Kettering NPS Exam with Accurate
Solutions
Which of the following should the neonatal/pediatric specialist recommend for an 8 year-
old child with cerebral atrophy and poor cognitive skills in order to promote bronchial
hygiene while delivering a bronchodilator?
a. intermittent positive pressure breathing
b. intrapulmonary percussive ventilation
c. external chest wall percussive device
d. in-exsufflator - ANS-b. intrapulmonary percussive ventilation
A 9 year-old boy was diagnosed with congenital muscular dystrophy at age 3 after
having frequent falls, difficulty getting up from a sitting position and walking on his toes.
He also has learning disabilities and difficulty with psychomotor coordination. After an
episode of influenza, he has an ineffective cough and is retaining secretions. Which of
the following should the neonatal/pediatric specialist recommend to assist with airway
clearance?
a. Cool aerosol
b. PEP device
c. In-exsufflator
d. IPPB therapy - ANS-c. in-exsufflator
A 9-year-old child aspirates while eating gummy bears with her twin sister. She was
laying on her left side at the time of aspiration. The child is in no apparent distress. The
neonatal/pediatric specialist quickly suctions the child. What should the specialist do
next?
a. Sit the patient up and perform the Heimlich maneuver
b. Order a chest x-ray
c. Perform back blows
d. Roll the patient to the right side for postural drainage - ANS-d. roll the patient to the
right side for postural drainage
A 15-year-old patient with asthma presents to the ED in moderate distress. After several
hours of treatment, no clinical improvement has occurred. The physician has ordered
heliox therapy. Which of the following should the neonatal/pediatric specialist select for
delivery of this therapy?
a. Nasal cannula
b. High-flow cannula
c. Non-rebreather mask
d. Air entrainment mask - ANS-c. non-rebreather mask
,A neonatal/pediatric specialist is called to the ED to administer a bronchodilator to a 7-
year-old child with asthma. The child is on oxygen via nasal cannula at 2L/min. Pulse
oximetry reveals a saturation of 84%. The specialst finds the end of the oxygen tubing
under the chair of the mother at the bedside. The specialist reattaches the tubing and
notes that the SpO2 is now 93%. The specialist should
a. Maintain the current oxygen flow
b. Change the device to a non-rebreather mask
c. Increase the oxygen flow
d. Contact the ED physician - ANS-a. maintain the current oxygen flow
Which of the following could cause a loss of pressure during delivery of nasal CPAP to
a neonate? 1. Baby is crying 2. Insufficient flow 3. Obstruction 4 misplaced nasal prongs
a. 1 and 2 only
b.3 and 4 only
c. 1, 2 and 4 only
d. 1, 2, 3, and 4 - ANS-c. 1, 2 and 4 only
A 7 year-old child was rescued from a burning building and brought to the ED for
treatment. Upon arrival, the child was placed on oxygen via a non-rebreather mask. The
neonatal/pediatric specialist notes that when the child inhales, the reservoir bag remains
completely inflated. The specialist should
a. Monitor the patient with pulse oximetry
b. Adjust the seal on the face mask
c. Increase the oxygen flow
d. Change the patient to an air-entrainment mask - ANS-b. adjust the seal on the face
mask
A 14-year-old patient is receiving volume-control ventilation with a hygroscopic
condenser humidifier following multiple trauma. Twelve hours after initiation of
mechanical ventilation, the neonatal/pediatric specialist notes an increase in the
viscosity of the patient's secretions. The specialist should
a. Administer a short acting bronchodilator
b. Suction the patient frequently
c. Change to a heated wick humidifier
d. Administer a mucolytic - ANS-c. change to a heated wick humidifier
A 3-year-old child arrives at the ED with a cough and increasing shortness of breath.
