Chapter 47: Cardiovascular Dysfunction
MULTIPLE CHOICE
1. A chest x-ray is ordered for a child with suspected cardiac problems. The child’s parent asks the
nurse, “What will the radiograph show about the heart?” What knowledge about the x-ray film
should the nurse base her response on?
a.
not the heart.
b. It will measure electrical potential
generated by the heart muscle.
c. It will provide a permanent record of
heart size and configuration.
d. It will provide a computerized image of
heart vessels and tissues.
ANS: C It will
show the bones of the chest but
A chest x-ray provides information on the heart size and pulmonary blood flow patterns, providing a
baseline for future comparisons. The heart, sternum, and ribs will be visible.
Electrocardiography measures the electrical potential generated from heart muscle.
Echocardiography produces a computerized image of the heart vessels and tissues by using
sound waves.
DIF: Cognitive Level: ComprehensionREF: p. 1477 | Table 47-1 OBJ:
Nursing Process: Implementation
2. Which complication may occur after a cardiac catheterization?
a. Transient dysrhythmias
b. Hypostatic pneumonia
c. Heart failure
d. Rapidly increasing blood pressure
ANS: A
Because a catheter is introduced into the heart, there is a risk that catheter-induced transient
dysrhythmias could occur during the procedure. Hypostatic pneumonia, heart failure, and
rapidly increasing blood pressure are not risks usually associated with cardiac catheterization.
DIF: Cognitive Level: Comprehension REF: p. 1478 OBJ: Nursing Process: Diagnosis
,3. A 4-year-old child is scheduled for a cardiac catheterization. Which statement reflects the correct
way for the nurse to provide preoperative teaching?
a. It should be given to his parents
because he is too young to
understand.
b. It should be detailed in regard to the
actual procedures so he will know
what to expect.
c. It should be done several days before
the procedure so that he will be
prepared.
d. It should be adapted to his level of
development so that he can
understand.
ANS: D
Preoperative teaching should always be adapted to the child’s stage of development. The
caregivers also benefit from the same explanations. The parents may ask additional questions,
which should be answered, but the child needs to receive the information in a way he can
understand. This age group does not understand in-depth descriptions. Preschoolers should be
prepared close to the time of the cardiac catheterization.
DIF: Cognitive Level: Application REF: p. 1478
OBJ: Nursing Process: Implementation
4. 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 is the priority nursing action?
a. Notify the physician.
b. Apply a new bandage with more
pressure.
c. Place the girl in the Trendelenburg
position.
d. Apply direct pressure above the
catheterization site.
ANS: D
If bleeding occurs, the nurse should apply direct, continuous pressure 2.5 cm above the
percutaneous skin site to localize pressure over the vessel puncture. Notifying the physician
and applying a new bandage with more pressure can be done after pressure is applied. The
nurse can have someone else notify the physician while the pressure is being maintained. The
, Trendelenburg position would not be helpful, as it would increase the drainage from the lower
extremities.
DIF: Cognitive Level: Analysis REF: p. 1479 |Nursing Alert OBJ:
Nursing Process: Implementation
5. Which defect results in increased pulmonary blood flow?
a. Pulmonic stenosis
b. Tricuspid atresia
c. Atrial septal defect
d. Transposition of the great arteries
ANS: C
The atrial septal defect results in increased pulmonary blood flow. Blood flows from the left
atrium (higher pressure) into the right atrium (lower pressure) and then to the lungs via the
pulmonary artery. Pulmonic stenosis is an obstruction to blood flowing from the ventricles.
Tricuspid atresia results in decreased pulmonary blood flow. Transposition of the great arteries
results in mixed blood flow.
DIF: Cognitive Level: ComprehensionREF: p. 1482 | Box 47-1 OBJ:
Nursing Process: Assessment
6. Which structural defects constitute tetralogy of Fallot?
a. Pulmonic stenosis, ventricular septal
defect, overriding aorta, right
ventricular hypertrophy
b. Aortic stenosis, ventricular septal
defect, overriding aorta, right
ventricular hypertrophy
c. Aortic stenosis, atrial septal defect,
overriding aorta, left ventricular
hypertrophy
d. Pulmonic stenosis, ventricular septal
defect, aortic hypertrophy, left
ventricular hypertrophy
ANS: A
Tetralogy of Fallot has these four characteristics: pulmonary stenosis, ventricular septal defect,
overriding aorta, and right ventricular hypertrophy. There is pulmonary stenosis but not atrial
stenosis, and right ventricular hypertrophy, not left ventricular hypertrophy in tetralogy of
Fallot, and an atrial septal defect, not aortic hypertrophy, is present.
