Please answer these questions   1. Which condition is the most…

Please answer these questions

 

1. Which condition is the most common heart defect found in children with Down syndrome?

1. Septal defects 
2. Coarctation of the aorta 
3. Aortic stenosis 
4. Congestive heart failure 

 

2.Which clinical manifestation would not be expected on the assessment of a child with Down syndrome?

1. Separated sagittal suture 
2. Upward, outward slant of eye fissures 
3. Large nasal septum 
4. Hyperflexibility of the muscles 

 

3.Which clinical manifestations might a nurse expect to observe in a patient with complications from ventricular septal defect?

1. Systolic murmur, atrial fibrillation, and bibasilar crackles 
2. Diastolic murmur, bounding pulses, and bibasilar crackles 
3. Holosystolic murmur, bibasilar crackles, and tachypnea 
4. Systolic murmur, hypertension, and dyspnea 

 

4.Which medication is primarily used to improve cardiac function in children?

1. Amiodarone 
2. Enalapril 
3. Lidocaine 
4. Digoxin 

 

5.Which signs and symptoms are indicative of digoxin toxicity in the pediatric patient? Select all that apply.

1. Nausea 
2. Dysrhythmias 
3. Vomiting 
4. Tachycardia 

 

6.A nurse is caring for a pediatric patient who is receiving furosemide for the treatment of congestive heart failure. The nurse notes frequent premature ventricular contractions (PVCs) on the cardiac monitor, which were not present earlier. Which order might the nurse anticipate?

1. Check serum potassium level 
2. Strict intakes and outputs 
3. Obtain 12-lead ECG 
4. Administer an anti-emetic 

 

7.A nurse is caring for a pediatric patient with a diagnosis of congestive heart failure. In her nursing care plan, the desired outcome for this patient is to have adequate cardiac output. Which clinical sign or symptom would be the best objective indicator of adequate cardiac output?

1. 1 kg weight loss 
2. Child free of pain 
3. Capillary refill of less than 2 seconds 
4. Sinus tachycardia on the monitor 

 

8.A nurse is preparing to administer digoxin to a pediatric patient with a cardiac abnormality. Which assessment is appropriate prior to the administration of digoxin?

1. Count apical heart rate for 1 minute 
2. Check most current serum potassium level 
3. Check most current serum digoxin level
4. All of the above are appropriate interventions for the nurse to complete 

 

9.A nurse is feeding a 9-month-old female patient with Down syndrome. During the feeding, the patient continues to thrust her tongue forward at the nurse. The nurse knows that this is most likely:

1. a sign that the patient is refusing to eat. 
2. a physiologic manifestation of Down syndrome. 
3. a developmental delay consistent with Down syndrome. 
4. a sign that the patient is not able to protect her airway. 

 

10.Which feeding goal is appropriate for a newborn admitted with heart failure in order to meet the newborn’s metabolic demands?

1. 150 mL/kg/day of formula 
2. Enough formula to produce a wet diaper every 3 hours 
3. 100 mL/kg/day of formula 
4. NPO until discharge 

 

11.When reviewing the chest x-ray results in Isabella’s chart, which objective sign assessed by the nurse is most clinically consistent with the radiographic findings related to heart failure?

1. Febrile 
2. PVCs on monitor 
3. Bibasilar crackles 
4. Cough 

 

12.After resolving Isabella’s hypokalemia, the nurse is planning to administer digoxin IV to the patient. The digoxin on hand is 100 mcg/1 mL. The nurse has drawn up a volume of 1 mL to administer to Isabella. Which statement regarding this planned medication administration is true?

1. Digoxin always needs to be diluted in 1 mL of solution. 
2. This amount should be a red flag for a dosage error. 
3. This is the correct dose to administer to Isabella. 
4. The rate of administration of IV digoxin is over 15 seconds. 

 

13.Which description best describes Isabella’s level of developmental functioning?

1. Delayed based on her chronological age
2. Appropriate based on her diagnosis of Down syndrome 
3. Not applicable to her hospitalization, related to the acuteness of her disease process 
4. Advanced based on her chronological age 

 

14.What would be the worst potential clinical outcome of failing to prioritize potassium administration for Isabella?

1. A life-threatening cardiac ventricular arrhythmia 
2. Continued nausea 
3. Pulmonary edema 
4. Neurogenic shock 

 

15.Isabella’s mother asks the nurse what the reason is for Isabella’s heart failure. What would be the best response to address the mother’s question?

1. “Heart failure is most likely a complication of her ventricular septal defect.” 
2. “Her heart failure is most likely related to her having Down syndrome.” 
3. “Her heart failure is most likely related to excessive fluid from an infection.” 
4. “Her heart failure is most likely related to her tetralogy of Fallot.” 

 

16.Which explanation correctly identifies the reason an echocardiogram was ordered for Isabella?

1. To monitor arrhythmias for 24 hours 
2. To comply with the standard of care for all hospitalized children with Down syndrome 
3. To visualize Isabella’s coronary arteries 
4. To determine ventricular function and validate the cause of heart failure 

 

17.Which sympathetic nervous system responses are seen in congestive heart failure? Select all that apply.

1. Sweating from stimulation of cholinergic fibers 
2. Decreased capillary refill related to peripheral vasoconstriction 
3. Tachycardia related to increased rate and force of contraction 
4. Bradycardia related to increased production of renin 

 

18.Isabella’s heart failure is most likely resultant from her ventricular septal defect (VSD). Which statement best describes a VSD?

1. Defect characterized by failure of the pulmonary veins to join the left atrium 
2. Defect characterized by the failure of the tricuspid valve to develop 
3. Defect characterized by a narrowing at the entrance to the pulmonary artery 
4. Defect characterized by an abnormal opening between the right and left ventricles 

 

 

 

 

 

 

19.If Isabella’s ventricular septal defect is not repaired, she will be at risk for:

1. cardiovascular collapse. 
2. ventricular arrhythmias. 
3. anoxic spells. 
4. pulmonary vascular obstructive disease. 

 

20.Which clinical manifestation of heart failure is most consistent with systemic venous congestion?

1. Dyspnea, weakness, and poor feeding 
2. Exercise intolerance, dyspnea, and wheezing 
3. Peripheral edema, weight gain, and hepatomegaly 
4. Loss of skin elasticity, edema, and flushing 

 

 

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