question

An Apgar Score of 4 indicates: 1. Normal score 2. No depression 3. Moderate depression 4. Severe depression

answer

Moderate depression

question

A normal sweat chloride test is: 1. >40 mEq/l 2. 60 mEq/l 4. 60 mEq/l

answer

<40 mEq/l

question

All of the following could add to high risk infant delivery, EXCEPT: 1. Maternal diabetes 2. Age of the mother 3. A heavy smoking mother 4. Prenatal care

answer

Prenatal care

question

The treatment of toxemia include: I. Bedrest II. Diet III.Salt restriction 1. I only 2. II only 3. I & II 4. I, II, III

answer

I, II, III

question

Transient tachypnea of the newborn (TTNB) is: 1. Respiratory distress due to delayed clearing of fetal lung fluid. 2. Respiratory distress due to a pneumothorax 3. Respiratory distress resulting from a low birth weight infant 4. Respiratory distress resulting from hyperglycemia

answer

Respiratory distress due to delayed clearing of fetal lung fluid.

question

Normal fetal heart rate is: 1. 80-100 bpm 2. 100-120 bpm 3. 110-160 bpm 4. 160-200 bpm

answer

110-160 bpm

question

Prolonged rupture of the membranes may result in: 1. Neonatal sepsis 2. Meconium aspiration 3. Persistent fetal circulation 4. Jaundice

answer

Neonatal sepsis

question

The Dubowitz method is used to: 1. Assess respiratory distress 2. Determine the gestional age 3. Determine the need for resuscitation 4. Identify a fetus in distress

answer

Determine the gestional age

question

Pre and Post ductal blood gas studies are done to evaluate: 1. R-L shunting across the ductus arterious 2. L-R shunting across the ductus arteriosus 3. Ventricular septal defect (VSD) 4. Post ductal coarctation of aorta

answer

1

question

At 33.3 C, a newborn will require: 1. The same amount of oxygen for survival 2. Twice as much oxygen for survival 3. Three times as much oxygen for survival 4. Four times as much oxygen for survival

answer

3

question

Clubbing of the fingers or toes is when: 1. The finger or toes become enlarged due to acute hypoxia 2. Loss of mobility occurs in the finger or toes due to hypercarbia 3. The angle of the nail bed is increased 4. Polycythemia due to heart disease

answer

3

question

Respiratory grunting is: 1. A sound heard at the end of inspiration just before a rapid exhalation 2. A sound heard at the end of expiration just before a rapid inspiration 3. A sound heard at the end of inspiration just before a normal exhalation 4. A sound heard at the end of expiration just before a normal inspiration

answer

2

question

Transillumination of the chest is recommended when you: 1. Suspect a pneumothorax 2. Suspect hylaline membrane disease 3. Suspect a diaphragmatic hernia 4. Suspect a pleural effusion

answer

1

question

Poor femoral pulses may indicate: 1. Patent ductus arteriosus 2. Ventricular septal defect 3. Coarctation of the aorta 4. Hypoplastic left heart syndrome

answer

3

question

Vibrations due to secretions that are felt on the chest wall are referred to as: 1. Vocal fremitus 2. Rhonchi 3. Rales 4. Tactile fremitus

answer

4

question

Wheezing is associated with all of the following, EXCEPT: 1. Epiglottis 2. Hyaline membrane disease 3. Asthma 4. Bronchopulmonary dysplasia

answer

1

question

Which of the following phases of human lung development occurs from 17-26 weeks of gestation and is characterized by the formation of a capillary network around airway passages? 1. Pseudoglandular 2. Saccular 3. Alveolar 4. Canalicular

answer

4

question

Regarding postnatal lung growth by approximately what age do most of the alveoli taht will be present in the lungs for life develop? 1. 6 months 2. 1 year 3. 1.5 years 4. 2 years

answer

3

question

What is the purpose of the material secreted by type II pneumocyte? 1. To increase the gas exchange surface area 2. To reduce surface tension 3. To maintain lung elasticity 4. To preserve the volume of the amniotic fluid

answer

2

question

What is the function of Wharton's jelly inside the umbilical cord? 1. To help provide nutrition to the fetus 2. To prevent the vessels inside the cord from kinking 3. To help protect the fetus 4. To regulate the temperature between the fetus and the mother

answer

2

question

During the third gestational week, which of the following organs is the first to form? 1. Heart 2. Brain 3. Lungs 4. Kidneys

answer

1

question

How should the therapist interpret an amniotic fluid index of 5 cm? 1. Polyhydramnios 2. Multihydramnios 3. Oligohydramnios 4. Anhydramnios

answer

3

question

Which of the following causes cessation of the R-L shunt through the foramen ovale? 1. Increased levels of Pa02 in the blood of the neonate 2. Decreased levels of PaCo2 in the blood of the newborn 3. Increased systemic vascular resistance 4. Removal fo the placenta, causing lowered blood volume returning to the right side of the fetal heart

answer

3

question

Which of the following anatomic structures constitute fetal shunts? I. Foramen ovale II. Sinus venosus III.Ductus venosus IV.Ductus arteriosus 1. I, II, III 2. I, III, IV 3. I, II, IV 4. II, III, IV only

answer

2

question

An L/S ratio of 2:1 indicates: 1. A high risk infant 2. Incidence of hyaline membrane disease approaches zero 3. A sign that respiratory distress will be present 4. The most reliable indicator of pulmonary maturity even with diabetes.

answer

2

question

Which of the following drugs is recommended to treat a group B Streptococcus infection for a patient who is allergic to penicillin? 1. Vancomycin 2. Clindamycin 3. Ampicillin 4. Ketoconazole

answer

2

question

After the umbilical cord has been cut in the delivery room during the delivery of a large for gestational age infant, the therapist notices that the umbilical cord is large and fat. Which of the following materanl conditions is likely present? 1. Congestive Heart Failure 2. Renal insufficiency 3. Diabetes mellitus 4. Hypertension

answer

3

question

When performing a physical examination of the throax, in what order should the therapist proceed with the assessment? 1. Inspection, palpation, percussion, and auscultation 2. Inspection, percussion, palpation, and auscultation 3. Palpation, inspection, percussion, and auscultation 4. Percussion, palpation, auscultation, and inspection

answer

1

question

Which of the following white blood counts constitutes the condition leukopenia? 1. Less than or equal to 3500/mm 2. 5000 to 10,000/mm 3. 10,000 to 20,000/mm 4. Greater than or equal to 25,000/mm

answer

1

question

A child who demonstrates head bobbing, nasal flaring, and grunting is exhibiting the signs of 1. Acidemia 2. Hypoxemia 3. Hypercapnia 4. Respiratory distress

answer

4

question

During a physical examination of a child's chest, the therapist perceives increased tactile fremitus over the patient's right lower lobe. Which of the following may cause this physical sign? 1. Mucous plug 2. Pneumothorax 3. Pulmonary consolidation 4. Aspirated foregin object

answer

3

question

The therapist has placed a pulse oximeter probe on a finger of the right hand of a newborn and another pulse onimeter probe on a toe of the infant's left foot. The pulse oximeter on the right hand reads 8 and the one on the left foot indicates 65%. Which of the following disease conditions does this neonate possible have? 1. Diaphragmatic hernia 2. Persistent pulmonary hypertension of the newborn 3. Chonal atresia 4. Suprapubic aspiration

answer

2

question

A newborn who presents as pale, mottled, floppy, with little interest in feeding, and slightly irritable most likely has which of the following conditions? 1. Sepsis 2. Respiratory distress syndrome 3. Retinopathy of prematurity 4. Cri du chat

answer

1

question

A term infant is born displaying acrocyanosis. What should the therapist do at this time? 1. Administer oxygen to the newborn 2. Begin resuscitative measures 3. Institute PPV mechanical ventilation 4. Do nothing, as this condition is often transient

answer

4

question

A preterm neonate with a heart rate of 55 beats/minute is receiving PPV immediately after delivery. What should the therapist do at this time? 1. Apply cardiac compressions and maintain PPV 2. Defibrillate the infant 3. Administer medication to increase myocardial contractillity and maintain PPV 4. Increase the respiratory rate on the ventilator

answer

1

question

As the head of a neonate contaminated with meconium emerges at birth, the heart rate monitor indicates 120 beats/minute, and the physician notices that the infant has good muscle tone and a strong respiratory effort. What should the physician do at this time to provide airway care? 1. Intubate the infant immediately 2. Perform pharyngeal and tracheal suctioning immediately 3. Perform tracheal suctioning only at this time 4. Do not perform tracheal suctioning on this infant at this time.

