PRACTICE QUESTIONS & ANSWERS 2026/2027
potential complications of prematurity - correct answer ✔✔1. Respiratory Distress Syndrome-
RDS
2. Apnea of Prematurity AOP
3. Retinopathy of prematurity - ROP
4. Intraventricular or Periventricular Hemorrhage -IVH
5. Necrotizing enterocolitis -NEC
6. Transient Tachypnea of the Newborn - TTN
7. Chronic Lung Disease (CLD) AKA Bronchopulmonary Dysplasia =BPD
prematurity - correct answer ✔✔baby is born before 37 weeks gestation.
higher rate of death & disability =>
-infants (espec those born before 32 weeks) brain, lungs, and liver are all immature
-those that survive may have issues (breathing, feeding, vision, hearing, neuromuscular and
cognitive, developmental)
,-These infants also take an emotional toll on a family and place many families in financial
hardship.
Apnea of Prematurity (AOP) - correct answer ✔✔Apnea of prematurity is one of the most
common complication of prematurity
% of AOP by prematurity
*100% born <28 weeks
*85% born ~30 weeks
*20% born~34 weeks
why are apneas important - correct answer ✔✔can cause ventilatory and perfusion
disturbances
for example:
1. retinopathy of prematurity
2. altered growth
discordant
3. cardiovascular regulation
4. neurodevelopmental disabilities.
apnea: - correct answer ✔✔-cessation of breathing for 20 sec or longer OR
,-shorter pause accompanied by bradycardia (<80), cyanosis (spo2 <80-85%), or pallor
etiology of apnea of prematurity - correct answer ✔✔etiology:
1. central (cessation of breathing effort)
2. obstructive (airflow)
3. mixed
-Diagnosis is not associated w/ inc. risk of SIDS (but regardless, preterm infants generally have
higher risk of SIDS).
treatment for Apnea of Prematurity - correct answer ✔✔methylxanthines (caffeine)
Caffeine citrate:
1. blocks adenosine receptors
2. inc minute ventilation
3. improved CO2 sensitivity
4. dec periodic breathing
5. dec hypoxic depression
6. improved diaphragmatic contractility
7. shorter duration of mechanical ventilation than earlier treatments initiated.
8. recommended for all infants born <28 weeks as well as 29-32 weeks (depending on clinical
course)
9. loading dose 20 mg/kg caffeine citrate
9. maintenance dose 10mg/kg/day
10. trial of caffeine after apnea-free period of 5-7 days OR 32-34 CGA whichever comes first
11. side effects of caffeine
, -tachycardia
-cardiac dysrhythmias
-seizures
-feeding intolerance
-increase metabolic demand
others treatments for apnea of prematurity: - correct answer ✔✔-Nasal CPAP (splints open the
upper airway to prevent pharyngeal collapse, decreases the risk of OSA). Also aids in dec
duration of O2 desaturation
-blood transfusions (can increase respiratory drive)
-treatment of GERD
what is not recommended in the treatment for apnea of prematurity? - correct answer ✔✔-
routine home monitoring (most apnea/bradycardia events resolve by 40 weeks CGA).
discharge instructions for infant who has apnea of prematurity - correct answer ✔✔discharge:
1. infants free of significant or apneic bradycardic events prior to discharge
2. initiate countdown period few days after discontinuation of caffeine therapy.
prevention of apnea of prematurity - correct answer ✔✔Preventative:
1. positioning: avoid extreme flexion or extension of neck (maintain patency of airway) -> prone
positioning
2. provide stable thermal environment