Neonatal and Pediatric Final Exam Test 1..docx

Neonatal and Pediatric Final Exam Test 1.
Which of the following statements describe truncus arteriosus?
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A. The pulmonary artery arises from the left ventricle, and the aorta stems from the right ventricle.
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B. A large VSD allows total mixing of blood from the two ventricles.
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C. If SVR decreases relative to PVR, blood flow will be shunted from right to left, bypassing the lungs.
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D. All of the above - ANS >> D. All of the above
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What factor is responsible for closure of the foramen ovale? A. Increased PaO2
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B. Increased pressure on the left side of the heart
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C. Blood flowing through the lungs
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D. High pulmonary vascular resistance - ANS >> B. Increased pressure on the left side of the heart
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What is the incidence of respiratory distress syndrome (RDS) among infants born at less than 28
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weeks of gestation?
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A. 30% to 40%
B B B B


B. 40% to 50%
B B B B


C. 60% to 80%
B B B B


D. >80% - ANS >> C. 60% to 80%
B B B B B B B B


What radiographic features is the therapist likely to see on a typical chest X-ray of an infant with
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MAS?
B B


A. Ground-glass appearance
B B B


B. Complete whiteout
B B B


C. Decreased lung volume
B B B B


D. Patchy areas of atelectasis - ANS >> D. Patchy areas of atelectasis
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The therapist is treating a child with TOF who appears to be having a "tet" spell. What should the
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therapist suggest to treat this event?
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A. Beta blockers
B B B


B. Knee-chest position to increase SVR
B B B B B B


C. Morphine sulfate
B B B


D. All of the above - ANS >> D. All of the above
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The therapist is setting pulse oximetry to determine the presence of right-to-left shunt in an infant
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suspected of having a heart defect. Where should the therapist place the pulse ox probe to obtain the
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most accurate measure of preductal oxygen saturation?
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A. Any finger of the right hand
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B. Any finger of the left hand
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C. Left earlobe
B B B


D. Lower extremities - ANS >> A. Any finger of the right hand
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Which of the following physiologic mechanisms need to be in place to ensure adequate systemic
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perfusion in infants with hypoplastic left heart syndrome (HLHS)?
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BA. Presence of an ASD
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B. Presence of a mitral regurgitation
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, C. Adequate left atrial function
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D. Presence of a PDA - ANS >> D. Presence of a PDA
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Blood samples are simultaneously obtained from both the right radial artery and the umbilical artery,
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and the arterial partial pressure of oxygen (PaO2) value from the right radial artery is 20 mm Hg
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greater than that analyzed from the umbilical artery sample. On the basis of this finding, which of the
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following conditions does the neonate likely have?
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A. PPHN
B B


B. MAS
B B


C. Neonatal pneumonia
B B


BD. RDS - ANS >> A. PPHN
B B B B B B


What ventilator settings should a therapist select for a newborn with respiratory distress syndrome?
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A. PIP 25-30 cm H2O
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B. PEEP 3-6 cm H2O
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C. VT 5-6 mL/kg
B B B B


D. Frequency 60 breaths per minute - ANS >> B. PEEP 3-6 cm H2O
B B B B B B B B B B B B B


0. Why does meconium staining occur predominantly in infants older than 36 weeks of gestational
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age?
B B


A. Because these infants can generate strong inspiratory efforts
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B. Because infants this age have significant cardiac outputs
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C. Because these infants demonstrate strong peristalsis
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D. Because these newborns have weak anal sphincter tone - ANS >> C. Because these infants
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demonstrate strong peristalsis
B B B


1. Which of the following clinical manifestations is consistent with an atrial septal defect (ASD)?
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A. An ASD often causes congestive heart failure (because of decreased pulmonary blood flow).
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B. The right ventricle may become hypertrophic (right ventricular hypertrophy).
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C. Most patients with an ASD are symptomatic in the neonatal intensive care unit, presenting with
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right atrial enlargement.
B B B B


D. Chest radiographs are usually abnormal. - ANS >> B. The right ventricle may become hypertrophic
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(right ventricular hypertrophy).
B B B


What is the typical type of airway obstruction that occurs with MAS?
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A. Ball valve
B B B


B. Complete
B B


C. No obstruction
B B B


D. Airway inflammation - ANS >> A. Ball valve
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How should the therapist interpret a preductal-to-postductal PaO2 difference of 8 mm Hg in a
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neonate?
B B


A. Unreliable data
B B B


B. Absence of ductal shunting
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C. Presence of ductal shunting
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D. Inconclusive data - ANS >> . Absence of ductal shunting
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Which of the following congenital cardiac anomalies is classified as conotruncal, associated with a
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"boot-shaped" appearance of the heart?
B B B B B