answer

4

question

Which of the following medications are used as tocolytics? I. Magnesium sulfate II. Sodium bicarbonate III.Calcium carbonate IV.Indomethacin 1. I and IV only 2. II and III only 3. III and IV only 4. I, II, and III only

answer

1

question

What measures can the therapist take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate? I. Dry the infant's skin II. Wrap the infant in prewarmed blankets III.Remove wet linens from around the infant Iv. Measure the neonate's body temperature 1. IV 2. I and II only 3. I, II, III 4. I, II, and IV only

answer

3

question

Which of th following medications is used to reverse respiratory depression induced by opioid overdose? 1. Epinephrine 2. Naloxone 3. Sodium bicarbonate 4. Oxygen

answer

2

question

What ratio of chest compressions and positive pressure breaths must the therapist administer to a newborn during CPR? 1. One compression for every three breaths 2. Two compressions for every five breaths 3. One compression for every 15 breaths 4. Three compressions for every 1 breath

answer

4

question

The therapist has been performing cardiopulmonary resuscitation on a neonate for about 90 seconds, applying ventilation with oxygen and chest compressions. The infant has maintained a spontaneous heart rate of 40 beats/minute. What should the therapist recommend at this time? 1. Continuing resuscitative measures 2. Administering epinephrine 3. Instituting extracorporeal membrane oxygenation 4. Initiating high frequency ventilation

answer

2

question

The umbilical cord normally has ____ artery(ies) and _____ vein(s). 1. 1 and 1 2. 2 and 2 3. 1 and 2 4. 2 and 1

answer

4

question

A physical examination is being performed on a newborn, and the therapist notices that the infant's arms do not move symmetrically. Which of the following situations could account for this problem? 1. An injury to the infant's brachial plexus may have occurred during birth 2. The infant may have been born breech 3. The baby was born via cesarean section. 4. The infant experienced nuchal cords during birth.

answer

1

question

Which of the following statements refers to the diagnostic procedure called transillumination? 1. Place a light source between the surface of the bed and the patients back, and orient the patient in a supine position. 2. Use a high-energy flash light in a darkened room over the suspected side. 3. Position a beam of light aganist a patient's chest wall in a well-lit room 4. Insert a fiberoptic light source down a patient's endotracheal tube and beyond the tube' distal tip.

answer

2

question

Which of the following conditions are associated with preeclampsia? I. Multiparity II. Proteinuria III.Generalized IV.Hypertension 1. II and III 2. I, II, III 3. I, III, IV 4. II, III, IV

answer

4

question

Which of the following actions constitutes appropriate stimulation of a neonate? I. Gently slapping infant's buttocks II. Gently shaking the infant's upper torso III. Flicking the bottoms of the infant's feet IV. Drying with a towel 1. III only 2. I and II only 3. III and IV only 4. II, III, and IV only

answer

3

question

The therapist has completed a 1 minute Apgar score. The following evaluations were obtained: (1) the infant is pale (2) the heart rate is 90 beats/minute (3) the respiratory effort is irregular (4) some muscle tone is noted (5) no response to nasal suctioning is found On the basis of these findings, what APGAR score is assigned to this neonate? 1. 1 2. 2 3. 3 4. 5

answer

3

question

What is the approximate fetal heart rate by the sixth week of gestation? 1. 120 bpm 2. 95 bpm 3. 80 bpm 4. 60 bpm

answer

2

question

The fetal circulation blood bypasses the infant's lungs through the: I. Umbilical artery II. Foramen ovale III.Umbilical vein IV.Ductus arteriosus 1. I and II only 2. II and III only 3. I and III only 4. II and IV only

answer

4

question

A newborn is receiving 6 oxygen via head hood. Arterial blood gases are drawn from an umbilical line and the results show the following result. pH 7.33 PC02 37 P02 40 HC03 21 BE -3 The therapist should recommend: 1. assisted ventilation 2. increase oxyhood to 7 3. administer sodium bicarbonate 4. Start nasal CPAP

answer

4

question

True or False: Primary apnea does not respond to stimulation.

answer

False, Secondary Apnea does not respond to stimulation

question

In suctioning a baby's nose and mouth, the rule is to first suction the 1.----- and then the 2.-----.

answer

Mouth then your nose (don't eat your boogers)

question

A newborn is still not breathing after a few seconds of stimulation, your next action should be to administer? 1. Additional stimulation 2. Positive pressure ventilation 3. Slap the baby on the back. 4. Give free-flow oxygen.

answer

Positive pressure ventilation

question

If you need to give oxygen for longer that a few minutes, the oxygen should be all of the following EXCEPT: 1. Heated 2. Humidified 3. Cooled

answer

Cooled Oxygen and compressed air that come from a wall source or tank are very cold and dry. To prevent heat loss and drying of te respiratory mucosa, oxygen given to newborn.

question

True or False: You give Epinephrine down the endotracheal tube:

answer

True

question

If a baby's heart rate remains below 60 beats per minute, you can repeat the dose of epinephrine every: 1. 1-3 minutes 2. 5-8 minutes 3. 3-5 minutes 4. 10 minutes

answer

3. 3-5 minutes Epi is given to increase strength and rate of cardiac contractions which causes peripheral vacoconstriction and increases blood flow to the brain and coronary arteries. Should be given RAPIDLY followed by a 1 ml flush. If given down ET tube double the dose 0.5 to 1ml/kg or .005 to 0.1 mg/kg. If given by IV the dose is 0.1-0.3 ml/kg. Epi can be given every 3-5 minutes.

question

If a diaphragmatic is suspected, such babies should NOT be resuscitated with: 1. Endotracheal intubation 2. PPV 3. High flow oxygen 4. low flow oxygen

answer

2. PPV Babies with known or suspected diaphragmatic hernia should not receive prolonged resuscitation with PPV, air will inflate the intestines in the chest. You should intubate the trachea expeditiously and place a OG or NG to evacuate the stomach contents.

question

The ratio of chest compressions to ventilation: 1. 5:1 2. 30:2 3. 15:2 4. 3:1

answer

4. 3:1 Repeat the words One-and-Two-and-Three-and-Breathe-and-One-and-Two-and-Three-and-Breathe.

question

The apgar score includes all of the following criteria EXCEPT: 1. Color 2. Heart rate 3. Evaluation of the Moro reflex 4. Reflex irritability

answer

3. Evaluation of the Moro reflex This is a neurologic assessment, occurs when the head is allowed to fall back slightly. Pg. 57 in your Neo/Ped book.

question

The best indicator of an infant's overall cardiopulmonary status immediately after birth is: 1. Apgar score 2. Color 3. Respiratory effort 4. Heart rate

answer

4. Heart rate 100% indicates life and death, if <100 do PPV! <60 CPR

question

Signs of respiratory distress in a newborn include all of the following EXCEPT: 1. Vesicular breath sounds 2. Grunting 3. Nasal Flaring 4. Substernal retractions

answer

1. Vesicular breath sounds Vesicular is a term used to describe normal breathing and would not indicate resp. distress.

question

The L/S ratio is used to evaluate? 1. Respiratory distress 2. Birth weight 3. Lung maturity 4. Gestional age

answer

3. Lung maturity withdrawing a sample of amniotic fluid through the mother's abdominal wall. A ratio of 2 or greater indicates sufficient lung maturity.

question

Which of the following is not part of the Pulmonary Examination? 1. General 2. Ausculation 3. Percussion 4. Inspection

answer

1. General General is part of the non-pulmonary Examination

question

What is the 3rd part of your Pulmonary Examination? 1. Ausculation 2. Palpation 3. Inspection 4. Percussion

answer

4. Percussion This is step 3 of the pulmonary examination. Your pulmonary examination should be started with 1. Inspection (what you see) 2. Palpation (what you feel) 3. Percussion (tap, tap, tap on chest wall) 4. Ausculation (what you hear)

question

When delivering PPV, the recommended breath rate is 1. 20-40 breaths/min 2. At least 100 breaths/min 3. 40-60 breaths/minutes 4. 60-80 breaths/minute

answer

3. 40-60 breaths/minutes

question

Acrocyanosis is defined as: 1. A left to right shunt 2. A sign of chronic hypoxemia 3. True cyanosis 4. Cyanosis of the hands and feet

answer

4. Cyanosis of the hands and feet Normal after delivery, we usually dont treat! It is a sign of peripheral vasoconstriction and is not indicative of hypoxia and is not associated with severe respiratory distress.

question

Which of the following is not stages of human lung development? 1. Chorionic 2. Embryonal 3. Saccular 4. Canalicular

answer

1. Chorionic

question

The preferred method of delivering chest compressions is the 1.----- technique.

answer

1. thumb

question

Transillumination is recommened when you suspect 1. Hyaline membrane disease 2. Bronchopulmonary dysplagia 3. A foreign body aspiration 4. A pneumothorax

answer

4. A pneumothorax Transillumination of the chest may be helpful as a screening procedure. It is indicated for any infant exhibiting asymmetrical chest movement with respiratory distress and decreased breath sounds and or absent heart sounds with a trachea shifting away. "Halo" is normal. In the presence of pneumothorax the entire hemithorax ligts up.

question

Supraglottic welling is consistent with: 1. Croup 2. Foreign body aspiration 3. Epiglottitis 4. Respiratory syncytial virus

answer

3. Epiglottitis Epiglottitis is "SUPRA" IMPORTANT and is SUPRAglottic. It is a IMMEDIATE EMERGENCY. Infection of all the tissues above the glottis and involves not only the epiglottitis but the ARYEPIGLOTTIC FOLDS and ARYTENOID CARTILAGES (Supralottic) swelling. Causative agent is a bacteria (H. influenza)

question

Your first day of class I told you the #1 cause of resuscitation in neonates is 1.-----

answer

1. asphyxia or suffocation

question

1.-----, is a drug that we use for prolonged respiratory arrest as long as adequate ventilation has first corrected any respiratory acidosis. This drug is also used to treat 2.----- acidosis.

