Question 1

What agent can be administered postnatally to a preterm infant to help reduce lung inflammation and the incidence of CLDI?

Accepted Answer

A)  Vitamin D 
B)  Bronchodilators 
C)  Ribavirin (Virazole) 
D)  Corticosteroids 
A)  Vitamin D 
B)  Bronchodilators 
C)  Ribavirin (Virazole) 
D)  Corticosteroids D

Question 2

An infant with severe CLDI has developed cor pulmonale. What can be given to promote pulmonary vasodilation?

Accepted Answer

A)  Furosemide (Lasix) 
B)  Inhaled nitric oxide (iNO) 
C)  Inhaled albuterol 
D)  FIO2 >50% 
A)  Furosemide (Lasix) 
B)  Inhaled nitric oxide (iNO) 
C)  Inhaled albuterol 
D)  FIO2 >50% B

Question 3

Which of the following is consistent with stage II of CLDI?
1) Occurs 4 to 10 days after birth.
2) Occurs 11 to 30 days after birth.
3) Extensive atelectasis.
4) Alternating areas of atelectasis and emphysema.

Accepted Answer

A) 2, 3 
B) 1, 4 
C) 2, 3, 4 
D) 1, 3, 4 
A) 2, 3 
B) 1, 4 
C) 2, 3, 4 
D) 1, 3, 4 D

Question 4

Diagnostic criteria for the diagnosis of mild CLDI in an infant less than 32 weeks includes:

Accepted Answer

A)  need for <30% oxygen at 36 weeks' PMA or discharge, whichever comes first. 
B)  breathing room air at 36 weeks' PMA or discharge, whichever comes first. 
C)  need for 30% oxygen and/or PPV or NCPAP at 36 weeks' PMA or discharge, whichever comes first. 
D)  breathing room air by 56 days' postnatal age or discharge, whichever comes first. 
A)  need for <30% oxygen at 36 weeks' PMA or discharge, whichever comes first. 
B)  breathing room air at 36 weeks' PMA or discharge, whichever comes first. 
C)  need for 30% oxygen and/or PPV or NCPAP at 36 weeks' PMA or discharge, whichever comes first. 
D)  breathing room air by 56 days' postnatal age or discharge, whichever comes first.

Question 5

What changes result when stress fractures of the capillary endothelium and basement membranes develop during mechanical ventilation?

Accepted Answer

A)  Fluid leakage into alveolar spaces 
B)  Bronchospasm 
C)  Pulmonary embolism 
D)  TTN 
A)  Fluid leakage into alveolar spaces 
B)  Bronchospasm 
C)  Pulmonary embolism 
D)  TTN

Question 6

What is the most significant treatment of the neonate for the prevention of CLDI?

Accepted Answer

A)  Corticosteroids 
B)  Diuretic therapy 
C)  Vitamin E therapy 
D)  Exogenous surfactant 
A)  Corticosteroids 
B)  Diuretic therapy 
C)  Vitamin E therapy 
D)  Exogenous surfactant

Question 7

What is the single most important causative factor associated with the development of chronic lung disease of infancy (CLDI)?

Accepted Answer

A)  Prematurity 
B)  Transient tachypnea of the newborn (TTN) 
C)  Asthma 
D)  Laryngotracheobronchitis 
A)  Prematurity 
B)  Transient tachypnea of the newborn (TTN) 
C)  Asthma 
D)  Laryngotracheobronchitis

Question 8

Which of the following ventilator parameters have been linked to the development of CLDI?
1) High peak inspiratory pressure
2) Overdistention of the lungs
3) Tidal volumes <5 mL/kg
4) High mean airway pressure

Accepted Answer

A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3 
A) 1, 3 
B) 1, 2, 4 
C) 2, 3, 4 
D) 1, 2, 3

Question 9

Which of the following is the major anatomic pathology associated with CLDI?

Accepted Answer

A)  Extensive pulmonary fibrosis 
B)  Extensive airway injury 
C)  Alveolar hypoplasia 
D)  Dextrocardia 
A)  Extensive pulmonary fibrosis 
B)  Extensive airway injury 
C)  Alveolar hypoplasia 
D)  Dextrocardia

Question 10

If a patient has severe CLDI, what cardiac problem may be identified on the chest radiograph?

Accepted Answer

A)  Pneumomediastinum 
B)  Cardiac tamponade 
C)  Change in point of maximum impulse 
D)  Cor pulmonale 
A)  Pneumomediastinum 
B)  Cardiac tamponade 
C)  Change in point of maximum impulse 
D)  Cor pulmonale

Question 11

Which of the following clinical manifestations are associated with CLDI?
1) Hyperresonant lungs
2) Wheezes and crackles
3) Nasal flaring
4) Intercostal retractions

Accepted Answer

A) 1, 3 
B) 2, 4 
C) 1, 2, 4 
D) 2, 3, 4 
A) 1, 3 
B) 2, 4 
C) 1, 2, 4 
D) 2, 3, 4

Question 12

A patient with classic stage II CLDI will have which of the following chest radiograph findings?

