC LEX:
Physiological Integrity: Physiological Adaptation
2. A child has an elevated antistreptol ysin O (ASO) titer. Which combination
of s ymptoms, in conjunction with this finding, would confirm a diagnosis
of rheumatic fever?
a. Subcutaneous nodules and fever
, b. Painful, tender joints and carditis
c. Erythema marginatum and arthralgia
d. Chorea and elevated sedimentation rate
ANS: B
The presence of two major Jones criteria would indicate a high
probabilit y of rheumatic feve r.
DIF: Cognitive Level: Application REF: Page 632 OBJ: 6
TOP: Rheumatic Fever KEY: Nursing Process Step:
Data Collection MSC: NC LEX: Health Promotion and
Maintenance: Prevention and Earl y Detection of Disease
3. An infant with congestive heart failur e is receiving digoxin (Lanoxin).
What does the nurse recognize as a sign of digoxin toxicit y?
a. Restlessness
b. Decreased respiratory rate
c. Increased urinary output
d. Vomiting
ANS: D
Symptoms of digoxin toxicit y include: nausea, vomiting, anorexia,
irregularit y in pulse rate and rhythm, and a sudden change in pulse.
DIF: Cognitive Level: Comprehension REF: Page 630
TOP: Heart Failure KEY: Nursing Process Step:
, Data Collection MSC: NC LEX: Physiological Integrit y:
Pharmacological Therapies
4. Through what does the infant born with hypoplastic left heart syndrome
acquire ox ygenated blood?
a. The patent ductus arteriosus
b. A ventricular septal defect
c. The closure of the foramen ovale
d. An atrial septal defect
ANS: D
Because the right side of the heart must take over p umping blood to
both the lungs and systemic circulation, the ductus arteriosus must
remain open to shunt the ox ygenated blood from the lungs.
DIF: Cognitive Level: Knowledge REF: Page 628 TOP:
Hypoplastic Left Heart S yndrome KEY: Nursing Process
Step: Planning MSC: NC LEX: Physiological Integrit y:
Physiological Adaptation
5. A child with rheumatic fever begins involuntary, purposeless movements
of her limbs. What does the nurse recognize that this indicates?
a. Seizure activit y
b. Hypoxia
c. Sydenhams chorea
d. Decreasing level of consciousness
ANS: C
