Nursing Hardest Questions Trivia Quiz! Practice Test

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  • 1/30 Questions

    The comment made by a parent of a 1-month-old that would alert the nurse about the presence of a congenital heart defect is:

    • “He is always hungry.”
    • “He tires out during feedings"
    • “He is fussy for several hours every day.”
    • “He sleeps all the time.”
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About This Quiz

Nurses in a hospital setting are designed to help a patient in their healing process when it comes to giving drugs and support where needed. If this is the career, you are heading towards and are looking for some of the nursing hardest questions to refresh your memory. Then this quiz is for you. Do give it a shot and See morekeep revising!

Nursing Hardest Questions Trivia Quiz! Practice Test - Quiz

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  • 2. 

    When a father asks why his child with tetralogy of Fallot seems to favor a squatting position, the nurse would explain that squatting:

    • Increases the return of venous blood back to the heart

    • Decreases arterial blood flow away from the heart.

    • Is a common resting position when a child is tachycardic

    • Increases the workload of the heart.

    Correct Answer
    A. Increases the return of venous blood back to the heart
    Explanation
    Squatting increases the return of venous blood back to the heart. When a child with tetralogy of Fallot squats, it helps to increase systemic vascular resistance and decrease the right-to-left shunting of blood. This position improves blood flow to the lungs and increases oxygenation. Squatting is a compensatory mechanism that the child instinctively adopts to relieve symptoms such as cyanosis and dyspnea. By increasing venous return, squatting helps to optimize cardiac output and improve overall cardiovascular function.

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  • 3. 

    The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. The nurse can determine the father understood the instructions when he states “If the baby turns blue, I will:

    • Hold him against my shoulder with his knees bent up toward his chest.”

    • Lay him down on a firm surface with his head lower than the rest of his body.”

    • Immediately put the baby upright in an infant seat.”

    • Put the baby in supine position with his head elevated.”

    Correct Answer
    A. Hold him against my shoulder with his knees bent up toward his chest.”
    Explanation
    In the event of a paroxysmal hypercyanotic or “tet” spell, the infant should be placed in a knee-chest position.

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  • 4. 

    The nurse explains that a ventricular septal defect will allow:

    • Blood to shunt left to right, causing increased pulmonary flow and no cyanosis

    • Blood to shunt right to left, causing decreased pulmonary flow and cyanosis

    • No shunting because of high pressure in the left ventricle.

    • Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume

    Correct Answer
    A. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
    Explanation
    A ventricular septal defect is a hole in the wall (septum) between the two lower chambers (ventricles) of the heart. This defect allows blood to flow from the left ventricle to the right ventricle, causing a left-to-right shunt. As a result, oxygenated blood from the left side of the heart mixes with deoxygenated blood from the right side of the heart, increasing the pulmonary flow. However, since the blood is still oxygenated, there is no cyanosis (bluish discoloration of the skin due to lack of oxygen).

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  • 5. 

    The assessment that would lead the nurse to suspect that a newborn infant has a ventricular septal defect is:

    • A loud, harsh murmur with a systolic tremor.

    • Cyanosis when crying.

    • Blood pressure higher in the arms than in the legs.

    • A machinery-like murmur

    Correct Answer
    A. A loud, harsh murmur with a systolic tremor.
    Explanation
    A loud, harsh murmur with a systolic tremor is indicative of a ventricular septal defect in a newborn infant. This type of murmur is caused by blood flowing through the abnormal opening between the ventricles, resulting in turbulent blood flow and vibrations that can be felt as a tremor. This assessment finding suggests that there is a hole in the wall separating the ventricles, allowing blood to mix between the two chambers.

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  • 6. 

    A child develops carditis from rheumatic fever. The nurse knows that the areas of the heart affected by carditis are the:

    • Coronary arteries

    • Heart muscle and the mitral valve.

    • Aortic and pulmonic valves.

    • Contractility of the ventricles

    Correct Answer
    A. Heart muscle and the mitral valve.
    Explanation
    Carditis refers to inflammation of the heart muscle and can also affect the valves. Rheumatic fever, which is caused by an untreated streptococcal infection, can lead to carditis. The inflammation can damage the heart muscle and the mitral valve, resulting in symptoms such as chest pain, shortness of breath, and heart murmurs. The other options, such as coronary arteries, aortic and pulmonic valves, and contractility of the ventricles, are not directly related to carditis.

