WorksheetsCongenital Heart Defects Assessment
Total questions: 50
Worksheet time: 52mins
A newborn is diagnosed with Tetralogy of Fallot. Which clinical manifestation should the nurse expect?
bounding peripheral pulses
cyanosis during crying and feeding
widened pulse pressure
frequent upper respiratory infections
Which congenital heart defect results in increased pulmonary blood flow?
Tetralogy of fallot
tricuspid atresia
Ventricular septal defect
coarctation of the aorta
The nurse assesses a newborn with a suspected patent ductus arteriosus (PDA). What sign supports this diagnosis?
systolic murmur at the apex
harch machine like murmur
weak femoral pulses
cyanosis that improves with crying
Which medication may be ordered to keep the ductus arteriosus open in some congenital heart defects?
indomethacin
ibuprofen
Prostaglandin E
digoxin
In a newborn with a ventricular septal defect (VSD), how does blood typically flow?
right atrium to left atrium
Left ventricle to right ventricle
Right ventricle to left ventricle
Right ventricle to aorta
Which congenital heart defect causes a right-to-left shunt, leading to cyanosis?
ASD
PDA
total anomalous pulmonary venous connection
coarctation of the aorta
In transposition of the great arteries (TGA), what is the primary problem with blood flow?
Mixed blood returns to the left atrium
Oxygenated and deoxygenated need to mix for survival
Blood shunts from the left to right atrium
Right-to-left shunting increases systemic oxygenation
In truncus arteriosus, how does blood flow?
Oxygenated blood goes directly to the body
There is no pulmonary blood flow
One large vessel sends mixed blood to lungs and body
Only deoxygenated blood enters the systemic circulation
A neonate with hypoplastic left heart syndrome (HLHS) relies on what for systemic blood flow?
ASD
right to left shunt through VSD
PDA
coarctation of the aorta
Which statement best describes the blood flow in an atrioventricular (AV) canal defect?
There is complete obstruction of blood to the lungs
Deoxygenated blood enters the left atrium
Oxygenated and deoxygenated blood mix in the heart chambers
Blood bypasses the pulmonary artery
In total anomalous pulmonary venous return (TAPVR), what abnormality occurs?
Pulmonary veins drain into the left atrium
Oxygenated blood returns to systemic circulation
Pulmonary veins connect to the right atrium
Blood bypasses the lungs completely
Which change in blood flow would you expect with coarctation of the aorta?
Increased blood flow to the lower extremities
Blood backing up into the pulmonary artery
Decreased perfusion to the lower body
Right-to-left shunt between atria
The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin. Which statement made by the parent indicates the need for further instruction?
I will can mix the medication with food
if more than one dose is missed, I will call the pediatrician
I will take my child's pulse before administering the medication
if my child vomits after medication administration, I will repeat the dose
A nurse is providing discharge teaching to parents of a newborn with Tricuspid Atresia. What instruction is most important to prevent complications during "tet spells"?
Offer feedings more frequently
Keep baby swaddled at all times
Place baby in a knee-chest position during spells
Administer acetaminophen for pain
The nurse is reviewing fetal circulation with a group of nursing students. Which statement by a student indicates a correct understanding of blood flow in a fetus?
“Deoxygenated blood enters the fetal heart through the inferior vena cava.”
“The foramen ovale allows blood to bypass the liver and enter the right atrium.”
“The ductus venosus connects the aorta to the pulmonary vein.”
“The foramen ovale allows blood to flow from the right atrium to the left atrium.”
A child diagnosed with Kawasaki disease is in the acute phase. Which intervention is the priority?
Monitor for signs of heart failure
Apply warm compresses to the joints
Provide quiet activities and distraction
Administer high-dose IV immunoglobulin (IVIG) and aspirin
A school-age child presents with a recent history of strep throat and is now showing signs of polyarthritis and a new murmur. What condition does the nurse suspect?
Endocarditis
Kawasaki disease
Acute glomerulonephritis
Rheumatic fever
Which medication is typically prescribed for long-term prophylaxis after a diagnosis of rheumatic fever?
Oral prednisone
Daily aspirin
Monthly penicillin injections
IVIG once per year
The nurse is teaching a parent about infective endocarditis prevention in a child with a history of congenital heart defect repair. What instruction is correct?
“Antibiotics are only needed if your child develops a fever.”
“Your child should take antibiotics before dental procedures.”
