NURS 232 PEDS EXAM 4 LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
Which of the following are clinical manifestations of HF? (select all apply)
a) hepatomegaly and ascites
b) bradypnea and cyanotic
c) nasal flaring and retractions
d) restlessness and irritability
e) fluid retention and edema -(answer)a) hepatomegaly and ascites
c) nasal flaring and retractions
d) restlessness and irritability
e) fluid retention and edema
*tachypnea, pallor, tachycardia, wheezing, crackles, grunting, ascites, weight gain from fluid, or poor
weight gain, poor feeding w diaphoresis, weak pulses, prolonged cap refill, cool extremities, oliguria,
restlessness, irritability
Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of
a) pulmonary infection.
b) right-to-left shunt of blood.
c) decreased workload on left side of heart.
d) increased pulmonary vascular congestion. -(answer)d) increased pulmonary vascular congestion
*A PDA allows blood to flow from the aorta (high pressure) to the pulmonary artery (low pressure).
*A PDA involves a left-to-right shunt of blood, so if the PDA stays open it can increase pulmonary
vascular congestion
*pulmonary infection may occur, but it is not the priority complication
,NURS 232 PEDS EXAM 4 LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A cardiac assessment is required to determine if a child's physical symptoms are related to possible
heart disease. The nurse is proceeding to auscultation techniques. When observing the nursing student,
which action would indicate that additional training was required?
a) Documentation of heart sounds in reference to anatomical location.
b) Determination that there is no evidence of carotid bruits.
c) Calculation of heart rate.
d) Ascertaining whether there is evidence of splenic enlargement. -(answer)d) Ascertaining whether
there is evidence of splenic enlargement.
*Evidence of splenic enlargement requires palpation
What should nurses stress when counseling parents regarding the home care of the child with a cardiac
defect before corrective surgery?
a) The importance of reducing caloric intake to decrease cardiac demands
b) The importance of relaxing discipline and limit setting to prevent crying
c) The need to be extremely concerned about cyanotic spells
d) The desirability of promoting normalcy within the limits of the child's condition -(answer)d) The
desirability of promoting normalcy within the limits of the child's condition
*child needs to have social interactions, discipline, and appropriate limit setting. Parents need to be
encouraged to promote as normal a life as possible for their child.
*child needs increased caloric intake after cardiac surgery.
*cyanotic spells will occur in children with some defects, the parents need to be taught how to assess
for and manage them appropriately, thereby decreasing their anxiety and concern.
,NURS 232 PEDS EXAM 4 LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A young child with tetralogy of Fallot (TOF) may assume a posturing position as a compensatory
mechanism. The position automatically assumed by the child is
a) the low Fowler position.
b) the prone position.
c) the supine position.
d) the squatting position. -(answer)d) the squatting position.
*squatting or knee-chest position increases the return of blood flow to the heart for oxygenation in a
child with a defect that consists of decreased pulmonary blood flow
What is an important nursing responsibility when a dysrhythmia is suspected?
a) Order an immediate electrocardiogram.
b) Count the radial pulse every 1 minute for five times.
c) Count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate.
d) Have someone else take the radial pulse simultaneously with the apical pulse. -(answer)c) Count the
apical pulse for 1 full min and compare the rate with the radial pulse rate.
*If a dysrhythmia is occurring, the radial pulse rate may be lower than the apical pulse rate.
What is considered a mixed cardiac defect?
a) Pulmonic stenosis (PS)
b) Atrial septal defect (ASD)
c) Patent ductus arteriosus (PDA)
d) Transposition of the great arteries (TGA) -(answer)d) Transposition of the great arteries
, NURS 232 PEDS EXAM 4 LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
*allows the mixing of both oxygenated and unoxygenated blood in the heart.
*PS is an obstructive defect
*ASD and PDA increased pulmonary blood flow
After a patient returns from cardiac catheterization, the nurse notes that the pulse distal to the catheter
insertion site is weaker (+1). The most appropriate nursing intervention is to
a) elevate the affected extremity.
b) document the findings and continue to monitor.
c) notify the health care provider of the finding.
d) apply warm compresses to the insertion site. -(answer)b) document the findings and continue to
monitor.
*Weaker distal pulse is expected for the first few hours after catheterization. It should gradually
increase in strength.
*The extremity is kept straight and immobile, but elevation is not necessary.
*The insertion site is kept dry. Warm compresses would increase the risk of bleeding from the insertion
Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. Based on the
nurse's knowledge of congenital heart defects, this system in clinical practice is
a) helpful, because it explains the hemodynamics involved.
b) helpful, because children with cyanotic defects are easily identified.
c) problematic, because cyanosis is rarely present in children.
d) problematic, because children with acyanotic heart defects may develop cyanosis. -(answer)d)
problematic, because children with acyanotic heart defects may develop cyanosis.
