Question 1

What is the initial manifestation of aortic coarctation observed in a neonate?

Accepted Answer

A) Heart failure (HF) 
B) Cor pulmonale 
C) Pulmonary hypertension 
D) Cerebral hypertension 
A) Heart failure (HF) 
B) Cor pulmonale 
C) Pulmonary hypertension 
D) Cerebral hypertension A

Question 2

An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. The healthcare professional suspects an atrial septal defect (ASD). For what other manifestation does the healthcare professional assess to confirm the suspicion?

Accepted Answer

A) Wide, fixed splitting of the second heart sound 
B) Loud, harsh holosystolic murmur 
C) Cyanosis with crying and feeding 
D) Rapid deterioration with acidosis 
A) Wide, fixed splitting of the second heart sound 
B) Loud, harsh holosystolic murmur 
C) Cyanosis with crying and feeding 
D) Rapid deterioration with acidosis A

Question 3

Which event triggers congenital heart defects that cause acyanotic congestive heart failure?

Accepted Answer

A) Right-to-left shunts 
B) Left-to-right shunts 
C) Obstructive lesions 
D) Mixed lesions 
A) Right-to-left shunts 
B) Left-to-right shunts 
C) Obstructive lesions 
D) Mixed lesions B

Question 4

A baby has been born with Down syndrome. What congenital heart defect does the healthcare professional assess this baby for?

Accepted Answer

A) Coarctation of the aorta (CO
A)  
B) Tetralogy of Fallot 
C) Atrial septal defect (AS
D)  
D) Ventricular septal defect (VS
D)  
A) Coarctation of the aorta (CO
A)  
B) Tetralogy of Fallot 
C) Atrial septal defect (AS
D)  
D) Ventricular septal defect (VS
D)

Question 5

A parent brings a 10-year-old child to the clinic and reports a mottled appearance to the skin and legs cramps when the child is in physical education class. What diagnostic testing or treatment does the healthcare professional prepare the family for?

Accepted Answer

A) Immediate cardiac catheterization 
B) Administration of prostaglandin 
C) Multiple-stage surgical correction 
D) An echocardiogram 
A) Immediate cardiac catheterization 
B) Administration of prostaglandin 
C) Multiple-stage surgical correction 
D) An echocardiogram

Question 6

Which condition is consistent with the cardiac defect of transposition of the great vessels?

Accepted Answer

A) The aorta arises from the right ventricle. 
B) The pulmonary trunk arises from the right ventricle. 
C) The right ventricle pumps blood to the lungs. 
D) An intermittent murmur is present. 
A) The aorta arises from the right ventricle. 
B) The pulmonary trunk arises from the right ventricle. 
C) The right ventricle pumps blood to the lungs. 
D) An intermittent murmur is present.

Question 7

Which symptoms meet the diagnostic criteria for Kawasaki disease in a child? (Select all that apply.)

Accepted Answer

A) Fever for 5 days or longer 
B) "Strawberry tongue" 
C) Peripheral edema 
D) Inguinal lymphadenopathy 
E) Bilateral conjunctival infection 
A) Fever for 5 days or longer 
B) "Strawberry tongue" 
C) Peripheral edema 
D) Inguinal lymphadenopathy 
E) Bilateral conjunctival infection

Question 8

A newborn has chronic sustained hypertension but otherwise appears healthy. What diagnostic testing does the healthcare professional facilitate as the priority?

Accepted Answer

A) Cardiac catheterization 
B) Echocardiogram 
C) Serum electrolytes 
D) Renal function studies 
A) Cardiac catheterization 
B) Echocardiogram 
C) Serum electrolytes 
D) Renal function studies

Question 9

An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole. The healthcare professional suspects a congenital heart disorder. What other assessment finding is inconsistent with the professional's knowledge about this disorder?

Accepted Answer

A) Bounding pulses 
B) Active precordium 
C) Thrill on palpation 
D) Signs of heart failure 
A) Bounding pulses 
B) Active precordium 
C) Thrill on palpation 
D) Signs of heart failure

Question 10

An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?

