Pathophysiology Chapter 34 Alterations of Cardiovascular Function in Children

Chapter 34: Alterations of Cardiovascular Function in Children

MULTIPLE CHOICE

1.            Most cardiovascular developments occur between which weeks of gestation?

a.            Fourth and seventh weeks

b.            Eighth and tenth weeks

c.             Twelfth and fourteenth weeks

d.            Fifteenth and seventeenth weeks

2.            The presence of the foramen ovale in a fetus allows what to occur?

a.            Right-to-left blood shunting

b.            Left-to-right blood shunting

c.             Blood flow from the umbilical cord

d.            Blood flow to the lungs

3.            The student studying pathophysiology learns which fact about circulation at birth?

a.            Systemic resistance and pulmonary resistance fall.

b.            Gas exchange shifts from the placenta to the lung.

c.             Systemic resistance falls and pulmonary resistance rises.

d.            Systemic resistance and pulmonary resistance rise.

4.            When does systemic vascular resistance in infants begin to increase?

a.            One month before birth

b.            During the beginning stage of labor

c.             One hour after birth

 d.           Once the placenta is removed from circulation

5.            Which event triggers congenital heart defects that cause acyanotic congestive heart failure?

a.            Right-to-left shunts

b.            Left-to-right shunts

c.             Obstructive lesions

d.            Mixed lesions

6.            Older children with an unrepaired cardiac septal defect experience cyanosis because of which factor?

a.            Right-to-left shunts

b.            Left-to-right shunts

c.             Obstructive lesions

d.            Mixed lesions

7.            A baby has been born with Down syndrome. What congenital heart defect does the healthcare professional assess this baby for?

a.            Coarctation of the aorta (COA)

b.            Tetralogy of Fallot

c.             Atrial septal defect (ASD)

d.            Ventricular septal defect (VSD)

8.            An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole. The healthcare professional suspects a congenital heart disorder. What other assessment finding is inconsistent with the professional’s knowledge about this disorder?

a.            Bounding pulses

b.            Active precordium

c.             Thrill on palpation

d.            Signs of heart failure

9.            An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. The healthcare professional suspects an atrial septal defect (ASD). For what other manifestation does the healthcare professional assess to confirm the suspicion?

a.            Wide, fixed splitting of the second heart sound

b.            Loud, harsh holosystolic murmur

c.             Cyanosis with crying and feeding

d.            Rapid deterioration with acidosis

10.          An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?

a.            Atrial septal defect (ASD)

b.            Ventricular septal defect (VSD)

c.             Patent ductus arteriosus (PDA)

d.            Atrioventricular canal (AVC) defect

11.          Where can coarctation of the aorta (COA) be located?

a.            Exclusively on the aortic arch

b.            Proximal to the brachiocephalic artery

c.             Between the origin of the aortic arch and the bifurcation of the aorta in the lower abdomen

d.            Between the origin of the aortic arch and the origin of the first intercostal artery

12.          A parent brings a 10-year-old child to the clinic and reports a mottled appearance to the skin and legs cramps when the child is in physical education class. What diagnostic testing or treatment does the healthcare professional prepare the family for?

 

a.            Immediate cardiac catheterization

b.            Administration of prostaglandin

c.             Multiple-stage surgical correction

d.            An echocardiogram

13.          What is the initial manifestation of aortic coarctation observed in a neonate?

a.            Heart failure (HF)

b.            Cor pulmonale

c.             Pulmonary hypertension

d.            Cerebral hypertension

14.          A parent asks the healthcare professional to explain why a child diagnosed with Tetralogy of Fallot squats frequently. What explanation by the professional is best?

a.            Reduces the chest pain

b.            Controls dizziness

c.             Relieves hypoxia

d.            Improves headache

15.          An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?

a.            Intermittent murmur

b.            Lack of symptoms

c.             Rapid decompensation

d.            Triad of congenital defects

16.          A newborn has chronic sustained hypertension but otherwise appears healthy. What diagnostic testing does the healthcare professional facilitate as the priority?

a.            Cardiac catheterization

b.            Echocardiogram

c.             Serum electrolytes

d.            Renal function studies

17.          Which condition is consistent with the cardiac defect of transposition of the great vessels?

a.            The aorta arises from the right ventricle.

b.            The pulmonary trunk arises from the right ventricle.

c.             The right ventricle pumps blood to the lungs.

d.            An intermittent murmur is present.

18.          Which scenario describes total anomalous pulmonary venous return?

a.            The foramen ovale closes after birth.

b.            Pulmonary venous return is to the right atrium.

c.             Pulmonary venous return is to the left atrium.

d.            The left atrium receives oxygenated blood.

19.          A healthcare professional assesses a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border. What condition does the professional prepare to educate the parents on?

a.            Coarctation of the aorta

b.            Pulmonic stenosis

c.             Aortic stenosis

d.            Hypoplastic left heart syndrome

20.          A healthcare professional is assessing a baby in the neonatal intensive care unit who is very unstable. The professional hears a systolic ejection click at the upper left sternal border with a thrill palpated at the upper left sternal border. What procedure does the professional prepare the parents for the baby to have?

a.            Heart transplant

b.            Balloon angioplasty

 

 

c.             Prostaglandin infusion

d.            High dose aspirin

21.          Which heart defect results in a single vessel arising from both ventricles, providing blood to both the pulmonary and systemic circulations?

a.            Coarctation of the aorta

b.            Tetralogy of Fallot

c.             Total anomalous pulmonary connection

d.            Truncus arteriosus

22.          A 9-year-old child has a blood pressure of 112/72 mmHg in the school nurse’s office. What action by the school nurse is most appropriate?

a.            Inform the parents the child might be dehydrated.

b.            Note the normal finding in the child’s records.

c.             Calculate the child’s Body Mass Index.

d.            Refer the child for medication.

MULTIPLE RESPONSE

 1.           What congenital heart defects are associated with intrauterine exposure to rubella? (Select all that apply.)

a.            Pulmonary stenosis (PS)

b.            Cardiomegaly

c.             Patent ductus arteriosus (PDA)

d.            Coarctation of aorta (COA)

e.            Ventricular septal defect (VSD)

2.            Which symptoms meet the diagnostic criteria for Kawasaki disease in a child? (Select all that apply.)

a.            Fever for 5 days or longer

b.            “Strawberry tongue”

c.             Peripheral edema

d.            Inguinal lymphadenopathy

e.            Bilateral conjunctival infection

 

3.            Which statements related to the ambulatory blood pressure monitoring (ABPM) system with children are true? (Select all that apply.)

a.            ABPM monitors blood pressure for a 24-hour period.

b.            ABPM assists in identifying children with white coat hypertension.

c.             ABPM is effective in identifying children at risk for target organ damage.

d.            ABPM assists in identifying children who demonstrate masked hypertension.

e.            ABPM is effective in determining blood pressure load for 48 hours.