Chapter 26: The Child with a Cardiovascular
Disorder
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated
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 pumping blood to both the lungs and
systemic circulation, the ductus arteriosus must remain open to shunt the oxygenated blood
from the lungs.
DIF: Cognitive Level: Knowledge REF: p. 630 OBJ: 3
TOP: Hypoplastic Left Heart Syndrome KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What
does the nurse recognize that this indicates?
a. Seizure activity
b. Hypoxia
c. Sydenham‘s chorea
d. Decreasing level of consciousness
ANS: C
As the effects of rheumatic fever affect the central nervous system, the child may develop
Sydenham‘s chorea, manifested by involuntary, purposeless movements of the limbs.
, DIF: Cognitive Level: Knowledge REF: p. 634 OBJ: 6
TOP: Sydenham‘s Chorea KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. How long should a 4-year-old child recovering from rheumatic fever need to receive monthly
injections of penicillin G?
a. 1 year
b. 2 years
c. 5 years
d. 10 years
ANS: C
Children who recover from rheumatic fever should have a chemoprophylaxis protocol of
penicillin G injections (about 200,000 units per dose) for a minimum of 5 years or up to the
age of 18 years to prevent further bouts of rheumatic fever.
DIF: Cognitive Level: Knowledge REF: p. 635 OBJ: 7
TOP: Prophylaxis for Rheumatic Fever KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
4. What is accurate about the characteristics of high-density lipoproteins (HDLs)?
a. They have high amounts of triglycerides.
b. They have only small amounts of protein.
c. They have little cholesterol.
d. They aid in steroid production.
ANS: C
HDLs have low amounts of triglycerides, large amounts of proteins, and low amount of
cholesterol, and are excreted via the liver. They have no role in the production of steroids.
DIF: Cognitive Level: Knowledge REF: p. 637 OBJ: 11
TOP: High-Density Lipoproteins KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
Disorder
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated
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 pumping blood to both the lungs and
systemic circulation, the ductus arteriosus must remain open to shunt the oxygenated blood
from the lungs.
DIF: Cognitive Level: Knowledge REF: p. 630 OBJ: 3
TOP: Hypoplastic Left Heart Syndrome KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What
does the nurse recognize that this indicates?
a. Seizure activity
b. Hypoxia
c. Sydenham‘s chorea
d. Decreasing level of consciousness
ANS: C
As the effects of rheumatic fever affect the central nervous system, the child may develop
Sydenham‘s chorea, manifested by involuntary, purposeless movements of the limbs.
, DIF: Cognitive Level: Knowledge REF: p. 634 OBJ: 6
TOP: Sydenham‘s Chorea KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. How long should a 4-year-old child recovering from rheumatic fever need to receive monthly
injections of penicillin G?
a. 1 year
b. 2 years
c. 5 years
d. 10 years
ANS: C
Children who recover from rheumatic fever should have a chemoprophylaxis protocol of
penicillin G injections (about 200,000 units per dose) for a minimum of 5 years or up to the
age of 18 years to prevent further bouts of rheumatic fever.
DIF: Cognitive Level: Knowledge REF: p. 635 OBJ: 7
TOP: Prophylaxis for Rheumatic Fever KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
4. What is accurate about the characteristics of high-density lipoproteins (HDLs)?
a. They have high amounts of triglycerides.
b. They have only small amounts of protein.
c. They have little cholesterol.
d. They aid in steroid production.
ANS: C
HDLs have low amounts of triglycerides, large amounts of proteins, and low amount of
cholesterol, and are excreted via the liver. They have no role in the production of steroids.
DIF: Cognitive Level: Knowledge REF: p. 637 OBJ: 11
TOP: High-Density Lipoproteins KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
