Question 1

How should the therapist interpret a lecithin-to-sphingomyelin (L:S) ratio of 2:1?

Accepted Answer

A)  The presence of lung maturity 
B)  A gestational age of less than 28 weeks 
C)  The likelihood of RDS 
D)  Laboratory error 
A)  The presence of lung maturity 
B)  A gestational age of less than 28 weeks 
C)  The likelihood of RDS 
D)  Laboratory error A

Question 2

What radiographic features is the therapist likely to see on a typical chest X-ray of an infant with MAS?

Accepted Answer

A)  Ground-glass appearance 
B)  Complete whiteout 
C)  Decreased lung volume 
D)  Widespread patchy areas of atelectasis 
A)  Ground-glass appearance 
B)  Complete whiteout 
C)  Decreased lung volume 
D)  Widespread patchy areas of atelectasis D

Question 3

How should the therapist interpret the lack of supernatant foam appearing during the shake test?

Accepted Answer

A)  The test needs to be redone. 
B)  The unborn infant's lungs have matured. 
C)  The infant's lungs are immature. 
D)  The patient has a 50% chance of developing RDS. 
A)  The test needs to be redone. 
B)  The unborn infant's lungs have matured. 
C)  The infant's lungs are immature. 
D)  The patient has a 50% chance of developing RDS. C

Question 4

The therapist is reviewing the chest radiograph of a newborn, preterm infant and observes diffuse, fine, reticulogranular densities, which provide a ground-glass appearance. On the basis of these radiographic findings, which of the following conditions should the therapist suspect is present?

Accepted Answer

A)  Persistent pulmonary hypertension of the newborn 
B)  Respiratory distress syndrome 
C)  Bronchopulmonary dysplasia 
D)  Pulmonary interstitial emphysema 
A)  Persistent pulmonary hypertension of the newborn 
B)  Respiratory distress syndrome 
C)  Bronchopulmonary dysplasia 
D)  Pulmonary interstitial emphysema

Question 5

Which of the following therapeutic interventions is generally needed to treat transient tachypnea of the newborn (TTN)?

Accepted Answer

A)  Endotracheal intubation 
B)  40% oxygen hood 
C)  Bronchial hygiene therapy 
D)  Bronchodilator therapy 
A)  Endotracheal intubation 
B)  40% oxygen hood 
C)  Bronchial hygiene therapy 
D)  Bronchodilator therapy

Question 6

The therapist is contemplating the possibility of intubating and suctioning a nonvigorous newborn with MAS. Which of the following clinical parameters confirms the indication for the procedure?

Accepted Answer

A)  Good muscle tone 
B)  Presence of dark green meconium on the skin 
C)  Heart rate <100 beats per minute 
D)  The AAP and AHA no longer recommend routine immediate endotracheal intubation and suctioning for nonvigorous infants 
A)  Good muscle tone 
B)  Presence of dark green meconium on the skin 
C)  Heart rate <100 beats per minute 
D)  The AAP and AHA no longer recommend routine immediate endotracheal intubation and suctioning for nonvigorous infants

Question 7

What is the greatest risk factor for respiratory distress syndrome (RDS)?

Accepted Answer

A)  Premature rupture of membranes 
B)  Male and white infants 
C)  Prematurity 
D)  Genetics 
A)  Premature rupture of membranes 
B)  Male and white infants 
C)  Prematurity 
D)  Genetics

Question 8

Which of the following is the most common bacteria isolated in preterm infants?

Accepted Answer

A)  Group B Streptococcus 
B)  Escherichia coli 
C)  Pseudomona spp. 
D)  Haemophilus influenza 
A)  Group B Streptococcus 
B)  Escherichia coli 
C)  Pseudomona spp. 
D)  Haemophilus influenza

Question 9

A neonate diagnosed with a pneumothorax was treated with a chest tube. After 36 hours, the therapist noticed that bubbling is present in the chest tube system. What should the therapist do at this time?

Accepted Answer

A)  Suggest removal of the chest tube in 24 hours. 
B)  Clamp the tube and obtain a CXR. 
C)  Keep the chest tube until bubbling stops. 
D)  Remove the chest tube and obtain a follow-up CXR. 
A)  Suggest removal of the chest tube in 24 hours. 
B)  Clamp the tube and obtain a CXR. 
C)  Keep the chest tube until bubbling stops. 
D)  Remove the chest tube and obtain a follow-up CXR.