“A flu shot will prevent endocarditis.”
“Avoid giving aspirin to your child.”
A teenager is diagnosed with primary hypertension. Which lifestyle change should the nurse prioritize teaching?
Increase daily sodium intake
Limit physical activity to prevent fatigue
Avoid caffeinated drinks
Reduce intake of processed foods and encourage exercise
Which of the following signs is most specific to subacute phase Kawasaki disease?
High fever
Strawberry tongue
Peeling skin on the hands and feet
Redness of the eyes
Which symptom suggests advanced infective endocarditis?
Pink, non-pruritic rash
Splinter hemorrhages under the nails
Pallor and swollen lymph nodes
Dry cough and weight gain
The nurse is caring for a child receiving chemotherapy. Which finding is most concerning?
loss of appetite
Oral ulcers
Mild alopecia
Rectal temperature of 100.4°F
A child is diagnosed with Wilms tumor. What is the priority nursing action during physical assessment?
Palpate the abdomen gently for mass size
Measure abdominal girth daily
Avoid palpating the abdomen
Monitor for signs of constipation
A 3-year-old undergoing chemotherapy develops thrombocytopenia. Which safety precaution is most important?
Use an N95 mask when visiting
Encourage fluid intake
Use a soft toothbrush and avoid IM injections
Monitor blood pressure every hour
A child receiving chemotherapy is neutropenic. Which intervention is the nurse’s priority?
Encourage the child to play in the unit playroom
Provide a high-fiber diet to prevent constipation
Place the child in protective isolation and monitor for fever
Administer antiemetics before meals
Which finding indicates a serious complication of chemotherapy in a child?
Mild hair loss
Persistent nausea
Oral mucositis
Bleeding gums and petechiae
The nurse is caring for a child undergoing chemotherapy who reports nausea. What is the best nursing action?
Offer small snacks with high-fat content
Administer prescribed ondansetron before chemotherapy
Encourage the child to lie flat after eating
Offer spicy foods to stimulate appetite
A nurse is discharging a pediatric oncology patient. Which parent teaching point about infection prevention is most important?
“You can take your child to crowded places if they wear a mask.”
“Let your child play outdoors frequently to build strength.”
“Check your child’s temperature daily and report a fever immediately.”
“Avoid letting your child nap during the day so they sleep better at night.”
A child is receiving external beam radiation therapy for a brain tumor. Which nursing instruction to the parents is most appropriate?
"Apply lotion and creams freely to the marked skin area to reduce dryness."
"Do not wash off the marks placed on the skin for radiation targeting."
"Your child can expose the treated area to sunlight for brief periods."
"Use ice packs on the site if the skin becomes red or sore."
The nurse provides a teaching session to the nursing staff regarding osteosarcoma. Which statement by a member of the nursing staff indicates a need for further instruction?
the femur is the most common site of this sarcoma
the child does not experience pain in the primary tumor site
limping, if a weight-bearing limb is affected, is a clinical manefestation
the symptoms in this disease in the early stage are almost always attributed to normal growing pains
A child undergoing chemotherapy is at risk for acute tumor lysis syndrome. Which lab finding would the nurse most likely expect?
high potassium, high phosphate, high calcium
High potassium, high uric acid, high phosphate
high sodium, high potassium, high calcium
High sodium, high uric acid, high phosphate
A child with cancer is diagnosed with superior vena cava syndrome. The nurse would assess for which of the following signs?
Headache, facial swelling, and distended neck veins
Nausea, vomiting, and severe abdominal pain
Jaundice, increased bilirubin levels, and dark urine
Severe chest pain and shortness of breath
A 4-year-old child sustains a full-thickness (third-degree) burn to the lower leg after a house fire. What is the primary concern in the first 24 hours after the burn injury?
Pain control and comfort measures
Infection prevention and wound care
Fluid resuscitation to prevent hypovolemic shock
Nutritional support to promote healing
A nurse is assessing a child with first-degree burns from a sunburn. Which of the following findings would the nurse expect?
Blisters and severe pain at the burn site
Erythema and mild pain without blister formation
non blanchable, dry
Charred tissue and deep tissue damage
A pediatric client is being digitalized with digoxin. The prescribed total digitalizing dose (TDD) is 30 mcg/kg. The child weighs 5 kg. The medication available is digoxin 50mcg/mL. How many mL should the nurse administer for the first dose?