answer

1. Sodium Bicarbonate 2. metabolic

question

Another name for respiratory distress syndrome (RDS) is: 1. Hyaline membrane disease 2. Tranisent tachypnea of the newborn 3. Type II RDS 4. Persistent pulmonary hypertension

answer

1. Hyaline membrane disease

question

What is the first clinical sign of RDS in the newborn infant? 1. Cyanosis 2. Wheezing 3. Hypertension 4. Tachypnea

answer

4. Tachypnea

question

Which of the following is NOT common with croup? 1. Stridor 2. Murmur 3. Coughing 4. Cyanosis

answer

2. Murmur

question

What physiologic abnormality is believed to be the cause of persistent pulmonary hypertension in the newborn (PPHN)? 1. Metabolic acidosis 2. Right-to-Left shunting 3. high cardiac output 4. high pulmonary vascular resistance

answer

4. high pulmonary vascular resistance

question

Prevention of retinopathy of prematurity is based on: 1. Maintaining low PaCO2 levels 2. Cautious use of oxygen 3. maintaining adequate blood pressure 4. keeping Pa02 levels >100mmHG

answer

2. Cautious use of oxygen

question

The cystic fibrosis gene occurs most frequently in which of the following races? 1. White 2. Black 3. Asian 4. There is no racial difference

answer

1. White

question

Which of the following diseases typically is accompanied by a high fever? 1. Bronchiolitis 2. Laryngotracheobronchitis 3. Epiglottitis 4. Asthma

answer

3. Epiglottitis

question

What condition is likely present if the Pa02 in an arterial blood sample obtained from the right artery is significantly highter than one obtained from an umbilical artery? 1. Respiratory distress syndrome 2. Persistent pulmonary hypertension of the newborn 3. Tracheoesophageal fistual 4. Meconium aspiration syndrome

answer

2. Persistent pulmonary hypertension of the newborn

question

In the case of a severe asthma attack, which of these drugs should be started FIRST in the emergency room treatment of asthma? 1. Theophylline 2. Cromolyn sodium 3. Corticosteroids 4. Oxygen

answer

4. Oxygen

question

What is the major emphasis in mechanically ventilating a patient with asthma? 1. Prolonging expiratory time 2. Avoiding high peak inspiratory pressures 3. Assuring a normal pH 4. Keeping the Sp02 >95%

answer

1. Prolonging expiratory time With Asthma or COPD patients you want to allow a long enough time for exhalation to prevent auto-peep. Do not give these patients PEEP due to the lungs being hyperinflated. PG. 595 in your neo/ped book.

question

The therapist is asked to recommend a short-onset, long-acting-agonist for a patient with asthma. Which of the following medications should the therapist recommend? 1. Tiotropium bromide 2. Salmeterol 3. Formoterolminutes. 4. Albuterol

answer

3. Formoterol 100% ol begins to work in 3-5 minutes, but salmeterol takes 30-90

question

Which of the following diseases are usually preceded by a "common cold?" I. Epiglottitis II. Laryngotracheobronchitis III.Bronchiolitis IV.Persistent pulmonary hypertension of the newborn 1. I, III only 2. II, III only 3. I, IV 4. I, II, III, IV

answer

2. II, III only 100%

question

In children, chloride levels greater than _____ are considered diagnostic for CF when the sweat chloride test is performed. 1. 20 mEq/L 2. 40 mEq/L 3. 60 mEq/L 4. 100 mEq/L

answer

3. 60 mEq/L

question

Which of the following drugs is considered the drug of choice of those in the parasympatholytic class for promoting bronchial smooth muscle relaxation? 1. Ipratropium bromide 2. Atropine 3. Glycopyrrolate 4. Racemic epinephrine

answer

1. Ipratropium bromide

question

Which of the following drugs is administered by the intravenous route to promote closure of the patent ductus arteriosus? 1. Alprostadil 2. Dopamine 3. Tolazoline 4. Indomethacin

answer

4. Indomethacin

question

When should positive pressure ventilation be given to a newborn infant with spontaneous respirations? 1. Heart rate >150 beats per minute 2. Heart rate >200 beats per minute 3. Heart rate <100 beats per minute 4. Heart rate <120 beats per minute

answer

3. Heart rate <100 beats per minute NRP study guide, if a baby is not vigorous, HR < 100 even though it has spont. respirations you should begin PPV.

question

What rate of ventilations should be administered to a newborn requiring positive pressure ventilation by bag-mask ventilation? 1. 10-20 breaths per minute 2. 20-40 breaths per minute 3. 40-60 breaths per minute 4. 60-100 breaths per minute

answer

3. 40-60 breaths per minute You will find this in your NRP study guide

question

A sunken or flat (scaphoid) abdomen may be significant for ______________. 1. Tracheoesophageal fistual 2. Cyanotic heart defect 3. Liver disease 4. Diaphragmatic hernia

answer

4. Diaphragmatic hernia

question

A minimum gas flow of __________ liters/minute should be supplied to an oxygen hood. 1. 6 2. 7 3. 12 4. 20

answer

2. 7

question

Attempts at intubation should be limited to _____ seconds to minimize hypoxemia. 1. 5 2. 10 3. 20 4. 30

answer

4. 30 You will find this answer in your NRP study guide. Your study guide says 20 but I told you the first day to mark it out and put 30.

question

Which of the following the is least useful for the treatment of ARDS? 1. Bronchial hygigene therapy 2. CPAP 3. surfactant replacement therapy 4. High frequency ventilation

answer

1. Bronchial hygigene therapy

question

Which of the following conditions is common in a baby delivered by cersarean section? 1. Aspiration pneumonia 2. Transient tachypnea of the newborn 3. Diaphragmatic hernia 4. Respiratory distress syndrome

answer

2. Transient tachypnea of the newborn Due to delayed clearance of fetal lung fluid.

question

You are caring for an infant with RDS. Nasal CPAP has been used; however, the infant suddenly deteriorates and is demonstrating severe hypoxemia on an FI02 of .60. What should be done next? 1. Increase CPAP 2. Intubate the infant and begin mechanical ventilation 3. Switch to nasal CPAP 4. Increase the FI02.

answer

2. Intubate the infant and begin mechanical ventilation

question

Which of the following is the most common radiographic finding that suggests the presence of croup? 1. Thumb sign 2. Flail chest 3. Sail sign 4. Steeple sign

answer

4. Steeple sign

question

Treatment of the infant with persistent pulmonary hypertension may include all the following except: 1. ECMO 2. High-frequency ventilation 3. Nitric oxide 4. Theophylline

answer

4. Theophylline

question

In which of the following conditions would increasing the oxygen be possibly harmful in closing the patent ductus arteriosus? 1. Complete transposition of the great vessels 2. Tetralogy of Fallot 3. Ventricular septal defect 4. Artial septal defect

answer

1. Complete transposition of the great vessels Need Patent Ductus arteriosus to mix the blood only case where increasing the oxygen may be harmful.

question

In epiglottitis, the pathological agent is usually: 1. Parainfluenza 2. influenza A 3. Haemophilus influenza 4. Adenovirus

answer

3. Haemophilus influenza

question

Pre and post-ductal blood gas studies are done to evaluate: 1. L-R shunt across the ductus arteriosus 2. R-L shunting across the ductus arteriosus 3. Ventricular septal defect (VSD) 4. Post-ductal coarctation of aorta

answer

2. R-L shunting across the ductus arteriosus To tell if you have a R-L shunt is to do pre and post ductal ABG's or p-ox's. With a R-L shunt your patient will be cyanotic.

