NURS 307-Week 3-Final Exam and All
Correct Answers 2026-2027 Update.
congenital heart disease - Answer Anatomic defects of the heart present normal blood flow
to the pulmonary and/or systemic system.
Defects are categorized by blood flow patterns in the heart
● Increased pulmonary blood flow: ASD, VSD, PDA
● Decreased pulmonary blood flow: Tetralogy of fallot, tricuspid atresia
● Obstruction to blood flow Coarctation of the aorta, pulmonary stenosis, aortic stenosis
● Mixed blood flow: Transposition of the great arteries, truncus arteriosus, hypoplastic left
heart syndrome
maternal risk factors for congenital heart diseases - Answer - infection
- alcohol or other substance use disorders during pregnancy
- diabetes mellitus
Causes of congenital heart disease - Answer - exposure to drugs, alcohol, smoking
- maternal infections like rubella, coxsackie B5 virus
- Maternal metabolic disorders like PKU, DM, hypercalcemia
- Increased maternal age
- Genetic factors
- Chromosomal abnormalities
- Idiopathic
Clinical Manifestations of congenital heart disease - Answer - First sign of concern is presence
of murmur -> blood is being shunted away from normal path of flow
- fetal heart has a patent ductus arteriosis (PDA) and patent foramen ovale (PFO)
- The PFO closes instantaneously upon first breath
- any persistence of opening can result in presence of murmur
,- the PDA should close shortly thereafter
- any persistence of opening will result in mixing of blood (oxygenated and deoxygenated)
cardiac output - Answer volume of blood ejected from left ventricle = stroke volume (amount
of blood ejected) x Heart Rate (beats per minute)
CO = SV x HR
- Compensate occurs by elevating HR to change CO
- Mixing blood saturations will result in O2 of 75-85%
- Chronic saturations of <85% will result in hypoxemic manifestations such as nail clubbing,
retractions, nasal flaring, pale/cyanotic tone, possible tripoding
genetic risk factors for congenital heart disease - Answer - history of congenital heart disease
in other family members
- syndromes (Trisomy 21)
- presence of other congenital anomalies or chromosomal abnormalities
defects that increase pulmonary blood flow - Answer Defects birth increased pulmonary
blood flow allow blood to shift from the high pressure left side of the heart to the right, lower
pressure side of the heart.
● Increased pulmonary blood volume on the right side of the heart increases pulmonary blood
flow
● These defects include manifestations and findings of heart failure.
- Higher pressures on the LEFT side of the heart
- more blood to the lungs
- increased pulmonary vascular resistance
- right ventricular hypertrophy occurs
- Blood is shunting LEFT to RIGHT
clinical manifestations of increased pulmonary blood flow - Answer - Manifestations:
- Tachy
,- Increased metabolic rate
- Increased work of breathing and diaphoretic with feeding
- frequent breaks, tube feeding
- poor weight gain, FTT
- if CHF develops,
- dyspnea
- tachypnea, retractions
-periorbital edema
- frequent respiratory infections
ventricular septal defect (VSD) - Answer a hole in the septum between the right and left
ventricle that results in increased pulmonary blood flow (left-to-right shunt)
- loud, harsh murmur with a fixed split second heart sound
- heart failure
- asymptomatic (possibly)
- Increased pulmonary blood flow
atrial septal defect (ASD) - Answer - a hole in the septum between the right and left atria that
results in increased pulmonary blood flow (left-to-right shunt)
- loud, harsh murmur with a fixed split second heart sound
- heart failure
- asymptomatic (possibly)
- Increased pulmonary blood flow
patent ductus arteriosus (PDA) - Answer a condition in which the normal fetal circulation
conduit between the pulmonary artery and the aorta fails to close and results in increased
pulmonary blood flow (left-to-right shunt)
- systolic murmur (machine hum)
- wide pulse pressure
, - bounding pulses
- asymptomatic (possibly)
- heart failure
- rales
- Increased pulmonary blood flow
obstructive defects - Answer obstructive defects include those where blood flow exiting the
heart meets an area of narrowing (stenosis), which causes obstruction of blood flow
● The pressure that occurs before the defect is increased (ventricle) and the pressure that
occurs after the defect is decreased. This results in a decrease in cardiac output.
● These children can present with manifestations of heart failure.
- obstructed blood flow from right side to the left
- right to left shunting due to increased pressures if in presence of a septal defect
- decreased oxygenation -> hypoxemia and cyanosis
- polycythemia as a compensatory response
- hypercyanosis with change of position, crying, feeding, activity, valsalva maeuvers
- hypoxemia, tet spells, severe respiratory distress
- stenosis leading to pressure overload in the left side of the heart can yield decreased cardiac
output and obstruction to normal flow
- high pressure in the ventricle can lead to decreased cardiac output and may progress to shock
clinical manifestations and therapy for obstructed systemic blood flow - Answer - diminished
pulses
- poor color
- delayed capillary refill
- decreased UOP
- CHF, pulmonary edema
- leg cramps, cooler lower extremities
- decreased cardiac output, shock
- palliative measures
Correct Answers 2026-2027 Update.
congenital heart disease - Answer Anatomic defects of the heart present normal blood flow
to the pulmonary and/or systemic system.
