Ventricular Septal Defect NCLEX questions for nursing students. Ventricular septal defect (VSD) is a congenital heart defect disorder.
After taking the quiz, don’t forget to watch the lecture on ventricular septal defect.
This quiz is part of a pediatric NCLEX review series.
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Ventricular Septal Defect (VSD) NCLEX Questions
1. A two-month-old is showing signs and symptoms of heart failure. An echocardiogram is ordered. The test shows the infant has a ventricular septal defect (VSD). Which statement below best describes the blood flow in the heart due to this congenital heart defect?
A. “The blood in the heart is shunting from the right ventricle to the left ventricle, which is increasing pulmonary blood flow.”
B. “The blood in the heart is shunting from the left ventricle to the right ventricle, which is decreasing pulmonary blood flow.”
C. “The blood in the heart is shunting from the left ventricle to the right ventricle, which is increasing pulmonary blood flow.”
D. “The blood in the heart is bypassing the left ventricle and is being shunted to the right ventricle, which is decreasing lung blood flow.”
The answer is C. In this condition, the blood in the heart is shunting from the LEFT ventricle to the RIGHT ventricle, which is INCREASING pulmonary blood flow.”
2. An infant has a large ventricular septal defect (VSD). The defect is located in the upper section of the ventricular septum and is near the tricuspid and aortic valve. Based on this description, what type of ventricular septal defect is this?
A. Outlet (conal or subarterial)
C. Inlet (atrioventricular)
The answer is D. This describes a membranous VSD. Please review the notes or video for the other types of VSDs (there are four of them).
3. TRUE or FALSE: A small muscular ventricular septal defect has a high probability of self-closure, and these types of VSDs are found in the lower portion of the ventricular septum.
The answer is TRUE.
4. TRUE or FALSE: The signs and symptoms of a ventricular septal defect are most commonly detected in a baby following birth.
The answer is FALSE. Signs and symptoms of a ventricular septal defect are NOT commonly found in a baby after birth, but rather a little later on. VSD signs and symptoms most likely start to present around 1-3 months after birth. WHY? In utero, the baby has the same pressure on the right and left side of the heart. However, after birth the lungs start to work and this pressure changes gradually over the next 2-3 weeks. The pressure in the right side will decrease compared to the left side. Therefore, when a large VSD is present the pressure changes will cause blood to begin shunting from the LEFT ventricle to the RIGHT ventricle (hence increasing lung blood flow which leads to pulmonary hypertension and eventually heart failure). Therefore, at about 1-3 months of life the infant will be presenting with heart failure, growth problems, and respiratory issues.
5. A concerned mother brings her 3-month-old to the clinic. The mother states the infant seems to be small for its age. In addition, she states the infant fatigues very easily while feeding and rarely finishes a feeding. While collecting a thorough health history, what other signs and symptoms described by the mother may indicate the child has a congenital heart defect, such as a ventricular septal defect? Select all that apply:
B. Frequent treatment for lung infections
C. Excessive wet diapers
D. Diaphoresis when nursing
E. Swelling in the hands and feet
The answers are: B, D, and E The nurse should listen for signs and symptoms that could represent heart failure or pulmonary hypertension. Options B, D, and E can be found in infants or children with a VSD.
6. After speaking with the mother of the infant in the previous question, who may have a ventricular septal defect, you auscultate heart sounds. If a ventricular septal defect was present, you may hear a harsh murmur that is _______________________.
A. Located at the lower left sternal border and starts at S1 and extends into S2.
B. Located at the upper left sternal border and is continuous during systole.
C. Located at the lower left sternal border and is continuous machine-like.
D. Located at the upper left sternal border and is only heard during diastole.
The answer is A. The size of the VSD depends on the how loud the murmur will be, but it will be heard at the LOWER LEFT sternal border and is considered a holosystolic or pansystolic murmur. This means it will start at S1 and extend into S2.
7. A 4-month-old is scheduled to take Digoxin for treatment of a ventricular septal defect. The patient’s apical pulse is 89 beats per minute. As the nurse you will? Select all that apply:
A. Hold the dose
B. Recheck the pulse via the brachial artery
C. Administer the dose as scheduled
D. Notify the physician
The answer is A and D. Before giving Digoxin, the apical pulse should be checked for 1 complete minute. The infant’s heart rate is too low in this scenario. Guidelines say to hold Digoxin in infants if the apical pulse rate is less than 90-110 beats per minute, children less than 70 bpm, or adults less than 60 bpm. The nurse would HOLD the dose and NOTIFY the physician for further orders. The physician needs to be informed of this and may want to investigate if the patient is experiencing toxicity of this medication.
8. As the nurse you know that if a patient has a large ventricular septal defect and does not receive treatment, the patient may develop Eisenmenger Syndrome. This syndrome causes?
A. A reversal of blood shunting in the heart from right to left and will cause pulmonary hypertension.
B. A reversal of blood shunting in the heart from left to right and will cause cyanosis.
C. A reversal of blood shunting in the heart from left to right and will cause pulmonary hypertension.
D. A reversal of blood shunting in the heart from right to left and will cause cyanosis.
The answer is D. If the VSD is not treated, (later on in life) a reversal of blood shunting (shunting from right to left) will occur due to the extensive pulmonary hypertension in a condition called Eisenmenger’s Syndrome. With this shunting, unoxygenated blood will start to enter circulation and cyanosis and clubbing can start to be seen. It is irreversible and a lung or heart transplant is the current option.
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