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  • 7. 

    The nurse is caring for a child with a diagnosis of Kawasaki disease. The child’s parent asks the nurse, “How does Kawasaki disease affect my child’s heart and blood vessels?” The nurse’s response is based on the understanding that:

    • Inflammation weakens blood vessels, leading to aneurysm

    • Increased lipid levels lead to the development of atherosclerosis

    • Untreated disease causes mitral valve stenosis.

    • Altered blood flow increases cardiac workload with resulting heart failure.

    Correct Answer
    A. Inflammation weakens blood vessels, leading to aneurysm
    Explanation
    Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.

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  • 8. 

    Which observation indicates that an infant with congestive heart failure (CHF) is carefully following the prescribed medical regimen?

    • The child takes antibiotics daily

    • The child exhibits normal weight for age

    • The child has an elevated RBC

    • The child’s pulse rate is less than 50 beats/min

    Correct Answer
    A. The child exhibits normal weight for age
    Explanation
    The observation that the child exhibits normal weight for age indicates that the infant with congestive heart failure (CHF) is carefully following the prescribed medical regimen. This is because CHF can cause fluid retention and weight gain, so if the child's weight is within the normal range for their age, it suggests that the prescribed treatment, which likely includes diuretics to reduce fluid retention, is effective in managing the condition.

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  • 9. 

    When the child with rheumatic fever begins involuntary, purposeless movements of her limbs, the nurse recognizes that this is an indication of:

    • Secure activity

    • Hypoxia

    • Sydenham's chorea

    • Decreasing level of consciousness 

    Correct Answer
    A. Sydenham's chorea
    Explanation
    As the effects of rheumatic fever affect the central nervous system, the child may develop
    Sydenham’s chorea manifested by involuntary, purposeless movements of the limbs.

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  • 10. 

    The finding the nurse would expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta is blood pressure that is:

    • Higher on the right side.

    • Higher on the left side.

    • Lower in the arms than in the legs

    • Lower in the legs than in the arms

    Correct Answer
    A. Lower in the legs than in the arms
    Explanation
    Coarctation of the aorta is a congenital heart defect where the aorta is narrowed. This narrowing restricts blood flow to the lower part of the body. When measuring blood pressure on all four extremities, the nurse would expect to find lower blood pressure in the legs compared to the arms. This is because the narrowed aorta creates resistance to blood flow, resulting in decreased pressure in the lower extremities.

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  • 11. 

    The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, “Why do my child’s fingertips look like that?” The nurse bases a response on the understanding that clubbing occurs as a result of:

    • Untreated congestive heart failure.

    • A left-to-right shunting of blood.

    • Decreased cardiac output.

    • Chronic hypoxia.

    Correct Answer
    A. Chronic hypoxia.
    Explanation
    Clubbing of the fingers develops in response to chronic hypoxia.

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  • 12. 

    A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever?

    • Subcutaneous nodules and fever

    • Painful, tender joints and carditis

    • Erythema marginatum and arthralgia

    • Chorea and elevated sedimentation rate

    Correct Answer
    A. Painful, tender joints and carditis
    Explanation
    The presence of two major Jones’ criteria would indicate a high probability of rheumatic
    fever.

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  • 13. 

    An appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant would be

    • Counting the apical rate for 30 seconds before administering the medication

    • Withholding a dose if the apical heart rate is less than 100 beats/min

    • Repeating a dose if the child vomits within 30 minutes of the previous dose.

    • Checking respiratory rate and blood pressure before each dose

    Correct Answer
    A. Withholding a dose if the apical heart rate is less than 100 beats/min
    Explanation
    If the apical heart rate of an infant is less than 100 beats/min, it may indicate that the infant is experiencing bradycardia, which is a potential side effect of digoxin. In this situation, withholding a dose of digoxin is an appropriate nursing action to prevent further complications. Digoxin is a medication that is used to treat certain heart conditions, but it can also cause adverse effects such as bradycardia. Monitoring the heart rate before administering the medication helps ensure the safety and effectiveness of the treatment.

