Resp 201 Exam 4 STUDY GUIDE 2026 COMPLETE
QUESTIONS WITH CORRECT DETAILED ANSWERS ||
100% GUARANTEED PASS <RECENT VERSION>
Resp 201 Exam 4 Study Guide: Comprehensive Q&A
Category 1: Neonatal & Pediatric Respiratory Care
1. What is the primary physiological trigger for a newborn's first breath?
o A. Increased PaCO2
o B. Decreased PaO2
o C. Physical stimulation and thermal change
o D. Chemical response to pH change
o Answer: The drastic change from a warm, fluid-filled uterus to a cold, dry,
gravity-based environment is the primary stimulus. Chemical changes (A, B, D)
contribute but are secondary.
2. A newborn is diagnosed with Respiratory Distress Syndrome (RDS). What is the
underlying pathophysiology?
o A. Surfactant deficiency leading to alveolar collapse
o B. Hyperactive bronchial smooth muscle
o C. Immature cilia leading to mucus plugging
o D. A diaphragmatic hernia
o Answer: RDS (Hyaline Membrane Disease) is primarily due to insufficient
surfactant production in premature infants, causing high surface tension,
atelectasis, and stiff lungs.
3. The treatment of choice for moderate to severe Neonatal RDS is:
o A. CPAP only
o B. Exogenous surfactant administration and CPAP or mechanical ventilation
o C. High-dose systemic steroids
, o D. Diuretic therapy
o Answer: Surfactant replacement therapy directly addresses the deficiency, while
respiratory support maintains adequate gas exchange.
4. What is a major potential complication of positive pressure ventilation in a premature
infant?
o A. Patent Ductus Arteriosus (PDA)
o B. Bronchopulmonary Dysplasia (BPD)
o C. Cystic Fibrosis
o D. Laryngomalacia
o Answer: BPD is a chronic lung disease often resulting from volutrauma and
barotrauma from prolonged mechanical ventilation in preemies.
5. What is the primary characteristic of Bronchopulmonary Dysplasia (BPD)?
o A. Persistent need for supplemental oxygen at 36 weeks post-menstrual age
o B. Recurrent episodes of viral bronchiolitis
o C. Congenital airway malformations
o D. Persistent pulmonary hypertension of the newborn (PPHN)
o Answer: This is the standard diagnostic criterion for BPD, indicating chronic lung
injury.
6. In Persistent Pulmonary Hypertension of the Newborn (PPHN), what pathological cycle
occurs?
o A. High pulmonary vascular resistance leads to right-to-left shunting, causing
hypoxemia.
o B. Low systemic resistance leads to left-to-right shunting, causing heart failure.
o C. Alveolar overdistension leads to pulmonary capillary damage.
o D. Air trapping leads to increased intrathoracic pressure and reduced cardiac
output.
o Answer: PPHN is characterized by failure of the fetal pulmonary vasculature to
relax, causing extrapulmonary shunting across the foramen ovale and PDA,
leading to severe hypoxemia.
,7. Which therapy is a cornerstone in the management of PPHN by promoting pulmonary
vasodilation?
o A. Inhaled Nitric Oxide (iNO)
o B. Inhaled Albuterol
o C. Systemic antibiotics
o D. Chest physiotherapy
o Answer: iNO is a selective pulmonary vasodilator, improving oxygenation without
causing systemic hypotension.
8. What is the most common cause of lower airway obstruction in infants under 1 year
old?
o A. Asthma
o B. Bronchiolitis (often caused by RSV)
o C. Epiglottitis
o D. Pneumonia
o Answer: RSV bronchiolitis causes inflammation, edema, and mucus in the small
airways (bronchioles), leading to wheezing and respiratory distress.
9. Clinical signs of severe respiratory distress in a pediatric patient include all EXCEPT:
o A. Nasal flaring, grunting, retractions
o B. Tachypnea and tachycardia
o C. Pink skin color and normal mental status
o D. Cyanosis and lethargy
o Answer: Pink skin and normal mental status are signs of adequate oxygenation
and perfusion. All other options are signs of distress/impending failure.
10. The "classic triad" of symptoms for Croup (Laryngotracheobronchitis) is:
o A. Fever, drooling, inspiratory stridor
o B. Barking cough, inspiratory stridor, hoarseness
o C. Expiratory wheeze, prolonged expiration, cough
, o D. Sudden fever, sore throat, exudative tonsils
o Answer: This triad distinguishes croup from other upper airway disorders like
epiglottitis (A).
Category 2: Mechanical Ventilation Principles & Management
11. The primary goal of mechanical ventilation is:
o A. To normalize ABGs
o B. To provide adequate ventilation and oxygenation while minimizing injury
o C. To eliminate the work of breathing completely
o D. To treat the underlying disease
o Answer: Ventilation is a supportive therapy. The goal is to support gas exchange
and buy time for healing, while preventing ventilator-induced lung injury (VILI).