question

All of the following are consistent with Tetralogy of Fallot, EXCEPT: 1. Egg-shaped heart 2. Strong peripheral pulses 3. Boot-shaped heart 4. Right-to-left shunt

answer

1. Egg-shaped heart

question

Steroid administration to the mother before delivery has been used to: 1. Decrease respiratory distress 2. Determine gestational age 3. Stimulate surfactant production 4. Treat respiratory distress

answer

3. Stimulate surfactant production

question

Supraglottic swelling is consistent with: 1. Croup 2. Foreign body aspiration 3. Respiratory syncytial virus 4. Epiglottitis

answer

4. Epiglottitis

question

Acrocyanosis is defined as: 1. A left to right shunt 2. Cyanosis of the hands and feet 3. True cyanosis 4. A sign of chronic hypoxemia

answer

2. Cyanosis of the hands and feet

question

A scaphoid abdomen is associated with: 1. Mecomium aspiration 2. Hyaline membrane disease 3. Diaphragmatic hernia 4. Cystic fibrosis

answer

3. Diaphragmatic hernia

question

What diagnostic parameter is most often used to confirm the diagnosis of RDS? 1. ABG 2. Chest radiograph 3. Pulmonary function test 4. Sereum enzymes

answer

2. Chest radiograph

question

What is believed to be the cause of tranisnet tachypnea of the newborn (TTN)? 1. Persistent hypoxemia 2. Immature surfactant 3. Delayed clearance fo fetal lung fluid 4. Persistent fetal circulation

answer

3. Delayed clearance fo fetal lung fluid

question

The X-Ray used to confirm the diagnosis of epiglottitis is a: 1. Lateral neck X-ray 2. Lateral decubitus film 3. Anterior-posterior 4. Posterior-anterior film

answer

1. Lateral neck X-ray

question

What treatment usually causes improvement in the initial treatment of transient tachypnea of the newborn? 1. Oxygen with low FIO2 2. Mechanical ventilation with PEEP 3. Bronchodilators 4. Mucolytics

answer

1. Oxygen with low FIO2

question

What radiographic finding is common in infants with transient tachypnea? 1. Low lung volumes 2. Bilateral perihilar lymphadenopathy 3. hyperinflation 4. mucus plugging

answer

3. hyperinflation

question

What treatment is indicated for infants with transient tachypnea requiring higher FIO2? 1. Frequent turning fo the infant 2. Oxygen 3. Mechanical ventilation 4. CPAP

answer

4. CPAP

question

What is the best strategy in the management of BPD? 1. Adequate fluid management 2. Prevention 3. Aggressive mechanical ventilation 4. PEEP

answer

2. Prevention

question

True or False: Infants who have apnea of prematurity are at greater risk of SIDS than other infants.

answer

True

question

True or False: Meconium-stained amniotic fluid is common among infants of less than 37 weeks gestational age.

answer

False

question

A newborn infant delivered after 36 weeks of gestaton has been discharged from the hospital. Nine days later, the newborn is brought to the ER with extreme peripheral cyanosis. An AP chest radiograph reveals an "egg shaped" heart. This would indicate: 1. Transposition of the great vessels 2. Epiglottitis 3. Persistent pulmonary hypertension 4. Coarctation of the aorta

answer

1. Transposition of the great vessels

question

A lateral neck radiograph of a 3 year old reveals ballooning of the the hypopharynx, thickening of the aryepiglottic folds and obliteration of the vallecula. The most likely diagnosis is 1. laryngotracheobronchitis 2. foreign body obstruction 3. epiglottitis 4. tonsilar abscess

answer

3. epiglottitis

question

Which of the following should the neonatal/pediatric specialist INITIALLY select to clear secreations from a neonates upper airway? 1. Bulb syringe 2. DeLee suction trap 3. meconium aspirator 4. tonsil suction tip

answer

1. Bulb syringe

question

Which of the following should be done in the treatment of non-virgorous infant with meconium aspiration syndrome? 1. Vasopressors 2. Antibiotics 3. Mask CPAP 4. Suctioning

answer

4. Suctioning

question

The L/S ratio is used to evaluate: 1. Gestational age 2. Respiratory distress 3. Lung maturity 4. Birth weight

answer

3. Lung maturity

question

Which of the following are evaluated with an Apgar Score? I. Color II. Heart rate III. Respirations IV. Activity V. Grimace 1. I, II, III, IV & V 2. II, III & IV only 3. I & V only 4. II only

answer

1. I, II, III, IV & V

question

What is the normal heart rate for a term infant? 1. 40-60 bpm 2. 100-130 bpm 3. 160-200 4. 120-170 bpm

answer

4. 120-170 bpm

question

Based upon the arterial blood gas results, the neonatal/pediatric specialist should recommed: 1. Increase the FIO2 2. Intubate and mechanically ventilate 3. Increase the flow 4. Initiate nasal CPAP

answer

3. Increase the flow The flow is set at 6lpm. The minimum flow to an oxygen hood should be 7lpm. The low flow is allowing the C02 to build up, causing the low pa02 and high C02.

question

What drug is used to decrease swelling in the upper airway? 1. albuterol 2. Intal 3. Ampicillin 4. Vaponephrine

answer

...4. Vaponephrine

question

Which of the following drugs is NOT delivered by aerosol? 1. Alupent 2. Cromolyn sodium 3. Theophylline 4. Terbutaline

answer

...3. Theophylline

question

How does theophylline cause bronchodilation? 1. to thin secreations 2. destroys the enzyme phosphodiesterase 100% pg 429 3. decrease cyclic GMP 4. prevents the release of histamine

answer

...

question

How does parasympatholytics different in the way they cause bronchodilation? 1. Cause direct bronchodilation 2. Increase cyclic AMP 3. Inhibits the degranulations of mast cells 4. Work aganist the bronchconstriction

answer

... 4. Work aganist the bronchconstriction

question

Which of the following is not used to administer theophylline? 1. Aerosol 2. IV 3. Injection 4. Tablet

answer

... 1. Aerosol

question

Pirbuterol is known by which of the following brand names? 1. Alupent 2. Serevent 3. Maxair 4. Xopenex

answer

... 3. Maxair

question

The physician asks the therapist to recommend a long-acting B2 agonist for a patient. Which of the following medications should the therapist recommend? 1. Levalbuterol 2. Formoterol 3. Metaproterenol 4. Terbutaline

answer

... 2. Formoterol

question

All of the following are complications of beta agonist drugs EXCEPT? 1. Tachycardia 2. Nervousness 3. Bronchospasm 4. tremors

answer

... 3. Bronchospasm Beta agonists helps prevent/treat bronchospasm

question

What is the most practical way to improve aerosol depostion during mechanical ventilation? 1. use a pMDI instead of nebulizer 2. Minimize inspiratory flow rates 3. use ramp versus square-wave pattern 4. Use a nebulizer with a small particle

answer

... 4. Use a nebulizer with a small particle size.

question

What is the most reliable way to determine how many actuations are left in a pMDI? 1. Use it for only one month 2. Actuate until it is empty 3. Count the number of doses 4. All of the above

answer

... 3. Count the number of doses

question

While working at the bedside of a small child who has myasthenia gravis, the therapist notices a new medication order prescribing glyopyrrolate (40ug/kg four times daily) for the control of secreations. What should the therapist do at this time? 1. Inform the nurse that this is contrindicated for patients with myasthenia gravis 2. Inform the nurse that the dose is incorrect 3. Inform the nurse that this medication is contraindicated in children 4. Mention nothing because the prescription is correct

answer

...1. Inform the nurse that this is contrindicated for patients with myasthenia gravis

question

What body position should a patient be placed when draining the apical segment? 1. Prone with the bed flat 2. Semi-Fowler's 3. Sims 4. Trendelenburg

answer

... 2. Semi-Fowler's

question

The primary objective of incentive spirometry is: 1. To treat aspiration pneumonitis 2. To treat and/or prevent aspiration 3. To treat and/or prevent pneumonia 4. To treat and/or prevent atelectasis

answer

... 4. To treat and/or prevent atelectasis

question

What is the most commonly cited complication of chest physiotherapy? 1. Hypoxemia 2. Hypercapnia 3. Alterations of blood pressure 4. Tachycardia

answer

... 1. Hypoxemia

question

Which of the following maneuvers is characterized by having a patient forcibly exhale, from a middle to low lung volume, through an open glottis? 1. Autogenic drainage 2. Directed cough 3. Active cycle of breathing 4. Positive expiratory pressure

answer

3. Active cycle of breathing

question

During the immediate postoperative period, what should be the volume goal for Sustained Maximal Inspiration? 1. 100% of the preoperative volume 2. 75% of the preoperative volume 3. 50% of the preoperative volume 4. 25% of the preoperative volume

answer

2. 75% of the preoperative volume

question

During autogenic drainage, at which of the following levels does the patient begin breathing? 1. Total lung capacity 2. Expiratory reserve volume 3. Inspiratory reserve volume 4. Tidal volume

answer

2. Expiratory reserve volume

question

When in the respiratory cycle should vibration be performed? 1. Expiration 2. Inspiratory 3. Total lung volume 4. Expiratroy reserve volume

answer

... 1. Expiration

question

What is the primary indication for Postural drainage? 1. Ineffective cough 2. Ciliary dysfunction 3. Accumulated or retained secreations 4. Ciliary dyskinesia

answer

... 3. Accumulated or retained secreations

question

All of the following procedures or devices are useful in maintaining good bronchial hygiene except: 1. Vibration 2. Chest physiotherapy 3. Sustain Maximal Inspiration 4. Peak Flow

answer

... 4. Peak Flow All of CH 14 are ways to improve bronchial hygiene. Not one time is peak flow mentioned in Ch. 14...

question

During a metered-dose inhaler (MDI) therapy, the patient slowly inhales a normal tidal volume breath and holds the breath for 10 secnds following the actuation of the MDI. Based on this observation, what should the RCP tell the patient? 1. Instruct the patient to inhale to the functional residual capacity level. 2. Instruct the patient to inhale to the total lung capacity level. 3. Ask the patient to hold their breath for at lest 30 seconds. 4. Do nothing because the patient is using the MDI correctly.

answer

... 2. Instruct the patient to inhale to the total lung capacity level.

