Question 1

How can a registered respiratory therapist minimize pressure delivered to the lungs while administering mechanical ventilation to an infant
I.Decrease peak inspiratory pressure, increase positive end-expiratory pressure, and increase I-time.
II.Increase peak inspiratory pressure, increase positive end-expiratory pressure, and increase I-time.
III.Decrease peak inspiratory pressure, positive end-expiratory pressure, and I-time as tolerated.
IV.Use volume-targeted ventilation.
V.Avoid auto-positive end-expiratory pressure.
VI.Use Controlled mandatory ventilation, which is the preferred method over high-frequency ventilation.

Accepted Answer

A)  III, IV, and V
B)  I, IV, and VI
C)  I, V, and VI
D)  II, IV, and VI A

Question 2

The administration of surfactant to infants less than 28 weeks of gestation has not significantly decreased infant mortality rates associated with pneumothorax.

Accepted Answer

A) True 
 B)False  False

Question 3

Re-intubation and mechanical ventilation should be based only on chest radiograph evidence.

Accepted Answer

A) True 
 B)False  False

Question 4

Which of the following are Considered risk factors for a pneumothorax
I.Aspiration of meConium
II.Subcutaneous emphysema
III.Abdominal distention
IV.Pneumonia
V.Pulmonary interstitial emphysema
VI.Respiratory distress syndrome
VII.Mechanical ventilation

Accepted Answer

A)  I, II, III, and IV
B)  I, III, V, and VII
C)  I, IV, VI, and VII
D)  I, II, IV, and VI

Question 5

Clinical manifestations for respiratory distress syndrome include which of the following
I.Tachypnea
II.Posturing
III.Tachycardia
IV.Hypertension
V.External retractions
VI.Chest radiograph reveals bell-shaped thorax as a result of generalized underaeration, lung volume is reduced, and the lung parenchyma has a diffused reticulogranular pattern.
VII.Grunting

Accepted Answer

A)  I, II, and IV
B)  I, IV, and VI
C)  I, V, and VII
D)  I, II, V, and VII
E)  I, II, III, IV, V, and VI

Question 6

What is the most effective way to treat pulmonary interstitial emphysema
I.Pressure-targeted ventilation
II.Volume-targeted ventilation
III.Hyperinflation of lungs
IV.Minimizing overdistention

Accepted Answer

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

Question 7

Prevention and early management of respiratory distress syndrome should progress to which of the following guidelines of care
I.Good bronchial hygiene
II.Frequent patient positioning
III.Arterial blood gas results obtained before making mechanical ventilation changes
IV.Prophylactic surfactant delivery
V.Pressure-volume loop interpretation essential
VI.Proper ventilator management
VII.Early withdrawal of noninvasive ventilation

Accepted Answer

A)  II, IV, V, and VI
B)  I, II, III, and IV
C)  I, II, III, IV, and V
D)  I, II, IV, V, and VI
E)  I, II, III, IV, V, VI, and VII

Question 8

Which of the following are guidelines when utilizing high-frequency jet ventilation (HFJV)
I.To increase PaCO₂, decreasing HFJV peak inspiratory pressure is the best option.
II.To increase PaCO₂, increasing HFJV peak inspiratory pressure is the best option.
III.In the presence of atelectasis, decrease positive end-expiratory pressure and add intermittent mandatory ventilation 5 to 10 breaths temporarily.
IV.In the presence of atelectasis, increase positive end-expiratory pressure and add intermittent mandatory ventilation 5 to 10 breaths temporarily.
V.In the absence of atelectasis.increase FiO₂.
VI.In the absence of atelectasis, decrease FiO₂
VII.Monitor servo pressure changes.

Accepted Answer

A)  I, III, V, and VII
B)  I, IV, V, and VII
C)  II, III, V1, and VII
D)  II, IV, VI, and VII

Question 9

Pneumonia presents in which of the following ways
I.Respiratory rates greater than 60 breaths/minute
II.Accessory muscle use and retractions
III.Bulging sternum
IV.Decreased heart sounds
V.Abrupt duskiness
VI.Hyperthermia
VII.Abdominal distention

Accepted Answer

A)  I, II, III, and IV
B)  I, III, IV, and V
C)  I, II, VI, and VII
D)  II, III, V, and VII

Question 10

Which of the following are organisms that predispose infants to pneumonia
I.Group B streptoCocci
II.StaphyloCoccus aureus
III.Cytomegalovirus
IV.Chlamydia trachomatis
V.Listeria monocytogenes
VI.Group A streptoCocci
VII.Gram-negative enteric bacteria

