NURS 203 Chapter 29 UPDATED ACTUAL
Exam Questions and CORRECT Answers
What term is defined as the volume of blood ejected by the heart in 1 minute? - CORRECT
ANSWER -Cardiac output
Cardiac output is defined as the volume of blood ejected by the heart in 1 minute. Cardiac output
= Heart rate x Stroke volume. Afterload is the resistance against which the ventricles must pump
when ejecting blood (ventricular ejection). A cardiac cycle is the sequential contraction and
relaxation of both the atria and ventricles. Stroke volume is the amount of blood ejected by the
heart in any one contraction.
A chest radiography examination is ordered for a child with suspected cardiac problems. The
child's parent asks the nurse, "What will the x-ray show about the heart?" The nurse's response
should be based on knowledge that the radiograph provides which information? - CORRECT
ANSWER -Supplies information on heart size and pulmonary blood flow patterns
Chest radiographs provide information on the size of the heart and pulmonary blood flow
patterns. The bones of the chest are visible on chest radiographs, but the heart and blood vessels
are also seen. Magnetic resonance imaging is a noninvasive technique that allows for evaluation
of vascular anatomy outside of the heart. A graphic measure of electrical activity of the heart is
provided by electrocardiography.
A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most
important in planning preoperative teaching? - CORRECT ANSWER -Preoperative
teaching should be adapted to his level of development so that he can understand.
Preoperative teaching should always be directed to the child's stage of development. The
caregivers also benefit from these explanations. The parents may ask additional questions, which
should be answered, but the child needs to receive the information based on developmental level.
This age group will not understand in-depth descriptions. School-age children should be
prepared close to the time of the cardiac catheterization.
,After returning from cardiac catheterization, the nurse monitors the child's vital signs. The heart
rate should be counted for how many seconds? - CORRECT ANSWER -60 seconds
The heart rate is counted for a full minute to determine whether arrhythmias or bradycardia is
present. Fifteen to 30 seconds are too short for accurate assessment. Sixty seconds is sufficient to
assess heart rate and rhythm.
After returning from cardiac catheterization, the nurse determines that the pulse distal to the
catheter insertion site is weaker. How should the nurse respond? - CORRECT ANSWER -
Record data on the assessment flow record
The pulse distal to the catheterization site may be weaker for the first few hours after
catheterization but should gradually increase in strength. Documentation of the finding provides
a baseline. The extremity is maintained straight for 4 to 6 hours. This is an expected change. The
pulse is monitored. If there are neurovascular changes in the extremity, the practitioner is
notified. The site is kept dry. Warm compresses are not indicated.
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the
nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood.
What nursing action is most appropriate to institute initially? - CORRECT ANSWER -
Apply direct pressure above the catheterization site
When bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the
percutaneous skin site to localize pressure on the vessel puncture. The physician can be notified,
and a new bandage with more pressure can be applied after pressure is applied. The nurse can
have someone else notify the physician while the pressure is being maintained. Trendelenburg
positioning would not be a helpful intervention. It would increase the drainage from the lower
extremities.
What statement best identifies the cause of heart failure (HF)? - CORRECT ANSWER -
Consequence of an underlying cardiac defect
HF is the inability of the heart to pump an adequate amount of blood to the systemic circulation
at normal filling pressures to meet the body's metabolic demands. HF is not a disease but rather a
result of the inability of the heart to pump efficiently. HF is not inherited. HF occurs most
, frequently secondary to congenital heart defects in which structural abnormalities result in
increased volume load or increased pressures on the ventricles.
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep.
What nursing intervention is most appropriate at this time? - CORRECT ANSWER -
Report data to the practitioner
One of the earliest signs of HF is tachycardia (sleeping heart rate >160 beats/min) as a direct
result of sympathetic stimulation. The practitioner needs to be notified for evaluation of possible
HF. Although oxygen or a semiupright position may be indicated, the first action is to report the
data to the practitioner.
What drug is an angiotensin-converting enzyme (ACE) inhibitor? - CORRECT
ANSWER -Captopril (Capoten)
Captopril is an ACE inhibitor. Furosemide is a loop diuretic. Chlorothiazide works on the distal
tubules. Spironolactone blocks the action of aldosterone and is a potassium-sparing diuretic.
A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and
withhold the medication if the apical pulse is less than which rate? - CORRECT
ANSWER -90 beats/min
If a 1-minute apical pulse is less than 90 beats/min for an infant or young child, the digoxin is
withheld. Sixty beats/min is the cut-off for holding the digoxin dose in an adult. One hundred to
120 beats/min is an acceptable pulse rate for the administration of digoxin.
What clinical manifestation is a common sign of digoxin toxicity? - CORRECT
ANSWER -Vomiting
Vomiting is a common sign of digoxin toxicity and is often unrelated to feedings. Seizures are
not associated with digoxin toxicity. The child will have a slower (not faster) heart rate but not a
slower respiratory rate.