Accepted Answer

A)  Ground-glass granular pattern 
B)  Emphysematous bullae 
C)  Honeycomb appearance 
D)  Patchy opaque areas of atelectasis next to areas of dark translucency 
A)  Ground-glass granular pattern 
B)  Emphysematous bullae 
C)  Honeycomb appearance 
D)  Patchy opaque areas of atelectasis next to areas of dark translucency

Question 13

A neonate is reported to have classic stage IV CLDI with emphysematous lung changes. What pulmonary function test finding(s) would confirm this?
1) Increased RV/TLC ratio
2) Increased FRC
3) Decreased VC
4) Increased RV

Accepted Answer

A) 3, 4 
B) 1, 2 
C) 2, 3, 4 
D) 1, 2, 4 
A) 3, 4 
B) 1, 2 
C) 2, 3, 4 
D) 1, 2, 4

Question 14

Which nutrient is essential for maintaining the epithelial cells of the tracheobronchial tree?

Accepted Answer

A)  Vitamin A 
B)  Vitamin C 
C)  Carbohydrates 
D)  Proteins 
A)  Vitamin A 
B)  Vitamin C 
C)  Carbohydrates 
D)  Proteins

Question 15

What is the most common chronic lung disease of premature infants?

Accepted Answer

A)  CLDI 
B)  Asthma 
C)  Cystic fibrosis 
D)  TTN 
A)  CLDI 
B)  Asthma 
C)  Cystic fibrosis 
D)  TTN

Question 16

Which of the following can increase an infant's likelihood of developing CLDI?

Accepted Answer

A)  Birth weight >3000 g 
B)  Overfeeding 
C)  Use of beta2-agonists 
D)  Postnatal bacterial sepsis 
A)  Birth weight >3000 g 
B)  Overfeeding 
C)  Use of beta2-agonists 
D)  Postnatal bacterial sepsis

Exam 40: Chronic Lung Disease of Infancy

What agent can be administered postnatally to a preterm infant to help reduce lung inflammation and the incidence of CLDI?

An infant with severe CLDI has developed cor pulmonale. What can be given to promote pulmonary vasodilation?

Which of the following is consistent with stage II of CLDI? 1) Occurs 4 to 10 days after birth. 2) Occurs 11 to 30 days after birth. 3) Extensive atelectasis. 4) Alternating areas of atelectasis and emphysema.

Diagnostic criteria for the diagnosis of mild CLDI in an infant less than 32 weeks includes:

What changes result when stress fractures of the capillary endothelium and basement membranes develop during mechanical ventilation?

What is the most significant treatment of the neonate for the prevention of CLDI?

What is the single most important causative factor associated with the development of chronic lung disease of infancy (CLDI)?

Which of the following ventilator parameters have been linked to the development of CLDI? 1) High peak inspiratory pressure 2) Overdistention of the lungs 3) Tidal volumes <5 mL/kg 4) High mean airway pressure

Which of the following is the major anatomic pathology associated with CLDI?

If a patient has severe CLDI, what cardiac problem may be identified on the chest radiograph?

Which of the following clinical manifestations are associated with CLDI? 1) Hyperresonant lungs 2) Wheezes and crackles 3) Nasal flaring 4) Intercostal retractions

A patient with classic stage II CLDI will have which of the following chest radiograph findings?

A neonate is reported to have classic stage IV CLDI with emphysematous lung changes. What pulmonary function test finding(s) would confirm this? 1) Increased RV/TLC ratio 2) Increased FRC 3) Decreased VC 4) Increased RV

Which nutrient is essential for maintaining the epithelial cells of the tracheobronchial tree?

What is the most common chronic lung disease of premature infants?

Which of the following can increase an infant's likelihood of developing CLDI?

The Patient Interview

The Physical Examination

The Pathophysiologic Basis for Common Clinical Manifestations

Pulmonary Function Testing

Blood Gas Assessment

Assessment of Oxygenation

Assessment of the Cardiovascular System

Radiologic Examination of the Chest

Other Important Tests and Procedures

The Therapist-Driven Protocol Program

Respiratory Insufficiency, Respiratory Failure and Ventilatory Management Protocols

Recording Skills and Intra-Professional Communication

Chronic Obstructive Pulmonary Disease, Chronic Bronchitis and Emphysema

Asthma

Cystic Fibrosis

Bronchiectasis

Atelectasis

Pneumonia, Lung Abscess Formation, and Important Fungal Diseases

Tuberculosis

Pulmonary Edema

Pulmonary Vascular Disease: Pulmonary Embolism and Pulmonary Hypertension

Flail Chest

Pneumothorax

Pleural Effusion and Empyema

Kyphoscoliosis

Cancer of the Lung, Prevention and Palliation

Interstitial Lung Diseases

Acute Respiratory Distress Syndrome

Guillain-Barré Syndrome

Myasthenia Gravis

Cardiopulmonary Assessment and Care of Patients With Neuromuscular Disease

Sleep Apnea

Newborn Assessment and Management

Pediatric Assessment, Protocols, and Pals Management

Meconium Aspiration Syndrome

Transient Tachypnea of the Newborn

Respiratory Distress Syndrome

Pulmonary Air Leak Syndrome

Respiratory Syncytial Virus Infection Bronchiolitis

Congenital Diaphragmatic Hernia

Congenital Heart Disease

Croup and Croup-Like Syndromes: Laryngotracheobronchitis, Bacterial Tracheitis, and Acute Epiglottitis

Near Drowningwet Drowning

Smoke Inhalation, Thermal Injuries, and Carbon Monoxide Intoxication

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