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

Tetralogy of Fallot causes right ventricular hypertrophy and reduced pulmonary blood flow, resulting in an upturned cardiac apex (boot or coeur en sabot appearance) on chest X-ray.

Question 2

Tetralogy of Fallot consists of which four anatomical abnormalities?

Accepted Answer

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

Answer

Tetralogy of Fallot is defined by a VSD, pulmonary stenosis (obstruction to right ventricular outflow), an aorta that overrides the VSD, and resultant right ventricular hypertrophy.

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

PGE1 stimulates prostaglandin receptors in the ductal wall to relax smooth muscle, maintaining ductal patency and preserving pulmonary or systemic blood flow in duct-dependent lesions.

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

Balloon atrial septostomy creates or enlarges an atrial communication, allowing mixing of oxygenated and deoxygenated blood and dramatically improving systemic oxygen delivery in TGA.

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

Small muscular VSDs commonly close spontaneously as the muscular septum grows; the decision to intervene is based on size, location, and hemodynamic significance.

Neonatal Intensive Care Nurse Exam Practice Test

Neonatal Intensive Care Nurse Exam Practice Test

RNC-NIC Neonatal Cardiovascular Assessment and Care 2