21. An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse’s first action should be to:

a. assess for neurologic defects.

b. place the child in the knee-chest position.

c. begin cardiopulmonary resuscitation.

d. prepare family for imminent death.

22. The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which is an important objective to decrease this risk?

a. Minimize seizures.

b. Prevent dehydration.

c. Promote cardiac output.

d. Reduce energy expenditure.

23. Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse’s reply should be based on which statement?

a. Child needs opportunities to play with peers.

b. Child needs to understand that peers’ activities are too strenuous.

c. Parents can meet all of the child’s needs.

d. Constant parental supervision is needed to avoid overexertion.

24. Which should the nurse consider when preparing a school-age child and the family for heart surgery?

a. Unfamiliar equipment should not be shown.

b. Let child hear the sounds of an ECG monitor.

c. Avoid mentioning postoperative discomfort and interventions.

d. Explain that an endotracheal tube will not be needed if the surgery goes well.

25. Seventy-two hours after cardiac surgery, a young child has a temperature of 101° F. Which action should the nurse take?

a. Keep child warm with blankets.

b. Apply a hypothermia blanket.

c. Record temperature on nurses’ notes.

d. Report findings to physician.

26. Which is an important nursing consideration when suctioning a young child who has had heart surgery?

a. Perform suctioning at least every hour.

b. Suction for no longer than 30 seconds at a time.

c. Administer supplemental oxygen before and after suctioning.

d. Expect symptoms of respiratory distress when suctioning.

27. The nurse is caring for a child after heart surgery. Which should the nurse do if evidence is found of cardiac tamponade?

a. Increase analgesia.

b. Apply warming blankets.

c. Immediately report this to physician.

d. Encourage child to cough, turn, and breathe deeply.

28. Which is an important nursing consideration when chest tubes will be removed from a child?

a. Explain that it is not painful.

b. Explain that only a Band-Aid will be needed.

c. Administer analgesics before procedure.

d. Expect bright red drainage for several hours after removal.

29. Which is the most common causative agent of bacterial endocarditis?

a. Staphylococcus albus

b. Streptococcus hemolyticus

c. Staphylococcus albicans

d. Streptococcus viridans

30. Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?

a. Osler nodes

b. Janeway lesions

c. Subcutaneous nodules

d. Aschoff nodes