A nurse is caring for an infant who has a congenital heart defect. Which of the following defects is associated with increased pulmonary blood flow?
Coarctation of the aorta
Patent ductus arteriosus
Tetralogy of Fallot
Tricuspid atresia
The Correct Answer is B
A patent ductus arteriosus (PDA) is a congenital heart defect associated with increased pulmonary blood flow. In normal fetal circulation, the ductus arteriosus allows blood to bypass the lungs since the baby receives oxygen from the mother's placenta. After birth, the ductus arteriosus should close, redirecting blood flow to the lungs for oxygenation. However, in some infants with PDA, the ductus arteriosus remains open, causing an abnormal connection between the aorta and the pulmonary artery. As a result, oxygenated blood from the aorta flows back into the pulmonary artery, increasing the workload on the lungs.
The other options are as follows:
A. Coarctation of the aorta - Coarctation of the aorta is a narrowing of the aorta, which obstructs blood flow and leads to increased blood pressure in the upper body and reduced blood flow to the lower body.
C. Tetralogy of Fallot - Tetralogy of Fallot is a combination of four heart defects that results in decreased pulmonary blood flow due to a ventricular septal defect (VSD), overriding aorta, pulmonary stenosis, and right ventricular hypertrophy.
D. Tricuspid atresia - Tricuspid atresia is a congenital heart defect where the tricuspid valve does not develop correctly, resulting in an absent or abnormal tricuspid valve. This defect prevents blood flow from the right atrium to the right ventricle and, therefore, reduces pulmonary blood flow.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rheumatic fever (RF) is a complication that can occur after an untreated or inadequately treated streptococcal throat infection (strep throat). It can affect the heart, joints, skin, and brain. One important aspect of managing RF is to prevent further episodes of strep throat, as it can trigger recurrent RF. Therefore, the child with a history of RF will require prophylactic antibiotics (usually penicillin or a related antibiotic) before certain invasive procedures, dental work, or surgeries to prevent strep throat and subsequent recurrence of RF.
Option A is not specific to rheumatic fever, and while electrolyte imbalances may be monitored and managed in certain cases of severe illness, it is not a core aspect of managing RF.
Option B is not accurate. While many children with RF do recover fully with appropriate treatment, they may be at risk of developing rheumatic heart disease, which can lead to long-term complications if not managed properly.
Option D is not a direct implication of RF. Rheumatic fever is not a genetically inherited condition, but a complication of strep throat caused by a bacterial infection. There is no evidence to suggest that having RF would directly affect the genetic implications for future offspring.
Correct Answer is A
Explanation
The nurse should expect to find irritability in an infant who is dehydrated. Dehydration in infants can lead to changes in behavior and irritability due to the imbalance in fluid and electrolytes. Other common signs of dehydration in infants may include:
Poor skin turgor (skin tenting)
Sunken fontanelles (soft spots on the baby's head)
Dry mucous membranes (dry mouth and tongue)
Decreased urine output or concentrated urine
Rapid heart rate (tachycardia)
Increased respiratory rate
Sunken eyes
Decreased tears when crying
B. Tetany is a condition characterized by involuntary muscle contractions and is more commonly associated with hypocalcemia (low calcium levels) rather than dehydration.
C. A slow, bounding pulse is not typically associated with dehydration. Dehydration often leads to a rapid heart rate (tachycardia) as the body attempts to compensate for the loss of fluid.
D. Decreased temperature is not a typical finding in dehydration. Dehydration can lead to fever in some cases due to an underlying infection, but it does not cause a decrease in body temperature on its own.
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