Question 1

Which of the following methods is involved in the management of a PDA?

Accepted Answer

A) Increasing the circulating volume 
B) Maintaining/optimizing the hematocrit at the low end of normal hemoglobin level 
C) Administering indomethacin 
D) Administering digoxin 
A) Increasing the circulating volume 
B) Maintaining/optimizing the hematocrit at the low end of normal hemoglobin level 
C) Administering indomethacin 
D) Administering digoxin C

Question 2

What factor is responsible for closure of the foramen ovale?

Accepted Answer

A) Increased PaO₂ 
B) Increased pressure on the left side of the heart 
C) Blood flowing through the lungs 
D) High pulmonary vascular resistance 
A) Increased PaO₂ 
B) Increased pressure on the left side of the heart 
C) Blood flowing through the lungs 
D) High pulmonary vascular resistance B

Question 3

At birth,what factor causes dilation of the pulmonary vascular bed and a decrease in the pulmonary vascular resistance?

Accepted Answer

A) Increased arterial partial pressure of oxygen (PaO₂) 
B) Decreased arterial partial pressure of carbon dioxide (PaCO₂ ) 
C) Lung inflation 
D) Circulating indomethacin 
A) Increased arterial partial pressure of oxygen (PaO₂) 
B) Decreased arterial partial pressure of carbon dioxide (PaCO₂ ) 
C) Lung inflation 
D) Circulating indomethacin A

Question 4

Which of the following blood flow patterns occurs in complete transposition of the great arteries?

Accepted Answer

A) The systemic venous blood passes through the right heart chambers. 
B) The pulmonary venous blood traverses the left side of the heart and then returns to the systemic circulation. 
C) When PVR increases relative to SVR,blood flow increases through the ductus arteriosus. 
D) Systemic venous blood flows to the lungs after leaving the right ventricle. 
A) The systemic venous blood passes through the right heart chambers. 
B) The pulmonary venous blood traverses the left side of the heart and then returns to the systemic circulation. 
C) When PVR increases relative to SVR,blood flow increases through the ductus arteriosus. 
D) Systemic venous blood flows to the lungs after leaving the right ventricle.

Question 5

Which of the following physiologic mechanisms need to be in place to ensure adequate systemic perfusion in infants with HLHS?

Accepted Answer

A) Presence of an ASD 
B) Presence of a mitral regurgitation 
C) Adequate left atrial function 
D) Presence of a PDA 
A) Presence of an ASD 
B) Presence of a mitral regurgitation 
C) Adequate left atrial function 
D) Presence of a PDA

Question 6

Which of the following medications is the most common preoperative treatment to minimize preductal constriction until surgical correction of coarctation of the aorta can be achieved?

Accepted Answer

A) Indomethacin 
B) Prostaglandin E₁ 
C) Negative inotropes 
D) Diuretics 
A) Indomethacin 
B) Prostaglandin E₁ 
C) Negative inotropes 
D) Diuretics

Question 7

Which of the following congenital cardiac anomalies is classified as conotruncal,associated with a "boot-shaped" appearance of the heart?

Accepted Answer

A) Tetralogy of Fallot 
B) Transposition of the great vessels 
C) Coarctation of the aorta 
D) Atrioventricular canal defect 
A) Tetralogy of Fallot 
B) Transposition of the great vessels 
C) Coarctation of the aorta 
D) Atrioventricular canal defect

Question 8

When using subambient oxygen therapy,what range of oxygen saturations should the therapist target?

Accepted Answer

A) >95% to 95% 
B) 85% to 90% 
C) 75% to 85% 
D) 70% to 80% 
A) >95% to 95% 
B) 85% to 90% 
C) 75% to 85% 
D) 70% to 80%

Question 9

Which of the following strategies can be used to increase PVR in infants with HLHS?

Accepted Answer

A) Fio₂ < 0.21 
B) Induce hypocapnia 
C) Administer indomethacin 
D) Close the PDA 
A) Fio₂ < 0.21 
B) Induce hypocapnia 
C) Administer indomethacin 
D) Close the PDA

Question 10

What should the therapist select as target gas exchange parameters after surgical intervention for infants with hypoplastic left ventricular syndrome HLHS?

