CHD & High Risk OB

A parent is told their infant has a heart defect with a left to right shunt. What is the best way for the nurse to explain this type of shunting to the parent?

• This type of shunting causes an increase of blood to the systemic circulation.

• This type of shunting causes an increase of blood to the lungs.

• This type of shunting causes a decrease of blood to the brain.

• This type of shunting causes a decrease of blood to the lungs.

A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating which of the following?

• Iron-deficiency anemia

• A multiple gestation pregnancy

• Greater-than-expected weight gain

• Hemodilution of pregnancy

A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding?

• Gallop and rales

• Right ventricular hypertrophy on ECG

• Widening pulse pressure

• Bounding pulses

• Heart murmur

When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which of the following would the nurse include as the underlying reason for the effect?

• Pancreatic function is affected by pregnancy.

• Glucose is utilized more rapidly during a pregnancy.

• The pregnant woman increases her dietary intake.

• Glucose moves through the placenta to assist the fetus.

While assessing a 4-month-old infant, the nurse notes that the baby experiences a hypercyanotic spell. What is the priority nursing action? Fill-in-the-blank.

The nurse is discussing the insulin needs of a primaparous client with diabetes who has been using insulin for the past few years. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurse’s understanding that the placenta produces:

• hCG, which increases maternal glucose levels

• hPL, which deceases the effectiveness of insulin

• Estriol, which interferes with insulin crossing the placenta

• Relaxin, which decreases the amount of insulin produced

The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next?

• Contact the physician

• Offer a snack and administer another dose

• Immediately administer another dose

• Administer next dose as ordered in 12 hours

• Immediately administer half of a dose

Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia? Fill-in-the-blank.

The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index of 26. The nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy? Fill-in-the-blank.

The nurse is conducting a physical examination of a child with a suspected cardiovascular disorder. Which of the following findings would the nurse most likely expect to assess if the child had transposition of the great vessels?

• Significant cyanosis without presence of a murmur

• Abrupt cessation of chest output with an increase in heart rate/filling pressure

• Soft systolic ejection

• Holosystolic murmur

• Machine-like murmur