NURS 3730 Exam 3 Questions with
Correct Answers
Indication for permanent pacemaker - ANSWER-- If they had an MI that wiped out
their SA node, they will need a device that initiates the pace of the heart (like the SA
node did)
What if you notice a pacing spike & then nothing on an EKG? - ANSWER-- It means
failure to capture --> MANDATORY REPORTING because the spike did not
generate an impulse
What's important to teach our patients with surgically implanted
cardioverter/defrbillator? - ANSWER-- If they feel their HR up, they need to SIT down
& STOP whatever they're doing because they will feel a shock & if they're driving
they will crash
- They cannot have an MRI (it's a magnet)
In fetal circulation, the majority of the most oxygenated blood is pumped through the:
A. Foramen Ovale
B. Lungs
C. Liver
D. Coronary Sinus - ANSWER-A. Foramen Ovale
In utero, gas transport occurs where? - ANSWER-At the placenta
At birth, oxygenation shifts from the placenta to where? - ANSWER-Lungs
Expanded lungs & open pulmonary vasculature dramatically decreases what? -
ANSWER-Right-sided pressure
Foramen ovale closes as pressure in what exceeds what? - ANSWER-Pressure in
the left atrium exceeds pressure in the right atrium
Ductus arteriosus closes as a result of? - ANSWER-Decreased prostaglandin levels
& increased oxygen concentration
Chronic hypoxemia results in what? - ANSWER-- Polycythemia
- Increased RR
- Tachycardia
Why does polycythemia occur in chronic hypoxemia? - ANSWER-It's a
compensatory mechanism. Body thinks we need more oxygen carrying capacity.
What does polycythemia put the patient at risk for? - ANSWER-Blood will be more
viscous, so they are at an increased risk for clots & clogging
,Sudden hypoxemia results in what? - ANSWER-Bradycardia
What's the first line treatment for bradycardia in children? - ANSWER-Oxygen
Give examples of volume overload - ANSWER-- Excess IV fluid
- Defect that allows more blood than normal to get somewhere it isn't supposed to be
going (ex: patent foramen ovale)
Give examples of pressure overload - ANSWER-- Pulmonic stenosis
- Aortic stenosis
- Systemic HTN
- Pulmonary HTN
Increased afterload = - ANSWER-Increased workload of the heart & blood will begin
to back up to where it came from
Give examples of decreased contractility - ANSWER-- HF
- Cardiomegaly
- Hypoplastic L. Heart Syndrome
Give examples of reasons for high cardiac output demands - ANSWER-- Exercise
- Pregnancy
- Sepsis
What will our patient look like with right-sided HF? - ANSWER-- Blood backs up into
systemic circulation, so jugular vein distention, hepatomegaly, splenomegaly,
dependent/pitting edema, etc.
What will our patient look like with left-sided HF? - ANSWER-- Blood backs up into
pulmonary circulation, so crackles, orthopnea, exercise intolerance, pink/frothy
sputum, dyspnea
How significant is "poor feeding?" - ANSWER-It's usually the chief complaint for an
infant with a heart problem, so it's very serious because a baby that will not eat, will
not survive. Maybe sucking & swallowing is too tiring because all their energy is
going to breathing & staying alive. They're exhausted & exerted.
What are some labs/diagnostic studies for a child with a heart problem? - ANSWER--
Baseline pulse ox reading
- CBC (looking for polycythemia)
- ABGs
- Platelet count (newborns have higher platelet count)
- Prothrombin time (if they're on an anticoagulant)
- Clotting factors
- Drug levels
- EKG monitoring
- Cardiac enzymes
What are [2] goals of cardiac symptom management? - ANSWER-- Improve cardiac
function/efficiency
, - Remove accumulated sodium & fluid
How will we accomplish these goals (improve cardiac function/efficiency & removing
accumulated sodium & fluid)? - ANSWER-- Diuretics (removes excess fluid)
- Inotropic drugs like Digoxin to improve cardiac contractility
- ACE-inhibitors/Beta-blockers/CCB to reduce afterload
- Viagra
- Squatting & positioning reduces preload by reducing venous return
What drug reduces pulmonary HTN? - ANSWER-Viagra
How does Viagra reduce pulmonary HTN? - ANSWER-It relaxes vascular smooth
muscle, which reduces the workload on the right ventricle
When caring for a child who is receiving both Digoxin & Lasix, the nurse should be
particularly alert for s/s of:
A. Hypokalemia
B. Hyponatremia
C. Hypoglycemia
D. Hypocalcemia - ANSWER-A. Hypokalemia: because lasix causes potassium
wasting & low potassium causes Dig toxicity
Nutritional needs of an infant with congenital heart disease are usually:
A. The same as an adult's
B. Less than a healthy infant's
C. Same as a healthy infant's
D. Greater than a healthy infants - ANSWER-D. Greater than a healthy infant's
What's a big nursing consideration for pre-cardiac catheterization? - ANSWER-Take
baseline pulses
What are [3] nursing considerations for post-cardiac catheterization? - ANSWER--
Assess site
- Measure pulses bilaterally (& compare them to pre-op)
- Monitor EKG (assess for dysrhythmias)
What artery is usually used on babies for a cardiac catheterization? - ANSWER-
Femoral because radial is too small
Why do we sedate babies a little more for a longer amount of time for a heart cath? -
ANSWER-They have to lay straight for a long amount of time
What is a consideration for both adults & children after heart surgery? - ANSWER-
The parents have to be checked off on CPR
Developmental delays in infants w/ congenital heart disease are most pronounced in
which area?
