RNC-NIC Congenital Anomalies 4

Question 1

A neonate is born with VACTERL association. Which component of this association poses the MOST immediate threat to survival?

Accepted Answer

Cardiac defects

Answer

Cardiac defects in VACTERL association (occurring in ~75% of cases) pose the most immediate life-threatening risk and require urgent evaluation.

Question 2

When caring for a neonate with an imperforate anus, which finding indicates a LOW lesion (below the levator ani) with the BEST prognosis for continence?

Accepted Answer

Anal dimple present with meconium visible at the perineum within 24 hours

Answer

A visible anal dimple and perineal meconium within 24 hours indicate a low lesion, which has better sphincter preservation and continence outcomes.

Question 3

A neonate with a myelomeningocele at the L3-L4 level. Which functional deficit should the nurse anticipate?

Accepted Answer

Flaccid paralysis of the lower extremities with bladder and bowel dysfunction

Answer

L3-L4 lesions affect motor and sensory function below that level, causing lower extremity paralysis and neurogenic bladder and bowel.

Question 4

A nurse is preparing to care for a neonate immediately post-op repair of myelomeningocele. Which position is CONTRAINDICATED?

Accepted Answer

Supine with the operative site directly against the bed surface

Answer

Supine positioning places direct pressure on the surgical repair site and is contraindicated; prone or side-lying positions protect the wound.

Question 5

Which PRENATAL finding on ultrasonography is MOST suggestive of an open neural tube defect?

Accepted Answer

Lemon sign (frontal bossing) and banana sign (curved cerebellum)

Answer

The lemon sign (scalloped frontal bones) and banana sign (effaced cerebellum pulled into the foramen magnum) are hallmark ultrasound findings of open spina bifida.

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

RNC-NIC Congenital Anomalies 4