Accepted Answer

A) pH  7.45 
D) PaO₂ of 40 mm Hg and PaCO₂ of 40 mm Hg 
A) pH  7.45 
D) PaO₂ of 40 mm Hg and PaCO₂ of 40 mm Hg

Question 11

The therapist is setting pulse oximetry to determine the presence of right-to-left shunt in an infant suspected of having a heart defect.Where should the therapist place the pulse ox probe to obtain the most accurate measure of preductal oxygen saturation?

Accepted Answer

A) Any finger of the right hand 
B) Any finger of the left hand 
C) Left earlobe 
D) Lower extremities 
A) Any finger of the right hand 
B) Any finger of the left hand 
C) Left earlobe 
D) Lower extremities

Question 12

Which of the following vessels return blood to the right ventricle?
I.Pulmonary vein
II.Inferior vena cava
III.Superior vena cava
IV.Coronary sinus

Accepted Answer

A) I and IV only 
B) II and III only 
C) I,II,and III only 
D) II,III,and IV only 
A) I and IV only 
B) II and III only 
C) I,II,and III only 
D) II,III,and IV only

Question 13

Identify the following congenital cardiac anomaly:

Accepted Answer

A) Truncus arteriosus 
B) Hypoplastic left ventricle 
C) Transposition of the great vessels 
D) Ventricular septal defect 
A) Truncus arteriosus 
B) Hypoplastic left ventricle 
C) Transposition of the great vessels 
D) Ventricular septal defect

Question 14

The therapist is treating a child with TOF who appears to be having a "tet" spell.What should the therapist suggest to treat this event?
I.Beta blockers
II.Knee-chest position to increase SVR
III.Morphine sulfate
IV.Oxygen

Accepted Answer

A) IV only 
B) I and III only 
C) I and IV only 
D) I,II,III,and IV 
A) IV only 
B) I and III only 
C) I and IV only 
D) I,II,III,and IV

Question 15

A therapist monitoring an infant after a Blalock-Tausig shunt placement notices a significant drop in the end-tidal carbon dioxide (ETCO₂)despite no changes in the infant's respiratory rate.How should the therapist interpret this change?

Accepted Answer

A) The infant has dramatically improved ventilation by breathing deeply. 
B) The ETCO₂ monitor is not accurate. 
C) Loss of pulmonary blood flow through the shunt 
D) Tricuspid regurgitation 
A) The infant has dramatically improved ventilation by breathing deeply. 
B) The ETCO₂ monitor is not accurate. 
C) Loss of pulmonary blood flow through the shunt 
D) Tricuspid regurgitation

Question 16

Which of the following clinical manifestations is consistent with an atrial septal defect (ASD)?

Accepted Answer

A) An ASD often causes congestive heart failure (because of decreased pulmonary blood flow). 
B) The right ventricle may become hypertrophic (right ventricular hypertrophy). 
C) Most patients with an ASD are symptomatic in the neonatal intensive care unit,presenting with right atrial enlargement. 
D) Chest radiographs are usually abnormal. 
A) An ASD often causes congestive heart failure (because of decreased pulmonary blood flow). 
B) The right ventricle may become hypertrophic (right ventricular hypertrophy). 
C) Most patients with an ASD are symptomatic in the neonatal intensive care unit,presenting with right atrial enlargement. 
D) Chest radiographs are usually abnormal.