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  • 14. 

    What assessment(s) in a child with tetralogy of Fallot would indicate the child is experiencing a paroxysmal hypercyanotic episode? Select all that apply.

    • Spontaneous cyanosis

    • Dyspnea

    • Weakness

    • Dry cough

    • Syncope

    Correct Answer(s)
    A. Spontaneous cyanosis
    A. Dyspnea
    A. Weakness
    A. Syncope
    Explanation
    Indicators of a paroxysmal hypercyanotic episode or a “tet” episode are spontaneous
    cyanosis, dyspnea, weakness, and syncope.

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  • 15. 

    The nurse clarifies to the parents of a 4-year-old child recovering from rheumatic fever that the child will need to receive monthly injections of penicillin G for a minimum of _____ year(s).

    • 1

    • 2

    • 5

    • 10

    Correct Answer
    A. 5
    Explanation
    Children who recover from rheumatic fever should have a chemoprophylaxis protocol of
    penicillin G injections (about 200,000 units per dose) for a minimum of 5 years or up to the
    age of 18 to prevent further bouts of rheumatic fever.

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  • 16. 

    An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). The nurse understands dyspnea occurs because blood is:

    • Circulated through the lungs again, causing pulmonary circulatory congestion

    • Shunted past the pulmonary circulation, causing pulmonary hypoxia.

    • Shunted past cardiac arteries, causing myocardial hypoxia

    • Circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

    Correct Answer
    A. Circulated through the lungs again, causing pulmonary circulatory congestion
    Explanation
    In a normal heart, the ductus arteriosus closes shortly after birth, allowing blood to flow from the pulmonary artery to the lungs for oxygenation. However, in the case of patent ductus arteriosus (PDA), the ductus remains open, causing blood to circulate back through the lungs again. This leads to an increased volume of blood in the pulmonary circulation, causing congestion and resulting in dyspnea (difficulty breathing). Therefore, the correct answer is that dyspnea occurs because blood is circulated through the lungs again, causing pulmonary circulatory congestion.

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  • 17. 

    The nurse is aware that the characteristics of high-density lipoproteins (HDLs) are that they:

    • Have high amounts of triglycerides.

    • Have only small amounts of protein.

    • Have little cholesterol.

    • Aid in steroid production.

    Correct Answer
    A. Have little cholesterol.
    Explanation
    HDLs have low amounts of triglycerides, large amounts of proteins, low amount of cholesterol,
    and are excreted via the liver. They have no role in the production of steroids.

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  • 18. 

    The nurse is caring for a child receiving digoxin (Lanoxin) for the diagnosis of heart failure. Which manifestation does the nurse recognize as a cardinal sin of digoxin toxicity?

    • Respiratory distress

    • Extreme bradycardia

    • Constipation

    • Headache

    Correct Answer
    A. Extreme bradycardia
    Explanation
    Digoxin is a medication commonly used to treat heart failure. It works by increasing the force of the heart's contractions, which helps to improve the heart's ability to pump blood. However, one of the potential side effects of digoxin is toxicity, which can occur if the medication builds up in the body to unsafe levels. Extreme bradycardia, or an abnormally slow heart rate, is a cardinal sign of digoxin toxicity. This is because digoxin affects the electrical conduction system of the heart, slowing down the heart rate. Other manifestations of digoxin toxicity may include nausea, vomiting, visual disturbances, and confusion.

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  • 19. 

    What are the priority nursing actions when administering Diuril (chlorothiazide) to a child diagnosed with congestive heart failure (CHF)?

    • Intake and output and periods of rest

    • Measure pulse for 1 minute and review ECG

    • Monitor serum electrolytes and daily weight

    • Hold dose if patient vomits and until doctors write order to repeat dose

    Correct Answer
    A. Monitor serum electrolytes and daily weight
    Explanation
    When administering Diuril to a child diagnosed with congestive heart failure (CHF), it is important for the nurse to monitor serum electrolytes and daily weight. Diuril is a diuretic medication that helps to remove excess fluid from the body, which is crucial in managing CHF. Monitoring serum electrolytes helps to ensure that the medication is not causing any imbalances in the child's electrolyte levels. Daily weight monitoring is important to assess for any fluid retention or weight gain, which may indicate worsening CHF. Intake and output and periods of rest are important considerations, but they are not the priority nursing actions in this situation. Measuring pulse and reviewing ECG are important assessments, but they are not specific to administering Diuril. Holding the dose if the patient vomits and waiting for a doctor's order to repeat the dose is not necessary unless there are specific contraindications or concerns.

