NURS 5315 PATHOPHYSIOLOGY THE BIOLOGIC
BASIS FOR DISEASE IN ADULTS AND CHILDREN
2026 COMPREHENSIVE REVIEW QUESTIONS
AND SOLUTIONS VERIFIED
◉ LEFT to RIGHT shunt (Congenital heart defect). Answer: -
Oxygenated blood from the left side of the heart mixes with
unoxygenated blood in the right side of the heart.
-Oxygen saturation on left side is usually 95%, whereas right side is
75%
- As blood mixes, right side's oxygen saturation increases to 80% or
more
-VOLUME OVERLOAD occurs on RIGHT side of heart occurs, leading
to PULMONARY HYPERTENSION, which causes RIGHT
VENTRICULAR HYPERTROPHY, (secondary to pulm. hptn.), and
LEFT VENTRICULAR HYPERTROPHY(secondary to blood being
returned to left ventricle)
Eisenmenger Syndrome: Reversal of left to right shunt to a right to
left shunt.
◉ Eisenmenger Syndrome. Answer: 1. Increased blood flow returns
to lungs rather than to the rest of the body.
2. Blood vessels become stiff and narrow - permanent damage.
,3. Increased pressure of the blood flow in the lung becomes so great
that the direction of blood flow through the shunt reverses.
4. Oxygen-poor (blue) blood from the right side of the heart flows
into the left ventricle and is pumped to the body and tissues do not
receive enough oxygen.
5. Results in late-onset cyanosis (as in, later in life) and clubbing of
fingernails.
◉ Ventricular Septal Defect
(most common congenital heart defect). Answer: -Hole allowing
blood to move from left ventricle to the right ventricle
-Sign: Harsh holosytolic murmur at the lower left sternal border
(high-pitched, begins at the first heart sound (S1) and continue to
the second heart sound (S2))
-Multiple VSDs are associated with Tetralogy of Fallot, Cri du Chat
Syndrome, and Fetal Alcohol Syndrome.
-Associated with development of atrial septal defects, patent ductus
arteriosus, coarction (congenital narrowing) of aorta, aortic valve
stenosis, INCREASED RISK FOR DEVELOPING ENDOCARDITIS at
some point in life ( infection of the heart's inner lining, usually
involving the heart valves)
◉ Atrial Septal Defect
(most common congenital heart defect in adults). Answer: -Most
common cause is a patent foramen ovale (hole) that does not close
,-Associated with FETAL ALCOHOL SYNDROME and DOWN
SYNDROME
-Sign: Midsystolic murmur at upper sternal border
-Increases risk for EMBOLUS
◉ Patent Ductus Arteriosus. Answer: Patent ductus arteriosus (PDA)
is a persistent opening between the two major blood vessels leading
from the heart. The opening, called the ductus arteriosus, is a
normal part of a baby's circulatory system before birth that usually
closes shortly after birth. If it remains open, however, it's called a
patent ductus arteriosus.
Sign: Machine-like murmur heard continuously throughout systole
and diastole
Reversal may occur if pulmonary hptn occurs from increased blood
flow through the pulmonary artery. If this happens, unoxygenated
blood will enter the aorta below the level of the subclavian artery
and the child will be cyanotic in the lower body, but not in the upper
body.
Associated with congenital rubella, Tetralogy of Fallot, respiratory
distress syndrome, and transposition of great vessels (unoxygenated
blood does not pick up oxygen in lungs and is pumped back to body)
, ◉ Right to left shunt. Answer: Tetralogy of Fallot is most common
cyanotic congenital heart defect.
*Impaired gas exchanged r/t decreased pulmonary blood flow*
Right side of heart = Deoxygenated
Left side = Oxygenated
1. Deoxygenated blood is mixed with oxygenated blood.
2. Blood on left side has oxygen saturation decrease from 95% to
80% or lower.
3. Cyanosis may or may not develop depending on how low the
oxygen saturation on the left side drops.
-Left side oxygen saturation 85% or high, cyanosis is not likely to
occur.
-Left side oxygen saturation below 80% is indicative of a large
amount of blood being shunted and will result in cyanosis.