Question 17

For which of the following congenital cardiac defects may spontaneous closure of the ductus arteriosus be catastrophic?
I.Tetralogy of Fallot with pulmonary atresia
II.Atrial septal defect
III.Severe coarctation of the aorta
IV.Hypoplastic left heart syndrome

Accepted Answer

A) I and III only 
B) III and IV only 
C) I,II,and IV only 
D) I,III,and IV only 
A) I and III only 
B) III and IV only 
C) I,II,and IV only 
D) I,III,and IV only

Question 18

Identify the congenital cardiac defect depicted in the following illustration:

Accepted Answer

A) Atrial septal defect 
B) Hypoplastic left ventricular syndrome 
C) Hypoplastic right ventricular syndrome 
D) Atrioventricular canal defect 
A) Atrial septal defect 
B) Hypoplastic left ventricular syndrome 
C) Hypoplastic right ventricular syndrome 
D) Atrioventricular canal defect

Question 19

Which of the following statements describe truncus arteriosus?
I.The pulmonary artery arises from the left ventricle,and the aorta stems from the right ventricle.
II.If PVR increases relative to systemic vascular resistance (SVR),more blood flows to the lungs through the truncus,decreasing systemic cardiac output.
III.If SVR decreases relative to PVR,blood flow will be shunted from right to left,bypassing the lungs.
IV.A large VSD allows total mixing of blood from the two ventricles.

Accepted Answer

A) I and III only 
B) II and IV only 
C) I,II,and IV only 
D) I,III,and IV only 
A) I and III only 
B) II and IV only 
C) I,II,and IV only 
D) I,III,and IV only

Question 20

The therapist is treating a child with a congenital heart defect who is unresponsive to oxygen therapy.Although the chest X-ray is relatively normal,the heart is described as "egg-shaped." Which of the following heart defects is more consistent with this description?

Accepted Answer

A) Complete transposition of the great arteries 
B) Coarctation of the aorta 
C) Truncus arteriosus 
D) Tetralogy of Fallot 
A) Complete transposition of the great arteries 
B) Coarctation of the aorta 
C) Truncus arteriosus 
D) Tetralogy of Fallot

Exam 24: Congenital Cardiac Defects

Which of the following methods is involved in the management of a PDA?

What factor is responsible for closure of the foramen ovale?

At birth,what factor causes dilation of the pulmonary vascular bed and a decrease in the pulmonary vascular resistance?

Which of the following blood flow patterns occurs in complete transposition of the great arteries?

Which of the following physiologic mechanisms need to be in place to ensure adequate systemic perfusion in infants with HLHS?

Which of the following medications is the most common preoperative treatment to minimize preductal constriction until surgical correction of coarctation of the aorta can be achieved?

Which of the following congenital cardiac anomalies is classified as conotruncal,associated with a "boot-shaped" appearance of the heart?

When using subambient oxygen therapy,what range of oxygen saturations should the therapist target?

Which of the following strategies can be used to increase PVR in infants with HLHS?

What should the therapist select as target gas exchange parameters after surgical intervention for infants with hypoplastic left ventricular syndrome HLHS?

The therapist is setting pulse oximetry to determine the presence of right-to-left shunt in an infant suspected of having a heart defect.Where should the therapist place the pulse ox probe to obtain the most accurate measure of preductal oxygen saturation?

Which of the following vessels return blood to the right ventricle? I.Pulmonary vein II.Inferior vena cava III.Superior vena cava IV.Coronary sinus

Identify the following congenital cardiac anomaly:

The therapist is treating a child with TOF who appears to be having a "tet" spell.What should the therapist suggest to treat this event? I.Beta blockers II.Knee-chest position to increase SVR III.Morphine sulfate IV.Oxygen

A therapist monitoring an infant after a Blalock-Tausig shunt placement notices a significant drop in the end-tidal carbon dioxide (ETCO₂)despite no changes in the infant's respiratory rate.How should the therapist interpret this change?

Which of the following clinical manifestations is consistent with an atrial septal defect (ASD)?

For which of the following congenital cardiac defects may spontaneous closure of the ductus arteriosus be catastrophic? I.Tetralogy of Fallot with pulmonary atresia II.Atrial septal defect III.Severe coarctation of the aorta IV.Hypoplastic left heart syndrome

Identify the congenital cardiac defect depicted in the following illustration:

The therapist is treating a child with a congenital heart defect who is unresponsive to oxygen therapy.Although the chest X-ray is relatively normal,the heart is described as "egg-shaped." Which of the following heart defects is more consistent with this description?

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