RNSG 1538 CORRECT EXAMS ANSWERS AND
QUESTIONS SET A+
✔✔What are the clinical manifestations of Ventricular Septal Defect (VSD)? - ✔✔-Poor
eating, failure to thrive
-Fast breathing or breathlessness
-Easy tiring
✔✔What are the clinical manifestations of Tetralogy of Fallot? - ✔✔-A bluish coloration
of the skin caused by blood low in oxygen (cyanosis)
-Shortness of breath and rapid breathing, especially during feeding or exercise
-Loss of consciousness (fainting)
-Clubbing of fingers and toes — an abnormal, rounded shape of the nail bed
-Poor weight gain
-Tiring easily during play or exercise
-Irritability
-Prolonged crying
-A heart murmur
✔✔You're providing an in-service to a group of new nurses who will be caring for
patients who have Tetralogy of Fallot. Which statement below is INCORRECT
concerning how the blood normally flows through the heart?
A. Unoxygenated blood enters through the superior and inferior vena cava and travels
to the left atrium.
B. The pulmonic valve receives blood from the right ventricle and allows blood to flow to
the lungs via the pulmonary artery.
C. The left atrium allows blood to flow down through the bicuspid valve (mitral) into the
left ventricle.
D. Oxygenated blood leaves the left ventricle and flows up through the aortic valve and
aorta to be pumped to the rest of the body. - ✔✔A. Unoxygenated blood enters through
the superior and inferior vena cava and travels to the left atrium.
✔✔2. A 4-month-old is diagnosed with Tetralogy of Fallot. You're providing an
illustration to the parent to help him understand the pathophysiology of this condition.
,What defects must be present in the illustration to help the parent understand their
child's condition? Select all that apply:
A. Aortic stenosis
B. Ventricular septal defect
C. Coarctation of aorta
D. Right ventricular hypertrophy
E. Displacement of the aorta
F. Pulmonic stenosis
G. Patent ductus arteriosus - ✔✔B. Ventricular septal defect
D. Right ventricular hypertrophy
E. Displacement of the aorta
F. Pulmonic stenosis
✔✔As the nurse you know which statements are TRUE about Tetralogy of Fallot?
Select all that apply:
A. "Tetralogy of Fallot is a cyanotic heart defect."
B. "In this condition the heart has to work harder to pump blood to the lungs, which
cause the right ventricle to work harder and enlarge."
C. "Tetralogy of Fallot is treated with only palliative surgery."
D. "Many patients with this condition will experience clubbing of the nails." - ✔✔A.
"Tetralogy of Fallot is a cyanotic heart defect."
B. "In this condition the heart has to work harder to pump blood to the lungs, which
cause the right ventricle to work harder and enlarge."
D. "Many patients with this condition will experience clubbing of the nails."
✔✔While feeding a 3-month-old infant, who has Tetralogy of Fallot, you notice the
infant's skin begins to have a bluish tint and the breathing rate has increased. Your
immediate nursing action is to?
A. Continue feeding the infant and place the infant on oxygen.
B. Stop feeding the infant and provide suction.
C. Stop feeding the infant and place the infant in the knee-to-chest position and
administer oxygen.
D. Assess the infant's heart rate and rhythm. - ✔✔C. Stop feeding the infant and place
the infant in the knee-to-chest position and administer oxygen.
✔✔You are assessing the heart sounds of a patient with a severe case of Tetralogy of
Fallot. You would expect to hear a __________ murmur at the _______ of the sternal
border?
A. diastolic; right
B. systolic; left
C. diastolic; left
D. systolic; right - ✔✔B. systolic; left
,✔✔As the registered nurse you are developing a plan of care for a patient with
Tetralogy of Fallot. Select all the appropriate nursing diagnoses below that would be
specific to this patient:
A. Risk for deficient fluid volume
B. Ineffective airway clearance
C. Activity Intolerance
D. Failure to thrive
E. Risk for impaired liver function - ✔✔C. Activity Intolerance
D. Failure to thrive
✔✔A family member, who is caring for a 2-year-old with Tetralogy of Fallot, asks you
why the child will periodically squat when playing with other children. Your response is:
A. "Squatting helps to increase systemic vascular resistance, which will decrease the
right to left shunt that is occurring in the ventricles and this helps increase oxygen
levels."
