HESI RN CASE STUDY: CONGENITAL
HEART DISEASE
300 Questions & Answers
Page 1
,1. A nurse is caring for a child with truncus arteriosus. Which assessment finding should the nurse
prioritize?
A. Dental alignment
B. Respiratory effort and oxygen saturation
C. Hair texture
D. Visual acuity
Answer: B. Respiratory effort and oxygen saturation
2. A parent is learning about TOF. Which assessment finding should the nurse prioritize?
A. Dental alignment
B. Hair texture
C. Visual acuity
D. Respiratory effort and oxygen saturation
Answer: D. Respiratory effort and oxygen saturation
3. A parent is learning about PDA. Which caregiver statement shows appropriate understanding?
A. I will ignore changes in activity.
B. I will report worsening breathing, color, or feeding tolerance.
C. I will skip scheduled follow-up visits.
D. I will stop medicines when the child looks better.
Answer: B. I will report worsening breathing, color, or feeding tolerance.
4. A parent is learning about pediatric heart failure. Which finding may indicate pulmonary congestion?
A. Improved oxygenation
B. Crackles with increased work of breathing
C. Clear lungs and comfortable breathing
D. Normal respiratory rate
Answer: B. Crackles with increased work of breathing
5. During assessment of an infant with TAPVR, which finding may indicate pulmonary congestion?
A. Improved oxygenation
B. Normal respiratory rate
C. Clear lungs and comfortable breathing
D. Crackles with increased work of breathing
Answer: D. Crackles with increased work of breathing
6. During assessment of an infant with TAPVR, which finding may indicate pulmonary congestion
(clinical judgment scenario 2)?
A. Crackles with increased work of breathing
B. Clear lungs and comfortable breathing
C. Improved oxygenation
D. Normal respiratory rate
Answer: A. Crackles with increased work of breathing
7. During assessment of an infant with TAPVR, which finding most strongly suggests decreased
cardiac output?
A. Improved feeding endurance
B. Warm skin with brisk refill
C. Cool extremities with delayed capillary refill
D. Normal urine output
Answer: C. Cool extremities with delayed capillary refill
Page 2
,8. While monitoring a child with TGA, Which professional may assist with breastfeeding technique?
A. Pathology technician
B. Optometrist
C. Radiology technologist
D. Certified lactation consultant
Answer: D. Certified lactation consultant
9. A nurse is caring for a child with truncus arteriosus. Which assessment helps evaluate peripheral
perfusion?
A. Pulses, capillary refill, color, and temperature
B. Pupil size only
C. Bowel sounds only
D. Hearing acuity
Answer: A. Pulses, capillary refill, color, and temperature
10. A parent is learning about TGA. Which feeding observation suggests poor tolerance?
A. Diaphoresis and increased respiratory effort
B. Normal color
C. Comfortable sucking
D. Calm breathing
Answer: A. Diaphoresis and increased respiratory effort
11. During assessment of an infant with PDA, which outcome suggests improvement?
A. Worsening tachypnea
B. Decreasing urine output
C. Increasing cyanosis
D. Better feeding tolerance with less respiratory distress
Answer: D. Better feeding tolerance with less respiratory distress
12. A parent is learning about TAPVR. Which finding should be reported promptly?
A. New cyanosis or increasing respiratory distress
B. Normal sleep
C. Improved appetite
D. Warm hands and feet
Answer: A. New cyanosis or increasing respiratory distress
13. A nurse is caring for a child with HLHS. Which assessment finding should the nurse prioritize?
A. Hair texture
B. Respiratory effort and oxygen saturation
C. Dental alignment
D. Visual acuity
Answer: B. Respiratory effort and oxygen saturation
14. A parent is learning about HLHS. Which finding most strongly suggests decreased cardiac output?
A. Cool extremities with delayed capillary refill
B. Improved feeding endurance
C. Normal urine output
D. Warm skin with brisk refill
Answer: A. Cool extremities with delayed capillary refill
15. During assessment of an infant with TOF, which assessment helps evaluate peripheral perfusion?
Page 3
, A. Bowel sounds only
B. Pupil size only
C. Hearing acuity
D. Pulses, capillary refill, color, and temperature
Answer: D. Pulses, capillary refill, color, and temperature
16. A parent is learning about pediatric heart failure. Which professional may help evaluate suspected
swallowing difficulty?
A. Dentist only
B. Speech-language pathologist or feeding specialist
C. Optician
D. Dermatologist
Answer: B. Speech-language pathologist or feeding specialist
17. A parent is learning about coarctation of the aorta. Which measurement is most useful for trending
fluid status?
A. Daily weight
B. Head circumference once a year
C. Hair length
D. Visual acuity
Answer: A. Daily weight
18. While monitoring a child with PDA, Which professional may assist with breastfeeding technique?
A. Radiology technologist
B. Optometrist
C. Pathology technician
D. Certified lactation consultant
Answer: D. Certified lactation consultant
19. A parent is learning about VSD. Which finding may indicate pulmonary congestion?
A. Improved oxygenation
B. Clear lungs and comfortable breathing
C. Normal respiratory rate
D. Crackles with increased work of breathing
Answer: D. Crackles with increased work of breathing
20. While monitoring a child with truncus arteriosus, Which finding may indicate pulmonary
congestion?
A. Improved oxygenation
B. Clear lungs and comfortable breathing
C. Normal respiratory rate
D. Crackles with increased work of breathing
Answer: D. Crackles with increased work of breathing
21. During assessment of an infant with truncus arteriosus, which assessment finding should the nurse
prioritize?