question

What body position should a patient be placed when draining the lateral basal segment of the left lower lobe? 1. Semi-Fowlers 2. Supine with the bed flat 3. Trendelenburg lying on the left side 4. Trendelenburg lying on the right side

answer

... 4. Trendelenburg lying on the right side THE AFFECTED SIDE UP!!!!! ALSO THE LOWER THE LOBE THE LOWER THE HEAD!!! This also improves oxygenation and ventilation with the affected side up.

question

Which of the following is commonly used to increase mucocillary clearance in patients with bronchiolitis and Cystic Fibrosis? 1. Albuterol 2. Pulmozyme 3. Pentamidine 4. 3% hypertonic sodium

answer

... 2. Pulmozyme

question

What anti-cholinergic is used to inhibit slavation and excessive secreations of the respriatory tract? 1. Ipratropium Bromide 2. Robinul 3. Alcohol 4. Atropine

answer

... 2. Robinul

question

The therapist is assembling a SPAG-2 (small particle aerosol generator) unit. This device is used to administer __________ for patients with __________? 1. Ribavirin; epiglottis 2. Ribavirin; viral bronchiolitis 3. Pentamindine; epiglottis 4. Pentamindine; bacterial bronchiolitis

answer

... 2. Ribavirin; viral bronchiolitis

question

In reviewing the physician's order for a patient recently admitted to the pulmonary unit, the therapist notices the order read "Advair 230/21 2 puffs qid." The therapist should: 1. Carry out the order as written 2. Recommend changing the dosage to 115/21 3. Recommend changing the dosage to 45/21 4. Call the physician to verify the written order

answer

... 4. Call the physician to verify the written order ADVAIR MDI is only given 2 puffs twice a day unless you have an Advair Diskus then it is one puff twice a day!

question

Which of the following medications is most suited for the treatment of post-extubation edema? 1. Racemic Epinephrine 2. Ephedrine 3. Norepinephrine 4. Fluticasone

answer

... 1. Racemic Epinephrine

question

On the basis of clinical evidence, which of the following medications appears to best relieve reversible airflow obstruction occuring in patients with COPD? 1. Pirbuterol 2. Salmeterol 3. Ipratropium bromide 4. Metaproterenol

answer

3. Ipratropium bromide

question

Which of the following mediations works to maintain the integrity of the mast cell? 1. Ipratropium bromide 2. Cromolyn sodium 3. Magnesium sulfate 4. Methylprednisolone

answer

2. Cromolyn sodium

question

What is the potential problem with the use of methylprednisolone in neonates? 1. Ventilation-perfusion effect 2. low cardiac output syndrome 3. Gasping syndrome 4. Renal failure

answer

... 3. Gasping syndrome

question

Overuse of inhaled B2-agonist has been associated with increased mortality from asthma. It is currently recommended that B2 agonist be used only as a _____ basis in the treatment of acute episodes? 1. prn 2. q4 and prn 3. q2 and prn 4. q2

answer

... 1. prn

question

Which of the following are the main therapeutic effects of Corticosteroids? I. Bronchodilation II. Anti-inflammatory III.Bronchoconstriction 1. I, II, III 2. II, III 3. I, II 4. I only

answer

... 3. I, II

question

What drug is used to treat Pneumocystis carinii? 1. Ribavirin 2. Magnesium 3. Pulmozyme 4. Pentamidine

answer

...4. Pentamidine

question

What sequence should the following therapies be performed? 1. Aerosol bronchodilator, Chest physical therapy, suctioning 2. Aerosol bronchodilator, suctioning, chest physical therapy 3. Chest physical therapy, aerosol bronchodilator, suctioning. 4. Suctioning, aerosol bronchodilator, chest physical therapy.

answer

... 1. Aerosol bronchodilator, Chest physical therapy, suctioning

question

While nebulizing albuterol to a patient via a small-volume nebulizer, the therapist hears a sputtering sound originating from the nebulizer. How should the neo/ped specalist respond to this situation? 1. He should tap the sides of the nebulizer so more medication gravitates to the bottom of the nebulizer cup. 2. He should terminate the treatment at this time. 3. He should wait until the nebulizer cup completely empties. 4. He should add more diluent to the nebulizer cup

answer

... 2. He should terminate the treatment at this time.

question

Which of the following considerations is most important when using a large-volume nebulizer to provide oxygen and humidification to an infant in an incubator? 1. Meeting the inspiratory flow demands of the infant 2. Supplying the infant with adequate humidification 3. Delivering sufficient oxygen to meet the infant's needs. 4. Preventing a high noise level from developing

answer

... 4. Preventing a high noise level from developing

question

Why should pMDI's containing steroids be used with a valved holding chamber? 1. To reduce the risk of oral yeast infections breath 4. To increase the dose of the medication.

answer

... 1. To reduce the risk of oral yeast infections Using a valved holding chamber decreases the the risk of oropharyngeal drug deposition that cause oral yeast infections (thrush). Rinse mouth after steroid inhalation and use a valved holding chamber to help reduce the risk.

question

An 18-month-old patient brought to the ER is exhibiting signs and symptoms consistent with an acute asthma episode, and is administered a B2-agonist to which the patient does not respond favorably. Which of the following conditions could be responsible for this patient's problem? 1. Bronchiolitis 2. Croup 3. Aspiration of a foreign object condition. 4. Pneumonia

answer

3. Aspiration of a foreign object Failure of B2 agonists to provide relief of the signs and symptoms of an acute asthmatic episode often indicates the presence of a nonasthmatic condition such as foreign body aspiration or tracheitis. Infants with bronchiolitis respond poorly to bronchodilator medications, which are therefore not recommended for this condition.

question

1. Amount of mucus obtained during and after treatment 2. Degree and persistence of coughing 3. Changes in color and consistency of mucus 4. Quality of the chest radiograph.

answer

1. Amount of mucus obtained during and after treatment 100% Because the goal of CPT is to promote the removal of excessive bronchial secreations, the most important variable for evaluating the effectiveness of CPT is the amount of secreations expectorated with therapy.

question

Your patient was extubated 30 minutes ago. She is hoarse and complains of "tightness in my troat"; inspiratory stridor can be heard. The drug of choice for treating this problem is 1. Racemic epinephrine (VapoNefrin) 2. Acetylcysteine (Mucomyst) 3. Levalbuterol (xopenex) 4. Isoetharine (Isoetharine HCL)

answer

1. Racemic epinephrine (VapoNefrin)

question

A 4 month-old pediatric patient has chronic lung disease secondary to recovering from infant respiratory distress syndrome (RDS). The patient now has pneumonia caused by RSV and is on mechanical ventilation. What can be given to improve the patient's condition? 1. Intravenous racemic epinephrine (microNefrin) 2. Ribavirin (Vibrazole) by SPAG II nebulizer 3. Intratracheal beractant (Survanta) 4. Cromolyn sodium (Intal) by SVN

answer

...2. Ribavirin (Vibrazole) by SPAG II nebulizer Given to stop the reproduction of RSV.

question

You are assisting with the delivery of high-risk infant. After evaluating the infant, you give ti a 5 minute Apgar score of 8 and recommend that the asisting nurse and physician: 1. Give the infant supplemental oxygen 2. Give the mother supplemental oxygen 3. Begin bag-mask rescue breathing on the infant 4. Give the infant to the mother as soon as possible for bonding.

answer

4. Give the infant to the mother as soon as possible for bonding. An Apgar score of 8 (of a maximum of 10) indicates that a newborn is in good condition and can be given to its mother. There is no need to give it or the mother oxygen or to begin bag-mask rescue breathing.

question

A 3-day-old newborn is brought into the ER with her father after they were involved in an automobile accident. The newborn is showing signs of respiratory distress with cyanosis and tachycardia. What test would you recommend to determine whether she has a pneumothorax? 1. ABG 2. Apgar Score 3. Transillumination 4. Thoracentesis

answer

3. Transillumination is an easy test for a pneumothorax in a newborn, because the chest wall is so thin.

question

You are assisting in the delivery of a high-risk neonate. At 1 minute after birth, the following are noted: *HR rate is 90 beats per minute *There is a weak cry *Arms and legs show some flexion *The baby grimaces when a nasal catheter inserted into a nostril *Extremities are blue with a pink body (acrocyanosis) You would give the neonate an Apgar score of: 1. 3 2. 5 3. 7 4. 9

answer

... 2. 5

question

You are called to the ER to help evaluate a pediatric patient. On entering the room, you observe the patient's breathing effort and can hear a harsh, high pitched sound on inspiration. Which of the following is true? 1. Sounds are tracheal and normal 2. Sounds are bronchovesicular and not normal 3. Sounds are bronchial and indicate a respiratory emergency 4. Sounds are stridorous and indicate a respiratory emergency.

answer

4. Sounds are stridorous and indicate a respiratory emergency. Inspiratory Stridor is a respiratory emergency and can be heard with the unaided ear.

