Neonatal Nurse Practitioner Practice Exam

Which method is used to distinguish structural congenital heart disease from pulmonary hypertension in newborns?

1. Hyperventilation

2. Hyperoxia and hyperventilation

3. Oxygen exposure up to 10 minutes

4. Chest X-ray

The correct answer is: Hyperoxia and hyperventilation

The use of hyperoxia and hyperventilation is a method employed to differentiate between structural congenital heart disease and pulmonary hypertension in newborns. This approach is based on the physiological responses of the newborn's blood vessels and oxygenation levels. In cases of pulmonary hypertension, the blood vessels in the lungs do not dilate effectively even when oxygen levels are increased. Therefore, administering supplemental oxygen can often lead to little or no improvement in oxygen saturation levels. In contrast, if the condition is due to a structural congenital heart defect, exposure to oxygen can result in improved oxygenation because the underlying issue may not involve the pulmonary vasculature directly. Hyperventilation, often a part of this method, can help further assess the response of the pulmonary system by decreasing carbon dioxide levels, which might mimic the effects of oxygen exposure, but it is not as comprehensive or revealing on its own compared to using both hyperoxia and hyperventilation. By utilizing both techniques in tandem, healthcare providers can gain clearer insights into whether the underlying issue is related to structural problems in the heart or primarily due to pulmonary vascular resistance. Using hyperoxia alone, as mentioned in one of the alternate choices, does not provide the same level of diagnostic clarity as the combined approach. Meanwhile, chest X