1.
The nurse explains that a ventricular
septal defect will allow:
a. blood to shunt left to right, causing
increased pulmonary flow and no
cyanosis.
2. The assessment that would lead
the nurse to suspect that a newborn
infant has a ventricular septal defect
is:
a. a loud, harsh murmur with a
systolic tremor.
3. The finding the nurse would
expect when measuring blood
pressure on all four extremities of a
child with coarctation of the aorta is
blood pressure that is:
d. lower in the legs than in the arms.
4. When a father asks why his child
with tetralogy of Fallot seems to
favor a squatting position, the nurse
would explain that squatting:
a. increases the return of venous
blood back to the heart.
5. An infant is experiencing dyspnea
related to patent ductus arteriosus
(PDA). The nurse understands
dyspnea occurs because blood is:
a. circulated through the lungs
again, causing pulmonary circulatory
congestion.
6. An appropriate nursing action
related to the administration of
digoxin (Lanoxin) to an infant would
be:
b. withholding a dose if the apical
heart rate is less than 100
beats/min.
7. A child develops carditis from
rheumatic fever. The nurse knows
that the areas of the heart affected
by carditis are the:
b. heart muscle and the mitral valve.
8. The comment made by a parent
of a 1-month-old that would alert the
nurse about the presence of a
congenital heart defect is:
b. "He tires out during feedings."
9. The nurse is caring for a child with
a diagnosis of Kawasaki disease.
The child's parent asks the nurse,
"How does Kawasaki disease affect
my child's heart and blood vessels?"
The nurse's response is based on
the understanding that:
a. inflammation weakens blood
vessels, leading to aneurysm.
10. The nurse explained how to
position an infant with tetralogy of
Fallot if the infant suddenly becomes
cyanotic. The nurse can determine
the father understood the
instructions when he states "If the
baby turns blue, I will:
a. hold him against my shoulder with
his knees bent up toward his chest."
11. The parent of a 1-year-old child
with tetralogy of Fallot asks the
nurse, "Why do my child's fingertips
look like that?" The nurse bases a
response on the understanding that
clubbing occurs as a result of:
d. chronic hypoxia.
12. A child has an elevated
antistreptolysin O (ASO) titer. Which
combination of symptoms, in
conjunction with this finding, would
confirm a diagnosis of rheumatic
fever?
b. Painful, tender joints and carditis
13. An infant with congestive heart
failure is receiving digoxin (Lanoxin).
The nurse recognizes a sign of
digoxin toxicity, which is:
.
d. vomiting.
14. The nurse is aware that the
infant born with hypoplastic left heart
syndrome must acquire his or her
oxygenated blood through:
d. an atrial septal defect.
15. When the child with rheumatic
fever begins involuntary,
purposeless movements of her
limbs, the nurse recognizes that this
is an indication of:
c. Sydenham's chorea.
16. The nurse clarifies to the parents
of a 4-year-old child recovering from
rheumatic fever that the child will
need to receive monthly injections of
penicillin G for a minimum of _____
year(s).
c. 5
19. How would the nurse caring for
an infant with congestive heart
failure (CHF) modify feeding
techniques to adapt for the child's
weakness and fatigue? Select all
that apply.
a. Feeding more frequently with
smaller feedings
b. Using a soft nipple with enlarged
holes
c. Holding and cuddling the child
during feeding
e. Offering high-caloric formula
20. The nurse uses a diagram to
illustrate what four structural heart
anomalies that comprise tetralogy of
Fallot? Select the four that apply.
a. Hypertrophied right ventricle
b. Patent ductus arteriosus
d. Narrowing of pulmonary artery
e. Dextroposition of aorta
21. What assessment(s) in a child
with tetralogy of Fallot would indicate
the child is experiencing a
paroxysmal hypercyanotic episode?
Select all that apply.
a. Spontaneous cyanosis
b. Dyspnea
c. Weakness
e. Syncope
22. The nurse explains that which
congenital cardiac defect(s) cause(s)
increased pulmonary blood flow?
Select all that apply.
a. Atrial septal defects (ASDs)
d. Patent ductus arteriosus
e. Ventricular septal defects (VSDs)
434. The nurse is monitoring an infant
with congenital heart disease closely for
signs of heart failure (HF). The nurse
should assess the infant for which
EARLY sign of HF?
3. Tachycardia
435. The nurse reviews the laboratory
results for a child with a suspected
diagnosis of rheumatic fever, knowing
that which laboratory study would assist
in confirming the diagnosis?
4. Anti-streptolysin O titer
436. On assessment of a child admitted
with a diagnosis of acute-stage
Kawasaki disease, the nurse expects to
note which clinical manifestation of the
acute stage of the disease?