question

A 10 year old boy with cystic fibrosis has been having recurrent episodes of Pseudomonas aeruginosa pneumonia. What should be recommended to prevent further episodes? 1. Pentamidine (Pentam) 2. Administer pentamidine (NebuPent) 3. Isonicotinic acid hydrazide (Isoniazid) 4. Tobramycin (TOBI)

answer

... 4. Tobramycin (TOBI)

question

An infant has just been delivered by cesarean section to an anesthetized mother. Because the infant is not breathing adequately, it has been intubated. What can be done to improve the infant's condition and get it to breathe? 1. Give intravenous epinephrine 2. Give intravenous naloxone (Narcan) 3. Begin bag-mask ventilation with oxygen 4. Give endotracheal atropine (atropine sulfate)

answer

... 2. Give intravenous naloxone (Narcan) NRP study guide pg. 7 Narcan can be given to reverse the sedating effect of the anesthetic drugs that passed from the mother to the infant. Epi and Atropine are cardiac stimulants, not breathing stimulants. Bag-mask may be needed but will not get the sedated infant to breathe by itself.

question

What is the minimal flow rate that should be used to deliver oxygen through a hood to an infant? 1. 15 lpm 2. 12 lpm 3. 7 lpm 4. 6 lpm

answer

3. 7 lpm It is important that a flow greater than 7 lpm be delivered to wash out any C02 that may accumulate inside the hood.

question

A patient has acute respiratory distress syndrome (ARDS) and is significantly hypoxemic. It is likely that the patient will exhibit all of the following EXCEPT 1. Normal respiratory rate 2. Nasal flaring 3. Intercostal retractions 4. Use of accessory muscles of inspiration

answer

1. Normal respiratory rate A patient with ARDS which results in small stiff lungs and significant hypoxemia would NOT be breathing with a normal respiratory rate. You would see Nasal flaring (to reduce airway resistance) intercostal retractions (because of stiff lungs), and use of accessory muscles of inspiration (to assist the diaphragm in breathing).

question

You are called to the Pediatrics Department to help in evaluation and care of a 4 year old girl who has been sick with a bad cold for the past 2 days. The nurse shows you the lateral neck radiograph of the child and asks for your opinion. You notice a clear air column through the upper airway but a pointed narrowing of the tracheal air column below the larynx. You tell the nurse that you suspect the child has: 1. Aspirated a coin 2. Laryngotracheobronchitis 3. Epiglottitis 4. Bilateral upper lobe pnemonia

answer

2. Laryngotracheobronchitis or (Croup) is a swelling of mucous membranes below the vocal cords (subglotic area). This is often identified by a narrowing of the dark air column below the vocal cords. This pointed narrowing is sometimes referred to as a steeple sign or pencil sign.

question

An infant is suspected to be at high risk for SIDS. Which of the following techniques would be used to monitor the infant? 1. Capnography 2. Oximetry 3. Polysomnography 4. Pneumogram

answer

4. Pneumogram

question

Which of the following is the least appropriate for assessment fo an infant's oxygenation status? 1. Arterialized heel stick 2. Unbilical arterial line 3. Pulse oximeter 4. Transcutaneous electrode

answer

1. Arterialized heel stick

question

Which of the following views may be best suited to evaluate foreign body osbstruction? 1. Lateral view 2. Forced expiratory film 3. Oblique view 4. Frontal view

answer

...Which of the following views may be best suited to evaluate foreign body osbstruction? 1. Lateral view 2. Forced expiratory film 3. Oblique view 4. Frontal view

question

Which of the following conditions is most commonly associated with stridor? 1. Tracheomalacia 2. Laryngomalacia 3. Bilateral abductor vocal cord paralysis 4. tacheostomy

answer

2. Laryngomalacia

question

Which of the following clinical signs receives the highest diagnostic yield in the neonatal population for flexible bronchoscopy? 1. Stridor 2. Wheezing 3. Discoid atelectasis on chest X-ray 4. Increased airway secretions

answer

1. Stridor

question

Which of the following ABG parameters will best evaluate ventilation? 1. pH 2. PaC02 3. Pa02 4. Sa02

answer

2. PaC02

question

Mixed venous blood for measurement of Pv02 and Sv02 is best drawn from? 1. Superior vena cava 2. Right atrium 3. Right ventricle 4. Pulmonary artery

answer

4. Pulmonary artery

question

The therapist is assessing a mechanically ventilated infant and observes that the trancutaneous electrode temperature is set between 43C and 44C. What action does the therapist need to take at this time? 1. The temperature range set is appropriate; therefore, no action is necessary 2. The therapist should increase the temperature range to 47 degrees C to 48 degrees C. 3. The temperature of the transcutaneous electrode needs to be reduced to 36 C to 38 C. 4. The electrode needs to be repositioned and maintained at the same temperature.

answer

1. The temperature range set is appropriate; therefore, no action is necessary

question

An aterial blood gas kit is required for obtaining and analyzing blood in which of the following EXCEPT: 1. Umbilical artery line 2. An arterial line 3. Capillary gas levels 4. Carboxyhemoglobin

answer

3. Capillary gas levels

question

While performing the Allen's Test on a neonate, you get a negative test on the right radial artery. The most appropriate action at this time would be to: 1. Go ahead and draw the sample from the right radial artery 2. Draw the sample from the right brachial artery 3. Perform the Allen's tet on the left radial artery 4. Draw the sample from the left brachial artery

answer

3. Perform the Allen's tet on the left radial artery

question

What is the single most important hemodynamic meaurement to evaluate cardiac function? 1. Stroke volume 2. Shunt fraction 3. Cardiac index 4. Cardiac output

answer

4. Cardiac output

question

A "super syringe" is used to calibrate a: 1. Pneumotachometer 2. Spirometer 3. Plethysmograph 4. Kymograph

answer

2. Spirometer 100%

question

What is measured at the peak of the curve of the capnograph tracing? 1. PetC02 2. PaC02 3. VD/VT 4. PvC02

answer

...1. PetC02 100% pg 142

question

Following a cardiopulmonary arrest, a patient has just been intubated with a siz 6.0 ETT. The capnograph is reading a PetC02 of 3 torr, this is indicative of: 1. A pulmonary embolism 2. ventilatory failure 3. Right mainstem intubation 4. E-T is in the esophagus

answer

... 4. E-T is in the esophagus 100% pg-142

question

Which of the following is the least appropriate for assessment of an infant's oxygenation status? 1. Arterialized heel stick 2. Umbilical arterial line 3. Pulse oximeter 4. Transcutaneous electrode

answer

...Arterialized heel stick

question

Which of the following test is performed to check the collateral cirulation of radial artery before puncture? 1. Wilson's test 2. Perfusion scan 3. Sack's test 4. Allen's test

answer

Allen's test

question

The neonatal/pediatric specialist is unable to obtain a pulmonary capillary wedge pressure. Which of the following could be substituted for the wedge pressure? 1. Pulmonary artery diastolic pressure 2. Pulmonary artery systolic pressure 3. Pulmonary vascualar resistance 4. Mean right artial pressure

answer

... 1. Pulmonary artery diastolic pressure If you are unable to get your wedge pressure you can use your Pulmonary artery diastolic pressure. If you look at Box 10-4 you will see that your normal values or PCWP and Pulmonary artery diastolic pressure have the same normal values.

question

Which of the following pulmonary function test would best measure a pediatric restrictive disorder? 1. Vital capacity 2. Peak flowrate 3. FEV1 4. MVV

answer

1. Vital capacity

question

You are the respiratory therapist attending the delivery of a preterm neonate. His vital signs are: HR 70 RR12 In addition, he has peripheral cyanosis and is responding minimally to stimulation. What should be done? 1. Direct supplemental oxygen to his face 2. Begin chest compressions 3. Begin manual ventilation with 100% oxygen 4. Continue to stimulate the newborn to breathe more deeply

answer

3. Begin manual ventilation with 100% oxygen

question

The waveform sequence seen during the insertion of a pulmonary artery catheter is 1. RA, RV, PAP, PCWP 2. RV, RA, PAP, PCWP 3. RA, RV, PCWP, PAP 4. Ao, RA, RV, PAP

answer

... 1. RA, RV, PAP, PCWP 100% pg 128

question

The lateral decubitus view is a frontal radiographic projection whereby the side down can be evaluated for the presence of ____________ and the side up may better define ______________. 1. Atelectasis; a pneumothorax 2. A pleural effusion; a pneumothorax 3. Consolidation; atelectasis 4. A pleural effusion; consolidation

answer

... 2. A pleural effusion; a pneumothorax

question

47. Why must caution be exercised when using a face mask while performing pulmonary function testing on neonates? i. To prevent trigeminal nerve stimulation ii. To avoid necrosis of the facial skin iii. To avert stimulation of vagal reflexes iv. To prevent gastric insufflations 1. I and II only 2. I and III only 3. I, II and III only 4. II, III and IV only

answer

... 2. I and III only

question

3. What percent lodocaine spray is used for neonatal flexible bronchoscopy? 1. 1% to 2% Lidocaine 2. Less than 1% lidocaine 3. 3% to 4% lidocaine 4. 5% to 6% lidocaine

answer

... 1. 1% to 2% Lidocaine

question

What is the clinical purpose for measuring the MIP? 1. to assess lung function before and after bronchodilator administration 2. to help with asthma management at home 3. to evaluate the strength of respiratory muscles 4. to assist in performing bronchial hygiene techniques

