RC 323 EXAM 2 QUESTIONS AND
ANSWERS 2026 VERIFIED.
Which one of the following best describes apnea of prematurity?
1. Intermittent cessation of breathing lasting <20 seconds per episode without bradycardia or
desaturation events
2. Cessation of breathing activity for >20 seconds OR <20 seconds accompanied by desaturation
events
3. Cessation of breathing activity in infants >37 weeks gestation
4. Periods of rapid shallow breaths folllowed by intermittent periods of no breathing activity -
ANS 2
True or False: Central apnea of prematurity may be attributed to a blunted response to CO2 -
ANS True
Select all of the following which are true regarding retinopathy of prematurity
1. Proliferation of vasculature caused by a hyperoxic environment is one cause of ROP
2. Significance of ROP is significantly related to postmenstrual gestational age
3. ROP often occurs in late preterm infants
4. All cases of ROP must be treated immediately - ANS 1
Select all of the following which may contribute to respiratory distress syndrome
1. Structurally immature lung
2. Surfactant deficiency
3. Pulmonary vasoconstriction
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,4. V/Q Mismatch - ANS 1, 2, 3 and 4
True or False: Pulmonary dysplasia and chronic lung disease may be the result of either
antenatal or postnatal insults, or both. - ANS True
Which one of the following best describes the primary goal of positive pressure ventilation in an
infant with surfactant deficiency (i.e., RDS)?
1. Support proliferation of type II alveolar cells
2. Increase and maintain optimal FRC
3. Allow infant time to grow
4. To decrease likelihood of needing surfactant - ANS 2
Which one of the following best describes the primary mechanism of TTN?
1. Pulmonary damage as a result of cyclical injury secondary to surfactant deficiency
2. Surfactant deficiency in a term neonate
3. Formation of hyaline membrane thickness in a preterm infant
4. Delayed absorption of fetal lung fluid in a term or near term neonate - ANS 4
You are working in the NICU when you are called to the precipitous (i.e., unexpected) delivery of
a 28 week infant. You do not have a history on mom. The infant is born and you follow the NRP
pathway. At 1 minute, the infant is trying intermittently, floppy, grunting, markedly retracting,
and centrally cyanotic. You attach an SpO2 monitor and begin CPAP of 5cmH2O. Select all of the
following which this infant is at risk of experiencing:
1. RDS
2. AOP
3. ROP
4. TTN - ANS 1, 2 and 3
True or False: Apnea of prematurity can be complicated by the structure of an infant's skull. -
ANS True
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 25
, True or False: Liberal use of oxygen to maintain a SpO2 >95% is the best way to help prevent
ROP - ANS false
what is respiratory distress? - ANS assessment of the efficiency and effectiveness of
ventilation and oxygenation
how can you measure respiratory distress? - ANS HR, RR, WOB, FiO2 requirements, breath
sounds, position, difficulty speaking (with older kids)
RDS - ANS group of symptoms that occur together that indicate signs of distress BECAUSE of
a specific cause
RDS definition - ANS surfactant deficiency resulting in decreased compliance and increased
alveolar surface tension (used to be called hyaline membrane disease or HMD), causes scarring
around AC membrane
Risk Factors for RDS - ANS prematurity <36 weeks, mostly <32 weeks
3 causes of respiratory distress - ANS pulmonary (happens inside the lung), extra-pulmonary
(happens outside the lung but in the pulmonary system, non-respiratory
Pathophysiology of RDS - ANS - infants born early have pulmonary immaturity and little to no
surfactant
- surfactant deficiency and immature lung lead to atelectasis
- atelectasis leads to V/Q mismatch and hypoventilation
- that causes hypoxemia and hypercarbia which leads to acidosis, which then causes pulmonary
vasoconstriction, this causes fluid in alveoli, fibrin, and RDS
When should you suspect RDS - ANS <32 weeks, low APGAR, LBW, L/S ratio <2
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 25
ANSWERS 2026 VERIFIED.
