Deck 25: Cardiac Structural Disorders

Question 1

What is the best response for the nurse to make when the parents of an infant, born with a congenital heart defect, ask the cause of the condition?

A) "It is caused by a genetic defect."
B) "It is caused by environmental factors."
C) "The cause is multifactorial."
D) "The cause is not known."

Answer 1

"The cause is multifactorial."

Question 2

When teaching a prenatal class, the nurse tells the class that the first fetal heart beat occurs:

A) on day 12.
B) on day 22.
C) on day 32.
D) at the end of the first trimester.

Answer 2

on day 22.

Question 3

What response should the nurse give, while teaching a prenatal class, when asked when cardiac defects occur?

A) "They may occur any time during gestation."
B) "They occur by the end of the ninth week."
C) "They occur before implantation has occurred."
D) "They occur shortly before birth."

Answer 3

"They occur by the end of the ninth week."

Question 4

An experienced labor and delivery nurse is orienting nurses new to labor and delivery. Which of the following does the experienced nurse teach about fetal circulation?

A) Oxygenated blood is carried to the fetus via the umbilical artery.
B) Oxygenated blood enters the right atrium.
C) Most of the blood in the right atrium crosses the foramen ovale into the left atrium.
D) Blood entering the right ventricle is pumped to the lungs.

Question 5

When assessing a newborn immediately after birth, which concept should the nurse keep in mind?

A) Pulmonary pressures rise.
B) Left atrial pressure rises.
C) Right atrial pressure rises.
D) Systemic vascular resistance falls.

Question 6

When performing a screening for critical congenital heart disease (CCHD), where should the nurse obtain the preductal pulse oximeter reading?

A) From the right hand
B) From the left hand
C) From the right foot
D) From the left foot

Question 7

What is the best response by the nurse when the mother of a 24-hour-old newborn asks why her baby is being screened for congenital heart disease?

A) "We don't trust you to notice possible heart problems in your baby."
B) "This is a routine mandatory newborn screening."
C) "Your baby's skin color is a little red."
D) "The doctor heard a heart murmur which is not normal at this stage after delivery."

Question 8

Which finding would alert the nurse to a potential problem in a newborn undergoing critical congenital heart disease testing?

A) An SpO₂ of 94% on room air on the right hand and right foot
B) An SpO₂ of 98% on room air on the right hand and right foot
C) An SpO₂ of 96% on room air on the right hand with less than a 3% difference on the left foot
D) An SpO₂ of 98% on room air on the right hand and left foot

Question 9

The nurse is explaining the goals of the Congenital Heart Disease Genetic Network Study (CHD GENES) to a couple considering genetic screening for congenital defects. Which statement by a parent indicates that more teaching is needed?

A) "There is a strong genetic role in the development of congenital heart disease."
B) "A goal of this study is to identify how genetics affects clinical outcomes."
C) "This study will help develop new therapies."
D) "This study has positively identified ways to prevent congenital heart disease."

Question 10

The nurse is performing a cardiac assessment on a newborn. Which findings would the nurse expect in a grade 4 murmur?

A) Murmur is barely audible.
B) Murmur is loud, but without a thrill.
C) Murmur is loud with a palpable thrill.
D) Murmur is audible without a stethoscope.

Question 11

When assessing a baby for a murmur caused by an atrial septal defect, where should the nurse place the stethoscope?

A) Upper left sternal border
B) Upper right sternal border
C) Lower left sternal border
D) Apex

Question 12

To improve ventricular contractility in a child with a ventricular septal defect, the nurse would expect to administer:

A) a diuretic.
B) a cardiac glycoside.
C) an ACE inhibitor.
D) an aldosterone receptor blocker.

Question 13

Which compensatory position will the nurse observe in a child with tetralogy of Fallot (TOF) who is experiencing a hypercyanotic spell?

A) In a high-Fowler position
B) Supine with the legs elevated
C) With knees pulled up to chest
D) On the left side

Question 14

Which medication would the nurse give to prevent renal reabsorption of sodium and chloride in the infant with pulmonary congestion secondary to congenital heart disease?

A) Prostaglandin
B) Loop diuretic
C) Inotropes
D) ACE inhibitors

Question 15

When assessing a patient with Ebstein anomaly, the nurse should assess for an anomaly of which heart valve?

A) Pulmonic valve
B) Mitral valve
C) Aortic valve
D) Tricuspid valve

Question 16

Which finding would the nurse expect to auscultate in a patient with rheumatic heart disease causing mitral stenosis?

A) Loud S1, split S2
B) S3 and S4 heart sounds
C) Loud high-pitched rumbling murmur
D) Murmur on diastole

Question 17

The nurse, assessing a patient with endocarditis, notes small red painful growths on the fingers and toe pads. The nurse documents these findings as:

A) Osler nodes.
B) Janeway lesions.
C) Roth spots.
D) Ebstein anomaly.

Question 18

Which information should the nurse include in the teaching plan for a patient receiving a biologic valve replacement?

A) Anticoagulation will be necessary.
B) An audible click may be heard.
C) There is a low risk of thromboemboli.
D) The valve may need to be replaced in the future.

Question 19

Which intervention should the nurse anticipate performing first after the birth of an infant with hypoplastic left heart syndrome?

A) Preparing the infant for surgery
B) Administering a prostaglandin infusion
C) Placing the infant on the transplant list
D) Preparing the parents for the death of the infant

Question 20

Which finding should the nurse anticipate in an infant with coarctation of the aorta?

A) Higher right ventricular pressure than left ventricular pressure
B) Lower blood pressure in the lower extremities than the upper extremities
C) Higher blood pressure in the upper extremities than the lower extremities
D) Higher blood pressure in the left arm tan the right arm