RNC-NIC Neonatal Cardiovascular Assessment and Care

Question 1

What is the normal resting heart rate range for a term neonate?

Accepted Answer

100-160 bpm

Answer

Term neonates have a normal resting heart rate of 100-160 bpm, which is higher than adult norms due to their elevated metabolic demands.

Question 2

Which clinical finding is most characteristic of a hemodynamically significant patent ductus arteriosus (PDA) in a premature neonate?

Accepted Answer

Bounding peripheral pulses with a continuous murmur

Answer

A hemodynamically significant PDA causes bounding pulses due to wide pulse pressure and a characteristic continuous 'machinery' murmur from left-to-right shunting.

Question 3

Four-extremity blood pressure measurement in a neonate is performed primarily to screen for which condition?

Accepted Answer

Coarctation of the aorta

Answer

Coarctation of the aorta creates a pressure gradient between the upper and lower extremities; a difference greater than 10-20 mmHg suggests significant coarctation.

Question 4

A neonate has a pre-ductal SpO2 of 98% and a post-ductal SpO2 of 88%. What does a difference greater than 3-5% most likely indicate?

Accepted Answer

Persistent pulmonary hypertension or a ductal-dependent cardiac lesion

Answer

A pre-to-post-ductal SpO2 difference greater than 3-5% indicates right-to-left shunting through the ductus arteriosus, suggesting PPHN or a duct-dependent cardiac defect.

Question 5

Which congenital heart defect is considered ductal-dependent for systemic circulation, requiring prostaglandin E1 to maintain cardiac output?

Accepted Answer

Hypoplastic left heart syndrome (HLHS)

Answer

HLHS has a severely underdeveloped left heart, making systemic perfusion entirely dependent on right-to-left flow through the ductus arteriosus; closing the ductus is fatal.

Neonatal Intensive Care Nurse Exam Practice Test

Neonatal Intensive Care Nurse Exam Practice Test

RNC-NIC Neonatal Cardiovascular Assessment and Care