A nurse is caring for a child diagnosed with Ventricular septal defect (VSD).
The child presents with poor feeding, fast breathing, and sweating with exertion.
Which of the following is the characteristic heart murmur associated with VSD?
A continuous "machinery" murmur that is loudest below the left clavicle.
A harsh holosystolic murmur that is best heard at the left lower sternal border.
A systolic ejection murmur that is best heard at the left upper sternal border.
A systolic ejection murmur that radiates to the back.
The Correct Answer is B
Choice A rationale:
A continuous "machinery" murmur that is loudest below the left clavicle is typically associated with a patent ductus arteriosus (PDA), not VSD.
PDA is a different congenital heart defect.
Choice B rationale:
A harsh holosystolic murmur that is best heard at the left lower sternal border is the characteristic murmur associated with Ventricular Septal Defect (VSD).
This murmur is caused by the blood flowing from the high-pressure left ventricle to the low-pressure right ventricle through the VSD hole throughout the cardiac cycle.
Choice C rationale:
A systolic ejection murmur that is best heard at the left upper sternal border is often associated with aortic stenosis, not VSD.
Choice D rationale:
A systolic ejection murmur that radiates to the back is characteristic of aortic regurgitation, which is a different cardiac condition.
The characteristic heart murmur in VSD is the result of blood flowing from the left ventricle to the right ventricle through the VSD hole during systole.
This causes a harsh holosystolic murmur, which is loudest at the left lower sternal border due to the location of the defect in the ventricular septum.
Therefore, choice B is The correct answer.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale:
Bluish discoloration of the skin, lips, or nail beds (cyanosis) is a classic symptom of cyanotic congenital heart disease (CCHD).
This occurs because of the inadequate oxygenation of the blood, which leads to oxygen-poor blood being circulated in the body.
Choice B rationale:
Poor feeding and inadequate weight gain can be associated with CCHD, especially when there is a significant reduction in cardiac output.
Infants with CCHD may have difficulty feeding due to the increased workload on their heart and may struggle to gain weight.
Choice C rationale:
Rapid breathing and shortness of breath are common symptoms in children with CCHD.
The inadequate oxygenation of the blood can lead to an increased respiratory rate and shortness of breath as the body tries to compensate for the lack of oxygen.
Choice D rationale:
Abnormal heart sounds heard during auscultation are characteristic of CCHD.
The specific type of abnormal heart sound may vary depending on the specific defect but can include murmurs, clicks, or other unusual sounds.
Choice E rationale:
Frequent respiratory infections are not typically associated with CCHD.
While children with CCHD may be more susceptible to infections due to their compromised oxygenation, it is not a direct symptom of the condition.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale:
Genetic factors can contribute to the development of congenital heart defects in children.
Certain genetic mutations or abnormalities can increase the risk of congenital heart conditions.
Choice B rationale:
Maternal health is a factor that may contribute to the development of congenital heart defects in children.
Maternal conditions such as diabetes or rubella during pregnancy can increase the risk of congenital heart defects in the fetus.
Choice C rationale:
Exposure to infections during pregnancy is a known risk factor for the development of congenital heart defects.
Infections like rubella and certain medications can increase the risk of congenital heart conditions.
Choice D rationale:
Chromosomal abnormalities, such as Down syndrome (Trisomy 21), can be associated with congenital heart defects.
These genetic abnormalities can impact the development of the heart.
Choice E rationale:
While paternal health is important for overall fetal development, it is not a well-established risk factor for congenital heart defects.
The primary factors are maternal and genetic.
Congenital heart defects in children can be influenced by a combination of genetic factors, maternal health, exposure to infections during pregnancy, and chromosomal abnormalities.
These factors interact to increase the risk of congenital heart conditions.
Therefore, choices A, B, C, and D are all correct answers.
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