NPS care Exam with Complete Solutions
D. Flow is not adequate - ANS-During mechanical ventilation in Pressure Control, the
preset inspiratory pressure will not be reached in which of the following conditions?
A. Inspiratory time is too long
B. Respiratory rate is too low
C. PEEP level is excessive
D. Flow is not adequate
D. initiate a CPAP trial. - ANS-A four-week-old, 28-week-gestation infant with RDS
remains on mechanical ventilation. Current ventilator parameters are:
PIP: 22 cm H2O
Rate 10 breaths/min
FIO2: 0.30
PEEP: 4 cm H2O
Arterial blood gas analysis reveals adequate oxygenation and ventilation. The infant is
breathing spontaneously above the set rate with minimal work of breathing. The
neonatal/pediatric specialist should:
A. decrease the respiratory rate to 8 breaths/min.
B. decrease the PIP to 18 cm H2O.
C. decrease the FIO2 to 0.28.
D. initiate a CPAP trial.
C. 15 cm H2O. - ANS-A six-week-old neonate is being ventilated with time-cycled,
pressure-limited ventilation. The neonatal/pediatric specialist should not allow the mean
airway pressure value to go above
A. 5 cm H2O.
B. 10 cm H2O.
C. 15 cm H2O.
D. 20 cm H2O.
D. prepare to extubate the neonate. - ANS-A neonate with RDS is receiving mechanical
ventilation at the following settings:
Mode: PC, SIMV
FIO2: 0.30
Rate: 20/min
,PIP: 22 cm H2O
PEEP: 4 cm H2O
One hour after the respiratory rate is changed to 12/min, the ABG results are: pH 7.40,
PaCO2 36 torr, PaO2 78 torr, SaO2 98%, HCO3 21 mEq/L. The neonatal/pediatric
specialist should
A. change the respiratory rate to 15/min.
B. change the PEEP to 3 cm H2O.
C. maintain the current settings
D. prepare to extubate the neonate.
A. mandatory rate. - ANS-The neonatal/pediatric specialist is managing a 4-year-old
child with ARDS on mechanical ventilation in the Assist/Control, Volume Control mode.
In order to increase minute ventilation, the specialist should increase the
A. mandatory rate.
B. FIO2.
C. PEEP.
D. I:E ratio.
C. initiate mechanical ventilation - ANS-A newborn term infant is receiving 60% oxygen
by oxyhood. Patient assessment reveals a respiratory rate of 78/min, nasal flaring and
grunting. SpO2 with the probe on the right hand is 72%. Blood gas results obtained from
an umbilical artery catheter reveal
pH: 7.20
PaCO2: 64 torr
PaO2: 40 torr
The neonatal/pediatric specialist should
A. repeat the blood gas in one hour.
B. initiate nasal CPAP.
C. initiate mechanical ventilation.
D. increase the FIO2
B. 1 and 3 only - ANS-During mechanical ventilation of neonatal patients, a peak
inspiratory pressure of 35 cm H2O increases the risk of
1. barotrauma.
2. retinopathy of prematurity.
3. pulmonary air leaks.
A. 2 only
B. 1 and 3 only
, C. 2 and 3 only
D. 1, 2, and 3
A. resume ventilation at the previous settings. - ANS-The neonatal/pediatric specialist is
asked to evaluate a 28-week-gestation neonate undergoing a CPAP trial after several
days of mechanical ventilation. Current assessment reveals heart rate 170/min,
respiratory rate 76/min, intercostal retractions and a tracheal tug. The specialist should
A. resume ventilation at the previous settings.
B. continue CPAP trial and obtain a blood gas in one hour.
C. request a chest X-ray.
D. insert a chest tube.
D. pasteurization
steam autoclave = 121 C, 15 PSI, sterilization
ethylene oxide = expose to gas over time, time consuming
alkalinie gluteraldehyde = bacterialcidal 10 mins, sporacidal 10 hours - ANS-A
disinfection process which uses moderate temperatures to kill vegetative organisms is
best described as
A. steam under pressure.
B. ethylene oxide.
C. alkaline glutaraldehyde.
D. pasteurization
C. Non-rebreather mask - ANS-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
A. maintain the current oxygen flow. - ANS-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 2 L/min. Pulse oximetry reveals a saturation of 84%. The
specialist 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.
