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 all of the following EXCEPT:

Accepted Answer

A)   cyanosis of dependent thoracic areas.
B)   "seesaw" breathing pattern.
C)   alveolar hyperinflation.
D)   intercostal retractions. C

Question 2

A newborn is flaccid and apneic, has a cyanotic body and a heart rate of 85/min, and shows no reaction to stimulation. Her Apgar score would be:

Accepted Answer

A)   8.
B)   5.
C)   2.
D)   1. D

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 intra-pulmonary 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.
E)   The infant has shunting across the ductus venosus. D

Question 4

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)   1, 2, 3, 4

Question 5

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
E)   Septic shock

Question 6

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 7

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 8

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 9

Apneic episodes in a premature neonate can be caused by all of the following EXCEPT:

Accepted Answer

A)   epiglottitis.
B)   immature central nervous system.
C)   immature airway receptors.
D)   immature chemoreceptors.

Question 10

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

Accepted Answer

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

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

Question 12

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 1st and 6th days of life.

Question 13

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
E)   Cardiac catheterization

Question 14

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

Accepted Answer

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

Question 15

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 16

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

Accepted Answer

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

Question 17

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

Exam 32: Clinical Manifestations Common with Newborn and Early Childhood Respiratory Dis

An infant in respiratory distress will often generate a high negative intrapleural pressure during inspiration. In comparison to an adult, this will result in all of the following EXCEPT:

A newborn is flaccid and apneic, has a cyanotic body and a heart rate of 85/min, and shows no reaction to stimulation. Her Apgar score would be:

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?

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

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

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

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 all of the following EXCEPT:

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

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) .

PPHN usually appears:

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

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

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

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

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

Exam 32: Clinical Manifestations Common with Newborn and Early Childhood Respiratory Dis

An infant in respiratory distress will often generate a high negative intrapleural pressure during inspiration. In comparison to an adult, this will result in all of the following EXCEPT:

A newborn is flaccid and apneic, has a cyanotic body and a heart rate of 85/min, and shows no reaction to stimulation. Her Apgar score would be:

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?

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

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

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

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 all of the following EXCEPT:

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

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) .

PPHN usually appears:

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

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

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

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

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

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