MULTIPLE CHOICE
1. A chest x-ray is ordered for a child with suspected cardiac problems. The child’s parent asks the
nurse, “What will the radiograph show about the heart?” What knowledge about the x-ray film
should the nurse base her response on?
a.
not the heart.
b. It will measure electrical potential
generated by the heart muscle.
c. It will provide a permanent record of
heart size and configuration.
d. It will provide a computerized image of
heart vessels and tissues.
ANS: C It will
show the bones of the chest but
A chest x-ray provides information on the heart size and pulmonary blood flow patterns, providing a
baseline for future comparisons. The heart, sternum, and ribs will be visible.
Electrocardiography measures the electrical potential generated from heart muscle.
Echocardiography produces a computerized image of the heart vessels and tissues by using
sound waves.
DIF: Cognitive Level: ComprehensionREF: p. 1477 | Table 47-1 OBJ:
Nursing Process: Implementation
2. Which complication may occur after a cardiac catheterization?
a. Transient dysrhythmias
b. Hypostatic pneumonia
c. Heart failure
d. Rapidly increasing blood pressure
ANS: A
Because a catheter is introduced into the heart, there is a risk that catheter-induced transient
dysrhythmias could occur during the procedure. Hypostatic pneumonia, heart failure, and
rapidly increasing blood pressure are not risks usually associated with cardiac catheterization.
DIF: Cognitive Level: Comprehension REF: p. 1478 OBJ: Nursing Process: Diagnosis
,3. A 4-year-old child is scheduled for a cardiac catheterization. Which statement reflects the correct
way for the nurse to provide preoperative teaching?
a. It should be given to his parents
because he is too young to
understand.
b. It should be detailed in regard to the
actual procedures so he will know
what to expect.
c. It should be done several days before
the procedure so that he will be
prepared.
d. It should be adapted to his level of
development so that he can
understand.
ANS: D
Preoperative teaching should always be adapted to the child’s stage of development. The
caregivers also benefit from the same explanations. The parents may ask additional questions,
which should be answered, but the child needs to receive the information in a way he can
understand. This age group does not understand in-depth descriptions. Preschoolers should be
prepared close to the time of the cardiac catheterization.
DIF: Cognitive Level: Application REF: p. 1478
OBJ: Nursing Process: Implementation
4. 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 is the priority nursing action?
a. Notify the physician.
b. Apply a new bandage with more
pressure.
c. Place the girl in the Trendelenburg
position.
d. Apply direct pressure above the
catheterization site.
ANS: D
If bleeding occurs, the nurse should apply direct, continuous pressure 2.5 cm above the
percutaneous skin site to localize pressure over the vessel puncture. Notifying the physician
and applying a new bandage with more pressure can be done after pressure is applied. The
nurse can have someone else notify the physician while the pressure is being maintained. The
, Trendelenburg position would not be helpful, as it would increase the drainage from the lower
extremities.
DIF: Cognitive Level: Analysis REF: p. 1479 |Nursing Alert OBJ:
Nursing Process: Implementation
5. Which defect results in increased pulmonary blood flow?
a. Pulmonic stenosis
b. Tricuspid atresia
c. Atrial septal defect
d. Transposition of the great arteries
ANS: C
The atrial septal defect results in increased pulmonary blood flow. Blood flows from the left
atrium (higher pressure) into the right atrium (lower pressure) and then to the lungs via the
pulmonary artery. Pulmonic stenosis is an obstruction to blood flowing from the ventricles.
Tricuspid atresia results in decreased pulmonary blood flow. Transposition of the great arteries
results in mixed blood flow.
DIF: Cognitive Level: ComprehensionREF: p. 1482 | Box 47-1 OBJ:
Nursing Process: Assessment
6. Which structural defects constitute tetralogy of Fallot?
a. Pulmonic stenosis, ventricular septal
defect, overriding aorta, right
ventricular hypertrophy
b. Aortic stenosis, ventricular septal
defect, overriding aorta, right
ventricular hypertrophy
c. Aortic stenosis, atrial septal defect,
overriding aorta, left ventricular
hypertrophy
d. Pulmonic stenosis, ventricular septal
defect, aortic hypertrophy, left
ventricular hypertrophy
ANS: A
Tetralogy of Fallot has these four characteristics: pulmonary stenosis, ventricular septal defect,
overriding aorta, and right ventricular hypertrophy. There is pulmonary stenosis but not atrial
stenosis, and right ventricular hypertrophy, not left ventricular hypertrophy in tetralogy of
Fallot, and an atrial septal defect, not aortic hypertrophy, is present.
