Congenital Heart Defect Practice Questions
A 3-month-old has been diagnosed with a ventricular septal defect (VSD). The flow of blood through the heart
is _____________________. - ansLeft to right.
The pressures in the left side of the heart are greater, causing the flow of blood to be from an area of higher
pressure to lower pressure, or left to right, increasing the pulmonary blood flow with the extra blood.
TEST-TAKING HINT: The test taker should know that the classification for this defect is left to right.
A 6-month-old who has episodes of cyanosis after crying could have the congenital heart defect (CHD) of
decreased pulmonary blood flow called _____________________. - ansTetralogy of Fallot (TOF). "Tet" spells
are characteristic of TOF.
TEST-TAKING HINT: Know the congenital heart defect classifi cations.
A child born with Down syndrome should be evaluated for which associated cardiac manifestation?
1. Congenital heart defect (CHD). 2. Systemic hypertension.
3. Hyperlipidemia.
4. Cardiomyopathy - ans1
1. CHD is found often in children with Down syndrome.
2. This is not associated with Down syndrome.
3. This is not associated with Down syndrome.
4. This is not associated with Down syndrome.
,TEST-TAKING HINT: A child with a genetic syndrome, such as Down, is likely to have other abnormalities
A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin (Lanoxin) and
furosemide (Lasix). She is rubbing her eyes when she is looking at the lights in the room, and her HR is 70 beats
per minute. The nurse expects which laboratory finding?
1. Hypokalemia.
2. Hypomagnesemia.
3. Hypocalcemia.
4. Hypophosphatemia - ans1
1. The rubbing of the child's eyes may mean that she is seeing halos around the lights, indicating digoxin
(Lanoxin) toxicity. The HR is slow for her age and also indicates digoxin toxicity. A decrease in serum potassium
because of the furosemide (Lasix) can increase the risk for digoxin toxicity.
2. Hypomagnesemia does not affect digoxin and is not related to the child rubbing her eyes.
3. Hypocalcemia does not affect digoxin and is not related to the child rubbing her eyes.
4. Hypophosphatemia does not affect digoxin and is not related to the child rubbing her eyes.
TEST-TAKING HINT: The test taker knows that furosemide (Lasix) causes the loss of potassium and can cause
digoxin (Lanoxin) toxicity.
A child diagnosed with tetralogy of Fallot becomes upset, crying and thrashing around when a blood specimen
is obtained. The child's color becomes blue and the respiratory rate increases to 44 breaths/min. Which of the
following actions should the nurse do first?
1.Obtain a prescription for sedation for the child.
2.Assess for an irregular heart rate and rhythm"
3.Explain to the child that it will only hurt for a short time.
,4.Place the child in a knee-to-chest position. - ans4
The child is experiencing a tet or hypoxic episode. Therefore the nurse should place the child in a knee-to-chest
position. Flexing the legs reduces venous flow of blood from the lower extremities and reduces the volume of
blood being shunted through the interventricular septal defect and the overriding aorta in the child with
tetralogy of Fallot. As a result, the blood then entering the systemic circulation has higher oxygen content, and
dyspnea is reduced. Flexing the legs also increases vascular resistance and pressure in the left ventricle. An
infant often assumes a knee-to-chest position in the crib, or the mother learns to put the infant over her
shoulder while holding the child in a knee-to-chest position to relieve dyspnea. If this position is ineffective,
then the child may need a sedative. Once the child is in the position, the nurse may assess for an irregular heart
rate and rhythm. Explaining to the child that it will only hurt for a short time does nothing to alleviate the
hypoxia
A child has been seen by the school nurse for dizziness since the start of the school term. It happens when
standing in line for recess and homeroom. The child now reports that she would rather sit and watch her
friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks
her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has:
1. Ventricular septal defect (VSD).
2. Aortic stenosis (AS).
3. Mitral valve prolapse.
4. Tricuspid atresia. - ans2
1. Murmur and CHF are often found in infancy.
2. AS can progress, and the child can develop exercise intolerance that can be better when resting.
3. Mitral valve prolapse causes a murmur and palpitations, usually in adulthood.
4. Tricuspid atresia causes hypoxemia in infancy.
TEST-TAKING HINT: What do "stenosis," "prolapse," and "atresia" mean, and what do those conditions cause?
