Question 1

An infant in respiratory distress will often generate a high negative intrapleural pressure during inspiration. In comparison to an adult, this will result in:
1) cyanosis of dependent thoracic areas.
2) "seesaw" breathing pattern.
3) alveolar hyperinflation.
4) intercostal retractions.

Accepted Answer

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

Question 2

A neonate in respiratory distress will often dilate his/her nostrils to:

Accepted Answer

A)   facilitate inspiration.
B)   nurse more easily.
C)   sneeze out amniotic fluid.
D)   raise the intrapleural pressure. A

Question 3

A premature infant has two pulse oximeters placed: one on the right hand and one on the left foot. The respiratory therapist notes that the reading on the right hand is consistently 12% greater than the reading on the left foot. Which of the following is the best interpretation of this finding?

Accepted Answer

A)   The infant has left-sided intrapulmonary shunting.
B)   The infant likely has pneumonia.
C)   The infant is in septic shock with systemic capillary shunting.
D)   The infant has persistent pulmonary hypertension of the newborn. D

Question 4

A neonatal patient has PPHN. What may develop as a consequence of this?

Accepted Answer

A)   Cardiomegaly
B)   Pulmonary embolism
C)   Mucosal edema
D)   Cardiac tamponade

Question 5

A newborn's 5-minute Apgar score is 7. How should this be interpreted?

Accepted Answer

A)   Normal adjustment to being born
B)   Moderate distress; intubate the airway and suction the lungs
C)   Moderate distress; administer supplemental oxygen
D)   Severe distress; begin bag-mask resuscitation

Question 6

When a neonate has PPHN, what structures does the blood flow through to bypass the lungs?
1) Ductus venosus
2) Foramen ovale
3) Hypogastric arteries
4) Ductus arteriosus

Accepted Answer

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

Question 7

A premature infant is suspected of having persistent pulmonary hypertension of the newborn. How is this diagnosis confirmed?

Accepted Answer

A)   Arterial blood gas analysis
B)   Chest radiography
C)   Pulmonary angiography
D)   Echocardiography

Question 8

PPHN usually appears:

Accepted Answer

A)   in utero during the last trimester.
B)   within 1 hour of birth.
C)   within the first 12 hours of birth.
D)   between the first and sixth days of life.

Question 9

Which of the following can trigger apnea in the premature infant?
1) Micrognathia
2) Intracranial hemorrhage
3) REM sleep
4) Hyperthermia

Accepted Answer

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

Question 10

A neonatal patient is found to have grunting on expiration. What physiologic effect does this produce?

Accepted Answer

A)   Increased vital capacity
B)   Increased PaO2
C)   Decreased PaCO2
D)   Closes the ductus arteriosus

Question 11

Apnea of prematurity can be defined as:
1) respiratory pause causing bradycardia.
2) cycles of short breathing pauses followed by faster breathing.
3) no breathing for >20 seconds.
4) sudden apnea and death (crib death).

Accepted Answer

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

Question 12

Respiratory causes of persistent pulmonary hypertension of the newborn (PPHN) include:
1) congenital heart disease.
2) hypoxia.
3) meconium aspiration syndrome (MAS).
4) respiratory distress syndrome (RDS).

Accepted Answer

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

Question 13

A premature infant is found to be "bobbing" her head. This is important because it can be a sign of which of the following?

Accepted Answer

A)   Hypoxemia
B)   Renal failure
C)   Intracranial hemorrhage
D)   Respiratory distress

Question 14

Late clinical manifestations of an infant with respiratory distress include:
1) elevated diaphragm.
2) decreased respiratory rate.
3) CO2 retention.
4) lethargy.

Accepted Answer

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

Question 15

Early clinical manifestations of an infant with respiratory distress include:
1) cyanosis.
2) substernal retractions.
3) expiratory grunting.
4) apnea.

Accepted Answer

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

Question 16

Apneic episodes in a premature neonate can be caused by which of the following?
1) Epiglottitis
2) Immature central nervous system
3) Immature airway receptors
4) Immature chemoreceptors

Accepted Answer

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

Exam 33: Newborn Assessment and Management

An infant in respiratory distress will often generate a high negative intrapleural pressure during inspiration. In comparison to an adult, this will result in: 1) cyanosis of dependent thoracic areas. 2) "seesaw" breathing pattern. 3) alveolar hyperinflation. 4) intercostal retractions.

