Pediatric ATI Practice Exam

What finding should a nurse expect when assessing an infant with a ventricular septal defect?

1. Loud, harsh murmur

2. Irregular heartbeat

3. Weak pulse

4. Abnormal breathing sounds

The correct answer is: Loud, harsh murmur

A loud, harsh murmur is a common finding in infants with a ventricular septal defect (VSD). This heart condition is characterized by an abnormal opening in the ventricular septum, which allows blood to flow from the left ventricle to the right ventricle. Because of this shunting of blood, there’s increased blood flow across the pulmonary valve, leading to turbulent blood flow that produces a distinct and often loud murmur when assessed with a stethoscope. The nature of the murmur can vary depending on the size of the defect and other hemodynamic factors, but a loud, harsh, continuous murmur is typically associated with this condition. This is a key point for nurses assessing infants because the presence of such a murmur aids in the recognition of potential cardiac issues. Other findings, such as an irregular heartbeat or weak pulse, may indicate more complex heart issues or complications, while abnormal breathing sounds could suggest respiratory involvement. However, these are not primary characteristics of a VSD itself. Thus, the expectation of a loud, harsh murmur stands out as a hallmark clinical finding in such cases.