Neonatal Nurse Practitioner Exam Cardiovascular Assessment and Management

Question 1

Which congenital heart defect presents with a 'boot-shaped' heart on chest X-ray and cyanosis?

Accepted Answer

Tetralogy of Fallot

Answer

Transposition of the great arteries

Answer

Ventricular septal defect

Answer

Patent ductus arteriosus

Question 2

A term neonate has differential cyanosis (pink upper body, blue lower body). Which defect is most likely?

Accepted Answer

Transposition of the great arteries with PDA

Answer

Coarctation of the aorta

Answer

Total anomalous pulmonary venous return

Answer

Hypoplastic left heart syndrome

Question 3

What is the primary mechanism by which prostaglandin E1 (PGE1) helps a ductal-dependent lesion?

Accepted Answer

Maintains or reopens the ductus arteriosus

Answer

Closes the ductus arteriosus

Answer

Increases systemic vascular resistance

Answer

Reduces pulmonary blood flow

Question 4

A murmur heard at the left upper sternal border in a premature infant, with a bounding pulse and widened pulse pressure, most likely represents:

Accepted Answer

Patent ductus arteriosus (PDA)

Answer

Ventricular septal defect

Answer

Atrial septal defect

Answer

Pulmonary stenosis

Question 5

Indomethacin is used to close a hemodynamically significant PDA. What is an important contraindication to its use?

Accepted Answer

Necrotizing enterocolitis or compromised renal function

Answer

Mild thrombocytopenia (platelets 120,000)

Answer

Hyperbilirubinemia

Answer

Mild anemia

Question 6

Which four-extremity blood pressure finding is most consistent with coarctation of the aorta?

Accepted Answer

Higher blood pressure in upper extremities than lower extremities by >10 mmHg

Answer

Equal pressures in all four limbs

Answer

Higher blood pressure in lower extremities than upper extremities

Answer

Low blood pressure in all extremities