answer

... 3. to evaluate the strength of respiratory muscles

question

How do well-expanded, air filled lungs appear on a chest radiograph? 1. White 2. Gray 3. Light colored 4. Black 100%

answer

... 4. Black 100%

question

Which type of bronchoscope would be preferred for therapeutic purposes? 1. Rigid bronchoscopy 2. Bronchial lavage 3. Thoracentesis 4. Flexible bronchoscopy

answer

1. Rigid bronchoscopy

question

Tommy, a 5 year-old, has been admitted to the ER of a Children's hospital for shortness of breath and increased work of breathing. Based on the available medical history and physical assessment, the physician wants to rule out an upper airway obstruction. Which of the following tests would be appropriate to confirm a diagnosis of upper airway obstruction? 1. Beside pulmonary function study 2. Chest radiography 3. Peak flow 4. lateral neck radiography

answer

... 4. lateral neck radiography

question

A therapist is viewing frontal and lateral neck X-rays of a 12 month-old child and notices what is described as the "church steeple" sign: subglottic narrowing below the vocal cords, and an overdistended hypopharynx. Which of the following conditions does this child likely have? 1. Larynogtracheobronchitis 2. Tracheomalacia 3. Adenoidal enlargement 4. Epiglottitis

answer

... 1. Larynogtracheobronchitis 100% pg 95

question

What type of X-ray view is obtained when the radiographic plate is placed between the patient's back and the bed with the X-ray tube in front of the patients chest? 1. Frontal view 2. Lateral view 3. Posteroanterior view 4. Anteroposterior view

answer

... 4. Anteroposterior view

question

The LEFT ventricular end-diastolic value can best be monitored by which of the following parameters? 1. CVP 2. PAP 3. PCWP 4. Cardiac Output

answer

... 3. PCWP 100%

question

The pulmonary artery catheter is also known as: 1. Swan-Ganz 2. PCWP 3. Ejection fraction 4. Cardiac index

answer

... 1. Swan-Ganz

question

The low placement of umbilical artery catheter should be confirmed at which anatomic landmark, using an X-ray? 1. T6-T8 2. T3-T4- 3. L3-L4 4. T1-T3

answer

...3. L3-L4

question

What is the single most important hemodynamic measurement to evaluate cardiac function? 1. Stroke volume 2. Shunt fraction 3. Cardiac index 4. Cardiac output

answer

... 4. Cardiac output

question

The cardiac output is calculated by the following equation? 1. Ca02/Sp02 X 100 2. Stroke volume X heart rate 3. Ca02 X C0 4. Cardiac output/BSA

answer

... 2. Stroke volume X heart rate

question

Which of the following procedures would be indicated to remove a large foreign-body obstruction from a child? 1. Rigid bronchoscopy 2. Flexible bronchoscopy 3. Bronchial lavage 4. Thoracentesis

answer

1. Rigid bronchoscopy

question

A 16 month old child is in the intensive care unit is being kept in a mist tent. Which of the following hemodyamic measurements will best indicate a fluid overload? 1. PAP 2. CVP 3. PCWP 4. Cardiac Output

answer

2. CVP

question

What parameter is useful in evaluating whether or not a patient may be extubated? 1. Rapid Shallow Breathing Index 2. Respiratory frequency 3. Total Lung Capacity 4. Airway Resistance

answer

... 1. Rapid Shallow Breathing Index Normal 100-105 VT/f if the value is less than 105 the patient may be extubated.

question

Which type of bronchoscope would be preferred for diagnostic purposes? 1. Rigid bronchoscopy 2. Bronchial lavage 3. Thoracentesis 4. Flexible bronchoscopy

answer

... 4. Flexible bronchoscopy

question

While viewing a lateral view of a neck radiograph of an 18 month-old child, a therapist notices that the epiglottis is enlarged, the aryepiglottic folds are thickened, and the hypopharynx is overidstended. Which of the following conditions does this child likely have? 1. Bronchopulmonary dysplasia 2. Epiglottitis 3. Croup 4. Esophageal fistula

answer

2. Epiglottitis

question

What is the greatest hazard associated with trancutaneous monitors when placed on newborn infants? 1. Hemorrhage 2. Edema 3. Thermal injury 4. Vasoconstriction

answer

... 3. Thermal injury

question

Which of the following conditions is a disadvantage to mainstream capnometry? 1. Condensation interfering with the reading 2. Additional deadspace in the circuit 3. Thermal injury 4. Risk of pneumothorax

answer

... 1. Condensation interfering with the reading

question

Which of the following equipment would be LEAST appropriate for a 10 year old child removed from a house fire? 1. Pulse oximeter 2. Arterial blood gas kit 3. Resuscitation equipment 4. Oxygen mask

answer

... 1. Pulse oximeter can read higher saturation with carbon monoxide poisoning. Also p-ox's do not measure carboxyhemmoglobin, therefore Sp02 cannot fully assess tissue oxygenation.

question

Dr. Lester is covering the neonatal ICU and is requesting your expertise concerning ABG'S. She wants to know how long you should wait before sticking a blood gas after adjusting the FI02 of a neonate without any lung disease that is on mechanical ventilation. Your response to Dr. Lester is: 1. 5 minutes 2. 10 minutes 3. 20-30 minutes 4. >30 minutes

answer

... 2. 10 minutes 100% pg 130

question

A 4 year old spontaneously breathing patient who is receiving 50% oxygen has the following blood gas results. pH 7.51 PC02 40 P02 60 HC03 32 BE +9 The acid-base interpretation for this ABG is: 1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic alkalosis 4. Metabolic acidosis

answer

... 3. Metabolic alkalosis 100%

question

A 3 year old boy who has been sick and vomiting for the past 2 days. pH 7.54 PC02 44 P02 71 HC03 30 BE +6 What treatment is indicated for this patient. 1. Increase FI02 2. Ventilate manually 3. administer KCL 4. Start CPAP

answer

...3. administer KCL KCL (Potassium Chloride) Loss of metabolic acids, dehydration, electrolyte imbalance, hypokalemia and nasogastric suctioning, vomiting, HCO3. Hint if your Bicarb is increased then you will have a decrease in potassium and if you have a decrease in HCO3 then you will have a increase in your potassium.

question

You have setup a transcutaneous monitor on a newborn infant and the nurse ask you how often the site should be changed, your response to her is: 1. every 8 hours 2. as needed 3. every hour 4. 3-4 hours

answer

... 4. 3-4 hours

question

A patient's minute volume is 7.5 liters and the respiratory rate is 15. What is the tidal volume. 1. 115 ml 2. 250 ml 3. 500 ml 4. 550 ml

answer

... 3. 500 ml Ve/f

question

If a patient has a tidal volume of 550 ml and their respiratory rate is 15 per minute, what is there minute ventilation? 1. 8.75 L/min 2. 8.25 L/min 3. 7.75 L/min 4. 6.75 L/min

answer

... 2. 8.25 L/min Vt X Rate

question

You are called to the nursery to help provide emergency care to a 9 month old infant. The infant has had a cardiac arrest. The ratio of compressions to breaths you should use is: 1. 2:1 2. 1:3 3. 5:1 4. 3:1

answer

... 4. 3:1 100% NRP study guide

question

A newborn with aspiration syndrome is breathing spontaneously in 80% oxygen hood. Arterial blood gas results are as follows. pH 7.18 PaC02 56 torr HCO3 17 mEq/L Pa02 40 torr Based upon the above results, the respiratory care practioner should recommend to: 1. administer bicarb 2. administer Narcan (naloxone) 3. Intubation with 100% oxygen 4. Mechanical ventilation

answer

4. Mechanical ventilation

question

Which of the following would be most apropriate ventilator for infant ventilation? 1. Pressure cycled ventilator 2. Constant pressure generator ventilator 3. Pressure limited, time cycled ventilator 4. Volume cycled, pressure linited ventilator

answer

... 3. Pressure limited, time cycled ventilator 100%

question

An adolescent's on a volume ventilator should have a delivered tidal volume within which of the following ranges: 1. 3-5 cc/kg 2. 5-10 cc/kg 3. 10-15 cc/kg 4. 15-20 cc/kg

answer

... 3. 10-15 cc/kg

question

The ideal respiratoary rate for ventilation of a newborn infant would be within which of the following ranges? 1. 20-40 b/min 2. 15-20 b/min 3. 14-18 b/min 4. 8-12 b/min

answer

... 1. 20-40 b/min 100%

question

Cpap and Pressure Support are modes most often utilized in: 1. Improving oxygenation 2. Increasing oxygen content 3. Preventing infant respiratory distress syndrome 4. Weaning

answer

... 4. Weaning 100%

question

The pressure alarm sounds with each breath and wide fluctuations are noticed on the pressure manometer. In this situation the most appropriate action would be to: 1. Sedate the patient and institute controlled ventilation 2. Increase the pressure limit 3. Increase the flowrate 4. Decrease the tidal volume

answer

... 3. Increase the flowrate when you dont know increase the flow

question

Which of the following modes can be utilized with IMV to decrease the work of breathing? 1. PEEP 2. CPAP 3. Extended mandatory minute ventilation 4. Pressure support ventilation

