NUR 254 Exam 3 | Questions and
Answers 2026 Update | 100%
Correct-Galen College of Nursing.
Course
NUR 254
1. A newborn has a patent ductus arteriosus (PDA). Which finding would the nurse expect?
A. Right-to-left shunting with severe cyanosis
B. Left-to-right shunting with increased pulmonary blood flow
C. Complete obstruction of pulmonary blood flow
D. Decreased pulmonary circulation
Answer: B. Left-to-right shunting with increased pulmonary blood flow
Rationale: PDA allows blood to flow from the higher-pressure aorta into the pulmonary artery.
This produces a left-to-right shunt and increases pulmonary blood flow. A characteristic finding
is a continuous "machine-like" murmur.
2. Which medication may be used to promote closure of a PDA in a premature infant?
A. Indomethacin
B. Prostaglandin E1
C. Epinephrine
D. Digoxin
Answer: A. Indomethacin
Rationale: Indomethacin, an NSAID, inhibits prostaglandin synthesis and can promote closure
of a PDA. Prostaglandin E1 has the opposite clinical purpose in certain ductal-dependent
congenital heart defects because it maintains ductal patency.
3. An infant has transposition of the great arteries. Which intervention is anticipated before
definitive surgical correction?
A. Administer prostaglandin E1
B. Restrict all oxygen
C. Administer indomethacin
D. Begin oral iron therapy
Answer: A. Administer prostaglandin E1
, Rationale: In transposition of the great arteries, systemic and pulmonary circulations run in
parallel. Maintaining ductal patency with prostaglandin E1 can improve mixing of oxygenated
and deoxygenated blood while the infant awaits definitive treatment.
4. Which finding is most concerning in an infant with heart failure?
A. Respiratory rate of 68/min
B. Sleeping for 16 hours daily
C. Heart rate of 110/min
D. Strong peripheral pulses
Answer: A. Respiratory rate of 68/min
Rationale: Tachypnea is an important early manifestation of heart failure in infants. Infants may
also demonstrate poor feeding, diaphoresis during feeds, tachycardia, hepatomegaly, and
inadequate weight gain.
5. A nurse is caring for an infant receiving digoxin. Which assessment is most important
before administration?
A. Bowel sounds
B. Apical heart rate
C. Pupil size
D. Temperature only
Answer: B. Apical heart rate
Rationale: Digoxin can cause bradycardia and other dysrhythmias. The nurse should assess the
apical pulse before administration and follow the prescribed pediatric parameters for withholding
the medication.
6. Which finding is characteristic of right-sided heart failure?
A. Pulmonary crackles only
B. Peripheral edema and hepatomegaly
C. Hemoptysis
D. Severe hypertension
Answer: B. Peripheral edema and hepatomegaly
Answers 2026 Update | 100%
Correct-Galen College of Nursing.
Course
NUR 254
1. A newborn has a patent ductus arteriosus (PDA). Which finding would the nurse expect?
A. Right-to-left shunting with severe cyanosis
B. Left-to-right shunting with increased pulmonary blood flow
C. Complete obstruction of pulmonary blood flow
D. Decreased pulmonary circulation
Answer: B. Left-to-right shunting with increased pulmonary blood flow
Rationale: PDA allows blood to flow from the higher-pressure aorta into the pulmonary artery.
This produces a left-to-right shunt and increases pulmonary blood flow. A characteristic finding
is a continuous "machine-like" murmur.
2. Which medication may be used to promote closure of a PDA in a premature infant?
A. Indomethacin
B. Prostaglandin E1
C. Epinephrine
D. Digoxin
Answer: A. Indomethacin
Rationale: Indomethacin, an NSAID, inhibits prostaglandin synthesis and can promote closure
of a PDA. Prostaglandin E1 has the opposite clinical purpose in certain ductal-dependent
congenital heart defects because it maintains ductal patency.
3. An infant has transposition of the great arteries. Which intervention is anticipated before
definitive surgical correction?
A. Administer prostaglandin E1
B. Restrict all oxygen
C. Administer indomethacin
D. Begin oral iron therapy
Answer: A. Administer prostaglandin E1
, Rationale: In transposition of the great arteries, systemic and pulmonary circulations run in
parallel. Maintaining ductal patency with prostaglandin E1 can improve mixing of oxygenated
and deoxygenated blood while the infant awaits definitive treatment.
4. Which finding is most concerning in an infant with heart failure?
A. Respiratory rate of 68/min
B. Sleeping for 16 hours daily
C. Heart rate of 110/min
D. Strong peripheral pulses
Answer: A. Respiratory rate of 68/min
Rationale: Tachypnea is an important early manifestation of heart failure in infants. Infants may
also demonstrate poor feeding, diaphoresis during feeds, tachycardia, hepatomegaly, and
inadequate weight gain.
5. A nurse is caring for an infant receiving digoxin. Which assessment is most important
before administration?
A. Bowel sounds
B. Apical heart rate
C. Pupil size
D. Temperature only
Answer: B. Apical heart rate
Rationale: Digoxin can cause bradycardia and other dysrhythmias. The nurse should assess the
apical pulse before administration and follow the prescribed pediatric parameters for withholding
the medication.
6. Which finding is characteristic of right-sided heart failure?
A. Pulmonary crackles only
B. Peripheral edema and hepatomegaly
C. Hemoptysis
D. Severe hypertension
Answer: B. Peripheral edema and hepatomegaly