B. "Squatting helps to decrease systemic vascular resistance, which will decrease the
left to right shunt that is occurring in the ventricles and this helps increase oxygen
levels."
C. "Squatting helps to decrease systemic vascular resistance, which will increase the
right to left shunt that is occurring in the ventricles and this helps increase oxygen
levels."
D. "Squatting helps to normalize systemic vascular resistance, which will increase the
left to right shunt that is occurring in the ventricles and this helps increase oxygen
levels." - ✔✔A. "Squatting helps to increase systemic vascular resistance, which will
decrease the right to left shunt that is occurring in the ventricles and this helps increase
oxygen levels."
✔✔You're caring for a newborn who has Tetralogy of Fallot with severe cyanosis. You
anticipate the newborn will be started on ___________?
A: Indomethacin
B. Diclofenac
C. Celecoxib
D. Alprostadil - ✔✔D. Alprostadil
✔✔You're caring for a 2-day-old infant with a large patent ductus arteriosus. The mother
of the infant is anxious and asks you to explain her child's condition to her again. Which
statement below BEST describes this condition?
A. "The vessel connecting the aorta and pulmonary vein has closed prematurely, which
is leading to increased blood flow to the lungs."
B. "The vessel connecting the aorta and pulmonary artery has failed to close at birth,
which is leading to a left-to-right shunt of blood."
C. The vessel connecting the aorta and pulmonary vein has failed to close at birth,
which is leading to a right-to-left shunt of blood."
D. "The vessel connecting the aorta and pulmonary artery has closed prematurely,
which is leading to a left-to-right shunt of blood." - ✔✔B. "The vessel connecting the
, aorta and pulmonary artery has failed to close at birth, which is leading to a left-to-right
shunt of blood."
✔✔As the nurse you know which statements below are correct about the ductus
arteriosus? Select all that apply:
A. "The ductus arteriosus is a structure that should be present in all babies in utero."
B. "The ductus arteriosus normally closes about 3 days after birth or sooner."
C. "The purpose of the ductus arteriosus is to help carry blood that is entering the left
side of the heart to the rest of the body, hence bypassing the lungs."
D. "The ductus arteriosus connects the aorta to the pulmonary vein." - ✔✔A. "The
ductus arteriosus is a structure that should be present in all babies in utero."
B. "The ductus arteriosus normally closes about 3 days after birth or sooner."
✔✔While assessing a newborn's heart sounds you note a loud murmur at the left upper
sternal border. You report this to the physician who suspects the infant may have patent
ductus arteriosus. The physician asks you to obtain a pulse pressure. If patent ductus
arteriosus is present, the pulse pressure would be ___________.
A. Narrow
B. Fluctuating
C. Wide
D. Normal - ✔✔C. Wide
✔✔As noted in the previous question, a loud murmur was noted during assessment of a
newborn with patent ductus arteriosus. As the nurse you know that what type of murmur
is a hallmark sign of this condition?
A. harsh, loud systolic murmur
B. soft, blowing diastolic murmur
C. systolic and diastolic machinery-like murmur
D. machinery-like murmur present on only diastole - ✔✔C. systolic and diastolic
machinery-like murmur
✔✔You're working on a unit that provides specialized cardiac care to the pediatric
population. Which patient below would be the best candidate for Indomethacin from the
treatment of patent ductus arteriosus?
A. A 25-year-old adult
B. A premature infant
C. An 8 month old child
D. A 12 year old child - ✔✔B. A premature infant
✔✔You're working in the NICU providing care to a neonate who has a large patent
ductus arteriosus. Which finding during your head-to-toe assessment would require you
to immediately notify the physician?