answer

4. Pressure support ventilation

question

A high frequency ventilator has a set rate of 2.5 hertz. This would be equivalent of 1. 50 b/min 2. 150 b/min 3. 250 b/min 4. 500 b/min

answer

... 2. 150 b/min 1 hertz is equal to 60 breaths. (60 X 2.5 equals 150)

question

The maximum mean airway pressure should not exceed: 1. 8 cmH20 2. 12 cmH20 3. 16 cmH20 4. 25 cmH20

answer

2. 12 cmH20

question

Mean airway pressure increases with increases in all of the following EXCEPT: 1. Total cycle time 2. Peak inspiratory pressure 3. Positive end expiratory pressures 4. Respiratory rate

answer

... 1. Total cycle time

question

All of the following are controls on a high frequency ventilator EXCEPT: 1. Drive pressure control 2. Frequency 3. Inspiratory time control 4. Tidal volume control

answer

... 4. Tidal volume control

question

Which of the following controls best determines tidal volumes delivered on a time cycled infant ventilator 1. Peak inspiratory pressure 2. Inspiratory time 3. Mean airway pressure 4. Driving pressure

answer

... 1. Peak inspiratory pressure

question

What is normal compliance in a newborn infant? 1. 1 to 2.5 ml/cmH20 2. 2.5 to 5 ml/cmH20 3. 5-10 ml/cmH20 4. 10 to 20 ml/cmH20

answer

... 2. 2.5 to 5 ml/cmH20

question

Which of the following modes of ventilation provides full ventilator support? 1. Continuous positive airway pressure 2. Pressure support ventilation 3. Synchronized intermittent mandatory ventilation at below normal rates 4. Continuous mandatory ventilation

answer

... 4. Continuous mandatory ventilation

question

What is the usual range of PEEP settings used for mechanically ventilating newborn infants? 1. 1-3 cmH20 2. 4-6 cmH20 3. 6-10 cmH20 4. 10-15 cmH20

answer

... 2. 4-6 cmH20

question

Which of the following parameters is considered the primary method of changing mean airway pressure to increase Pa02? 1. PEEP 2. PIP 3. Flow rate 4. Inspiratory time

answer

1. PEEP

question

According to the FDA, high frequency ventilation is any form of mechanical ventilation delivering rates higher than _________ breaths per minute. 1. 60 2. 100 3. 150 4. 1000

answer

... 3. 150

question

Infant ventilator settings are FI02 .80, rate of 60 bpm, PIP 30 cmH20, and PEEP 5 cmH20 in the SIMV mode. Assuming adequate ABG's which parameter should be weaned first? 1. FI02 2. Rate 3. PIP 4. PEEP

answer

1. FI02 oxygen is a drug, decrease oxygen first! Use with adults and infants!

question

Which of the following would be the best initial ventilator settings for a 5 month infant with viral pneumonia, going on the ventilator? 1. PIP: 15 IT:1.0 Flowrate 6lpm RR 35 2. PIP: 18 IT: 0.8 Flow rate 8 lpm RR 25 3. PIP:20 IT 0.6 Flowrate 10 lpm RR 18 4. PIP: 25 IT 0.4 Flowrate 12 lpm RR 10

answer

... 3. PIP:20 IT 0.6 Flowrate 10 lpm RR 18

question

Which of the following IMV systems is the most preferred in minimizing resistance to flow? 1. Demand flow IMV 2. Intermittent flow IMV 3. Low Flow IMV 4. Constant Flow IMV

answer

... 4. Constant Flow IMV

question

Which of the following is NOT an indication of ECMO? 1. A-aD02 <400 2. Pa02 40 4. PIP >35

answer

... 1. A-aD02 <400

question

What is the most preferred type of ECMO 1. Survanta 2. Venoarterial 3. Exosurf 4. Venovenous

answer

2. Venoarterial

question

Which of the following is not a sign of respiratory distress syndrome? 1. Nasal flaring 2. Eupnea 3. Grunting 4. Retractions

answer

... 2. Eupnea

question

The main goal of ECLS is to: 1. Support cardiac function 2. Support lung function 3. Provide adequate tissue oxygen delivery 4. Remove carbon dioxide

answer

...3. Provide adequate tissue oxygen delivery 100%

question

In general, the criteria for ECMO is an estimated risk of mortality greater than 1. 50% 2. 65% 3. 80% 4. 90%

answer

... 3. 80%

question

In venovenous ECMO the arterial cannula is inserted into the: 1. Right atrium 2. Femoral vein 3. Right common carotid artery

answer

1. Right atrium

question

To increase minute ventilation on a HFV, you would recommend increasing 1. tidal volume 2. frequency 3. FIO2 4. amplitude

answer

4. amplitude

question

Which of the following parameter is not used with the initial setup of a time-cycled pressure limited ventilator? 1. PIP 2. Rates 3. Inspiratory time 4. Tidal volume

answer

... 4. Tidal volume 100%

question

What is the initial inspiratory time used when setting up a ventilator on a term infant? 1. 0.25 - 0.5 sec 2. 0.5 - 0.6 sec 3. 0.7 - 0.9 sec 4. >10 sec

answer

... 2. 0.5 - 0.6 sec

question

What ventilation mode is preferred for neonates? 1. Continous mandatory ventilation 2. CPAP 3. IMV 4. Control mode

answer

... 3. IMV

question

The pressure alarm is sounding on a volume ventilator. It is determined that there is a decrease in the patient's lung compliance. At this time you would recommend: 1. Sedating the patient 2. Increasing the pressure limit 3. Decreasing the tidal volume 4. Decreasing the flowrate

answer

... 2. Increasing the pressure limit 100%

question

With a time-cycled pressure-limited ventilator, what should be adjusted FIRST to achieve adequate ventilation? 1. PIP 2. Frequency 3. IT 4. I:E ratio

answer

1. PIP

question

To increase PaC02 on a time-cycled pressure limited ventilator, what parameter should you decrease first? 1. Frequency 2. Tidal volume 3. Deadspace

answer

4. PIP

question

What is the main goal of PEEP? 1. to increase FRC 2. Improve oxygenation 3. Recruitment of collapsed alveoli 4. Decreased intrapulmonary shunting

answer

to increase FRC

question

Full term infant should be set at a tidal volume of: 1. 6-8 ml/kg 2. 8-10 ml/kg 3. 1-2 ml/kg 4. 3-5 ml/kg

answer

2. 8-10 ml/kg 100%

question

What determines the a patient's PaC02 on a volume ventilator? 1. tidal volume 2. Respiratory rate 3. Minute volume 4. Flow

answer

3. Minute volume

question

Please match the following causes with your response to these high pressure alarms? 1. decreased compliance 2. Secreations in airway 3. Water in tubing 4. Obstructed tube 5. Bronchospasm A. Suction the patient B. Administer bronchodilator C. Increase alarm limit D. Empty water into container E. Suction, remove tube

answer

1- C 2 - A 3 - D 4 - E 5 - B

question

The appropriate tidal volume for a child is 1. 6 ml/kg 2. 8 ml/kg 3. 9 ml/kg 4. 10 ml/kg

answer

4. 10 ml/kg

question

High pressure limits aree usually set at __________ above peak inspiratory pressures in volume ventilators? 1. 5-10 cmH20 cmH20 2. 10-15 cmH20 3. 15-20 cmH20 4. >20 cmH20

answer

... 1. 5-10 cmH20 cmH20 100%

question

Which of the following improves oxygenation by maintaining FRC 1. Continuous Positive Expiratory Pressure 2. SIMV 3. Pressure Support 4. Volume ventilation

answer

... 1. Continuous Positive Expiratory Pressure 100%

question

An infant on a HFV has the following arterial blood gases pH 7.30 PaC02 50 HCO3 21 Pa02 60 Which of the following changes would you recommend to correct these results? 1. Add PEEP 2. Increase the drive pressure 3. Decrease the frequency 4. Increase the FIO2

answer

... 2. Increase the drive pressure 100%

question

Peak inspiratory pressures above what value are to be avoided in the initial setup of full term infant? 1. 15 2. 20 3. 25 4. 30 100%

answer

4. 30 100%

question

When deciding which babies need tracheal suctioning, the term "vigorous" is defined by what 3 caracteristics except 1. HR greater than 100 2. HR greater than 60 100% 3. Good muscle tone 4. Strong respiratory effort

answer

2. HR greater than 60 100%

question

You have stimulated a newborn and suctioned her mouth. It is now 30 seconds after birth, and she is still apneic and pale. Her heart rate is 80 beats per minute. Your next action is to 1.-----.

answer

provide PPV

question

The heart rate is 40 bpm as determined by auscultation, and the oximeter has stopped working. Chest compressions have begun, but the baby is still receiving room air oxygen. what should be done about oxygen delivery? 1.-----

answer

Increase oxygen to 100%

question

Which treatment or medication is appropriate for the treatment of a patient in asystole? 1. Atropine 2. Defibrillation 3. Epinephrine 4. Transcutaneous pacing

answer

3. Epinephrine

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