Accepted Answer

A)  I, II, III, IV, and VII
B)  I, III, IV, V, and VII
C)  II, III, V, VI, and VII
D)  I, II, III, IV, V, VI, and VII

Question 11

How does pulmonary interstitial emphysema present
I.Hypoxemia
II.Hypercapnia
III.Hypertension
IV.Episodes of apnea
V.Cyst-like formations 4-10 mm in diameter
VII.Mediastinal shift and atelectasis of Contralateral lung
VIII.Air bronchograms

Accepted Answer

A)  I, II, III, IV, V, VI, and VII
B)  I, II, V, VI, and VII
C)  II, III, IV, and VII
D)  II, IV, V, VI, and VII

Question 12

In the treatment of pneumonia, all of the following treatment options should be used except:

Accepted Answer

A)  Antibiotic administration
B)  Promoting hand washing
C)  Bronchial hygiene therapy
D)  Oxygen therapy
E)  Surfactant delivery

Question 13

What are the clinical manifestations of pneumopericardium
I.Muffled or absent heart tones
II.Decreased arterial blood pressure
III.Tachycardia
IV.Bradycardia and hypoxia
V.Pulseless electrical activity
VI.Cyanosis
VII.Hypertension

Accepted Answer

A)  I, IV, V, VI, and VII
B)  I, III, IV, V, and VI
C)  II, III, IV, V, and VI
D)  I, II, IV, V, and VI

Question 14

What are some of the causes for a pneumomediastinum
I.Airway obstruction
II.Mechanical ventilation
III.Infections
IV.Obstructive lung disease
V.Trauma
VI.Valsalva's maneuver

Accepted Answer

A)  I, III, and V
B)  II, IV, and VI
C)  I, III, and VI
D)  I, II, III, IV, V, and VII

Question 15

What are the reCommended initial nasal Continuous positive airway pressures reCommended by the American Association of Respiratory Care Clinical Practice Guidelines for a neonate

Accepted Answer

A)  4-5 cm H₂O
B)  5-7 cm H₂O
C)  7-8 cm H₂O
D)  8-10 cm H₂O

Question 16

Which of the following treatments should be used in the management of an infant who presents with a simple pneumothorax

Accepted Answer

A)  Needle deCompression
B)  ThoraCotomy
C)  Chest tube
D)  100% oxygen hood

Question 17

What are some of the Contributing factors for neonatal atelectasis
I.MeConium obstruction in terminal airways
II.Neurogenic pulmonary edema
III.Lung Compression from masses, tumors, or gastric Contents
IV.Emphysema
V.Respiratory failure and hypoventilation as a result of a decrease in Compliance and surfactant deficiency

Accepted Answer

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

Exam 7: Common Neonatal Complications: Pulmonary Complications

The administration of surfactant to infants less than 28 weeks of gestation has not significantly decreased infant mortality rates associated with pneumothorax.

Re-intubation and mechanical ventilation should be based only on chest radiograph evidence.

Which of the following are Considered risk factors for a pneumothorax I.Aspiration of meConium II.Subcutaneous emphysema III.Abdominal distention IV.Pneumonia V.Pulmonary interstitial emphysema VI.Respiratory distress syndrome VII.Mechanical ventilation

What is the most effective way to treat pulmonary interstitial emphysema I.Pressure-targeted ventilation II.Volume-targeted ventilation III.Hyperinflation of lungs IV.Minimizing overdistention

Pneumonia presents in which of the following ways I.Respiratory rates greater than 60 breaths/minute II.Accessory muscle use and retractions III.Bulging sternum IV.Decreased heart sounds V.Abrupt duskiness VI.Hyperthermia VII.Abdominal distention

Which of the following are organisms that predispose infants to pneumonia I.Group B streptoCocci II.StaphyloCoccus aureus III.Cytomegalovirus IV.Chlamydia trachomatis V.Listeria monocytogenes VI.Group A streptoCocci VII.Gram-negative enteric bacteria

How does pulmonary interstitial emphysema present I.Hypoxemia II.Hypercapnia III.Hypertension IV.Episodes of apnea V.Cyst-like formations 4-10 mm in diameter VII.Mediastinal shift and atelectasis of Contralateral lung VIII.Air bronchograms

In the treatment of pneumonia, all of the following treatment options should be used except:

What are the clinical manifestations of pneumopericardium I.Muffled or absent heart tones II.Decreased arterial blood pressure III.Tachycardia IV.Bradycardia and hypoxia V.Pulseless electrical activity VI.Cyanosis VII.Hypertension

What are some of the causes for a pneumomediastinum I.Airway obstruction II.Mechanical ventilation III.Infections IV.Obstructive lung disease V.Trauma VI.Valsalva's maneuver

What are the reCommended initial nasal Continuous positive airway pressures reCommended by the American Association of Respiratory Care Clinical Practice Guidelines for a neonate

Which of the following treatments should be used in the management of an infant who presents with a simple pneumothorax