A. Loud, harsh continuous murmur
B. Abnormal pulse pressure
C. Crackles
QUESTIONS SET A+
✔✔What are the clinical manifestations of Ventricular Septal Defect (VSD)? - ✔✔-Poor
eating, failure to thrive
-Fast breathing or breathlessness
-Easy tiring
✔✔What are the clinical manifestations of Tetralogy of Fallot? - ✔✔-A bluish coloration
of the skin caused by blood low in oxygen (cyanosis)
-Shortness of breath and rapid breathing, especially during feeding or exercise
-Loss of consciousness (fainting)
-Clubbing of fingers and toes — an abnormal, rounded shape of the nail bed
-Poor weight gain
-Tiring easily during play or exercise
-Irritability
-Prolonged crying
-A heart murmur
✔✔You're providing an in-service to a group of new nurses who will be caring for
patients who have Tetralogy of Fallot. Which statement below is INCORRECT
concerning how the blood normally flows through the heart?
A. Unoxygenated blood enters through the superior and inferior vena cava and travels
to the left atrium.
B. The pulmonic valve receives blood from the right ventricle and allows blood to flow to
the lungs via the pulmonary artery.
C. The left atrium allows blood to flow down through the bicuspid valve (mitral) into the
left ventricle.
D. Oxygenated blood leaves the left ventricle and flows up through the aortic valve and
aorta to be pumped to the rest of the body. - ✔✔A. Unoxygenated blood enters through
the superior and inferior vena cava and travels to the left atrium.
✔✔2. A 4-month-old is diagnosed with Tetralogy of Fallot. You're providing an
illustration to the parent to help him understand the pathophysiology of this condition.
,What defects must be present in the illustration to help the parent understand their
child's condition? Select all that apply:
A. Aortic stenosis
B. Ventricular septal defect
C. Coarctation of aorta
D. Right ventricular hypertrophy
E. Displacement of the aorta
F. Pulmonic stenosis
G. Patent ductus arteriosus - ✔✔B. Ventricular septal defect
D. Right ventricular hypertrophy
E. Displacement of the aorta
F. Pulmonic stenosis
✔✔As the nurse you know which statements are TRUE about Tetralogy of Fallot?
Select all that apply:
A. "Tetralogy of Fallot is a cyanotic heart defect."
B. "In this condition the heart has to work harder to pump blood to the lungs, which
cause the right ventricle to work harder and enlarge."
C. "Tetralogy of Fallot is treated with only palliative surgery."
D. "Many patients with this condition will experience clubbing of the nails." - ✔✔A.
"Tetralogy of Fallot is a cyanotic heart defect."
B. "In this condition the heart has to work harder to pump blood to the lungs, which
cause the right ventricle to work harder and enlarge."
D. "Many patients with this condition will experience clubbing of the nails."
✔✔While feeding a 3-month-old infant, who has Tetralogy of Fallot, you notice the
infant's skin begins to have a bluish tint and the breathing rate has increased. Your
immediate nursing action is to?
A. Continue feeding the infant and place the infant on oxygen.
B. Stop feeding the infant and provide suction.
C. Stop feeding the infant and place the infant in the knee-to-chest position and
administer oxygen.
D. Assess the infant's heart rate and rhythm. - ✔✔C. Stop feeding the infant and place
the infant in the knee-to-chest position and administer oxygen.
✔✔You are assessing the heart sounds of a patient with a severe case of Tetralogy of
Fallot. You would expect to hear a __________ murmur at the _______ of the sternal
border?
A. diastolic; right
B. systolic; left
C. diastolic; left
D. systolic; right - ✔✔B. systolic; left
,✔✔As the registered nurse you are developing a plan of care for a patient with
Tetralogy of Fallot. Select all the appropriate nursing diagnoses below that would be
specific to this patient:
A. Risk for deficient fluid volume
B. Ineffective airway clearance
C. Activity Intolerance
D. Failure to thrive
E. Risk for impaired liver function - ✔✔C. Activity Intolerance
D. Failure to thrive
✔✔A family member, who is caring for a 2-year-old with Tetralogy of Fallot, asks you
why the child will periodically squat when playing with other children. Your response is:
A. "Squatting helps to increase systemic vascular resistance, which will decrease the
right to left shunt that is occurring in the ventricles and this helps increase oxygen
levels."