, A child has had open heart surgery to repair a tetralogy of Fallot with a patch. The nurse should instruct the
parents to:
1.Notify all health care providers before invasive procedures for the next 6 months.
2.Maintain adequate hydration of at least 10 glasses of water a day.
3.Provide for frequent rest periods and naps during the first 4 weeks.
4.Restrict the ingestion of bananas and citrus fruit. - ans1
Children who have undergone open heart surgery with a patch are at risk for infection, especially subacute
bacterial endocarditis (SBE), for the first 6 months following surgery. The newest evidence-based guidelines
suggest that once the patch has epithelialized, these precautions are no longer necessary. Therefore, parents
are instructed about SBE precautions including the need to notify providers before invasive procedures so
antibiotics can be prescribed for that time period. Having the child drink a very large amount of water may lead
to fluid overload. Children gear their rest schedule to their activities making it unnecessary to schedule
frequent rest periods. Bananas and citrus fruit are high in potassium, but there is no evidence provided that the
child has an elevated serum potassium requiring restrictio
A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal that the lumen of the duct
between the aorta and pulmonary artery remains open. This defect is known as _____________________. -
ansPatent ductus arteriosus (PDA).
TEST-TAKING HINT: This is a defect with increased pulmonary fl ow. It should close in the fi rst few weeks of
life.
A nurse is caring for a child with congenital heart disease who is being treated with digoxin (Lanoxin). Which is
included in the family's discharge teaching?
1. Make sure the medication is taken with food.
2. Repeat the dose if the child vomits.
3. Take the child's pulse prior to administration.
4. Weigh the child daily. - ans3
A 3-month-old has been diagnosed with a ventricular septal defect (VSD). The flow of blood through the heart
is _____________________. - ansLeft to right.
The pressures in the left side of the heart are greater, causing the flow of blood to be from an area of higher
pressure to lower pressure, or left to right, increasing the pulmonary blood flow with the extra blood.
TEST-TAKING HINT: The test taker should know that the classification for this defect is left to right.
A 6-month-old who has episodes of cyanosis after crying could have the congenital heart defect (CHD) of
decreased pulmonary blood flow called _____________________. - ansTetralogy of Fallot (TOF). "Tet" spells
are characteristic of TOF.
TEST-TAKING HINT: Know the congenital heart defect classifi cations.
A child born with Down syndrome should be evaluated for which associated cardiac manifestation?
1. Congenital heart defect (CHD). 2. Systemic hypertension.
3. Hyperlipidemia.
4. Cardiomyopathy - ans1
1. CHD is found often in children with Down syndrome.
2. This is not associated with Down syndrome.
3. This is not associated with Down syndrome.
4. This is not associated with Down syndrome.
,TEST-TAKING HINT: A child with a genetic syndrome, such as Down, is likely to have other abnormalities
A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin (Lanoxin) and
furosemide (Lasix). She is rubbing her eyes when she is looking at the lights in the room, and her HR is 70 beats
per minute. The nurse expects which laboratory finding?
1. Hypokalemia.
2. Hypomagnesemia.
3. Hypocalcemia.
4. Hypophosphatemia - ans1
1. The rubbing of the child's eyes may mean that she is seeing halos around the lights, indicating digoxin
(Lanoxin) toxicity. The HR is slow for her age and also indicates digoxin toxicity. A decrease in serum potassium
because of the furosemide (Lasix) can increase the risk for digoxin toxicity.