Which one of the following best describes apnea of prematurity?
1. Intermittent cessation of breathing lasting <20 seconds per episode without bradycardia or
desaturation events
2. Cessation of breathing activity for >20 seconds OR <20 seconds accompanied by desaturation
events
3. Cessation of breathing activity in infants >37 weeks gestation
4. Periods of rapid shallow breaths folllowed by intermittent periods of no breathing activity -
ANS 2
True or False: Central apnea of prematurity may be attributed to a blunted response to CO2 -
ANS True
Select all of the following which are true regarding retinopathy of prematurity
1. Proliferation of vasculature caused by a hyperoxic environment is one cause of ROP
2. Significance of ROP is significantly related to postmenstrual gestational age
3. ROP often occurs in late preterm infants
4. All cases of ROP must be treated immediately - ANS 1
Select all of the following which may contribute to respiratory distress syndrome
1. Structurally immature lung
2. Surfactant deficiency
3. Pulmonary vasoconstriction
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 25
,4. V/Q Mismatch - ANS 1, 2, 3 and 4
True or False: Pulmonary dysplasia and chronic lung disease may be the result of either
antenatal or postnatal insults, or both. - ANS True
Which one of the following best describes the primary goal of positive pressure ventilation in an
infant with surfactant deficiency (i.e., RDS)?
1. Support proliferation of type II alveolar cells
2. Increase and maintain optimal FRC
3. Allow infant time to grow
4. To decrease likelihood of needing surfactant - ANS 2
Which one of the following best describes the primary mechanism of TTN?
1. Pulmonary damage as a result of cyclical injury secondary to surfactant deficiency
2. Surfactant deficiency in a term neonate
3. Formation of hyaline membrane thickness in a preterm infant
4. Delayed absorption of fetal lung fluid in a term or near term neonate - ANS 4
You are working in the NICU when you are called to the precipitous (i.e., unexpected) delivery of
a 28 week infant. You do not have a history on mom. The infant is born and you follow the NRP
pathway. At 1 minute, the infant is trying intermittently, floppy, grunting, markedly retracting,
and centrally cyanotic. You attach an SpO2 monitor and begin CPAP of 5cmH2O. Select all of the
following which this infant is at risk of experiencing:
1. RDS
2. AOP
3. ROP
4. TTN - ANS 1, 2 and 3
True or False: Apnea of prematurity can be complicated by the structure of an infant's skull. -
ANS True
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 25
, True or False: Liberal use of oxygen to maintain a SpO2 >95% is the best way to help prevent
ROP - ANS false
what is respiratory distress? - ANS assessment of the efficiency and effectiveness of
ventilation and oxygenation
how can you measure respiratory distress? - ANS HR, RR, WOB, FiO2 requirements, breath
sounds, position, difficulty speaking (with older kids)
RDS - ANS group of symptoms that occur together that indicate signs of distress BECAUSE of
a specific cause
RDS definition - ANS surfactant deficiency resulting in decreased compliance and increased
alveolar surface tension (used to be called hyaline membrane disease or HMD), causes scarring
around AC membrane
Risk Factors for RDS - ANS prematurity <36 weeks, mostly <32 weeks
3 causes of respiratory distress - ANS pulmonary (happens inside the lung), extra-pulmonary
(happens outside the lung but in the pulmonary system, non-respiratory
Pathophysiology of RDS - ANS - infants born early have pulmonary immaturity and little to no
surfactant
- surfactant deficiency and immature lung lead to atelectasis
- atelectasis leads to V/Q mismatch and hypoventilation
- that causes hypoxemia and hypercarbia which leads to acidosis, which then causes pulmonary
vasoconstriction, this causes fluid in alveoli, fibrin, and RDS
When should you suspect RDS - ANS <32 weeks, low APGAR, LBW, L/S ratio <2
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 25