3. Conjunctival hyperemia
437. The nurse provides home care
instructions to the parents of a child with
heart failure regarding the procedure for
administration of digoxin (Lanoxin).
Which statement made by the parent
indicates the NEED FOR FURTHER
INSTRUCTION?
4. "If my child vomits after medication
administration, I will repeat the dose."
438. The nurse is closely monitoring the
intake and output of an infant with heart
failure who is receiving diuretic therapy.
The nurse should use which MOST
APPROPRIATE method to assess the
urine output?
1. Weighing the diapers
439. The clinic nurse reviews the record
of a child just seen by a health care
provider and diagnosed with suspected
aortic stenosis. The nurse expects to
note documentation of which clinical
manifestation specifically found in this
disorder?
3. Exercise intolerance
440. The nurse has provided home care
instructions to the parents of a child who
is being discharged after cardiac
surgery. Which statement made by the
parents indicates a NEED FOR
FURTHER INSTRUCTIONS?
2. "I can apply lotion or powder to the
incision if it is itchy."
441. A child with rheumatic fever will be
arriving in the nursing unit for admission.
On admission assessment, the nurse
should ask the parents which question
to elicit assessment information specific
to the development of rheumatic fever?
4. "Did the child have a sore throat or
fever within the last 2 months?"
442. A health care provider has
prescribed oxygen as needed for an
infant with heart failure. In which
situation should the nurse administer the
oxygen to the infant?
4. When drawing blood for electrolyte
level testing
443. Assessment findings of an infant
admitted to the hospital reveal a
machinery-like murmur on auscultation
of the heart and signs of heart failure.
The nurse reviews congenital cardiac
anomalies and identifies the infant's
condition as which disorder? REFER TO
FIGURE (the circled area) to determine
the condition. (check book on page 498)
3. Patent ductus arteriosus
The nurse explains that a ventricular
septal defect will allow:
a. blood to shunt left to right, causing
increased pulmonary flow and no
cyanosis.
The assessment that would lead the
nurse to suspect that a newborn infant
has a ventricular septal defect is:
a. a loud, harsh murmur with a systolic
tremor.
The finding the nurse would expect
when measuring blood pressure on all
four extremities of a child with
coarctation of the aorta is blood
pressure that is:
d. lower in the legs than in the arms.
When a father asks why his child with
tetralogy of Fallot seems to favor a
squatting position, the nurse would
explain that squatting:
d. increases the workload of the heart.
An infant is experiencing dyspnea
related to patent ductus arteriosus
(PDA). The nurse understands dyspnea
occurs because blood is:
a. circulated through the lungs again,
causing pulmonary circulatory
congestion.
An appropriate nursing action related to
the administration of digoxin (Lanoxin)
to an infant would be:
b. withholding a dose if the apical heart
rate is less than 100 beats/min.
A child develops carditis from rheumatic
fever. The nurse knows that the areas of
the heart affected by carditis are the:
b. heart muscle and the mitral valve.
The comment made by a parent of a 1-
month-old that would alert the nurse
about the presence of a congenital heart
defect is:
b. "He tires out during feedings."
The nurse explained how to position an
infant with tetralogy of Fallot if the infant
suddenly becomes cyanotic. The nurse
can determine the father understood the
instructions when he states "If the baby
turns blue, I will:

a. hold him against my shoulder with his
knees bent up toward his chest."
The parent of a 1-year-old child with
tetralogy of Fallot asks the nurse, "Why
do my child's fingertips look like that?"
The nurse bases a response on the
understanding that clubbing occurs as a
result of:
d. chronic hypoxia.
A child has an elevated antistreptolysin
O (ASO) titer. Which combination of
symptoms, in conjunction with this
finding, would confirm a diagnosis of
rheumatic fever?
b. Painful, tender joints and carditis
An infant with congestive heart failure is
receiving digoxin (Lanoxin). The nurse
recognizes a sign of digoxin toxicity,
which is:
d. vomiting.
The nurse is aware that the infant born
with hypoplastic left heart syndrome
must acquire his or her oxygenated
blood through:
d. an atrial septal defect.
When the child with rheumatic fever
begins involuntary, purposeless
movements of her limbs, the nurse
recognizes that this is an indication of:
c. Sydenham's chorea.
The nurse clarifies to the parents of a 4-
year-old child recovering from rheumatic
fever that the child will need to receive
monthly injections of penicillin G for a
minimum of _____ year(s).
c. 5
The nurse is aware that the
characteristics of high-density
lipoproteins (HDLs) are that they:
c. have little cholesterol.
