A cardiovascular alteration seen in a newborn diagnosed with respiratory distress syndrome in-cludes:

a. left-to-right shunt.
b. left ventricular dilation.
c. pulmonary hypotension.
d. opening of fetal shunt pathways.

ANS: D
Increased pulmonary vascular resistance may even cause a partial return to fetal circulation, with right-to-left shunting of blood through the ductus arteriosus and foramen ovale. A left-to-right shunt does not occur. This situation is not associated with either ventricular dilation or pulmonary hypotension.