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

Tetralogy of Fallot causes right ventricular hypertrophy and decreased pulmonary flow, producing a classic boot-shaped heart on CXR and cyanosis.

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

TGA with a right-to-left ductal shunt causes unoxygenated blood to flow to the lower body while oxygenated blood perfuses the upper body.

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

PGE1 prevents closure of the ductus arteriosus, maintaining pulmonary or systemic blood flow in ductal-dependent congenital heart defects.

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

A PDA produces a continuous machinery murmur at the left upper sternal border with bounding pulses and wide pulse pressure due to left-to-right shunting.

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

Indomethacin reduces renal and mesenteric blood flow via prostaglandin inhibition, making NEC and renal impairment contraindications to its use.

Neonatal Nurse Practitioner Exam Practice Test

Neonatal Nurse Practitioner Exam Practice Test

Neonatal Nurse Practitioner Exam Cardiovascular Assessment and Management