Question 10

While reviewing the chest X-ray of a newborn recently delivered via cesarean section, the therapist observes the following features:
Pulmonary vascular congestion
Prominent perihilar streaking
Fluid in the interlobular fissures
Hyperexpansion
Flat diaphragm
Which of the following conditions does this patient likely have?

Accepted Answer

A)  RDS 
B)  Persistent pulmonary hypertension of the newborn 
C)  Transient tachypnea of the newborn 
D)  Barotrauma 
A)  RDS 
B)  Persistent pulmonary hypertension of the newborn 
C)  Transient tachypnea of the newborn 
D)  Barotrauma

Question 11

Which of the following medications should the therapist recommend for an infant with apnea of prematurity experiencing episodes of apnea?

Accepted Answer

A)  Canthine derivatives 
B)  Benzodiazepines 
C)  Antibiotics 
D)  Doxapram 
A)  Canthine derivatives 
B)  Benzodiazepines 
C)  Antibiotics 
D)  Doxapram

Question 12

Which of the following blood gas parameters should the therapist target when managing patients with PPHN on mechanical ventilation?
I. Preductal SpO2 maintained between 90% and 99%
II. PaCO2 40 to 50 mm Hg
III. pH 7.35 to 7.45
IV. PaO2 >95 mm Hg

Accepted Answer

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

Question 13

What ventilator settings should a therapist select for a newborn with respiratory distress syndrome?
I. PIP 25 to 30 cm H2O
II. PEEP 4 to 6 cm H2O
III. VT 5 to 6 mL/kg
IV. Frequency 20 to 40 breaths per minute

Accepted Answer

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

Question 14

Which of the following are considered mechanical ventilation strategies used for infants with pulmonary hemorrhage?

Accepted Answer

A)  A ventilation strategy of high PEEP (up to 6-8 cm H2O) 
B)  A ventilation strategy of low PEEP (1-2 cm H2O) 
C)  Infrequent suctioning 
D)  Maintaining low mean airway pressures 
A)  A ventilation strategy of high PEEP (up to 6-8 cm H2O) 
B)  A ventilation strategy of low PEEP (1-2 cm H2O) 
C)  Infrequent suctioning 
D)  Maintaining low mean airway pressures

Question 15

When should a therapist consider CPAP for a newborn with respiratory distress?

Accepted Answer

A)  Oxygen saturation cannot be kept in acceptable range by hood or cannula O2 
B)  pH 2 50 to 60 mm Hg 
A)  Oxygen saturation cannot be kept in acceptable range by hood or cannula O2 
B)  pH 2 50 to 60 mm Hg

Question 16

Which of the following risk factors contribute to the pathogenesis of BPD?
I. Lung immaturity
II. Respiratory failure
III. Oxygen supplementation
IV. Positive-pressure ventilation

Accepted Answer

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

Question 17

What is the significance of an infant with RDS demonstrating a grunt during each exhalation?

Accepted Answer

A)  Resolution of the RDS 
B)  An effort to maintain its functional residual capacity (FR
C)  
C)  An attempt to overcome increased airway resistance 
D)  Impending death 
A)  Resolution of the RDS 
B)  An effort to maintain its functional residual capacity (FR
C)  
C)  An attempt to overcome increased airway resistance 
D)  Impending death

Question 18

Which of the following is the most common bacteria isolated in early-onset infection in term and near-term infants?

Accepted Answer

A)  Group B Streptococcus 
B)  Escherichia coli 
C)  Pseudomona spp. 
D)  Haemophilus influenza 
A)  Group B Streptococcus 
B)  Escherichia coli 
C)  Pseudomona spp. 
D)  Haemophilus influenza

Question 19

Blood samples are simultaneously obtained from both the right radial artery and the umbilical artery, and the arterial partial pressure of oxygen (PaO2) value from the right radial artery is 20 mm Hg greater than that analyzed from the umbilical artery sample. On the basis of this finding, which of the following conditions does the neonate likely have?

Accepted Answer

A)  PPHN 
B)  MAS 
C)  Neonatal pneumonia 
D)  RDS 
A)  PPHN 
B)  MAS 
C)  Neonatal pneumonia 
D)  RDS

Question 20

What is the typical type of airway obstruction that occurs with MAS?