A neonate in respiratory distress will often dilate his/her nostrils to:

A premature infant has two pulse oximeters placed: one on the right hand and one on the left foot. The respiratory therapist notes that the reading on the right hand is consistently 12% greater than the reading on the left foot. Which of the following is the best interpretation of this finding?

A neonatal patient has PPHN. What may develop as a consequence of this?

A newborn's 5-minute Apgar score is 7. How should this be interpreted?

When a neonate has PPHN, what structures does the blood flow through to bypass the lungs? 1) Ductus venosus 2) Foramen ovale 3) Hypogastric arteries 4) Ductus arteriosus

A premature infant is suspected of having persistent pulmonary hypertension of the newborn. How is this diagnosis confirmed?

PPHN usually appears:

Which of the following can trigger apnea in the premature infant? 1) Micrognathia 2) Intracranial hemorrhage 3) REM sleep 4) Hyperthermia

A neonatal patient is found to have grunting on expiration. What physiologic effect does this produce?

Apnea of prematurity can be defined as: 1) respiratory pause causing bradycardia. 2) cycles of short breathing pauses followed by faster breathing. 3) no breathing for >20 seconds. 4) sudden apnea and death (crib death) .

Respiratory causes of persistent pulmonary hypertension of the newborn (PPHN) include: 1) congenital heart disease. 2) hypoxia. 3) meconium aspiration syndrome (MAS) . 4) respiratory distress syndrome (RDS) .

A premature infant is found to be "bobbing" her head. This is important because it can be a sign of which of the following?

Late clinical manifestations of an infant with respiratory distress include: 1) elevated diaphragm. 2) decreased respiratory rate. 3) CO₂ retention. 4) lethargy.

Early clinical manifestations of an infant with respiratory distress include: 1) cyanosis. 2) substernal retractions. 3) expiratory grunting. 4) apnea.

Apneic episodes in a premature neonate can be caused by which of the following? 1) Epiglottitis 2) Immature central nervous system 3) Immature airway receptors 4) Immature chemoreceptors

Exam 33: Newborn Assessment and Management

An infant in respiratory distress will often generate a high negative intrapleural pressure during inspiration. In comparison to an adult, this will result in: 1) cyanosis of dependent thoracic areas. 2) "seesaw" breathing pattern. 3) alveolar hyperinflation. 4) intercostal retractions.

A neonate in respiratory distress will often dilate his/her nostrils to:

A premature infant has two pulse oximeters placed: one on the right hand and one on the left foot. The respiratory therapist notes that the reading on the right hand is consistently 12% greater than the reading on the left foot. Which of the following is the best interpretation of this finding?

A neonatal patient has PPHN. What may develop as a consequence of this?

A newborn's 5-minute Apgar score is 7. How should this be interpreted?

When a neonate has PPHN, what structures does the blood flow through to bypass the lungs? 1) Ductus venosus 2) Foramen ovale 3) Hypogastric arteries 4) Ductus arteriosus

A premature infant is suspected of having persistent pulmonary hypertension of the newborn. How is this diagnosis confirmed?

PPHN usually appears:

Which of the following can trigger apnea in the premature infant? 1) Micrognathia 2) Intracranial hemorrhage 3) REM sleep 4) Hyperthermia

A neonatal patient is found to have grunting on expiration. What physiologic effect does this produce?

Apnea of prematurity can be defined as: 1) respiratory pause causing bradycardia. 2) cycles of short breathing pauses followed by faster breathing. 3) no breathing for >20 seconds. 4) sudden apnea and death (crib death) .

Respiratory causes of persistent pulmonary hypertension of the newborn (PPHN) include: 1) congenital heart disease. 2) hypoxia. 3) meconium aspiration syndrome (MAS) . 4) respiratory distress syndrome (RDS) .

A premature infant is found to be "bobbing" her head. This is important because it can be a sign of which of the following?

Late clinical manifestations of an infant with respiratory distress include: 1) elevated diaphragm. 2) decreased respiratory rate. 3) CO2 retention. 4) lethargy.

Early clinical manifestations of an infant with respiratory distress include: 1) cyanosis. 2) substernal retractions. 3) expiratory grunting. 4) apnea.

Apneic episodes in a premature neonate can be caused by which of the following? 1) Epiglottitis 2) Immature central nervous system 3) Immature airway receptors 4) Immature chemoreceptors

Late clinical manifestations of an infant with respiratory distress include: 1) elevated diaphragm. 2) decreased respiratory rate. 3) CO₂ retention. 4) lethargy.