Accepted Answer

A) Atrial septal defect (AS
D)  
B) Ventricular septal defect (VS
D)  
C) Patent ductus arteriosus (PD
A)  
D) Atrioventricular canal (AV
C)  defect 
A) Atrial septal defect (AS
D)  
B) Ventricular septal defect (VS
D)  
C) Patent ductus arteriosus (PD
A)  
D) Atrioventricular canal (AV
C)  defect

Question 11

Where can coarctation of the aorta (COA) be located?

Accepted Answer

A) Exclusively on the aortic arch 
B) Proximal to the brachiocephalic artery 
C) Between the origin of the aortic arch and the bifurcation of the aorta in the lower abdomen 
D) Between the origin of the aortic arch and the origin of the first intercostal artery 
A) Exclusively on the aortic arch 
B) Proximal to the brachiocephalic artery 
C) Between the origin of the aortic arch and the bifurcation of the aorta in the lower abdomen 
D) Between the origin of the aortic arch and the origin of the first intercostal artery

Question 12

A healthcare professional assesses a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border. What condition does the professional prepare to educate the parents on?

Accepted Answer

A) Coarctation of the aorta 
B) Pulmonic stenosis 
C) Aortic stenosis 
D) Hypoplastic left heart syndrome 
A) Coarctation of the aorta 
B) Pulmonic stenosis 
C) Aortic stenosis 
D) Hypoplastic left heart syndrome

Question 13

Which scenario describes total anomalous pulmonary venous return?

Accepted Answer

A) The foramen ovale closes after birth. 
B) Pulmonary venous return is to the right atrium. 
C) Pulmonary venous return is to the left atrium. 
D) The left atrium receives oxygenated blood. 
A) The foramen ovale closes after birth. 
B) Pulmonary venous return is to the right atrium. 
C) Pulmonary venous return is to the left atrium. 
D) The left atrium receives oxygenated blood.

Question 14

A healthcare professional is assessing a baby in the neonatal intensive care unit who is very unstable. The professional hears a systolic ejection click at the upper left sternal border with a thrill palpated at the upper left sternal border. What procedure does the professional prepare the parents for the baby to have?

Accepted Answer

A) Heart transplant 
B) Balloon angioplasty 
C) Prostaglandin infusion 
D) High dose aspirin 
A) Heart transplant 
B) Balloon angioplasty 
C) Prostaglandin infusion 
D) High dose aspirin

Question 15

What congenital heart defects are associated with intrauterine exposure to rubella? (Select all that apply.)

Accepted Answer

A) Pulmonary stenosis (PS) 
B) Cardiomegaly 
C) Patent ductus arteriosus (PD
A)  
D) Coarctation of aorta (CO
A)  
E) Ventricular septal defect (VS
D)  
A) Pulmonary stenosis (PS) 
B) Cardiomegaly 
C) Patent ductus arteriosus (PD
A)  
D) Coarctation of aorta (CO
A)  
E) Ventricular septal defect (VS
D)

Question 16

An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?

Accepted Answer

A) Intermittent murmur 
B) Lack of symptoms 
C) Rapid decompensation 
D) Triad of congenital defects 
A) Intermittent murmur 
B) Lack of symptoms 
C) Rapid decompensation 
D) Triad of congenital defects

Question 17

The student studying pathophysiology learns which fact about circulation at birth?

Accepted Answer

A) Systemic resistance and pulmonary resistance fall. 
B) Gas exchange shifts from the placenta to the lung. 
C) Systemic resistance falls and pulmonary resistance rises. 
D) Systemic resistance and pulmonary resistance rise. 
A) Systemic resistance and pulmonary resistance fall. 
B) Gas exchange shifts from the placenta to the lung. 
C) Systemic resistance falls and pulmonary resistance rises. 
D) Systemic resistance and pulmonary resistance rise.

Question 18

Which statements related to the ambulatory blood pressure monitoring (ABPM) system with children are true? (Select all that apply.)

Accepted Answer

A) ABPM monitors blood pressure for a 24-hour period. 
B) ABPM assists in identifying children with white coat hypertension. 
C) ABPM is effective in identifying children at risk for target organ damage. 
D) ABPM assists in identifying children who demonstrate masked hypertension. 
E) ABPM is effective in determining blood pressure load for 48 hours. 
A) ABPM monitors blood pressure for a 24-hour period. 
B) ABPM assists in identifying children with white coat hypertension. 
C) ABPM is effective in identifying children at risk for target organ damage. 
D) ABPM assists in identifying children who demonstrate masked hypertension. 
E) ABPM is effective in determining blood pressure load for 48 hours.

