NUR 311 Exam 3 Study Questions and
Correct Answers
What is the name for defects in which blood exiting the heart meets an area of anatomic
narrowing?
a. Mixed
b. Cyanotic
c. Acyanotic
d. Obstructive ✅D
- Narrowing causes an obstruction of blood flow.
- Acyanotic is classification of heart defect when the patient does not have signs of
cyanosis.
- Cyanotic is when children have symptoms of cyanosis.
- Mixed is when saturated and desaturated blood flow mixes.
What is a priority patient outcome for a child with congestive heart failure?
a. The child will have a rapid heart rate
b. The child will have skin that is cool to touch
c. The child will not have distended neck veins
d. The child will sleep with the head down and feet elevated ✅C
- Absent JVD is good, it indicates excessive fluid is not being retained.
- HR should be appropriate, not rapid.
- Skin should be warm, not cool.
- Child should sleep with head elevated, not feet elevated.
A nurse is to give her patient Digoxin. Which of the following would be appropriate for
the nurse to perform?
a. Hold Digoxin if apical HR is 170
b. Hold Digoxin if Digoxin levels are 1 ng/ml
c. Hold both Digoxin and Lasix for weight increased of 5% in one day
d. Hold both Digoxin and Lasix for potassium of 3.2 mEq/L ✅D
- Low potassium level; Lasix will further deplete potassium levels, and both Digoxin and
low potassium can cause arrhythmias. Administering Digoxin and Lasix when potassium
is low puts the patient at risk for Digoxin toxicity.
- Therapeutic levels for Digoxin is 0.8-2 ng/ml, so 1 is within normal.
- A and C are consistent with congestive heart failure, and warrant Digoxin
administration.
, The nurse is caring for a newborn that has transposition of the great vessels and is in
congestive heart failure. Which of the following symptoms should the nurse expect in
this child? Select all that apply.
a. Tachypneic
b. High BP
c. Tachycardiac
d. Cyanosis
e. Increased urine output
f. Large head circumference ✅A, C & D
- Increased HR, increased RR, cyanosis, sweating, decrease urinary output., and failure
to thrive are all signs of congestive heart failure.
- Infants cannot regulate BP yet because they can't control the contractility of the heart,
therefore they can only increase their HR.
During an examination of an infant with a patent ductus arteriosus (PDA), the healthcare
provider should expect to observe: (Select all that apply)
a. Profound cyanosis
b. Widening pulse pressure
c. Systolic murmur
d. Bounding peripheral pulses
e. Clubbing of fingers and toes ✅B, C & D
- Blood is being shunted from the aorta, to the pulmonary artery, to the left side of the
heart, causing increased stroke volume, bounding pulses, a murmur, increased systolic
pressure, and a widening pulse pressure.
- They generally will not have cyanosis.
A 3-year-old patient with a congenital atrial septal defect has lived with the defect
without significant problems until now. Which of the following is an indication that the
patient is becoming hemodynamically symptomatic?
a. Bronchoconstriction
b. Wheezing
c. Extertional dyspnea
d. Intermittent claudication
e. BP 140/90 ✅C
- Bronchoconstriction and wheezing are caused by smooth muscle constriction, not a
cardiac problem.
- Intermitten claudication is cramping in the legs when blood is not perfused adequately
to the lower extremities during exercise. This can happen without cardiac issues.
Correct Answers
What is the name for defects in which blood exiting the heart meets an area of anatomic
narrowing?
a. Mixed
b. Cyanotic
c. Acyanotic
d. Obstructive ✅D
- Narrowing causes an obstruction of blood flow.
- Acyanotic is classification of heart defect when the patient does not have signs of
cyanosis.
- Cyanotic is when children have symptoms of cyanosis.
- Mixed is when saturated and desaturated blood flow mixes.
What is a priority patient outcome for a child with congestive heart failure?
a. The child will have a rapid heart rate
b. The child will have skin that is cool to touch
c. The child will not have distended neck veins
d. The child will sleep with the head down and feet elevated ✅C
- Absent JVD is good, it indicates excessive fluid is not being retained.
- HR should be appropriate, not rapid.
- Skin should be warm, not cool.
- Child should sleep with head elevated, not feet elevated.
A nurse is to give her patient Digoxin. Which of the following would be appropriate for
the nurse to perform?
a. Hold Digoxin if apical HR is 170
b. Hold Digoxin if Digoxin levels are 1 ng/ml
c. Hold both Digoxin and Lasix for weight increased of 5% in one day
d. Hold both Digoxin and Lasix for potassium of 3.2 mEq/L ✅D
- Low potassium level; Lasix will further deplete potassium levels, and both Digoxin and
low potassium can cause arrhythmias. Administering Digoxin and Lasix when potassium
is low puts the patient at risk for Digoxin toxicity.
- Therapeutic levels for Digoxin is 0.8-2 ng/ml, so 1 is within normal.
- A and C are consistent with congestive heart failure, and warrant Digoxin
administration.
, The nurse is caring for a newborn that has transposition of the great vessels and is in
congestive heart failure. Which of the following symptoms should the nurse expect in
this child? Select all that apply.
a. Tachypneic
b. High BP
c. Tachycardiac
d. Cyanosis
e. Increased urine output
f. Large head circumference ✅A, C & D
- Increased HR, increased RR, cyanosis, sweating, decrease urinary output., and failure
to thrive are all signs of congestive heart failure.
- Infants cannot regulate BP yet because they can't control the contractility of the heart,
therefore they can only increase their HR.
During an examination of an infant with a patent ductus arteriosus (PDA), the healthcare
provider should expect to observe: (Select all that apply)
a. Profound cyanosis
b. Widening pulse pressure
c. Systolic murmur
d. Bounding peripheral pulses
e. Clubbing of fingers and toes ✅B, C & D
- Blood is being shunted from the aorta, to the pulmonary artery, to the left side of the
heart, causing increased stroke volume, bounding pulses, a murmur, increased systolic
pressure, and a widening pulse pressure.
- They generally will not have cyanosis.
A 3-year-old patient with a congenital atrial septal defect has lived with the defect
without significant problems until now. Which of the following is an indication that the
patient is becoming hemodynamically symptomatic?
a. Bronchoconstriction
b. Wheezing
c. Extertional dyspnea
d. Intermittent claudication
e. BP 140/90 ✅C
- Bronchoconstriction and wheezing are caused by smooth muscle constriction, not a
cardiac problem.
- Intermitten claudication is cramping in the legs when blood is not perfused adequately
to the lower extremities during exercise. This can happen without cardiac issues.