◉ Tetralogy of Fallot. Answer: Most common cyanotic congenital
heart defect
Tetralogy of Fallot involves four heart defects:
1. A large ventricular septal defect
2. Pulmonary stenosis
3. Right ventricular hypertrophy
BASIS FOR DISEASE IN ADULTS AND CHILDREN
2026 COMPREHENSIVE REVIEW QUESTIONS
AND SOLUTIONS VERIFIED
◉ LEFT to RIGHT shunt (Congenital heart defect). Answer: -
Oxygenated blood from the left side of the heart mixes with
unoxygenated blood in the right side of the heart.
-Oxygen saturation on left side is usually 95%, whereas right side is
75%
- As blood mixes, right side's oxygen saturation increases to 80% or
more
-VOLUME OVERLOAD occurs on RIGHT side of heart occurs, leading
to PULMONARY HYPERTENSION, which causes RIGHT
VENTRICULAR HYPERTROPHY, (secondary to pulm. hptn.), and
LEFT VENTRICULAR HYPERTROPHY(secondary to blood being
returned to left ventricle)
Eisenmenger Syndrome: Reversal of left to right shunt to a right to
left shunt.
◉ Eisenmenger Syndrome. Answer: 1. Increased blood flow returns
to lungs rather than to the rest of the body.
2. Blood vessels become stiff and narrow - permanent damage.
,3. Increased pressure of the blood flow in the lung becomes so great
that the direction of blood flow through the shunt reverses.
4. Oxygen-poor (blue) blood from the right side of the heart flows
into the left ventricle and is pumped to the body and tissues do not
receive enough oxygen.
5. Results in late-onset cyanosis (as in, later in life) and clubbing of
fingernails.
◉ Ventricular Septal Defect
(most common congenital heart defect). Answer: -Hole allowing
blood to move from left ventricle to the right ventricle
-Sign: Harsh holosytolic murmur at the lower left sternal border
(high-pitched, begins at the first heart sound (S1) and continue to
the second heart sound (S2))
-Multiple VSDs are associated with Tetralogy of Fallot, Cri du Chat
Syndrome, and Fetal Alcohol Syndrome.
-Associated with development of atrial septal defects, patent ductus
arteriosus, coarction (congenital narrowing) of aorta, aortic valve
stenosis, INCREASED RISK FOR DEVELOPING ENDOCARDITIS at
some point in life ( infection of the heart's inner lining, usually
involving the heart valves)
◉ Atrial Septal Defect
(most common congenital heart defect in adults). Answer: -Most
common cause is a patent foramen ovale (hole) that does not close
,-Associated with FETAL ALCOHOL SYNDROME and DOWN
SYNDROME
-Sign: Midsystolic murmur at upper sternal border
-Increases risk for EMBOLUS
◉ Patent Ductus Arteriosus. Answer: Patent ductus arteriosus (PDA)
is a persistent opening between the two major blood vessels leading
from the heart. The opening, called the ductus arteriosus, is a
normal part of a baby's circulatory system before birth that usually
closes shortly after birth. If it remains open, however, it's called a
patent ductus arteriosus.
Sign: Machine-like murmur heard continuously throughout systole
and diastole
Reversal may occur if pulmonary hptn occurs from increased blood
flow through the pulmonary artery. If this happens, unoxygenated
blood will enter the aorta below the level of the subclavian artery
and the child will be cyanotic in the lower body, but not in the upper
body.
Associated with congenital rubella, Tetralogy of Fallot, respiratory
distress syndrome, and transposition of great vessels (unoxygenated
blood does not pick up oxygen in lungs and is pumped back to body)
, ◉ Right to left shunt. Answer: Tetralogy of Fallot is most common
cyanotic congenital heart defect.
*Impaired gas exchanged r/t decreased pulmonary blood flow*
Right side of heart = Deoxygenated
Left side = Oxygenated
1. Deoxygenated blood is mixed with oxygenated blood.
2. Blood on left side has oxygen saturation decrease from 95% to
80% or lower.
3. Cyanosis may or may not develop depending on how low the
oxygen saturation on the left side drops.
-Left side oxygen saturation 85% or high, cyanosis is not likely to
occur.
-Left side oxygen saturation below 80% is indicative of a large
amount of blood being shunted and will result in cyanosis.
◉ Tetralogy of Fallot. Answer: Most common cyanotic congenital
heart defect
Tetralogy of Fallot involves four heart defects:
1. A large ventricular septal defect
2. Pulmonary stenosis
3. Right ventricular hypertrophy
