Question 1

The structure of the fetal heart that guides fetal blood from the pulmonary artery to the descending aorta is the

Accepted Answer

The ductus arteriosus guides fetal blood from the pulmonary artery to the descending aorta so that it can bypass the fetal lungs, which are not developed. If the ductus arteriosus remains open after birth, abnormal blood flow occurs in the heart.

Question 2

The type of congenital heart disease (CHD) that is less threatening at birth and may not be detected on maternal prenatal assessment is

Accepted Answer

Acyanotic heart defects are characterized as less threatening and may not be detected on maternal prenatal assessment. Symptoms of acyanotic heart defects usually develop after post-delivery changes occur within the pulmonary and systemic systems.

Question 3

A newborn's lungs and pulmonary system begin to exchange gases:

Accepted Answer

At birth, the previously fluid-filled lungs of the newborn fill with air, and the lungs and pulmonary system begin to exchange gases. In utero, the exchange of gases is handled by the mother's placenta.

Question 4

The permanent left-to-right circulation pattern needed for newborns to breathe on their own is established by which circulation changes?

Accepted Answer

The permanent left-to-right circulation pattern is established by the decrease in pulmonary vascular resistance and increase in pulmonary blood flow, which results in increases in both the left atrial volume and pressures. The blood flow is then redistributed due to increased systemic vascular resistance and the decrease in right atrial pressures.

Question 5

Apgar assessments and scoring should be performed

Accepted Answer

Apgar assessments and scoring should be performed at 1 and 5 minutes of life and up to 10 and 20 minutes if initial scores are low. Apgar scores range from 0 to 10, with 10 being the highest, healthiest score.

Question 6

The landmark located at the third intercostal space midclavicular line where the heart rate and rhythm should be assessed for at least 1 minute is known as

Accepted Answer

The point of maximal impulse (PMI) is the landmark where the apical pulse can be assessed. The normal resting heart rate for a newborn is 120 to 160 beats per minute (bpm).

Question 7

Which of the following oxygen saturation screening findings in a newborn would require a referral to a pediatric cardiologist?

Accepted Answer

Oxygen saturation readings of a newborn are considered normal if the hand and foot are greater than 95% and a difference of no more than 3% oxygen saturation exists. If findings outside of this range are present, the newborn should be referred to a pediatric cardiologist.

Question 8

Which is an appropriate nutrition recommendation for a newborn with congenital heart disease?

Accepted Answer

Newborns with cardiac diagnoses may require a slower weight gain schedule and more frequent, smaller-volume feedings. They may be breastfed or formula fed and, in some cases, may require fortification of breastmilk or formula to provide more calories.

Question 9

Prostaglandin therapy (PgE2) may be administered to stabilize a newborn with congenital cardiac defects by

Accepted Answer

Prostaglandin therapy (PgE2) is administered to maintain the patency of the ductus arteriosus if needed for the specific cardiac defect.

Question 10

The procedure in which a catheter is placed in the heart and a contrast dye is injected to highlight any abnormalities present is called

Accepted Answer

Angiography is a procedure in which a catheter is placed in the heart and contrast dye is injected, allowing visualization of the valves, blood vessels, ventricles, and septal defects.

Question 11

Cardiac defects that can be repaired using closure devices include:

Accepted Answer

Closure devices can be utilized in the cardiac catheterization laboratory to repair atrial septal defects, patent foramen ovale, or patent ductus arteriosus.

Question 12

In a newborn with tricuspid atresia, the abnormal blood flow would occur

Accepted Answer

The tricuspid atresia is a defect in which the tricuspid valve, which is normally located between the right atrium and right ventricle, is not formed.

Question 13

Cyanosis, heart failure, arrhythmias, fatigue, and edema are symptoms associated with

Accepted Answer

Ebstein's anomaly is a defect in the tricuspid valves in which the valve improperly closes and blood leaks through the valve from the right ventricle back into the right atrium. Cyanosis, heart failure, arrhythmias, fatigue, and edema are symptoms associated with the defect.

Question 14

The congenital defect that may be auscultated as a systolic murmur with an S3 is

Accepted Answer

Coarctation of the aorta is characterized by left-to-right shunting from narrowing of the aorta and can potentially lead to left-sided heart failure. The defect may be auscultated as a systolic murmur with an S3.

Question 15

When reviewing Case Study 3: Newborn Nutrition, which is often the initial symptom of volvulus in a newborn?

Accepted Answer

Bilious vomiting is often the initial symptom of volvulus, or malrotation, in a newborn. Sudden stretches of crying, the newborn drawing their legs up as if in pain, lethargy or decreased activity, elevation in both breathing and heart rates, and abdominal distention are other symptoms of volvulus.

Quiz 11: Congenital Heart Disease