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  • 20. 

    An infant with congestive heart failure is receiving digoxin (Lanoxin). The nurse recognizes a sign of digoxin toxicity, which is:

    • Restlessness

    • Decreased respiratory rate

    • Increased urinary output

    • Vomiting

    Correct Answer
    A. Vomiting
    Explanation
    Symptoms of digoxin toxicity include: nausea, vomiting, anorexia, irregularity in pulse rate
    and rhythm, and a sudden change in pulse.

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  • 21. 

    Which disorder causes deoxygenated blood to enter the systemic arterial circulation?

    • Patent ductus arteriosus

    • Tetralogy of Fallot

    • Coarctation of the aorta

    • Atrial stenosis

    Correct Answer
    A. Tetralogy of Fallot
    Explanation
    Tetralogy of Fallot is a congenital heart defect that consists of four abnormalities, including a ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. One of the main characteristics of this disorder is the presence of a ventricular septal defect, which allows deoxygenated blood from the right ventricle to mix with oxygenated blood from the left ventricle, resulting in deoxygenated blood entering the systemic arterial circulation. This leads to the characteristic cyanosis seen in individuals with Tetralogy of Fallot.

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  • 22. 

    The school nurse recommends a heart healthy diet that limits fats to no more than ____% of the total dietary intake.

    • 10

    • 15

    • 20

    • 30

    Correct Answer
    A. 30
    Explanation
    The correct answer is 30%. A heart healthy diet should limit the intake of fats to no more than 30% of the total dietary intake. This is because high fat intake can lead to an increased risk of heart disease and other health problems. By limiting fats to 30% or less, individuals can maintain a healthier heart and overall well-being.

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  • 23. 

    How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the child’s weakness and fatigue? Select all that apply.

    • Feeding more frequently with smaller feedings

    • Using a soft nipple with enlarged holes

    • Holding and cuddling the child during feeding

    • Substituting glucose water for formula

    • Offering high-caloric formula

    Correct Answer(s)
    A. Feeding more frequently with smaller feedings
    A. Using a soft nipple with enlarged holes
    A. Holding and cuddling the child during feeding
    A. Offering high-caloric formula
    Explanation
    Infants with CHF fatigue easily. Feeding can be given more frequently in smaller amounts
    through a soft large-holed nipple. Formulas with a denser caloric content can be offered. The
    child may be encouraged to nurse if he or she is held.

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  • 24. 

    Which diagnostic test is a standardized test for rheumatic fever?

    • Sedimentation rate

    • WBC count

    • Antistreptolysin O titer

    • Rubella titer

    Correct Answer
    A. Rubella titer
    Explanation
    An elevated antistreptolysin O titer (ASO) is a standardized diagnostic test for
    rheumatic fever

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  • 25. 

    The nurse explains that which congenital cardiac defect(s) cause(s) increased pulmonary blood flow? Select all that apply.

    • Atrial septal defects (ASDs)

    • Tetralogy of Fallot

    • Dextroposition of aorta

    • Patent ductus arteriosus

    • Ventricular septal defects (VSDs)

    Correct Answer(s)
    A. Atrial septal defects (ASDs)
    A. Patent ductus arteriosus
    A. Ventricular septal defects (VSDs)
    Explanation
    The congenital heart defects that cause increased pulmonary blood flow are ASDs, VSDs,
    and patent ductus arteriosus.

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  • 26. 

    The nurse is aware that the infant born with hypoplastic left heart syndrome must acquire his or her oxygenated blood through:

    • The patent ductus arteriosus.

    • A ventricular septal defect.

    • The closure of the foramen ovale.

    • An atrial septal defect.