Exam Questions and CORRECT Answers
What term is defined as the volume of blood ejected by the heart in 1 minute? - CORRECT
ANSWER -Cardiac output
Cardiac output is defined as the volume of blood ejected by the heart in 1 minute. Cardiac output
= Heart rate x Stroke volume. Afterload is the resistance against which the ventricles must pump
when ejecting blood (ventricular ejection). A cardiac cycle is the sequential contraction and
relaxation of both the atria and ventricles. Stroke volume is the amount of blood ejected by the
heart in any one contraction.
A chest radiography examination is ordered for a child with suspected cardiac problems. The
child's parent asks the nurse, "What will the x-ray show about the heart?" The nurse's response
should be based on knowledge that the radiograph provides which information? - CORRECT
ANSWER -Supplies information on heart size and pulmonary blood flow patterns
Chest radiographs provide information on the size of the heart and pulmonary blood flow
patterns. The bones of the chest are visible on chest radiographs, but the heart and blood vessels
are also seen. Magnetic resonance imaging is a noninvasive technique that allows for evaluation
of vascular anatomy outside of the heart. A graphic measure of electrical activity of the heart is
provided by electrocardiography.
A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most
important in planning preoperative teaching? - CORRECT ANSWER -Preoperative
teaching should be adapted to his level of development so that he can understand.
Preoperative teaching should always be directed to the child's stage of development. The
caregivers also benefit from these explanations. The parents may ask additional questions, which
should be answered, but the child needs to receive the information based on developmental level.
This age group will not understand in-depth descriptions. School-age children should be
prepared close to the time of the cardiac catheterization.
,After returning from cardiac catheterization, the nurse monitors the child's vital signs. The heart
rate should be counted for how many seconds? - CORRECT ANSWER -60 seconds
The heart rate is counted for a full minute to determine whether arrhythmias or bradycardia is
present. Fifteen to 30 seconds are too short for accurate assessment. Sixty seconds is sufficient to
assess heart rate and rhythm.
After returning from cardiac catheterization, the nurse determines that the pulse distal to the
catheter insertion site is weaker. How should the nurse respond? - CORRECT ANSWER -
Record data on the assessment flow record
The pulse distal to the catheterization site may be weaker for the first few hours after
catheterization but should gradually increase in strength. Documentation of the finding provides
a baseline. The extremity is maintained straight for 4 to 6 hours. This is an expected change. The
pulse is monitored. If there are neurovascular changes in the extremity, the practitioner is
notified. The site is kept dry. Warm compresses are not indicated.
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the
nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood.
What nursing action is most appropriate to institute initially? - CORRECT ANSWER -
Apply direct pressure above the catheterization site
When bleeding occurs, direct continuous pressure is applied 2.5 cm (1 inch) above the
percutaneous skin site to localize pressure on the vessel puncture. The physician can be notified,
and a new bandage with more pressure can be applied after pressure is applied. The nurse can
have someone else notify the physician while the pressure is being maintained. Trendelenburg
positioning would not be a helpful intervention. It would increase the drainage from the lower
extremities.
What statement best identifies the cause of heart failure (HF)? - CORRECT ANSWER -
Consequence of an underlying cardiac defect
HF is the inability of the heart to pump an adequate amount of blood to the systemic circulation
at normal filling pressures to meet the body's metabolic demands. HF is not a disease but rather a
result of the inability of the heart to pump efficiently. HF is not inherited. HF occurs most
, frequently secondary to congenital heart defects in which structural abnormalities result in
increased volume load or increased pressures on the ventricles.
The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep.
What nursing intervention is most appropriate at this time? - CORRECT ANSWER -
Report data to the practitioner
One of the earliest signs of HF is tachycardia (sleeping heart rate >160 beats/min) as a direct
result of sympathetic stimulation. The practitioner needs to be notified for evaluation of possible
HF. Although oxygen or a semiupright position may be indicated, the first action is to report the
data to the practitioner.
What drug is an angiotensin-converting enzyme (ACE) inhibitor? - CORRECT
ANSWER -Captopril (Capoten)
Captopril is an ACE inhibitor. Furosemide is a loop diuretic. Chlorothiazide works on the distal
tubules. Spironolactone blocks the action of aldosterone and is a potassium-sparing diuretic.
A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and
withhold the medication if the apical pulse is less than which rate? - CORRECT
ANSWER -90 beats/min
If a 1-minute apical pulse is less than 90 beats/min for an infant or young child, the digoxin is
withheld. Sixty beats/min is the cut-off for holding the digoxin dose in an adult. One hundred to
120 beats/min is an acceptable pulse rate for the administration of digoxin.
What clinical manifestation is a common sign of digoxin toxicity? - CORRECT
ANSWER -Vomiting
Vomiting is a common sign of digoxin toxicity and is often unrelated to feedings. Seizures are
not associated with digoxin toxicity. The child will have a slower (not faster) heart rate but not a
slower respiratory rate.