Question 19

The presence of the foramen ovale in a fetus allows what to occur?

Accepted Answer

A) Right-to-left blood shunting 
B) Left-to-right blood shunting 
C) Blood flow from the umbilical cord 
D) Blood flow to the lungs 
A) Right-to-left blood shunting 
B) Left-to-right blood shunting 
C) Blood flow from the umbilical cord 
D) Blood flow to the lungs

Question 20

Older children with an unrepaired cardiac septal defect experience cyanosis because of which factor?

Accepted Answer

A) Right-to-left shunts 
B) Left-to-right shunts 
C) Obstructive lesions 
D) Mixed lesions 
A) Right-to-left shunts 
B) Left-to-right shunts 
C) Obstructive lesions 
D) Mixed lesions

Exam 34: Alterations of Cardiovascular Function in Children

What is the initial manifestation of aortic coarctation observed in a neonate?

Which event triggers congenital heart defects that cause acyanotic congestive heart failure?

A baby has been born with Down syndrome. What congenital heart defect does the healthcare professional assess this baby for?

A parent brings a 10-year-old child to the clinic and reports a mottled appearance to the skin and legs cramps when the child is in physical education class. What diagnostic testing or treatment does the healthcare professional prepare the family for?

Which condition is consistent with the cardiac defect of transposition of the great vessels?

Which symptoms meet the diagnostic criteria for Kawasaki disease in a child? (Select all that apply.)

A newborn has chronic sustained hypertension but otherwise appears healthy. What diagnostic testing does the healthcare professional facilitate as the priority?

An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole. The healthcare professional suspects a congenital heart disorder. What other assessment finding is inconsistent with the professional's knowledge about this disorder?

An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?

Where can coarctation of the aorta (COA) be located?

A healthcare professional assesses a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border. What condition does the professional prepare to educate the parents on?

Which scenario describes total anomalous pulmonary venous return?

What congenital heart defects are associated with intrauterine exposure to rubella? (Select all that apply.)

An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?

The student studying pathophysiology learns which fact about circulation at birth?

Which statements related to the ambulatory blood pressure monitoring (ABPM) system with children are true? (Select all that apply.)

The presence of the foramen ovale in a fetus allows what to occur?

Older children with an unrepaired cardiac septal defect experience cyanosis because of which factor?

Cellular Biology

Altered Cellular and Tissue Biology: Environmental Agents

The Cellular Environment: Fluids and Electrolytes, Acids and Bases

Genes and Genetic Diseases

Genes, Environment-Lifestyle, and Common Diseases

Epigenetics and Disease

Innate Immunity: Inflammation and Wound Healing

Adaptive Immunity

Alterations in Immunity and Inflammation

Infection

Stress and Disease

Cancer Biology

Cancer Epidemiology

Cancer in Children

Structure and Function of the Neurologic System

Pain, Temperature Regulation, Sleep, and Sensory Function

Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function

Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction

Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders

Alterations of Neurologic Function in Children

Mechanisms of Hormonal Regulation

Alterations of Hormonal Regulation

Obesity and Disorders of Nutrition

Structure and Function of the Reproductive Systems

Alterations of the Female Reproductive System

Alterations of the Male Reproductive System

Sexually Transmitted Infections

Structure and Function of the Hematologic System

Alterations of Erythrocytes, Platelets, and Hemostatic Function

Alterations of Leukocyte and Lymphoid Function

Alterations of Hematologic Function in Children

Structure and Function of the Cardiovascular and Lymphatic Systems

Alterations of Cardiovascular Function

Structure and Function of the Pulmonary System

Alterations of Pulmonary Function

Alterations of Pulmonary Function in Children

Structure and Function of the Renal and Urologic Systems

Alterations of Renal and Urinary Tract Function

Alterations of Renal and Urinary Tract Function in Children

Structure and Function of the Digestive System

Alterations of Digestive Function

Alterations of Digestive Function in Children

Structure and Function of the Musculoskeletal System

Alterations of Musculoskeletal Function

Alterations of Musculoskeletal Function in Children

Structure, Function, and Disorders of the Integument

Alterations of the Integument in Children

Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults

Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children

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