COMPLETE 200 Q&A WITH VERIFIED
RATIONALES | PEDIATRIC NURSING: CARDIAC,
RESPIRATORY, NEUROLOGICAL, RENAL,
ENDOCRINE, GI, HEMATOLOGIC, ONCOLOGIC,
INFECTIOUS DISEASES | LATEST UPDATE
2026/2027
NSG 3600 Exam 2 Practice Exam
Questions & Answers with Rationales
SECTION 1: CONGENITAL HEART DEFECTS &
CARDIAC DISORDERS
Question 1
A nurse is assessing a newborn with a
,suspected congenital heart defect. Which
finding is most suggestive of a cyanotic defect?
A. Bounding peripheral pulses
B. Oxygen saturation of 85% on room air
C. Hepatomegaly
D. Systolic murmur
☑VERIFIED ANSWER: B. Oxygen saturation of
85% on room air
Rationale: Cyanotic defects result in right-to-
left shunting, causing deoxygenated blood to
enter systemic circulation, leading to hypoxemia
(SpO2 typically <90%). Bounding pulses suggest
PDA (acyanotic). Hepatomegaly suggests heart
failure, which can occur in both types of
defects. Murmurs can occur in both types.
,Question 2
The nurse is caring for a child with a ventricular
septal defect (VSD). Which pathophysiologic
change does the nurse expect?
A. Increased pulmonary blood flow
B. Decreased pulmonary blood flow
C. Mixed blood flow with cyanosis
D. Obstruction of blood flow from the left
ventricle
☑VERIFIED ANSWER: A. Increased pulmonary
blood flow
Rationale: VSD is an acyanotic defect with left-
to-right shunting. Higher pressure in the left
ventricle forces blood through the hole into the
right ventricle and pulmonary artery, increasing
pulmonary blood flow.
, Question 3
A 4-month-old infant with a history of a large
VSD is showing signs of heart failure. Which
finding would the nurse expect?
A. Bounding pulses and hypertension
B. Tachypnea and poor feeding
C. Decreased respiratory rate
D. Weight gain and increased appetite
☑VERIFIED ANSWER: B. Tachypnea and poor
feeding
Rationale: Infants with heart failure exhibit
tachypnea, tachycardia, poor feeding, and
failure to thrive. The increased pulmonary
blood flow from the VSD causes pulmonary
congestion, leading to respiratory distress and
difficulty feeding.