Accepted Answer

A)  Ball valve 
B)  Complete 
C)  No obstruction 
D)  Airway inflammation 
A)  Ball valve 
B)  Complete 
C)  No obstruction 
D)  Airway inflammation

Exam 22: Neonatal Pulmonary Disorders

How should the therapist interpret a lecithin-to-sphingomyelin (L:S) ratio of 2:1?

What radiographic features is the therapist likely to see on a typical chest X-ray of an infant with MAS?

How should the therapist interpret the lack of supernatant foam appearing during the shake test?

The therapist is reviewing the chest radiograph of a newborn, preterm infant and observes diffuse, fine, reticulogranular densities, which provide a ground-glass appearance. On the basis of these radiographic findings, which of the following conditions should the therapist suspect is present?

Which of the following therapeutic interventions is generally needed to treat transient tachypnea of the newborn (TTN)?

The therapist is contemplating the possibility of intubating and suctioning a nonvigorous newborn with MAS. Which of the following clinical parameters confirms the indication for the procedure?

What is the greatest risk factor for respiratory distress syndrome (RDS)?

Which of the following is the most common bacteria isolated in preterm infants?

A neonate diagnosed with a pneumothorax was treated with a chest tube. After 36 hours, the therapist noticed that bubbling is present in the chest tube system. What should the therapist do at this time?

Which of the following medications should the therapist recommend for an infant with apnea of prematurity experiencing episodes of apnea?

Which of the following blood gas parameters should the therapist target when managing patients with PPHN on mechanical ventilation? I. Preductal SpO2 maintained between 90% and 99% II. PaCO2 40 to 50 mm Hg III. pH 7.35 to 7.45 IV. PaO2 >95 mm Hg

What ventilator settings should a therapist select for a newborn with respiratory distress syndrome? I. PIP 25 to 30 cm H2O II. PEEP 4 to 6 cm H2O III. VT 5 to 6 mL/kg IV. Frequency 20 to 40 breaths per minute

Which of the following are considered mechanical ventilation strategies used for infants with pulmonary hemorrhage?

When should a therapist consider CPAP for a newborn with respiratory distress?

Which of the following risk factors contribute to the pathogenesis of BPD? I. Lung immaturity II. Respiratory failure III. Oxygen supplementation IV. Positive-pressure ventilation

What is the significance of an infant with RDS demonstrating a grunt during each exhalation?

Which of the following is the most common bacteria isolated in early-onset infection in term and near-term infants?

What is the typical type of airway obstruction that occurs with MAS?

Fetal Lung Development

Fetal Gas Exchange and Circulation

Antenatal Assessment and High-Risk Delivery

Examination and Assessment of the Neonatal and Pediatric Patient

Pulmonary Function Testing and Bedside Pulmonary Mechanics

Radiographic Assessment

Pediatric Flexible Bronchoscopy

Invasive Blood Gas Analysis and Cardiovascular Monitoring

Noninvasive Monitoring in Neonatal and Pediatric Care

Oxygen Administration

Aerosols and Administration of Inhaled Medications

Airway Clearance Techniques and Hyperinflation Therapy

Airway Management

Surfactant Replacement Therapy

Noninvasive Mechanical Ventilation and Continuous Positive Pressure of the Neonate

Noninvasive Mechanical Ventilation of the Infant and Child

Invasive Mechanical Ventilation of the Neonate and Pediatric Patient

Administration of Gas Mixtures

Extracorporeal Membrane Oxygenation

Pharmacology

Thoracic Organ Transplantation

Surgical Disorders in Childhood That Affect Respiratory Care

Congenital Cardiac Defects

Pediatric Sleep-Disordered Breathing

Pediatric Airway Disorders and Parenchymal Lung Diseases

Asthma

Cystic Fibrosis

Acute Respiratory Distress Syndrome

Shock

Pediatric Trauma

Disorders of the Pleura

Neurological and Neuromuscular Disorders

Transport of Infants and Children

Home Care

Quality and Safety

Filters

Which of the following blood gas parameters should the therapist target when managing patients with PPHN on mechanical ventilation? I. Preductal SpO₂ maintained between 90% and 99% II. PaCO₂ 40 to 50 mm Hg III. pH 7.35 to 7.45 IV. PaO₂ >95 mm Hg

What ventilator settings should a therapist select for a newborn with respiratory distress syndrome? I. PIP 25 to 30 cm H₂O II. PEEP 4 to 6 cm H₂O III. VT 5 to 6 mL/kg IV. Frequency 20 to 40 breaths per minute