    Correct Answer
    A. An atrial septal defect.
    Explanation
    The correct answer is an atrial septal defect. In infants with hypoplastic left heart syndrome, the left side of the heart is underdeveloped, making it unable to pump oxygenated blood effectively. In order to compensate for this, the infant relies on an atrial septal defect, which is an abnormal opening between the atria of the heart. This allows oxygenated blood from the right atrium to mix with deoxygenated blood in the left atrium, providing the body with some oxygenated blood. The other options mentioned, such as the patent ductus arteriosus or ventricular septal defect, do not play a role in the circulation of oxygenated blood in this condition.

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  • 27. 

    Which signs indicate congenital cardiac problems?

    • Greater than normal weight gain

    • Clubbing of fingers

    • Bradycardia

    • Tachypnea

    • Pulsations in neck veins

    • Dyspnea

    Correct Answer(s)
    A. Clubbing of fingers
    A. Tachypnea
    A. Pulsations in neck veins
    A. Dyspnea
    Explanation
    Congenital cardiac problems can cause various signs and symptoms. Clubbing of fingers is one such sign, where the fingers appear rounded and the nails become curved. Tachypnea, or rapid breathing, can also be an indication of congenital cardiac problems. Pulsations in neck veins can occur when there is increased pressure in the heart, which can be a result of congenital cardiac issues. Dyspnea, or difficulty in breathing, can also be a symptom of congenital cardiac problems.

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  • 28. 

    Which defects are associated with tetralogy of Fallot?

    • Atrial septal defect

    • Ventricular septal defect

    • Dextroposition of the arts

    •  Pulmonary artery stenosis

    • Hypertrophy of the right ventricle

    • Patent ductus arteriosus

    Correct Answer(s)
    A. Ventricular septal defect
    A. Dextroposition of the arts
    A.  Pulmonary artery stenosis
    A. Hypertrophy of the right ventricle
    Explanation
    Tetralogy of Fallot is a congenital heart defect that consists of four specific abnormalities: ventricular septal defect (VSD), dextroposition of the aorta, pulmonary artery stenosis, and hypertrophy of the right ventricle. These defects result in a combination of cyanosis (bluish discoloration of the skin) and decreased oxygen levels in the blood. The VSD allows blood to flow between the left and right ventricles, causing mixing of oxygenated and deoxygenated blood. Dextroposition of the aorta refers to the aorta being shifted to the right, rather than located over the left ventricle. Pulmonary artery stenosis refers to a narrowing of the pulmonary artery, which restricts blood flow to the lungs. Hypertrophy of the right ventricle is an enlargement of the right ventricle due to increased workload.

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  • 29. 

    Which symptoms are indicative of rheumatic fever (RF)?

    • Abdominal pain

    • Migratory polyartgritis

    • Peeling skin

    • Chorea

    • Vomiting

    Correct Answer(s)
    A. Abdominal pain
    A. Migratory polyartgritis
    A. Chorea
    Explanation
    The symptoms of abdominal pain, migratory polyarthritis, and chorea are indicative of rheumatic fever (RF). Rheumatic fever is an inflammatory disease that can develop after an infection with streptococcus bacteria, such as strep throat. Abdominal pain may occur due to inflammation of the abdominal organs, migratory polyarthritis refers to the joint pain that moves from one joint to another, and chorea is a movement disorder characterized by involuntary jerky movements. These symptoms, along with a history of recent streptococcal infection, help in diagnosing rheumatic fever.

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  • 30. 

    The nurse uses a diagram to illustrate what four structural heart anomalies that comprise tetralogy of Fallot? Select the four that apply.

    • Hypertrophied right ventricle

    • Patent ductus arteriosus

    • Ventral septal defect

    • Narrowing of pulmonary artery

    • Dextroposition of aorta

    Correct Answer(s)
    A. Hypertrophied right ventricle
    A. Patent ductus arteriosus
    A. Narrowing of pulmonary artery
    A. Dextroposition of aorta
    Explanation
    The four anomalies that comprise tetralogy of Fallot are hypertrophied right ventricle, patent
    ductus arteriosus, stenosis of pulmonary artery, and dextroposition of the aorta.

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  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 11, 2019
    Quiz Created by
    Borovskisc

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