The neonatal/pediatric specialist notes bilateral expiratory wheezes and moderate
intercostal and subcostal retractions. Which of the following should the specialist utilize
to deliver a short acting beta agonist to the patient?
a. Small volume nebulizer
b. Ultrasonic nebulizer
c. Small particle aerosol generator
d. Metered dose inhaler - ANS-a. small volume nebulizer
, A 3-year-old child with a respiratory rate of 34/minute and oxygen saturation of 87% is
on 50% oxygen via a simple mask. Which of the following should the neonatal/pediatric
specialist recommend?
a. Maintain current therapy
b. 40% air entrainment mask
c. Oxygen hood with 50% oxygen
d. High flow nasal cannula - ANS-d. high flow nasal cannula
A neonatal/pediatric specialist is using a galvanic fuel cell to analyze the FiO2 for a
neonate in an oxyhood. The specialist is unable to calibrate the oxygen analyzer. The
most appropriate action would be to
a. Replace the battery
b. Change the fuel cell
c. Check the electrolyte level
d. Obtain a mass spectrometer - ANS-b. change the fuel cell
A 10-year-old boy is to perform hyperinflation with an incentive spirometer following
abdominal surgery. Preoperative spirometry documented a vital capacity of 2400 mL
and an inspiratory capacity of 1400mL. The neonatal/pediatric specialist should set the
initial volume goal on the incentive spirometer at
a. 700 mL
b. 1200 mL
c. 1400 mL
d. 2400 mL - ANS-a. 700 mL
A 3-year-old with asthma receives albuterol via MDI with a spacer for episodes of
wheezing and coughing. Her mother reports that the symptoms seem to persist for a
while following administration of the medication. To improve the efficacy of this
medication, the neonatal/pediatric specialist should recommend
a. Removing the spacer
b. Switching to a small volume nebulizer
c.Holding the spacer 1-2 inches in front of the child's lips
d. Incorporating a mask with the MDI and spacer - ANS-d. incorporating a mask with the
MDI and spacer
The neonatal/pediatric specialist collects a sputum sample for culture and sensitivity
from a 14-year-old child with pneumonia, labels the sample, and sends it to the
laboratory. Several hours later, the specialist checks the medical record and notes that
upon microscopic examination, the medical technologist reports that there were 20
squamous cells seen in the sample in the low power field. The specialist should
a. Collect an additional sputum sample
b. Wait for further evaluation of the sample
c. Ask the medical technologist to discard the sample.
d. Recommend antimicrobial therapy - ANS-b. wait for further evaluation of the sample
Solutions
Which of the following should the neonatal/pediatric specialist recommend for an 8 year-
old child with cerebral atrophy and poor cognitive skills in order to promote bronchial
hygiene while delivering a bronchodilator?
a. intermittent positive pressure breathing
b. intrapulmonary percussive ventilation
c. external chest wall percussive device
d. in-exsufflator - ANS-b. intrapulmonary percussive ventilation
A 9 year-old boy was diagnosed with congenital muscular dystrophy at age 3 after
having frequent falls, difficulty getting up from a sitting position and walking on his toes.
He also has learning disabilities and difficulty with psychomotor coordination. After an
episode of influenza, he has an ineffective cough and is retaining secretions. Which of
the following should the neonatal/pediatric specialist recommend to assist with airway
clearance?
a. Cool aerosol
b. PEP device
c. In-exsufflator
d. IPPB therapy - ANS-c. in-exsufflator
A 9-year-old child aspirates while eating gummy bears with her twin sister. She was
laying on her left side at the time of aspiration. The child is in no apparent distress. The
neonatal/pediatric specialist quickly suctions the child. What should the specialist do
next?
a. Sit the patient up and perform the Heimlich maneuver
b. Order a chest x-ray
c. Perform back blows
d. Roll the patient to the right side for postural drainage - ANS-d. roll the patient to the
right side for postural drainage
A 15-year-old patient with asthma presents to the ED in moderate distress. After several
hours of treatment, no clinical improvement has occurred. The physician has ordered
heliox therapy. Which of the following should the neonatal/pediatric specialist select for
delivery of this therapy?