Defects are categorized by blood flow patterns in the heart
● Increased pulmonary blood flow: ASD, VSD, PDA
● Decreased pulmonary blood flow: Tetralogy of fallot, tricuspid atresia
● Obstruction to blood flow Coarctation of the aorta, pulmonary stenosis, aortic stenosis
● Mixed blood flow: Transposition of the great arteries, truncus arteriosus, hypoplastic left
heart syndrome
maternal risk factors for congenital heart diseases - Answer - infection
- alcohol or other substance use disorders during pregnancy
- diabetes mellitus
Causes of congenital heart disease - Answer - exposure to drugs, alcohol, smoking
- maternal infections like rubella, coxsackie B5 virus
- Maternal metabolic disorders like PKU, DM, hypercalcemia
- Increased maternal age
- Genetic factors
- Chromosomal abnormalities
- Idiopathic
Clinical Manifestations of congenital heart disease - Answer - First sign of concern is presence
of murmur -> blood is being shunted away from normal path of flow
- fetal heart has a patent ductus arteriosis (PDA) and patent foramen ovale (PFO)
- The PFO closes instantaneously upon first breath
- any persistence of opening can result in presence of murmur
,- the PDA should close shortly thereafter
- any persistence of opening will result in mixing of blood (oxygenated and deoxygenated)
cardiac output - Answer volume of blood ejected from left ventricle = stroke volume (amount
of blood ejected) x Heart Rate (beats per minute)
CO = SV x HR
- Compensate occurs by elevating HR to change CO
- Mixing blood saturations will result in O2 of 75-85%
- Chronic saturations of <85% will result in hypoxemic manifestations such as nail clubbing,
retractions, nasal flaring, pale/cyanotic tone, possible tripoding
genetic risk factors for congenital heart disease - Answer - history of congenital heart disease
in other family members
- syndromes (Trisomy 21)
- presence of other congenital anomalies or chromosomal abnormalities
defects that increase pulmonary blood flow - Answer Defects birth increased pulmonary
blood flow allow blood to shift from the high pressure left side of the heart to the right, lower
pressure side of the heart.
● Increased pulmonary blood volume on the right side of the heart increases pulmonary blood
flow
● These defects include manifestations and findings of heart failure.
- Higher pressures on the LEFT side of the heart
- more blood to the lungs
- increased pulmonary vascular resistance
- right ventricular hypertrophy occurs
- Blood is shunting LEFT to RIGHT
clinical manifestations of increased pulmonary blood flow - Answer - Manifestations:
- Tachy
,- Increased metabolic rate
- Increased work of breathing and diaphoretic with feeding
- frequent breaks, tube feeding
- poor weight gain, FTT
- if CHF develops,
- dyspnea
- tachypnea, retractions
-periorbital edema
- frequent respiratory infections
ventricular septal defect (VSD) - Answer a hole in the septum between the right and left
ventricle that results in increased pulmonary blood flow (left-to-right shunt)
- loud, harsh murmur with a fixed split second heart sound
- heart failure
- asymptomatic (possibly)
- Increased pulmonary blood flow
atrial septal defect (ASD) - Answer - a hole in the septum between the right and left atria that
results in increased pulmonary blood flow (left-to-right shunt)
- loud, harsh murmur with a fixed split second heart sound
- heart failure
- asymptomatic (possibly)
- Increased pulmonary blood flow
patent ductus arteriosus (PDA) - Answer a condition in which the normal fetal circulation
conduit between the pulmonary artery and the aorta fails to close and results in increased
pulmonary blood flow (left-to-right shunt)
- systolic murmur (machine hum)
- wide pulse pressure
, - bounding pulses
- asymptomatic (possibly)
- heart failure
- rales
- Increased pulmonary blood flow
obstructive defects - Answer obstructive defects include those where blood flow exiting the
heart meets an area of narrowing (stenosis), which causes obstruction of blood flow
● The pressure that occurs before the defect is increased (ventricle) and the pressure that
occurs after the defect is decreased. This results in a decrease in cardiac output.
● These children can present with manifestations of heart failure.
- obstructed blood flow from right side to the left
- right to left shunting due to increased pressures if in presence of a septal defect
- decreased oxygenation -> hypoxemia and cyanosis
- polycythemia as a compensatory response
- hypercyanosis with change of position, crying, feeding, activity, valsalva maeuvers
- hypoxemia, tet spells, severe respiratory distress
- stenosis leading to pressure overload in the left side of the heart can yield decreased cardiac
output and obstruction to normal flow
- high pressure in the ventricle can lead to decreased cardiac output and may progress to shock
clinical manifestations and therapy for obstructed systemic blood flow - Answer - diminished
pulses
- poor color
- delayed capillary refill
- decreased UOP
- CHF, pulmonary edema
- leg cramps, cooler lower extremities
- decreased cardiac output, shock
- palliative measures