0.75ml
1.5ml
3ml
0.15ml
A nurse is providing education to the parents of a child who has a cast applied for a fractured arm. Which of the following statements by the parents indicates the need for further teaching?
“We should elevate the arm above the heart to reduce swelling.”
“We can remove the padding if it becomes wet to prevent infection.”
“We will check the fingers every few hours for signs of circulation problems.”
“We should avoid putting anything inside the cast to scratch the skin.”
A 4-year-old child is in spica cast following a hip fracture. Which of the following is the most important nursing intervention to prevent complications?
Turn the child every 2 hours to maintain skin integrity
Place the child in a prone position for comfort
Ensure the child is on a low-calcium diet to prevent bone complications
Monitor for signs of respiratory distress due to immobility
A nurse is performing a physical examination on a newborn and suspects Developmental Dysplasia of the Hip (DDH). Which of the following findings would support this diagnosis?
The infant’s legs are of equal length, and there is no hip click.
The infant’s legs are uneven, with one leg appearing shorter than the other.
The infant has normal muscle tone with no signs of asymmetry.
The infant has bilateral hip clicks when the hips are flexed and abducted.
A nurse is caring for a 6-month-old infant diagnosed with hip dysplasia and prescribed a Pavlik harness. Which of the following interventions is the most important for the nurse to include in the plan of care?
Ensure the infant’s legs remain in abduction while wearing the harness.
Allow the infant to wear the harness only during sleep to prevent skin irritation.
Monitor the infant’s hip for signs of dislocation after the harness is applied.
Apply lotion or powder to the skin under the harness to prevent irritation.
A nurse is educating the parents of a newborn diagnosed with clubfoot. The nurse explains the importance of serial casting. Which of the following statements by the parents indicates a need for further teaching?
"We will ensure the cast is kept clean and dry."
"We should monitor for any skin breakdown or irritation under the cast."
"We will check for swelling of the toes and pain in the foot."
"We should expect to see immediate improvement in the foot's position."
A 5-year-old child with osteogenesis imperfecta (OI) presents with a newly fractured leg. Which of the following interventions should the nurse prioritize?
Encourage the child to ambulate as soon as possible to promote healing.
Apply a rigid cast and avoid handling the child to reduce further injury.
Manage pain and handle the child gently to avoid additional fractures.
Prescribe bed rest to prevent further stress on the bones.
Which of the following children is most at risk for developing Slipped Capital Femoral Epiphysis?
4-year-old girl with a history of developmental dysplasia of the hip
16-year-old male with low body mass index
12-year-old obese male during a growth spurt
7-year-old girl recovering from a femur fracture
A child is admitted with a diagnosis of Slipped Capital Femoral Epiphysis. Which of the following is the priority nursing action?
Encourage ambulation to prevent stiffness
Apply ice to reduce inflammation
Maintain non-weight-bearing status on the affected limb
Begin range-of-motion exercises immediately
Which assessment finding in a child with nephrotic syndrome should be reported immediately to the healthcare provider?
Periorbital edema in the morning
Proteinuria on urinalysis
Blood pressure 104/66 mmHg
Respiratory rate of 36/min and crackles in lungs
A school-age child is admitted with acute glomerulonephritis. The nurse should expect which most likely history finding?
A recent GI infection
Exposure to nephrotoxic medications
Recent streptococcal throat infection
Family history of diabetes
A newborn is born with bladder exstrophy. Which of the following is the priority nursing intervention immediately after birth?
Apply a dry gauze dressing to the exposed bladder
Cover the bladder with a sterile, non-adherent moist dressing
Begin oral feeding as soon as possible
Place the infant prone to reduce bladder exposure
Which laboratory result is most consistent with HUS?
High platelet count
Normal BUN and creatinine
Low hemoglobin and hematocrit
Low white blood cell count
A child with end-stage renal disease (ESRD) is receiving peritoneal dialysis (PD). Which finding should the nurse report to the provider immediately?
Clear, straw-colored dialysate outflow
Complaints of mild abdominal fullness
Cloudy or foul-smelling peritoneal fluid
Weight loss of 0.5 kg after dialysis
Which of the following is a benefit of peritoneal dialysis (PD) in children?
Requires less frequent dialysis sessions
Can be done at home while the child sleeps
Requires surgical placement of a shunt in the arm
Eliminates the need for dietary restrictions
