RNC-NIC Neonatal Cardiovascular Assessment and Care 2

Question 1

Which congenital heart defect is classically associated with a 'boot-shaped' cardiac silhouette on chest X-ray?

Accepted Answer

Tetralogy of Fallot

Answer

Transposition of the great arteries

Answer

Total anomalous pulmonary venous return

Answer

Truncus arteriosus

Question 2

Tetralogy of Fallot consists of which four anatomical abnormalities?

Accepted Answer

VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy

Answer

VSD, ASD, PDA, and coarctation of the aorta

Answer

ASD, VSD, aortic stenosis, and left ventricular hypertrophy

Answer

PDA, VSD, pulmonary hypertension, and tricuspid atresia

Question 3

Prostaglandin E1 (PGE1) is initiated in a neonate with suspected ductal-dependent congenital heart disease. What is its primary mechanism of action?

Accepted Answer

Maintains or reopens the ductus arteriosus

Answer

Increases cardiac contractility and heart rate

Answer

Decreases pulmonary vascular resistance

Answer

Reduces systemic vascular resistance

Question 4

A neonate diagnosed with transposition of the great arteries (TGA) is hemodynamically unstable. Which intervention is most critical to improve oxygenation before surgical repair?

Accepted Answer

Balloon atrial septostomy (Rashkind procedure) to improve intracardiac mixing

Answer

Indomethacin infusion to close the ductus arteriosus

Answer

Immediate arterial switch operation within the first hour of birth

Answer

High-frequency oscillatory ventilation

Question 5

Which statement about ventricular septal defects (VSD) in newborns is most accurate?

Accepted Answer

Small, muscular VSDs frequently close spontaneously within the first year of life

Answer

All VSDs require surgical repair within the first week of life

Answer

VSDs always produce audible murmurs immediately at birth

Answer

VSDs are the least common congenital heart defect diagnosed in neonates

Question 6

A neonate with hypoplastic left heart syndrome (HLHS) is awaiting the Norwood procedure. Which management strategy is CONTRAINDICATED in the preoperative period?

Accepted Answer

Administration of supplemental oxygen above room air

Answer

Prostaglandin E1 infusion to maintain ductal patency

Answer

Monitoring four-extremity oxygen saturations

Answer

Nasogastric tube feedings to support caloric intake

Question 7

Which chest X-ray finding is classically described as an 'egg on a string' appearance and is associated with which congenital heart defect?

Accepted Answer

Egg on a string; transposition of the great arteries

Answer

Boot-shaped heart; Tetralogy of Fallot

Answer

Snowman sign; total anomalous pulmonary venous return

Answer

Box-shaped heart; Ebstein anomaly