2. Hypomagnesemia does not affect digoxin and is not related to the child rubbing her eyes.
3. Hypocalcemia does not affect digoxin and is not related to the child rubbing her eyes.
4. Hypophosphatemia does not affect digoxin and is not related to the child rubbing her eyes.
TEST-TAKING HINT: The test taker knows that furosemide (Lasix) causes the loss of potassium and can cause
digoxin (Lanoxin) toxicity.
A child diagnosed with tetralogy of Fallot becomes upset, crying and thrashing around when a blood specimen
is obtained. The child's color becomes blue and the respiratory rate increases to 44 breaths/min. Which of the
following actions should the nurse do first?
1.Obtain a prescription for sedation for the child.
2.Assess for an irregular heart rate and rhythm"
3.Explain to the child that it will only hurt for a short time.
,4.Place the child in a knee-to-chest position. - ans4
The child is experiencing a tet or hypoxic episode. Therefore the nurse should place the child in a knee-to-chest
position. Flexing the legs reduces venous flow of blood from the lower extremities and reduces the volume of
blood being shunted through the interventricular septal defect and the overriding aorta in the child with
tetralogy of Fallot. As a result, the blood then entering the systemic circulation has higher oxygen content, and
dyspnea is reduced. Flexing the legs also increases vascular resistance and pressure in the left ventricle. An
infant often assumes a knee-to-chest position in the crib, or the mother learns to put the infant over her
shoulder while holding the child in a knee-to-chest position to relieve dyspnea. If this position is ineffective,
then the child may need a sedative. Once the child is in the position, the nurse may assess for an irregular heart
rate and rhythm. Explaining to the child that it will only hurt for a short time does nothing to alleviate the
hypoxia
A child has been seen by the school nurse for dizziness since the start of the school term. It happens when
standing in line for recess and homeroom. The child now reports that she would rather sit and watch her
friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks
her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has:
1. Ventricular septal defect (VSD).
2. Aortic stenosis (AS).
3. Mitral valve prolapse.
4. Tricuspid atresia. - ans2
1. Murmur and CHF are often found in infancy.
2. AS can progress, and the child can develop exercise intolerance that can be better when resting.
3. Mitral valve prolapse causes a murmur and palpitations, usually in adulthood.
4. Tricuspid atresia causes hypoxemia in infancy.
TEST-TAKING HINT: What do "stenosis," "prolapse," and "atresia" mean, and what do those conditions cause?
, A child has had open heart surgery to repair a tetralogy of Fallot with a patch. The nurse should instruct the
parents to:
1.Notify all health care providers before invasive procedures for the next 6 months.
2.Maintain adequate hydration of at least 10 glasses of water a day.
3.Provide for frequent rest periods and naps during the first 4 weeks.
4.Restrict the ingestion of bananas and citrus fruit. - ans1
Children who have undergone open heart surgery with a patch are at risk for infection, especially subacute
bacterial endocarditis (SBE), for the first 6 months following surgery. The newest evidence-based guidelines
suggest that once the patch has epithelialized, these precautions are no longer necessary. Therefore, parents
are instructed about SBE precautions including the need to notify providers before invasive procedures so
antibiotics can be prescribed for that time period. Having the child drink a very large amount of water may lead
to fluid overload. Children gear their rest schedule to their activities making it unnecessary to schedule
frequent rest periods. Bananas and citrus fruit are high in potassium, but there is no evidence provided that the
child has an elevated serum potassium requiring restrictio
A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal that the lumen of the duct
between the aorta and pulmonary artery remains open. This defect is known as _____________________. -
ansPatent ductus arteriosus (PDA).
TEST-TAKING HINT: This is a defect with increased pulmonary fl ow. It should close in the fi rst few weeks of
life.
A nurse is caring for a child with congenital heart disease who is being treated with digoxin (Lanoxin). Which is
included in the family's discharge teaching?
1. Make sure the medication is taken with food.
2. Repeat the dose if the child vomits.
3. Take the child's pulse prior to administration.
4. Weigh the child daily. - ans3
