NUR-631 Final Exam Study Guide (Download to pass)

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NUR-631 Final Exam Study Guide (Download to pass) 5. Which congenital heart defects occur in trisomy 13, trisomy 18 and down syndrome? a. Coarctation of the aorta and pulmonary stenosis b. Tetralogy of Fallot and persistent truncus arteriosus c. Atrial septal defect and dextrocardia d. Ventricular septal defect and patent ductus arteriosus: d. Ventricular septal defect and patent ductus arteriosus Exp: Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18 and down syndrome include VSD and PDA see Table 33-2 The other defects are not associated with dysfunction of trisomy 13 or 17 and down syndrome. pg 1200 6. An infant has a continuous machine/type murmur best heard at the left upper sternal border throughout systole and diastole as well as a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect? a. Atrial septal defect b. Ventricular septal defect c. Patent ductus arteriosus d. Atrioventricular canal defect: c. Patent ductus arteriosus Exp: If pulmonary vascular resistance has fallen then infants with will characteristi- cally have a continuous machine/type murmur best heard at the left upper sternal border throughout systole and diastole. If the PDA is significant then the infant also will have bounding pulses an active precordium, a thrill on palpation and signs and symptoms of pulmonary over circulation. The presentations of the other congenital heart defects are not consistent with the described the symptoms pages 1203-1204 7. Which compensatory mechanism is spontaneously used by children diag- nosed with tetralogy of Fallot to relieve hypoxic spells? a. Lying on their left side b. Performing the valsalva maneuver c. Squatting d. hyperventilating: c. Squatting Exp: squatting is a spontaneous compensatory mechanism used by older children to alleviate hypoxic spells. Squatting and its variants increase systemic resistance while decreasing venous return to the heart from the inferior vena cava. The other options would not result in these changes. pg 1209

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