Neonatal Nurse Practitioner Exam Cardiovascular Assessment and Management 2

Question 1

A neonate with hypoplastic left heart syndrome (HLHS) becomes critically ill when the ductus closes. The primary reason is:

Accepted Answer

The ductus was providing the only source of systemic blood flow

Answer

The ductus was providing pulmonary blood flow

Answer

Closing the ductus reduces right heart preload

Answer

The ductus was delivering oxygenated blood to the brain

Question 2

What is the hallmark finding on ECG in a neonate with complete heart block?

Accepted Answer

P waves that bear no relationship to QRS complexes

Answer

Short PR interval with delta waves

Answer

Prolonged QT interval

Answer

ST elevation in all leads

Question 3

A neonate with supraventricular tachycardia (SVT) at a rate of 280 bpm and hemodynamic instability requires:

Accepted Answer

Immediate synchronized cardioversion

Answer

Adenosine IV push as initial treatment

Answer

Digoxin loading

Answer

Oral propranolol

Question 4

Which echocardiographic finding is characteristic of total anomalous pulmonary venous return (TAPVR) with obstruction?

Accepted Answer

Severe pulmonary hypertension with right heart enlargement and small left heart

Answer

Large left-to-right shunt at the atrial level

Answer

Small right ventricle with left ventricular hypertrophy

Answer

Dilated coronary arteries

Question 5

Which neonatal cardiac finding requires emergent balloon atrial septostomy (Rashkind procedure)?

Accepted Answer

Transposition of the great arteries with intact atrial septum

Answer

Tetralogy of Fallot

Answer

Ventricular septal defect

Answer

Patent ductus arteriosus

Question 6

Dopamine at low doses (2-5 mcg/kg/min) primarily acts on which receptors in neonates?

Accepted Answer

Dopaminergic receptors increasing renal and mesenteric perfusion

Answer

Beta-2 adrenergic receptors causing bronchodilation

Answer

Alpha-1 receptors causing vasoconstriction

Answer

Cholinergic receptors decreasing heart rate