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
Which of the following are clinical manifestations of HF? (select all apply)
a) hepatomegaly and ascites
b) bradypnea and cyanotic
c) nasal flaring and retractions
d) restlessness and irritability
e) fluid retention and edema -(answer)a) hepatomegaly and ascites
c) nasal flaring and retractions
d) restlessness and irritability
e) fluid retention and edema
*tachypnea, pallor, tachycardia, wheezing, crackles, grunting, ascites, weight gain from fluid, or poor
weight gain, poor feeding w diaphoresis, weak pulses, prolonged cap refill, cool extremities, oliguria,
restlessness, irritability
Surgical repair for patent ductus arteriosus (PDA) is done to prevent the complication of
a) pulmonary infection.
b) right-to-left shunt of blood.
c) decreased workload on left side of heart.
d) increased pulmonary vascular congestion. -(answer)d) increased pulmonary vascular congestion
*A PDA allows blood to flow from the aorta (high pressure) to the pulmonary artery (low pressure).
*A PDA involves a left-to-right shunt of blood, so if the PDA stays open it can increase pulmonary
vascular congestion
*pulmonary infection may occur, but it is not the priority complication
,NURS 232 PEDS EXAM 4 LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A cardiac assessment is required to determine if a child's physical symptoms are related to possible
heart disease. The nurse is proceeding to auscultation techniques. When observing the nursing student,
which action would indicate that additional training was required?
a) Documentation of heart sounds in reference to anatomical location.
b) Determination that there is no evidence of carotid bruits.
c) Calculation of heart rate.
d) Ascertaining whether there is evidence of splenic enlargement. -(answer)d) Ascertaining whether
there is evidence of splenic enlargement.
*Evidence of splenic enlargement requires palpation
What should nurses stress when counseling parents regarding the home care of the child with a cardiac
defect before corrective surgery?
a) The importance of reducing caloric intake to decrease cardiac demands
b) The importance of relaxing discipline and limit setting to prevent crying
c) The need to be extremely concerned about cyanotic spells
d) The desirability of promoting normalcy within the limits of the child's condition -(answer)d) The
desirability of promoting normalcy within the limits of the child's condition
*child needs to have social interactions, discipline, and appropriate limit setting. Parents need to be
encouraged to promote as normal a life as possible for their child.
*child needs increased caloric intake after cardiac surgery.
*cyanotic spells will occur in children with some defects, the parents need to be taught how to assess
for and manage them appropriately, thereby decreasing their anxiety and concern.
,NURS 232 PEDS EXAM 4 LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
A young child with tetralogy of Fallot (TOF) may assume a posturing position as a compensatory
mechanism. The position automatically assumed by the child is
a) the low Fowler position.
b) the prone position.
c) the supine position.
d) the squatting position. -(answer)d) the squatting position.
*squatting or knee-chest position increases the return of blood flow to the heart for oxygenation in a
child with a defect that consists of decreased pulmonary blood flow
What is an important nursing responsibility when a dysrhythmia is suspected?
a) Order an immediate electrocardiogram.
b) Count the radial pulse every 1 minute for five times.
c) Count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate.
d) Have someone else take the radial pulse simultaneously with the apical pulse. -(answer)c) Count the
apical pulse for 1 full min and compare the rate with the radial pulse rate.
*If a dysrhythmia is occurring, the radial pulse rate may be lower than the apical pulse rate.
What is considered a mixed cardiac defect?
a) Pulmonic stenosis (PS)
b) Atrial septal defect (ASD)
c) Patent ductus arteriosus (PDA)
d) Transposition of the great arteries (TGA) -(answer)d) Transposition of the great arteries
, NURS 232 PEDS EXAM 4 LATEST ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+
*allows the mixing of both oxygenated and unoxygenated blood in the heart.
*PS is an obstructive defect
*ASD and PDA increased pulmonary blood flow
After a patient returns from cardiac catheterization, the nurse notes that the pulse distal to the catheter
insertion site is weaker (+1). The most appropriate nursing intervention is to
a) elevate the affected extremity.
b) document the findings and continue to monitor.
c) notify the health care provider of the finding.
d) apply warm compresses to the insertion site. -(answer)b) document the findings and continue to
monitor.
*Weaker distal pulse is expected for the first few hours after catheterization. It should gradually
increase in strength.
*The extremity is kept straight and immobile, but elevation is not necessary.
*The insertion site is kept dry. Warm compresses would increase the risk of bleeding from the insertion
Congenital heart defects have traditionally been divided into acyanotic or cyanotic defects. Based on the
nurse's knowledge of congenital heart defects, this system in clinical practice is
a) helpful, because it explains the hemodynamics involved.
b) helpful, because children with cyanotic defects are easily identified.
c) problematic, because cyanosis is rarely present in children.
d) problematic, because children with acyanotic heart defects may develop cyanosis. -(answer)d)
problematic, because children with acyanotic heart defects may develop cyanosis.
