1|Page
NUR 631 FINAL EXAM PRACTICE ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURES PASS
When considering hemolytic anemia, which statement is true regarding the
occurrence of jaundice?
a. Erythrocytes are destroyed in the spleen.
b. Heme destruction exceeds the liver's ability to conjugate and excrete
bilirubin.
c. The patient has elevations in aspartate transaminase AST and alanine
transaminase ALT.
d. The erythrocytes are coated with an immunoglobulin. - ✔✔✔ ANSWER:
b. Heme destruction exceeds the liver's ability to conjugate and excrete bilirubin.
Explanation: Jaundice (icterus) is present when heme destruction exceeds the
liver's ability to conjugate and excrete bilirubin. This selection is the only option
that accurately describes the process that affects the occurrence of hemolytic
anemia-related jaundice. page 1000
A patient is diagnosed with pulmonary disease and elevated pulmonary vascular
resistance. Which of the following heart failures may result from this condition?
a. Right heart failure
b. Left heart failure
c. Low-output failure
d. High-output failure - ✔✔✔ ANSWER: a. Right heart failure
Explanation: Right heart failure is defined as the inability of the right ventricle to
provide adequate blood flow into the pulmonary circulation at a normal central
venous pressure. It most often results from the left heart failure when the increase
,2|Page
in left ventricular filling pressure that is reflected back into the pulmonary
circulation is severe enough. As pressure in the pulmonary circulation rises, the
resistance to right ventricular emptying increases.
What is the chromosomal variation that causes Klinefelter syndrome?
a. Nondisjunction of the X chromosome in the father
b. Translocation of the X chromosome in the mother
c. Nondisjunction of X chromosome in the mother
d. Translocation of the Y chromosome in the father - ✔✔✔ ANSWER: c.
Nondisjunction of X chromosome in the mother
Explanation: Nondisjunction of the X chromosomes in the mother causes
Klinefelter syndrome in the majority of infants, and the frequency of the disorder
rises with maternal age. The correct option is the only one that accurately describes
the chromosomal variation characteristic of Klinefelter syndrome. page 148
What physical sign is the result of turbulent blood flow through a vessel?
a. Increased blood pressure during periods of stress
b. Bounding pulse felt on palpation
c. Cyanosis observed on excretion
d. Murmur heard on auscultation - ✔✔✔ ANSWER: d. Murmur heard on
auscultation
Explanation: Where flow is obstructed the vessel turns or blood flows over rough
surfaces. The flow becomes turbulent with whorls or eddy currents that produce
noise causing a murmur to be heard on auscultation such as occurs during blood
pressure measurement with a sphygomanometer. This selection is the only option
that accurately identifies the physical sign of turbulent vascular blood flow. pg
1113
,3|Page
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 - ✔✔✔ ANSWER: d.
Ventricular septal defect and patent ductus arteriosus
Explanation: 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
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 - ✔✔✔ ANSWER: c. Patent ductus arteriosus
Explanation: If pulmonary vascular resistance has fallen then infants with will
characteristically 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
, 4|Page
Which compensatory mechanism is spontaneously used by children diagnosed with
tetralogy of Fallot to relieve hypoxic spells?
a. Lying on their left side
b. Performing the valsalva maneuver
c. Squatting
d. hyperventilating - ✔✔✔ ANSWER: c. Squatting
Explanation: 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
An infant diagnosed with a small patent ductus arteriosus would likely exhibit
which symptom?
a. Intermittent murmur
b. Lack of symptoms
c. Need for surgical repair
d. Triad of congenital defects - ✔✔✔ ANSWER: b. Lack of symptoms
Explanation: Infants with a small PDA usually remain asymptomatic. page 1203-
1204
Fluid in the pleural space characterizes which condition?
a. Pleural effusion
b. Atelectasis
c. Bronchiectasis
NUR 631 FINAL EXAM PRACTICE ACTUAL PREP
QUESTIONS AND WELL REVISED ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURES PASS
When considering hemolytic anemia, which statement is true regarding the
occurrence of jaundice?
a. Erythrocytes are destroyed in the spleen.
b. Heme destruction exceeds the liver's ability to conjugate and excrete
bilirubin.
c. The patient has elevations in aspartate transaminase AST and alanine
transaminase ALT.
d. The erythrocytes are coated with an immunoglobulin. - ✔✔✔ ANSWER:
b. Heme destruction exceeds the liver's ability to conjugate and excrete bilirubin.
Explanation: Jaundice (icterus) is present when heme destruction exceeds the
liver's ability to conjugate and excrete bilirubin. This selection is the only option
that accurately describes the process that affects the occurrence of hemolytic
anemia-related jaundice. page 1000
A patient is diagnosed with pulmonary disease and elevated pulmonary vascular
resistance. Which of the following heart failures may result from this condition?
a. Right heart failure
b. Left heart failure
c. Low-output failure
d. High-output failure - ✔✔✔ ANSWER: a. Right heart failure
Explanation: Right heart failure is defined as the inability of the right ventricle to
provide adequate blood flow into the pulmonary circulation at a normal central
venous pressure. It most often results from the left heart failure when the increase
,2|Page
in left ventricular filling pressure that is reflected back into the pulmonary
circulation is severe enough. As pressure in the pulmonary circulation rises, the
resistance to right ventricular emptying increases.
What is the chromosomal variation that causes Klinefelter syndrome?
a. Nondisjunction of the X chromosome in the father
b. Translocation of the X chromosome in the mother
c. Nondisjunction of X chromosome in the mother
d. Translocation of the Y chromosome in the father - ✔✔✔ ANSWER: c.
Nondisjunction of X chromosome in the mother
Explanation: Nondisjunction of the X chromosomes in the mother causes
Klinefelter syndrome in the majority of infants, and the frequency of the disorder
rises with maternal age. The correct option is the only one that accurately describes
the chromosomal variation characteristic of Klinefelter syndrome. page 148
What physical sign is the result of turbulent blood flow through a vessel?
a. Increased blood pressure during periods of stress
b. Bounding pulse felt on palpation
c. Cyanosis observed on excretion
d. Murmur heard on auscultation - ✔✔✔ ANSWER: d. Murmur heard on
auscultation
Explanation: Where flow is obstructed the vessel turns or blood flows over rough
surfaces. The flow becomes turbulent with whorls or eddy currents that produce
noise causing a murmur to be heard on auscultation such as occurs during blood
pressure measurement with a sphygomanometer. This selection is the only option
that accurately identifies the physical sign of turbulent vascular blood flow. pg
1113
,3|Page
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 - ✔✔✔ ANSWER: d.
Ventricular septal defect and patent ductus arteriosus
Explanation: 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
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 - ✔✔✔ ANSWER: c. Patent ductus arteriosus
Explanation: If pulmonary vascular resistance has fallen then infants with will
characteristically 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
, 4|Page
Which compensatory mechanism is spontaneously used by children diagnosed with
tetralogy of Fallot to relieve hypoxic spells?
a. Lying on their left side
b. Performing the valsalva maneuver
c. Squatting
d. hyperventilating - ✔✔✔ ANSWER: c. Squatting
Explanation: 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
An infant diagnosed with a small patent ductus arteriosus would likely exhibit
which symptom?
a. Intermittent murmur
b. Lack of symptoms
c. Need for surgical repair
d. Triad of congenital defects - ✔✔✔ ANSWER: b. Lack of symptoms
Explanation: Infants with a small PDA usually remain asymptomatic. page 1203-
1204
Fluid in the pleural space characterizes which condition?
a. Pleural effusion
b. Atelectasis
c. Bronchiectasis