The school nurse recommends a heart
healthy diet that limits fats to no more
than ____% of the total dietary intake.
d. 30
19. How would the nurse caring for an
infant with congestive heart failure
(CHF) modify feeding techniques to
adapt for the child's weakness and
fatigue? Select all that apply.
a. Feeding more frequently with smaller
feedings
b. Using a soft nipple with enlarged
holes
c. Holding and cuddling the child during
feeding
e. Offering high-caloric formula
The nurse uses a diagram to illustrate
what four structural heart anomalies that
comprise tetralogy of Fallot? Select the
four that apply.
a. Hypertrophied right ventricle
b. Patent ductus arteriosus
d. Narrowing of pulmonary artery
e. Dextroposition of aorta
ABDE
What assessment(s) in a child with
tetralogy of Fallot would indicate the
child is experiencing a paroxysmal
hypercyanotic episode? Select all that
apply.
a. Spontaneous cyanosis
b. Dyspnea
c. Weakness
e. Syncope
The nurse explains that which
congenital cardiac defect(s) cause(s)
increased pulmonary blood flow? Select
all that apply.
a. Atrial septal defects (ASDs)
d. Patent ductus arteriosus
e. Ventricular septal defects (VSDs)
Which of the following are correct
statements regarding Digoxin
(Lanoxin)? Check all that apply.
A. Digoxin is the drug of choice to
improve myocardial contractility
B. Often prescribed to increase
contractility and decrease afterload
C. ALWAYS check dose with another
Registered Nurse before administration
Which nursing intervention best helps
decrease anxiety for the parents of a
child scheduled for cardiac surgery?
D. Explain the steps that will occur
before and after surgery. The parents
need something tangible to focus on.
Which medication is usually given to
children diagnosed with Kawasaki
disease?
C. Aspirin daily
When palpating the brachial, radial, and
femoral pulses of a neonate, the nurse
notes a difference in pulse amplitude
between the femoral and radial pulses
bilaterally. This difference suggests:
B. Coarctation of the aorta
When caring for a 3 year old with
tetralogy of Fallot, he nurse expects to
see fatigue and poor activity tolerance.
This is caused by:
B. Inadequate oxygenation of tissues.
What congenital heart defect causes
cyanosis in children?
D. Trasposition of the great vessels
The nurse is aware that a common
physiologic adaptation of children with
tetralogy of Fallot is:
A. Clubbing of fingers
The nurse explains to the parents of a 5
year old with a VSD that a cardiac cath
has been scheduled to:
A. Identify the specific location of the
defect
1. Which of the following arteries
primarily feeds the anterior wall
of the heart?
C. Left anterior descending artery
2. When do coronary arteries
primarily receive blood flow?
B. During diastole
3. Which of the following
illnesses is the leading cause of
death in the US?
B. Coronary artery disease
4. Which of the following
conditions most commonly
results in CAD?
A. Atherosclerosis
5. Atherosclerosis impedes
coronary blood flow by which of
the following mechanisms?
B. Plaques obstruct the artery
6. Which of the following risk
factors for coronary artery
disease cannot be corrected?
C. Heredity
7. Exceeding which of the
following serum cholesterol
levels significantly increases the
risk of coronary artery disease?
D. 200 mg/dl
8. Which of the following actions
is the first priority care for a
client exhibiting signs and
symptoms of coronary artery
disease?
B. Enhance myocardial oxygenation
9. Medical treatment of coronary
artery disease includes which of
the following procedures?
C. Oral medication administration
10. Prolonged occlusion of the
right coronary artery produces
an infarction in which of the
following areas of the heart?
C. Inferior
11. Which of the following is the
most common symptom of
myocardial infarction?
A. Chest pain
12. Which of the following
landmarks is the correct one for
obtaining an apical pulse?
B. Left fifth intercostal space,
midclavicular line
13. Which of the following
systems is the most likely origin
of pain the client describes as
knifelike chest pain that
increases in intensity with
inspiration?
D. Pulmonary
14. A murmur is heard at the
second left intercostal space
along the left sternal border.
Which valve area is this?
C. Pulmonic
15. Which of the following blood
tests is most indicative of
cardiac damage?
C. Troponin I
16. What is the primary reason
for administering morphine to a
client with myocardial
infarction?
D. To decrease oxygen demand on
the client’s heart
17. Which of
the following conditions is most
commonly responsible for
myocardial infarction?
C. Coronary artery thrombosis
18. What supplemental
medication is most frequently
ordered in conjuction with
furosemide (Lasix)?
C. Potassium
19. After myocardial infarction,
serum glucose levels and free
fatty acids are both increased.
What type of physiologic changes
are these?
D. Metabolic
20. Which of the following
complications is indicated by a
third heart sound (S3)?