B. "Squatting helps to decrease systemic vascular resistance, which will decrease the
left to right shunt that is occurring in the ventricles and this helps increase oxygen
levels."
C. "Squatting helps to decrease systemic vascular resistance, which will increase the
right to left shunt that is occurring in the ventricles and this helps increase oxygen
levels."
D. "Squatting helps to normalize systemic vascular resistance, which will increase the
left to right shunt that is occurring in the ventricles and this helps increase oxygen
levels." - ✔✔A. "Squatting helps to increase systemic vascular resistance, which will
decrease the right to left shunt that is occurring in the ventricles and this helps increase
oxygen levels."
✔✔You're caring for a newborn who has Tetralogy of Fallot with severe cyanosis. You
anticipate the newborn will be started on ___________?
A: Indomethacin
B. Diclofenac
C. Celecoxib
D. Alprostadil - ✔✔D. Alprostadil
✔✔You're caring for a 2-day-old infant with a large patent ductus arteriosus. The mother
of the infant is anxious and asks you to explain her child's condition to her again. Which
statement below BEST describes this condition?
A. "The vessel connecting the aorta and pulmonary vein has closed prematurely, which
is leading to increased blood flow to the lungs."
B. "The vessel connecting the aorta and pulmonary artery has failed to close at birth,
which is leading to a left-to-right shunt of blood."
C. The vessel connecting the aorta and pulmonary vein has failed to close at birth,
which is leading to a right-to-left shunt of blood."
D. "The vessel connecting the aorta and pulmonary artery has closed prematurely,
which is leading to a left-to-right shunt of blood." - ✔✔B. "The vessel connecting the
, aorta and pulmonary artery has failed to close at birth, which is leading to a left-to-right
shunt of blood."
✔✔As the nurse you know which statements below are correct about the ductus
arteriosus? Select all that apply:
A. "The ductus arteriosus is a structure that should be present in all babies in utero."
B. "The ductus arteriosus normally closes about 3 days after birth or sooner."
C. "The purpose of the ductus arteriosus is to help carry blood that is entering the left
side of the heart to the rest of the body, hence bypassing the lungs."
D. "The ductus arteriosus connects the aorta to the pulmonary vein." - ✔✔A. "The
ductus arteriosus is a structure that should be present in all babies in utero."
B. "The ductus arteriosus normally closes about 3 days after birth or sooner."
✔✔While assessing a newborn's heart sounds you note a loud murmur at the left upper
sternal border. You report this to the physician who suspects the infant may have patent
ductus arteriosus. The physician asks you to obtain a pulse pressure. If patent ductus
arteriosus is present, the pulse pressure would be ___________.
A. Narrow
B. Fluctuating
C. Wide
D. Normal - ✔✔C. Wide
✔✔As noted in the previous question, a loud murmur was noted during assessment of a
newborn with patent ductus arteriosus. As the nurse you know that what type of murmur
is a hallmark sign of this condition?
A. harsh, loud systolic murmur
B. soft, blowing diastolic murmur
C. systolic and diastolic machinery-like murmur
D. machinery-like murmur present on only diastole - ✔✔C. systolic and diastolic
machinery-like murmur
✔✔You're working on a unit that provides specialized cardiac care to the pediatric
population. Which patient below would be the best candidate for Indomethacin from the
treatment of patent ductus arteriosus?
A. A 25-year-old adult
B. A premature infant
C. An 8 month old child
D. A 12 year old child - ✔✔B. A premature infant
✔✔You're working in the NICU providing care to a neonate who has a large patent
ductus arteriosus. Which finding during your head-to-toe assessment would require you
to immediately notify the physician?
A. Loud, harsh continuous murmur
B. Abnormal pulse pressure
C. Crackles