A. Dental alignment
B. Respiratory effort and oxygen saturation
C. Hair texture
D. Visual acuity
Answer: B. Respiratory effort and oxygen saturation
Page 4
HEART DISEASE
300 Questions & Answers
Page 1
,1. A nurse is caring for a child with truncus arteriosus. Which assessment finding should the nurse
prioritize?
A. Dental alignment
B. Respiratory effort and oxygen saturation
C. Hair texture
D. Visual acuity
Answer: B. Respiratory effort and oxygen saturation
2. A parent is learning about TOF. Which assessment finding should the nurse prioritize?
A. Dental alignment
B. Hair texture
C. Visual acuity
D. Respiratory effort and oxygen saturation
Answer: D. Respiratory effort and oxygen saturation
3. A parent is learning about PDA. Which caregiver statement shows appropriate understanding?
A. I will ignore changes in activity.
B. I will report worsening breathing, color, or feeding tolerance.
C. I will skip scheduled follow-up visits.
D. I will stop medicines when the child looks better.
Answer: B. I will report worsening breathing, color, or feeding tolerance.
4. A parent is learning about pediatric heart failure. Which finding may indicate pulmonary congestion?
A. Improved oxygenation
B. Crackles with increased work of breathing
C. Clear lungs and comfortable breathing
D. Normal respiratory rate
Answer: B. Crackles with increased work of breathing
5. During assessment of an infant with TAPVR, which finding may indicate pulmonary congestion?
A. Improved oxygenation
B. Normal respiratory rate
C. Clear lungs and comfortable breathing
D. Crackles with increased work of breathing
Answer: D. Crackles with increased work of breathing
6. During assessment of an infant with TAPVR, which finding may indicate pulmonary congestion
(clinical judgment scenario 2)?
A. Crackles with increased work of breathing
B. Clear lungs and comfortable breathing
C. Improved oxygenation
D. Normal respiratory rate
Answer: A. Crackles with increased work of breathing
7. During assessment of an infant with TAPVR, which finding most strongly suggests decreased
cardiac output?
A. Improved feeding endurance
B. Warm skin with brisk refill
C. Cool extremities with delayed capillary refill
D. Normal urine output
Answer: C. Cool extremities with delayed capillary refill
Page 2
,8. While monitoring a child with TGA, Which professional may assist with breastfeeding technique?
A. Pathology technician
B. Optometrist
C. Radiology technologist
D. Certified lactation consultant
Answer: D. Certified lactation consultant
9. A nurse is caring for a child with truncus arteriosus. Which assessment helps evaluate peripheral
perfusion?
A. Pulses, capillary refill, color, and temperature
B. Pupil size only
C. Bowel sounds only
D. Hearing acuity
Answer: A. Pulses, capillary refill, color, and temperature
10. A parent is learning about TGA. Which feeding observation suggests poor tolerance?
A. Diaphoresis and increased respiratory effort
B. Normal color
C. Comfortable sucking
D. Calm breathing
Answer: A. Diaphoresis and increased respiratory effort
11. During assessment of an infant with PDA, which outcome suggests improvement?
A. Worsening tachypnea
B. Decreasing urine output
C. Increasing cyanosis
D. Better feeding tolerance with less respiratory distress
Answer: D. Better feeding tolerance with less respiratory distress
12. A parent is learning about TAPVR. Which finding should be reported promptly?
A. New cyanosis or increasing respiratory distress
B. Normal sleep
C. Improved appetite
D. Warm hands and feet
Answer: A. New cyanosis or increasing respiratory distress
13. A nurse is caring for a child with HLHS. Which assessment finding should the nurse prioritize?
A. Hair texture
B. Respiratory effort and oxygen saturation
C. Dental alignment
D. Visual acuity
Answer: B. Respiratory effort and oxygen saturation
14. A parent is learning about HLHS. Which finding most strongly suggests decreased cardiac output?
A. Cool extremities with delayed capillary refill
B. Improved feeding endurance
C. Normal urine output
D. Warm skin with brisk refill
Answer: A. Cool extremities with delayed capillary refill
15. During assessment of an infant with TOF, which assessment helps evaluate peripheral perfusion?
Page 3
, A. Bowel sounds only
B. Pupil size only
C. Hearing acuity
D. Pulses, capillary refill, color, and temperature
Answer: D. Pulses, capillary refill, color, and temperature
16. A parent is learning about pediatric heart failure. Which professional may help evaluate suspected
swallowing difficulty?
A. Dentist only
B. Speech-language pathologist or feeding specialist
C. Optician
D. Dermatologist
Answer: B. Speech-language pathologist or feeding specialist
17. A parent is learning about coarctation of the aorta. Which measurement is most useful for trending
fluid status?
A. Daily weight
B. Head circumference once a year
C. Hair length
D. Visual acuity
Answer: A. Daily weight
18. While monitoring a child with PDA, Which professional may assist with breastfeeding technique?
A. Radiology technologist
B. Optometrist
C. Pathology technician
D. Certified lactation consultant
Answer: D. Certified lactation consultant
19. A parent is learning about VSD. Which finding may indicate pulmonary congestion?
A. Improved oxygenation
B. Clear lungs and comfortable breathing
C. Normal respiratory rate
D. Crackles with increased work of breathing
Answer: D. Crackles with increased work of breathing
20. While monitoring a child with truncus arteriosus, Which finding may indicate pulmonary
congestion?
A. Improved oxygenation
B. Clear lungs and comfortable breathing
C. Normal respiratory rate
D. Crackles with increased work of breathing
Answer: D. Crackles with increased work of breathing
21. During assessment of an infant with truncus arteriosus, which assessment finding should the nurse
prioritize?
A. Dental alignment
B. Respiratory effort and oxygen saturation
C. Hair texture
D. Visual acuity
Answer: B. Respiratory effort and oxygen saturation
Page 4