a. Nasal cannula
b. High-flow cannula
c. Non-rebreather mask
d. Air entrainment mask - ANS-c. non-rebreather mask
,A neonatal/pediatric specialist is called to the ED to administer a bronchodilator to a 7-
year-old child with asthma. The child is on oxygen via nasal cannula at 2L/min. Pulse
oximetry reveals a saturation of 84%. The specialst finds the end of the oxygen tubing
under the chair of the mother at the bedside. The specialist reattaches the tubing and
notes that the SpO2 is now 93%. The specialist should
a. Maintain the current oxygen flow
b. Change the device to a non-rebreather mask
c. Increase the oxygen flow
d. Contact the ED physician - ANS-a. maintain the current oxygen flow
Which of the following could cause a loss of pressure during delivery of nasal CPAP to
a neonate? 1. Baby is crying 2. Insufficient flow 3. Obstruction 4 misplaced nasal prongs
a. 1 and 2 only
b.3 and 4 only
c. 1, 2 and 4 only
d. 1, 2, 3, and 4 - ANS-c. 1, 2 and 4 only
A 7 year-old child was rescued from a burning building and brought to the ED for
treatment. Upon arrival, the child was placed on oxygen via a non-rebreather mask. The
neonatal/pediatric specialist notes that when the child inhales, the reservoir bag remains
completely inflated. The specialist should
a. Monitor the patient with pulse oximetry
b. Adjust the seal on the face mask
c. Increase the oxygen flow
d. Change the patient to an air-entrainment mask - ANS-b. adjust the seal on the face
mask
A 14-year-old patient is receiving volume-control ventilation with a hygroscopic
condenser humidifier following multiple trauma. Twelve hours after initiation of
mechanical ventilation, the neonatal/pediatric specialist notes an increase in the
viscosity of the patient's secretions. The specialist should
a. Administer a short acting bronchodilator
b. Suction the patient frequently
c. Change to a heated wick humidifier
d. Administer a mucolytic - ANS-c. change to a heated wick humidifier
A 3-year-old child arrives at the ED with a cough and increasing shortness of breath.
The neonatal/pediatric specialist notes bilateral expiratory wheezes and moderate
intercostal and subcostal retractions. Which of the following should the specialist utilize
to deliver a short acting beta agonist to the patient?
a. Small volume nebulizer
b. Ultrasonic nebulizer
c. Small particle aerosol generator
d. Metered dose inhaler - ANS-a. small volume nebulizer
, A 3-year-old child with a respiratory rate of 34/minute and oxygen saturation of 87% is
on 50% oxygen via a simple mask. Which of the following should the neonatal/pediatric
specialist recommend?
a. Maintain current therapy
b. 40% air entrainment mask
c. Oxygen hood with 50% oxygen
d. High flow nasal cannula - ANS-d. high flow nasal cannula
A neonatal/pediatric specialist is using a galvanic fuel cell to analyze the FiO2 for a
neonate in an oxyhood. The specialist is unable to calibrate the oxygen analyzer. The
most appropriate action would be to
a. Replace the battery
b. Change the fuel cell
c. Check the electrolyte level
d. Obtain a mass spectrometer - ANS-b. change the fuel cell
A 10-year-old boy is to perform hyperinflation with an incentive spirometer following
abdominal surgery. Preoperative spirometry documented a vital capacity of 2400 mL
and an inspiratory capacity of 1400mL. The neonatal/pediatric specialist should set the
initial volume goal on the incentive spirometer at
a. 700 mL
b. 1200 mL
c. 1400 mL
d. 2400 mL - ANS-a. 700 mL
A 3-year-old with asthma receives albuterol via MDI with a spacer for episodes of
wheezing and coughing. Her mother reports that the symptoms seem to persist for a
while following administration of the medication. To improve the efficacy of this
medication, the neonatal/pediatric specialist should recommend
a. Removing the spacer
b. Switching to a small volume nebulizer
c.Holding the spacer 1-2 inches in front of the child's lips
d. Incorporating a mask with the MDI and spacer - ANS-d. incorporating a mask with the
MDI and spacer
The neonatal/pediatric specialist collects a sputum sample for culture and sensitivity
from a 14-year-old child with pneumonia, labels the sample, and sends it to the
laboratory. Several hours later, the specialist checks the medical record and notes that
upon microscopic examination, the medical technologist reports that there were 20
squamous cells seen in the sample in the low power field. The specialist should
a. Collect an additional sputum sample
b. Wait for further evaluation of the sample
c. Ask the medical technologist to discard the sample.
d. Recommend antimicrobial therapy - ANS-b. wait for further evaluation of the sample
