NRSG 1330 EXAM 2 2025 QUESTIONS
AND ANSWERS
What are the three anatomic shunts in fetal circulation? - ANS - foramen ovale
- ductus arteriosus
- ductus venosus
What/where is the foramen ovale? - ANS An opening between the two atria that allows for
the mixing of oxygenated and deoxygenated blood
What/where is the ductus arteriosus? - ANS A ligamentous vessel connecting the ascending
aorta to the pulmonary arteries that allows for the mixing for oxygenated and deoxygenated
blood
Fetal specific cardiovascular structures should close and transition to newborn heart structure
by what time frame? - ANS By 24 hours after the baby is born, we expect all fetal heart
structures to close and transition to newborn heart structure.
This is why we wait until the 24 hour mark of life to perform a cardiac screening.
By what age should capillary refill be < 3 seconds? - ANS 12 months
What are innocent murmurs? - ANS Turbulent or inceased blood flow through a heart with
normal anatomy and function
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,Requires frequent monitoring to rule of the presence of defects
Will eventually grow out of it
What abnormal signs/symptoms would lead to suspected cardiac pathology? - ANS - failure
to thrive, poor weight gain
- cyanosis, pallor
- visualized pulsating neck veins (JVD)
- tachypnea, dyspnea
- irregular pulse rate
- clubbing of fingers
- fatigue during feeding or activity
- excessive perspiration, especially over forehead
What is failure to thrive? - ANS Consistently at or below the third percentile for height and
weight
Acyanotic congenital heart defects are caused by one of what two things? - ANS Increased
pulmonary blood flow
- atrial septal defect
- ventricular septal defect
- patent ductus arteriosus
- atrioventricular canal
Obstruction to blood flow from ventricles
- coarctation of aorta
- aortic stenosis
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,- pulmonic stenosis
Cyanotic congenital heart defects are caused by one of what two things? - ANS Decreased
pulmonary blood flow
- tetralogy of fallot
- tricuspid atresia
Mixed blood flow
- transposition of great arteries
- total anomalous pulmonary venous return
- truncus arteriosus
- hypoplastic left heart syndrome
True or false: Cyanotic congenital heart diseases/defects are usually more serious than
acyanotic diseases/defects. - ANS True
Give an example of a noninvasive and an invasive diagnostic study for congenital heart defects.
- ANS Noninvasive: electrocardiogram
Invasive: angiogram
True or false: Most cardiac defects require surgical intervention. - ANS True
The mixing of blood in a heart that should have normal circulation results in what? -
ANS While the baby is in the womb, the blood is mixed to promote better oxygenation to the
body, because the baby is not oxygenating its own blood.
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, Once the baby starts breathing outside the womb, the changes from fetal to newborn
circulation are meant to prevent the mixing of blood as the baby is now oxygenating its own
blood through the lungs.
The mixing of blood in a newborn heart results in desaturated blood and hypoxemia.
What is polycythemia? What lab results indicate polycythemia? - ANS Bone marrow
responds to chronic hypoxemia by producing more RBCs to increase the amount of hemoglobin
available for oxygenation
Lab results:
- increased RBCs
- increased Hgb
- increased Hct
True or false: Bradycardia is a late sign of cardiac problems. - ANS True
Bradycardia indicates longterm hypoxemia, likely due to a cardiac defect. This is a *warning sign
of impending cardiac arrest and/or shock.*
How do we prevent cardiac arrest in children? - ANS Correct hypoxemia
Most of the time, cardiac arrest is caused by a respiratory/oxygenation issue that is responsible
for prolonged, severe hypoxemia.
What are the three classifications for congential heart defects? - ANS *Increased* pulmonary
blood flow
- need support for congestive heart failure (CHF)
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AND ANSWERS
What are the three anatomic shunts in fetal circulation? - ANS - foramen ovale
- ductus arteriosus
- ductus venosus
What/where is the foramen ovale? - ANS An opening between the two atria that allows for
the mixing of oxygenated and deoxygenated blood
What/where is the ductus arteriosus? - ANS A ligamentous vessel connecting the ascending
aorta to the pulmonary arteries that allows for the mixing for oxygenated and deoxygenated
blood
Fetal specific cardiovascular structures should close and transition to newborn heart structure
by what time frame? - ANS By 24 hours after the baby is born, we expect all fetal heart
structures to close and transition to newborn heart structure.
This is why we wait until the 24 hour mark of life to perform a cardiac screening.
By what age should capillary refill be < 3 seconds? - ANS 12 months
What are innocent murmurs? - ANS Turbulent or inceased blood flow through a heart with
normal anatomy and function
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 1
,Requires frequent monitoring to rule of the presence of defects
Will eventually grow out of it
What abnormal signs/symptoms would lead to suspected cardiac pathology? - ANS - failure
to thrive, poor weight gain
- cyanosis, pallor
- visualized pulsating neck veins (JVD)
- tachypnea, dyspnea
- irregular pulse rate
- clubbing of fingers
- fatigue during feeding or activity
- excessive perspiration, especially over forehead
What is failure to thrive? - ANS Consistently at or below the third percentile for height and
weight
Acyanotic congenital heart defects are caused by one of what two things? - ANS Increased
pulmonary blood flow
- atrial septal defect
- ventricular septal defect
- patent ductus arteriosus
- atrioventricular canal
Obstruction to blood flow from ventricles
- coarctation of aorta
- aortic stenosis
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 2
,- pulmonic stenosis
Cyanotic congenital heart defects are caused by one of what two things? - ANS Decreased
pulmonary blood flow
- tetralogy of fallot
- tricuspid atresia
Mixed blood flow
- transposition of great arteries
- total anomalous pulmonary venous return
- truncus arteriosus
- hypoplastic left heart syndrome
True or false: Cyanotic congenital heart diseases/defects are usually more serious than
acyanotic diseases/defects. - ANS True
Give an example of a noninvasive and an invasive diagnostic study for congenital heart defects.
- ANS Noninvasive: electrocardiogram
Invasive: angiogram
True or false: Most cardiac defects require surgical intervention. - ANS True
The mixing of blood in a heart that should have normal circulation results in what? -
ANS While the baby is in the womb, the blood is mixed to promote better oxygenation to the
body, because the baby is not oxygenating its own blood.
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 3
, Once the baby starts breathing outside the womb, the changes from fetal to newborn
circulation are meant to prevent the mixing of blood as the baby is now oxygenating its own
blood through the lungs.
The mixing of blood in a newborn heart results in desaturated blood and hypoxemia.
What is polycythemia? What lab results indicate polycythemia? - ANS Bone marrow
responds to chronic hypoxemia by producing more RBCs to increase the amount of hemoglobin
available for oxygenation
Lab results:
- increased RBCs
- increased Hgb
- increased Hct
True or false: Bradycardia is a late sign of cardiac problems. - ANS True
Bradycardia indicates longterm hypoxemia, likely due to a cardiac defect. This is a *warning sign
of impending cardiac arrest and/or shock.*
How do we prevent cardiac arrest in children? - ANS Correct hypoxemia
Most of the time, cardiac arrest is caused by a respiratory/oxygenation issue that is responsible
for prolonged, severe hypoxemia.
What are the three classifications for congential heart defects? - ANS *Increased* pulmonary
blood flow
- need support for congestive heart failure (CHF)
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 4