A. Fine motor skill
B. Gross motor skill
C. Social skill
Correct Answers
Indication for permanent pacemaker - ANSWER-- If they had an MI that wiped out
their SA node, they will need a device that initiates the pace of the heart (like the SA
node did)
What if you notice a pacing spike & then nothing on an EKG? - ANSWER-- It means
failure to capture --> MANDATORY REPORTING because the spike did not
generate an impulse
What's important to teach our patients with surgically implanted
cardioverter/defrbillator? - ANSWER-- If they feel their HR up, they need to SIT down
& STOP whatever they're doing because they will feel a shock & if they're driving
they will crash
- They cannot have an MRI (it's a magnet)
In fetal circulation, the majority of the most oxygenated blood is pumped through the:
A. Foramen Ovale
B. Lungs
C. Liver
D. Coronary Sinus - ANSWER-A. Foramen Ovale
In utero, gas transport occurs where? - ANSWER-At the placenta
At birth, oxygenation shifts from the placenta to where? - ANSWER-Lungs
Expanded lungs & open pulmonary vasculature dramatically decreases what? -
ANSWER-Right-sided pressure
Foramen ovale closes as pressure in what exceeds what? - ANSWER-Pressure in
the left atrium exceeds pressure in the right atrium
Ductus arteriosus closes as a result of? - ANSWER-Decreased prostaglandin levels
& increased oxygen concentration
Chronic hypoxemia results in what? - ANSWER-- Polycythemia
- Increased RR
- Tachycardia
Why does polycythemia occur in chronic hypoxemia? - ANSWER-It's a
compensatory mechanism. Body thinks we need more oxygen carrying capacity.
What does polycythemia put the patient at risk for? - ANSWER-Blood will be more
viscous, so they are at an increased risk for clots & clogging
,Sudden hypoxemia results in what? - ANSWER-Bradycardia
What's the first line treatment for bradycardia in children? - ANSWER-Oxygen
Give examples of volume overload - ANSWER-- Excess IV fluid
- Defect that allows more blood than normal to get somewhere it isn't supposed to be
going (ex: patent foramen ovale)
Give examples of pressure overload - ANSWER-- Pulmonic stenosis
- Aortic stenosis
- Systemic HTN
- Pulmonary HTN
Increased afterload = - ANSWER-Increased workload of the heart & blood will begin
to back up to where it came from
Give examples of decreased contractility - ANSWER-- HF
- Cardiomegaly
- Hypoplastic L. Heart Syndrome
Give examples of reasons for high cardiac output demands - ANSWER-- Exercise
- Pregnancy
- Sepsis
What will our patient look like with right-sided HF? - ANSWER-- Blood backs up into
systemic circulation, so jugular vein distention, hepatomegaly, splenomegaly,
dependent/pitting edema, etc.
What will our patient look like with left-sided HF? - ANSWER-- Blood backs up into
pulmonary circulation, so crackles, orthopnea, exercise intolerance, pink/frothy
sputum, dyspnea
How significant is "poor feeding?" - ANSWER-It's usually the chief complaint for an
infant with a heart problem, so it's very serious because a baby that will not eat, will
not survive. Maybe sucking & swallowing is too tiring because all their energy is
going to breathing & staying alive. They're exhausted & exerted.
What are some labs/diagnostic studies for a child with a heart problem? - ANSWER--
Baseline pulse ox reading
- CBC (looking for polycythemia)
- ABGs
- Platelet count (newborns have higher platelet count)
- Prothrombin time (if they're on an anticoagulant)
- Clotting factors
- Drug levels
- EKG monitoring
- Cardiac enzymes
What are [2] goals of cardiac symptom management? - ANSWER-- Improve cardiac
function/efficiency
, - Remove accumulated sodium & fluid
How will we accomplish these goals (improve cardiac function/efficiency & removing
accumulated sodium & fluid)? - ANSWER-- Diuretics (removes excess fluid)
- Inotropic drugs like Digoxin to improve cardiac contractility
- ACE-inhibitors/Beta-blockers/CCB to reduce afterload
- Viagra
- Squatting & positioning reduces preload by reducing venous return
What drug reduces pulmonary HTN? - ANSWER-Viagra
How does Viagra reduce pulmonary HTN? - ANSWER-It relaxes vascular smooth
muscle, which reduces the workload on the right ventricle
When caring for a child who is receiving both Digoxin & Lasix, the nurse should be
particularly alert for s/s of:
A. Hypokalemia
B. Hyponatremia
C. Hypoglycemia
D. Hypocalcemia - ANSWER-A. Hypokalemia: because lasix causes potassium
wasting & low potassium causes Dig toxicity
Nutritional needs of an infant with congenital heart disease are usually:
A. The same as an adult's
B. Less than a healthy infant's
C. Same as a healthy infant's
D. Greater than a healthy infants - ANSWER-D. Greater than a healthy infant's
What's a big nursing consideration for pre-cardiac catheterization? - ANSWER-Take
baseline pulses
What are [3] nursing considerations for post-cardiac catheterization? - ANSWER--
Assess site
- Measure pulses bilaterally (& compare them to pre-op)
- Monitor EKG (assess for dysrhythmias)
What artery is usually used on babies for a cardiac catheterization? - ANSWER-
Femoral because radial is too small
Why do we sedate babies a little more for a longer amount of time for a heart cath? -
ANSWER-They have to lay straight for a long amount of time
What is a consideration for both adults & children after heart surgery? - ANSWER-
The parents have to be checked off on CPR
Developmental delays in infants w/ congenital heart disease are most pronounced in
which area?
A. Fine motor skill
B. Gross motor skill
C. Social skill
