Neonatal and pediatric respiratory care test 5

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Neonatal and pediatric respiratory care test 5

An infant is born with respiratory distress soon after birth. The infant has a boat-shaped or scaphoid abdomen. Bowel sounds are heard in the left thorax. This infant most likely has:

Diaphragmatic hernia

An infant who had which of the following diseases would go home on an apnea monitor?

Apnea of prematurity

A two-day-old infant born at 27-weeks gestation has increasing oxygen requirements, increased respiratory distress. Chest x-ray reveals a ground-glass appearance. This neonate has most likely developed:

Respiratory distress syndrome

The organism which most frequently causes epiglottitis is:

Hemophilus influenza

Pneumothorax and persistent pulmonary hypertension are potential complications of:

Meconium aspiration syndrome

Which of the following would primarily be found in premature infants?

Respiratory distress syndrome and intraventricular hemorrhage

The most common cause of neonatal pneumonia is:

Group B, Streptococcus

Racemic epinephrine would most likely be used in the treatment of:

Croup

An infant who has been in NICU for four months seems to be able to tolerate CPAP via endotracheal tube but not CPAP via nasal prongs. A possible explanation for this could be:

Tracheomalacia

A 38-week gestation infant is born by cesarean section. Three hours after delivery the infant develops respiratory distress and has a breathing rate of 110. Chest x-ray reveals some mild haziness throughout. This infant has most likely developed:

Transient tachypnea of the newborn

The primary factor that will determine the severity of retinopathy of prematurity is:

Degree of prematurity

Selectively intubating one lung might be a treatment for:

Pulmonary hemorrhage

Cystic fibrosis is a:

Genetic abnormality of the exocrine glands

Surfactant replacement therapy would most likely be used in the management/treatment of:

Respiratory distress syndrome

Albuterol would most likely be used in the treatment of:

Bronchiolitis

A 26-week gestation infant who is currently on mechanical ventilation on the Pressure Control mode suddenly has a desaturation episode with the pulse oximeter dropping and oxygen requirements increasing. The neonate has absent breath sounds on the left side and the apical pulse has shifted more to the right. The neonate's blood pressure has dropped significantly. You would recommend:

Needle aspiration on the left side

An infant presents with cyanosis and retractions soon after birth. The infant has more cyanosis at rest and color actually improves with crying. You try to pass a suction catheter and you can't pass it through the nose. This infant most likely has:

Choanal atresia

Which of the following lung diseases will patients with cystic fibrosis often develop?

Bronchiectasis

We think the primary issue with transient tachypnea of the new born is:

Delay in absorption of fetal lung fluid

You are asked to suction a neonate who has a 3.5 mm endotracheal tube in place. What size suction catheter would you use?

8 French

You are asked to deliver an albuterol aerosol treatment to a six-month old child. Which of the following methods will be the best way to deliver the medication.

aerosol mask

Usual starting dose for nitric oxide therapy is:

20 ppm

Which of the following blood abnormalities can be a side effect of nitric oxide therapy?

methemoglobinemia

According to NRP guidelines, chest compressions will be administered on a newborn if heart rate is below:

60

According to NRP guidelines positive pressure breathing will be administered to a newborn if:

There is apnea or heart rate is less than 100

An infant is born and suddenly develops severe respiratory distress. The infant has absent breath sounds on the right and sounds that sound like bowel sounds on the left. The abdomen of the infant is severely depressed. What would you do next?

Deliver 100% oxygen by blow-by and prepare to intubate

Surfactant replacement therapy would most likely be used in the management of:

Respiratory distress syndrome

High frequency oscillatory ventilation would most likely be used in the management of:

Pulmonary interstitial emphysema

Pneumothorax would most likely be a complication of:

Meconium aspiration syndrome and pulmonary interstitial emphysema

The best way to prevent retinopathy of prematurity is to:

Avoid premature deliveries and judicious use of oxygen

A term infant who was born by C-section and had some late decelerations during labor is now presenting with moderate respiratory distress. The infant has a breathing rate of 86 and a heart rate of 162. You would now:

Place the infant in an oxyhood at 40% oxygen

CPAP would be most useful for which of the following disease processes?

Respiratory Distress Syndrome

You are asked to assist in a delivery of a 38-week gestation infant. After delivery the infant becomes cyanotic with signs of respiratory distress. The infant's color improves when the infant is crying. What would you do next?

Insert an oral airway

Which of the following would be most likely to occur in a post term infant?

Meconium aspiration syndrom

The most common cause of neonatal pneumonia is:

Group B Streptococcus

An infant who has been on a mechanical ventilator with a PIP of 26 cm H2O suddenly develops cyanosis. Heart rate is 92. SpO2 is 79%. Apical pulse is shifted drastically to the right and breath sounds are absent on the left. You would recommend:

Needle aspiration on the left side of the chest

A "ground-glass" appearance on chest x-ray often indicates:

Respiratory Distress Syndrome

An infant tolerates a CPAP of 5 cm H2O while intubated but when we extubate the infant to a Vapotherm at 2 lpm they develop severe respiratory distress with marked retractions and stridor. This infant most likely has:

Tracheomalacia

Inflammation of the subglottic area most often refers to:

Croup

The two main organ systems that are affected by cystic fibrosis are the

Lungs and pancrease

The current recommendation for preventing SIDS is to avoid having the infant sleep in which position?

Prone

The best way to deliver bronchodilator aerosol therapy to a six-montho old child is by:

aerosol mask

You are asked to suction a neonate that has a size 3.0 mm endotracheal tube inserted in their airway. What size suction catheter would you select?