D. Flow is not adequate - ANS-During mechanical ventilation in Pressure Control, the
preset inspiratory pressure will not be reached in which of the following conditions?
A. Inspiratory time is too long
B. Respiratory rate is too low
C. PEEP level is excessive
D. Flow is not adequate
D. initiate a CPAP trial. - ANS-A four-week-old, 28-week-gestation infant with RDS
remains on mechanical ventilation. Current ventilator parameters are:
PIP: 22 cm H2O
Rate 10 breaths/min
FIO2: 0.30
PEEP: 4 cm H2O
Arterial blood gas analysis reveals adequate oxygenation and ventilation. The infant is
breathing spontaneously above the set rate with minimal work of breathing. The
neonatal/pediatric specialist should:
A. decrease the respiratory rate to 8 breaths/min.
B. decrease the PIP to 18 cm H2O.
C. decrease the FIO2 to 0.28.
D. initiate a CPAP trial.
C. 15 cm H2O. - ANS-A six-week-old neonate is being ventilated with time-cycled,
pressure-limited ventilation. The neonatal/pediatric specialist should not allow the mean
airway pressure value to go above
A. 5 cm H2O.
B. 10 cm H2O.
C. 15 cm H2O.
D. 20 cm H2O.
D. prepare to extubate the neonate. - ANS-A neonate with RDS is receiving mechanical
ventilation at the following settings:
Mode: PC, SIMV
FIO2: 0.30
Rate: 20/min
,PIP: 22 cm H2O
PEEP: 4 cm H2O
One hour after the respiratory rate is changed to 12/min, the ABG results are: pH 7.40,
PaCO2 36 torr, PaO2 78 torr, SaO2 98%, HCO3 21 mEq/L. The neonatal/pediatric
specialist should
A. change the respiratory rate to 15/min.
B. change the PEEP to 3 cm H2O.
C. maintain the current settings
D. prepare to extubate the neonate.
A. mandatory rate. - ANS-The neonatal/pediatric specialist is managing a 4-year-old
child with ARDS on mechanical ventilation in the Assist/Control, Volume Control mode.
In order to increase minute ventilation, the specialist should increase the
A. mandatory rate.
B. FIO2.
C. PEEP.
D. I:E ratio.
C. initiate mechanical ventilation - ANS-A newborn term infant is receiving 60% oxygen
by oxyhood. Patient assessment reveals a respiratory rate of 78/min, nasal flaring and
grunting. SpO2 with the probe on the right hand is 72%. Blood gas results obtained from
an umbilical artery catheter reveal
pH: 7.20
PaCO2: 64 torr
PaO2: 40 torr
The neonatal/pediatric specialist should
A. repeat the blood gas in one hour.
B. initiate nasal CPAP.
C. initiate mechanical ventilation.
D. increase the FIO2
B. 1 and 3 only - ANS-During mechanical ventilation of neonatal patients, a peak
inspiratory pressure of 35 cm H2O increases the risk of
1. barotrauma.
2. retinopathy of prematurity.
3. pulmonary air leaks.
A. 2 only
B. 1 and 3 only
, C. 2 and 3 only
D. 1, 2, and 3
A. resume ventilation at the previous settings. - ANS-The neonatal/pediatric specialist is
asked to evaluate a 28-week-gestation neonate undergoing a CPAP trial after several
days of mechanical ventilation. Current assessment reveals heart rate 170/min,
respiratory rate 76/min, intercostal retractions and a tracheal tug. The specialist should
A. resume ventilation at the previous settings.
B. continue CPAP trial and obtain a blood gas in one hour.
C. request a chest X-ray.
D. insert a chest tube.
D. pasteurization
steam autoclave = 121 C, 15 PSI, sterilization
ethylene oxide = expose to gas over time, time consuming
alkalinie gluteraldehyde = bacterialcidal 10 mins, sporacidal 10 hours - ANS-A
disinfection process which uses moderate temperatures to kill vegetative organisms is
best described as
A. steam under pressure.
B. ethylene oxide.
C. alkaline glutaraldehyde.
D. pasteurization
C. Non-rebreather mask - ANS-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
A. maintain the current oxygen flow. - ANS-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 2 L/min. Pulse oximetry reveals a saturation of 84%. The
specialist 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.
