Question 1

The therapist has completed a 1-minute Apgar score.The following evaluations were obtained:
(1)the infant is pale
(2)the heart rate is 90 beats/minute
(3)the respiratory effort is irregular
(4)some muscle tone is noted;and
(5)no response to nasal suctioning is found.
On the basis of these findings,what Apgar score should be assigned to this neonate?

Accepted Answer

A)  1
B)  2
C)  3
D)  5 C

Question 2

The gestational age of a newborn has been evaluated to be 34 weeks.The newborn's birth weight is greater than the 90th percentile.How should the therapist classify this infant?

Accepted Answer

A)  Small for gestational age
B)  Average for gestational age
C)  Large for gestational age
D)  Very large for gestational age C

Question 3

Which of the following pulmonary diseases are not chest wall deformities but are characterized by an increased anteroposterior diameter?

Accepted Answer

A)  Pectus excavatum
B)  Interstitial pulmonary disease
C)  Pneumonia
D)  Cystic fibrosis D

Question 4

A physical examination is being performed on a newborn,and the therapist notices that the infant's arms do not move symmetrically.Which of the following situations could account for this problem?

Accepted Answer

A)  An injury to the infant's brachial plexus may have occurred during birth.
B)  The infant may have been born breach.
C)  The baby was born via cesarean section.
D)  The infant experienced nuchal cords during birth.

Question 5

A newborn does not appear to respond to the extrauterine environment.Cry is weak and the respiratory effort is not strong.Which of the following methods should the therapist use to stimulate the newborn?

Accepted Answer

A)  Hold the newborn upside down.
B)  Rub over the sternal area.
C)  Suction the nasopharynx.
D)  Gently rub the back.

Question 6

As the head of a neonate contaminated with meconium emerges at birth,the heart rate monitor indicates 120 beats/minute,and the physician notices that the infant has good muscle tone and a strong respiratory effort.What should the physician do at this time to provide airway care?

Accepted Answer

A)  Intubate the infant immediately.
B)  Perform pharyngeal and tracheal suctioning immediately.
C)  Perform tracheal suctioning only at this time.
D)  Only routine monitoring of respiratory vital signs is needed at this time.

Question 7

The therapist is evaluating a newborn with an abdominal defect consisting of protrusion of the membranous sac that encloses abdominal contents through an opening in the abdominal wall into the umbilical cord.Which of the following conditions is consistent with this description?

Accepted Answer

A)  Enterocolitis
B)  Ascites
C)  Congenital diaphragmatic hernia
D)  Omphalocele

Question 8

Which of the following statements refers to the diagnostic procedure called transillumination?

Accepted Answer

A)  Place a light source between the surface of the bed and the patient's back,and orient the patient in a supine position.
B)  Direct a light source toward the ipsilateral surface of the patient's thorax.
C)  Position a beam of light against a patient's chest wall in a well-lit room.
D)  Insert a fiberoptic light source down a patient's endotracheal tube and beyond the tube's distal tip.

Question 9

Which of the following pieces of information represent components of patient history for a new pediatric patient?
I.Chief complaint
II.History of present illness
III.Past medical history
IV.Occupational history

Accepted Answer

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

Question 10

The therapist notices that an infant presents with irregular areas of dusky skin alternating with areas of pale skin.On the basis of this observation,which of the following conditions should the therapist anticipate this patient having?

Accepted Answer

A)  Polycythemia
B)  Hypotension
C)  Situs inversus with dextrocardia
D)  Renal insufficiency

Question 11

Which of the following neonatal skin presentations at birth is associated with a high hematocrit value or polycythemia and neonatal hyperviscosity syndrome?

Accepted Answer

A)  Mottling
B)  Lanugo
C)  Reddish blue appearance
D)  Vernix

Question 12

Which of the following factors are taken into consideration when assessing the gestational age of a neonate?
I.Previous maternal pregnancies
II.Prenatal ultrasound evaluations
III.Postnatal findings based on physical and neurologic examinations
IV.Gestational duration based on the last menstrual cycle

Accepted Answer

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

Question 13

What should the therapist do to avert injury and atelectasis,and to avoid interfering with the infant's ability to establish adequate ventilation,while stabilizing a preterm neonate before resuscitation?
I.Use a bulb syringe.
II.Avoid excessive suctioning of clear fluid from the nasopharynx.
III.Use a suction catheter clearing the mouth first and then the nose.
IV.Suction using direct laryngoscopy.

Accepted Answer

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

Question 14

Which of the following components of a patient's medical history is intended to determine the presence of symptoms not identified in the history of present illness and may be related or contribute to the child's underlying condition?

Accepted Answer

A)  Chief complaint
B)  Past medical history
C)  Review of systems
D)  History of present illness

Question 15

A neonate is found to have a bounding pulse.Which of the following conditions may contribute to this finding?

Accepted Answer

A)  Low cardiac output
B)  Coarctation of the aorta
C)  Left-to-right shunt
D)  Patent foramen ovale

Question 16

Why is it difficult to localize auscultation findings of the thorax of a newborn?

Accepted Answer

A)  Because the neonate's chest is small and sounds are difficult to differentiate
B)  Because the newborn infant is frequently crying
C)  Because the neonate's tidal volume is so small
D)  Because the newborn's pulmonary compliance is low

Question 17

While performing a physical examination on a newborn infant,the therapist notices that the point of maximal cardiac impulse is to the left of the sternal border.Which of the following conditions can cause this situation?

Accepted Answer

A)  Atelectasis of the right lung
B)  Bilateral pulmonary consolidation
C)  Right-sided pneumothorax
D)  Left main stem bronchus intubation

Question 18

For the purpose of assessing right-to-left shunting,as in the case of persistent pulmonary hypertension,which of the following sites would render postductal blood?
I.Right arm
II.Left arm
III.Right leg
IV.Left leg

Accepted Answer

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

Question 19

During a physical examination of a child's chest,the therapist perceives increased tactile fremitus over the patient's right lower lobe.Which of the following conditions may cause this physical sign?

Accepted Answer

A)  Pulmonary consolidation
B)  Pneumothorax
C)  Mucous plug
D)  Aspirated foreign object

Question 20

An infant arrives in the newborn nursery with an axillary body temperature of 95.6° F.Which of the following events may be responsible for this infant's temperature?

Accepted Answer

A)  The neonate was in an infant warmer in the delivery room.
B)  The infant was swaddled in numerous blankets.
C)  The delivery room temperature was low.
D)  The newborn has protracted diarrhea.

Exam 4: Exam and Assessment of the Neonatal and Pediatric Patient