6 French

You are ventilating a neonate in the Pressure Control mode with a servoI ventilator. The infant receives surfactant replacement therapy. What you would expect to happen if the surfactant replacement therapy is effective?

The tidal volume on delivered breaths would increase

A condition where an infant is born with the abdominal viscera protruding through the abdominal wall is

Gastroschisis

The treatment where an infant is cannulated and blood is removed, oxygenated and carbon dioxide is removed is called

ECMO

Which blood gas abnormality should be monitored as a side effect of nitric oxide therapy?

methemoglobinemia

According to the NRP guidelines in an infant is breathing, their heart rate is 110 but they have central cyanosis..you would

give supplemental oxygen

The primary duty of the respiratyr therapist during a high risk delivery or transport is to

Maintain an airway and maintain oxygenation

Sweat chloride testing is most commonly done for the diagnosis of

Cystic fibrosis

A 31-week gestation infant is currently on the mechanical ventilator. The baby is unstable and has frequent changes in his oxygen requirements and many fluctuations in his pulse oximetry readings. The infant has large residuals in his stomach with tube feedings and is starting to have bloody discharge from his rectum. This infant most likely has:

necrotizing enterocolitis

Transient Tachypnea of the Newborn is most commonly treated with:

oxygen by oxy hood

An infant has excessive drooling and significant choking and gagging. When the infant cries they have increased stomach distention. This infant most likely has:

tracheoesophageal fistula

An infant with previously diagnosed RDS has a sudden drop in blood pressure, frequent apneic episodes, and frank blood coming from the endotracheal tube. This infant most likely has developed:

pulmonary hemorrhage

Bronchodilator therapy would be most useful in which of the following diseases?

bronchopulmonary dysplasia

Name two diseases that an infant would show increased cyanosis with bottle feedings

Tracheosophageal fistula and Cohanal atresia

An infant who has been intubated and ventilated for six months is currently on CPAP and doing well. The physician orders the infant to be extubated. After extubation the baby's condition deteriorates drastically. The baby is reintubated and placed back on CPAP. The baby's condition improves once she is reintubated. This infant most likely has:

tracheomalacia

The diet of a patient with cystic fibrosis should normally be:

low fat, high protein and high calorie

Name two diseases that albuterol would be helpful..

Cystic fibrosis and bronchiolitis

Name three things used for management or prevention of RDS

CPAP, Steroids admin maternally, surfactant

Which of the following would be components of the arterial blood gasses in a baby with RDS?

hypoxemia and respiratory acidosis

Which disease processes would ECMO be used?

PPHN, Sepsis and Congenital diaphragmatic hernia

If two parents are carriers of the cystic fibrosis gene but neither has cystic fibrosis, what is the per cent chance that their child will have cystic fibrosis?

25%

What size suction catheter would you use on a size 5.0 endotracheal tube?

10 French

The disease process which will benefit the most from surfactant replacement therapy is:

RDS

Which of the following is the most common cause of neonatal pneumonia?

Group B, beta-hemolytic Streptococcus

Antioxidant therapy has been suggested in the treatment of which of the following diseases?

bronchopulmonary dysplasia

How long should you try to wait before suctioning a neonate after they have received exogenous surfactant?

one hour

Name two diseases that would be diagnosed using a lateral neck x-ray

epiglottitis, croup

Which of the following diseases would most likely be found in a 40 week gestation infant?

transient tachypnea of the newborn

Which of the following diseases will most likely resolve on its own within 48 hours?

transient tachypnea of the newborn

Immediate insertion of an oral airway would be helpful in the treatment of:

choanal atresia

High fever would most likely be seen with which of the following diseases?

epiglottitis

Which of the following patients would you LEAST likely put in trendelenburg for their postural drainage with percussion treatment?

1-week-old premature infant with neonatal pneumonia

The most immediate treatment for a tension pneumothorax in an infant is:

needle aspiration

Which of the following diseases require surgical intervention?

congenital diaphragmatic hernia and gastroschisis

Which of the following lobes seems to be prone to atelectasis in the intubated newborn?

right upper lobe

A "ground-glass" appearance on chest x-ray usually indicates:

respiratory distress syndrome

The most immediate treatment for confirmed epiglottitis is:

endotracheal intubation

Pneumothorax is a relatively common complication of what disease process

meconium aspiration syndrome and PIE

The primary problem with RDS is:

lack of surfactant

A condition where the abdominal viscera protrudes through the abdominal wall best describes:

gastroschisis

Which of the following diseases would most likely be treated with a lobectomy?

congenital lobar emphysema

Which of the following diseases would most likely be seen in a postterm infant?

meconium aspiration syndrome

A 23-week gestation infant who has been on the ventilator for one week has an episode where the oxygen saturation drops into the 70's and stays there for 10 minutes. At the same time the baby's heart rate drops into the 70's and stays there. Blood gases on this infant after this episode reveals a metabolic acidosis. The infant's mental status and responsiveness have diminished. This baby has most likely has:

intraventricular hemorrhage

Which blood gas abnormality is a potential complication of nitric oxide therapy?

methemoglobinemia

Which of the following is the best way to transport a potentially sick neonate?

en utero

The pathophysiology of bronchopulmonary dysplasia includes

metaplasia of bronciolar smooth muscle, interstitial fibrosis, emphysematous bllae, pulmonary hypertension

The age group most commonly affected by croup is:

6 months - 3 years

Bowel sounds in the thorax, a boat-shaped abdomen, absent breath sounds on the left side and an apical pulse on the right would indicate:

Diaphragmatic hernia

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