A. Ventricular dilation
21. After an anterior wall
myocardial infarction, which of
the following problems is
indicated by auscultation of
crackles in the lungs?
A. Left-sided heart failure
22. Which of the following
diagnostic tools is most
commonly used to determine
the location of myocardial
damage?
D. Electrocardiogram
23. What is the first intervention
for a client experiencing
myocardial infarction?
B. Administer oxygen
24. What is the most appropriate
nursing response to a myocardial
infarction client who is fearful of
dying?
A. “Tell me about your feeling right
now.”
25. Which of the following
classes of medications protects
the ischemic myocardium by
blocking catecholamines and
sympathetic nerve stimulation?
A. Beta-adrenergic blockers
26. What is the most common
complication of a myocardial
infarction?
C. Arrhythmias
27. With which of the following
disorders is jugular vein
distention most prominent?
B. Heart failure
28. What position should
the nurse place the head of the
bed in to obtain the most
accurate reading of jugular vein
distention?
C. Raised 30 degrees
29. Which of the following
parameters should be checked
before administering digoxin?
A. Apical pulse
30. Toxicity from which of the
following medications may cause
a client to see a green halo
around lights?
A. Digoxin
31. Which of the following
symptoms is most commonly
associated with left-sided heart
failure?
A. Crackles
32. In which of the following
disorders would the nurse
expect to assess sacral edema in
bedridden client?
D. Right-sided heart failure
33. Which of the following
symptoms might a client with
right-sided heart failure exhibit?
C. Oliguria
34. Which of the following
classes of medications
maximizes cardiac performance
in clients with heart failure by
increasing ventricular
contractility?
D. Inotropic agents
35. Stimulation of the
sympathetic nervous
system produces which of the
following responses?
B. Tachycardia
36. Which of the following
conditions is most closely
associated with weight
gain, nausea, and a decrease in
urine output?
D. Right-sided heart failure
37. What is the most common
cause of abdominal aortic
aneurysm?
A. Atherosclerosis
38. In which of the following
areas is an abdominal aortic
aneurysm most commonly
located?
B. Distal to the renal arteries
39. A pulsating abdominal mass
usually indicates which of the
following conditions?
A. Abdominal aortic aneurysm
40. What is the most common
symptom in a client with
abdominal aortic aneurysm?
A. Abdominal pain
41. Which of the following
symptoms usually signifies rapid
expansion and impending
rupture of an abdominal aortic
aneurysm?
D. Lower back pain
42. What is the definitive test
used to diagnose an abdominal
aortic aneurysm?
B. Arteriogram
43. Which of the following
complications is of greatest
concern when caring for a
preoperative abdominal
aneurysm client?
B. Aneurysm rupture
44. Which of the following blood
vessel layers may be damaged in
a client with an aneurysm?
C. Media
45. When assessing a client for
an abdominal aortic aneurysm,
which area of the abdomen is
most commonly palpated?
B. Directly over the umbilicus
46. Which of the following
conditions is linked to more than
50% of clients with abdominal
aortic aneurysms?
B. HPN
47. Which of the following
sounds is distinctly heard on
auscultation over the abdominal
region of an abdominal aortic
aneurysm client?
A. Bruit
48. Which of the following groups
of symptoms indicated a
ruptured abdominal aneurysm?
B. Severe lower back pain,
decreased BP, decreased RBC,
increased WBC
49. Which of the following
complications of an abdominal
aortic repair is indicated by
detection of a hematoma in the
perineal area?
C. Retroperitoneal rupture at the
repair site
50. Which hereditary disease is
most closely linked to
aneurysm?
C. Marfan’s syndrome
51. Which of the following
treatments is the definitive one
for a ruptured aneurysm?
D. Surgical intervention
52. Which of the following
heart muscle diseases is
unrelated to other
cardiovascular diseases?
A. Cardiomyopathy
53. Which of the following types
of cardiomyopathy can be
associated with childbirth?
A. Dilated
54. Septal involvement occurs in
which type of cardiomyopathy?
C. Hypertrophic
55. Which of the following
recurring conditions most
commonly occurs in clients with
cardiomyopathy?
A. Heart failure
56. What is the term used to
describe an enlargement of the
heart muscle?
A. Cardiomegaly
57. Dyspnea, cough,
expectoration, weakness, and
edema are classic signs and
symptoms of which of the
following conditions?
D. Restrictive
58. Which of the following types
of cardiomyopathy does not
affect cardiac output?
B. Hypertrophic
59. Which of the following
cardiac conditions does a fourth
heart sound (S4) indicate?
D. Failure of the ventricle to eject
all the blood during systole

60. Which of the following

classes of drugs is most widely
used in the treatment of
cardiomyopathy?
B. Beta-adrenergic blockers