The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur.
This finding is associated with which congenital heart defect?
Pulmonary stenosis
Patent ductus arteriosus
Ventricular septal defect
Coarctation of the aorta
The Correct Answer is B
This is because a patent ductus arteriosus is a congenital heart defect that involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. This causes a continuous machinery-like murmur that can be heard on auscultation.
Choice A is wrong because pulmonary stenosis is a narrowing of the pulmonary valve or artery that obstructs blood flow to the lungs. It causes a systolic ejection murmur that is best heard at the upper left sternal border.
Choice C is wrong because the ventricular septal defect is a hole in the wall between the ventricles that allows blood to flow from the left to the right side of the heart. It causes a loud, harsh holosystolic murmur that is best heard at the left lower sternal border.
Choice D is wrong because coarctation of the aorta is a narrowing of the aorta that reduces blood flow to the lower body. It causes a systolic murmur that radiates to the back and weak or absent femoral pulses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
This is because self-monitoring of blood glucose allows children to learn how their blood sugar levels change in response to different factors such as food, exercise, stress, and medication.
It also helps them to adjust their insulin doses and dietary intake accordingly. Self-monitoring of blood glucose can improve glycemic control and reduce the risk of complications.
Choice A is wrong because it is not a less expensive method of testing.
Self-monitoring of blood glucose requires a glucose meter, test strips, lancets, and a logbook, which can be costly for some families.
Choice B is wrong because it is not less accurate than laboratory testing.
Self-monitoring of blood glucose can provide accurate and reliable results if done correctly and regularly.
Laboratory testing is usually done periodically to measure the average blood sugar level over the past 2 to 3 months (hemoglobin A1c).
Choice D is wrong because it implies that the parents are not involved in the child’s diabetes management.
Parents should still provide support and guidance to their children with diabetes, especially when they are young or newly diagnosed. Parents should also monitor their child’s blood glucose levels and help them with insulin administration if needed.
Correct Answer is A
Explanation
Vernix caseosa is a cheese-like, whitish substance that fuses with the epidermis and serves as a protective coating for the newborn.

Some possible explanations for the other choices are:
- Choice B. Surfactant is a protein that lines the alveoli of the infant’s lungs and helps prevent them from collapsing.
- Choice C. Caput succedaneum is a swelling of the tissue over the presenting part of the fetal head caused by pressure during delivery.
- Choice D. Acrocyanosis is a bluish discoloration of the hands and feet due to reduced peripheral circulation.
Normal ranges for vernix caseosa are not applicable as it varies depending on the gestational age and skin maturity of the newborn. However, it is usually more abundant in preterm infants than in term or post-term infants.
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