Chapter 41 Maternal and Child Health Nursing 7th Edition

Chapter 41  Maternal and Child Health Nursing 7th Edition

Complete Chapter Questions And Answers
 

Sample Questions

1.
The nurse is caring for a newborn diagnosed with patent ductus arteriosus. Which finding will the nurse assess that is consistent with this diagnosis?
A)
Slow heart rate
B)
Expiratory grunt
C)
Wide pulse pressure
D)
Absent femoral pulses
Ans:
C

Feedback:

On physical examination, the child with patent ductus arteriosus usually has a wide pulse pressure. The diastolic pressure is low because of the shunt or runoff of blood, which reduces resistance. Manifestations of patent ductus arteriosus do not include a slow heart rate, expiratory grunt, or absent femoral pulses.

2.
Which of the following nursing diagnoses would best apply to a child during the acute phase of rheumatic fever?
A)
Disturbed sleep pattern related to hyperexcitability
B)
Ineffective breathing pattern related to cardiomegaly
C)
Risk for self-directed violence related to development of cerebral anoxia
D)
Activity intolerance related to inability of heart to sustain extra workload
Ans:
D

Feedback:

The course of rheumatic fever is about 6 to 8 weeks. Children are maintained on bed rest only during the acute phase of illness until the pulse rate returns to normal. Because pulse rate is a valuable sign of improvement, monitoring vital signs is essential during and following the acute phase. Obtain an apical pulse for a full minute for best results. Taking it while the child is asleep as well as when the child is awake helps to measure the effect of activity on the pulse rate; another way to judge inflammation is decreasing and the child’s heart action is improving. Chorea occurs in some children with rheumatic fever; however, it is not known if this manifestation will disturb the child’s sleep. Children with rheumatic fever may develop congestive heart failure; however, cardiomegaly is not a long-term effect of the disease. The child is not at risk for self-directed violence because cerebral anoxia is not a manifestation of the disease.

3.
The nurse is planning a program for community family members that focuses on the 2020 National Health Goals to improve cardiovascular health. Which content should the nurse include in this program? (Select all that apply.)
A)
Measures to reduce obesity
B)
Importance of daily exercise
C)
Starting reduced-fat diets upon birth
D)
Engaging in stress-reduction activities
E)
Following a diet that supports heart function
Ans:
A, B, E

Feedback:

Nurses can help the nation achieve the 2020 National Health Goals by educating parents and children about the importance of reducing obesity and planning exercise and nutrition programs for sound cardiovascular health. Parents should be cautioned not to start their children on reduced-fat diets until they are 2 years old to allow for myelination of nerve cells. Stress-reduction activities are not identified as actions to achieve the 2020 National Health Goals for cardiovascular health.

4.
A newborn is diagnosed with coarctation of the aorta. Which assessment should the nurse make when caring for this infant?
A)
Observing for excessive crying
B)
Auscultating for a cardiac murmur
C)
Assessing for the presence of femoral pulses
D)
Recording an upper extremity blood pressure
Ans:
C

Feedback:

If the coarctation is slight, absence of palpable femoral pulses from the decreased blood pressure in the lower body may be the only symptom seen. To help detect this, the nurse should always include evaluation of femoral pulses in all initial newborn assessments and admission inspections to newborn nurseries. Excessive crying, cardiac murmur, and blood pressure changes are not manifestations of coarctation of the aorta.

5.
What should the nurse teach the parents of a child with tetralogy of Fallot to do if the child suddenly becomes cyanotic and dyspneic?
A)
Place in a knee–chest position.
B)
Lie prone and maintain the airway.
C)
Lie supine with the head turned to one side.
D)
Place in a semi-Fowler’s position in an infant seat.
Ans:
A

Feedback:

Parents need to try to keep hypercyanotic episodes to a minimum and learn what steps to take if one should occur. Placing the baby in a knee–chest position to trap blood in the lower extremities and keep the heart from being overwhelmed generally reduces symptoms. Lying prone, supine, or in the semi-Fowler’s position will not help reduce cyanosis and dyspnea.