The nurse is conducting an admission assessment of an infant with heart failure who is scheduled for repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. Which pathophysiologic mechanism supports these findings?

The lumen of the aorta reduces the volume of blood flow to the lower extremities.

The aortic semilunar valve obstructs blood flow into the systemic circulation.

The pulmonic valve prevents adequate blood volume into the pulmonary circulation.

An opening in the atrial septum causes a murmur due to a turbulent left to right shunt.

Answer and Explanation

The Correct Answer is A

Choice A reason: The lumen of the aorta reduces the volume of blood flow to the lower extremities is the correct pathophysiologic mechanism that supports the findings. This is because coarctation of the aorta is a congenital condition that causes a narrowing of the aorta, usually near the ductus arteriosus. This results in increased resistance to blood flow from the heart to the lower body, leading to higher blood pressure and stronger pulses in the upper extremities and lower blood pressure and weaker pulses in the lower extremities.

Choice B reason: The aortic semilunar valve obstructs blood flow into the systemic circulation is not the correct pathophysiologic mechanism that supports the findings. This is because the aortic semilunar valve is located at the base of the aorta and prevents blood from flowing back into the left ventricle. If the valve is obstructed, it would cause aortic stenosis, which is a different condition from coarctation of the aorta. Aortic stenosis would cause symptoms such as chest pain, shortness of breath, and fainting.

Choice C reason: The pulmonic valve prevents adequate blood volume into the pulmonary circulation is not the correct pathophysiologic mechanism that supports the findings. This is because the pulmonic valve is located at the base of the pulmonary artery and prevents blood from flowing back into the right ventricle. If the valve is obstructed, it would cause pulmonic stenosis, which is a different condition from coarctation of the aorta. Pulmonic stenosis would cause symptoms such as cyanosis, fatigue, and heart murmur.

Choice D reason: An opening in the atrial septum causes a murmur due to a turbulent left to right shunt is not the correct pathophysiologic mechanism that supports the findings. This is because an opening in the atrial septum is a defect in the wall that separates the two upper chambers of the heart. It would cause a condition called atrial septal defect, which is different from coarctation of the aorta. Atrial septal defect would cause symptoms such as difficulty breathing, frequent respiratory infections, and heart palpitations.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason: Chickenpox is not the most significant illness that may be associated with acute rheumatic fever. Chickenpox is a viral infection that causes an itchy rash and blisters. It is not caused by group A streptococcus (GAS) bacteria, which are the main trigger of acute rheumatic fever.

Choice B reason: Sore throat is the most significant illness that may be associated with acute rheumatic fever. Sore throat can be caused by GAS bacteria, which can also cause strep throat or scarlet fever. If these infections are not properly treated with antibiotics, they can lead to acute rheumatic fever, which is an inflammatory disease that can affect the heart, joints, skin, and brain.

Choice C reason: Mumps is not the most significant illness that may be associated with acute rheumatic fever. Mumps is a viral infection that causes swelling of the salivary glands. It is not caused by GAS bacteria, which are the main trigger of acute rheumatic fever.

Choice D reason: Influenza is not the most significant illness that may be associated with acute rheumatic fever. Influenza is a viral infection that causes fever, cough, sore throat, and muscle aches. It is not caused by GAS bacteria, which are the main trigger of acute rheumatic fever.

A. "We should be sure to start our daughter on birth control pills." B. "We should encourage her to dress in clothing that suits her sexual maturity level." C. "Our daughter will be on this hormone treatment the rest of her life." D. "Sexual maturity differences between my daughter and her peers will disappear within a few years."

Correct Answer is D

Explanation

Choice A reason: Starting the daughter on birth control pills is not necessary and may interfere with the LHRH treatment. LHRH injections suppress the production of sex hormones and prevent ovulation and menstruation. Birth control pills contain synthetic hormones that may have unwanted side effects and may not be effective in preventing pregnancy in girls with precocious puberty.

Choice B reason: Encouraging the daughter to dress in clothing that suits her sexual maturity level is not advisable and may cause psychological distress. Girls with precocious puberty may feel self-conscious and embarrassed about their early physical development and may face teasing or bullying from their peers. Dressing in clothing that accentuates their sexual maturity may make them feel more uncomfortable and isolated. They should be allowed to dress in clothing that matches their age and emotional development.

Choice C reason: The daughter will not be on this hormone treatment the rest of her life. LHRH injections are usually given until the age of normal puberty, around 11 or 12 years old. Then, the treatment is stopped and the natural puberty process resumes. The injections are meant to delay puberty, not stop it permanently.

Choice D reason: Sexual maturity differences between the daughter and her peers will disappear within a few years is the correct statement that shows understanding of the treatment. LHRH injections slow down the growth and development of the sex organs and secondary sexual characteristics, such as breasts and pubic hair. This allows the girl to grow at a normal rate and reach her full adult height potential. It also reduces the social and emotional problems that may arise from being sexually mature too early. Once the treatment is stopped, the girl will go through puberty at the same time as her peers and the differences will no longer be noticeable.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A school-aged child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's parent, the recent occurrence of which illness is most significant?

Correct Answer is B

Explanation

An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?

Correct Answer is D

Explanation

The nurse is caring for a child with chronic kidney disease who is experiencing renal osteodystrophy. Which outcome should the nurse explain to the parents about the sequela for their child with renal osteodystrophy?

The nurse is performing a routine assessment of a 3-year-old at a community health center. Which behavior by the child should alert the nurse to request a follow-up for a possible autism spectrum disorder (ASD)?

The parents of a child with acute lymphoblastic leukemia (ALL) are learning to care for their child at home. Which statement made by the parents should the nurse recognize as correct monitoring for early signs of an infection in the child?

The nurse is providing discharge instructions to the caregiver of an infant with recurrent otitis media. Which statement made by the caregiver should the nurse recognize as needing additional education about minimizing subsequent infections?

The nurse is caring for an infant admitted with dehydration, irritability, signs of extreme hunger, and a palpable olive-like mass in the upper right abdominal quadrant. When feeding the infant, the nurse should monitor for which development?

A school-age child with bronchial asthma has a prescription for albuterol. The child's parent tells the nurse that the medication is used when the child is having difficulty breathing. Which is the best response by the nurse?