12. Which ventilator mode provides a set number of mandatory breaths per minute, but
the patient can trigger additional breaths that are also fully supported?
o A. Assist/Control (A/C)
o B. Synchronized Intermittent Mandatory Ventilation (SIMV)
o C. Pressure Support Ventilation (PSV)
o D. Continuous Positive Airway Pressure (CPAP)
o Answer: In A/C, every patient effort above the set rate triggers a full ventilator
breath. All breaths (mandatory and assisted) look the same.
13. In SIMV mode, what characterizes the patient-triggered breaths between mandatory
breaths?
o A. They are pressure-supported (if set) or unsupported (flow-by).
o B. They are always full volume-controlled breaths.
o C. They are identical to the mandatory breaths.
o D. They are not allowed.
o Answer: SIMV delivers mandatory breaths at a set rate. Between these, the
patient can breathe spontaneously at their own rate and volume, often with an
added pressure support level.
QUESTIONS WITH CORRECT DETAILED ANSWERS ||
100% GUARANTEED PASS <RECENT VERSION>
Resp 201 Exam 4 Study Guide: Comprehensive Q&A
Category 1: Neonatal & Pediatric Respiratory Care
1. What is the primary physiological trigger for a newborn's first breath?
o A. Increased PaCO2
o B. Decreased PaO2
o C. Physical stimulation and thermal change
o D. Chemical response to pH change
o Answer: The drastic change from a warm, fluid-filled uterus to a cold, dry,
gravity-based environment is the primary stimulus. Chemical changes (A, B, D)
contribute but are secondary.
2. A newborn is diagnosed with Respiratory Distress Syndrome (RDS). What is the
underlying pathophysiology?
o A. Surfactant deficiency leading to alveolar collapse
o B. Hyperactive bronchial smooth muscle
o C. Immature cilia leading to mucus plugging
o D. A diaphragmatic hernia
o Answer: RDS (Hyaline Membrane Disease) is primarily due to insufficient
surfactant production in premature infants, causing high surface tension,
atelectasis, and stiff lungs.
3. The treatment of choice for moderate to severe Neonatal RDS is:
o A. CPAP only
o B. Exogenous surfactant administration and CPAP or mechanical ventilation
o C. High-dose systemic steroids
, o D. Diuretic therapy
o Answer: Surfactant replacement therapy directly addresses the deficiency, while
respiratory support maintains adequate gas exchange.
4. What is a major potential complication of positive pressure ventilation in a premature
infant?
o A. Patent Ductus Arteriosus (PDA)
o B. Bronchopulmonary Dysplasia (BPD)
o C. Cystic Fibrosis
o D. Laryngomalacia
o Answer: BPD is a chronic lung disease often resulting from volutrauma and
barotrauma from prolonged mechanical ventilation in preemies.
5. What is the primary characteristic of Bronchopulmonary Dysplasia (BPD)?
o A. Persistent need for supplemental oxygen at 36 weeks post-menstrual age
o B. Recurrent episodes of viral bronchiolitis
o C. Congenital airway malformations
o D. Persistent pulmonary hypertension of the newborn (PPHN)
o Answer: This is the standard diagnostic criterion for BPD, indicating chronic lung
injury.
6. In Persistent Pulmonary Hypertension of the Newborn (PPHN), what pathological cycle
occurs?
o A. High pulmonary vascular resistance leads to right-to-left shunting, causing
hypoxemia.
o B. Low systemic resistance leads to left-to-right shunting, causing heart failure.
o C. Alveolar overdistension leads to pulmonary capillary damage.
o D. Air trapping leads to increased intrathoracic pressure and reduced cardiac
output.
o Answer: PPHN is characterized by failure of the fetal pulmonary vasculature to
relax, causing extrapulmonary shunting across the foramen ovale and PDA,
leading to severe hypoxemia.
,7. Which therapy is a cornerstone in the management of PPHN by promoting pulmonary
vasodilation?
o A. Inhaled Nitric Oxide (iNO)
o B. Inhaled Albuterol
o C. Systemic antibiotics
o D. Chest physiotherapy
o Answer: iNO is a selective pulmonary vasodilator, improving oxygenation without
causing systemic hypotension.
8. What is the most common cause of lower airway obstruction in infants under 1 year
old?
o A. Asthma
o B. Bronchiolitis (often caused by RSV)
o C. Epiglottitis
o D. Pneumonia
o Answer: RSV bronchiolitis causes inflammation, edema, and mucus in the small
airways (bronchioles), leading to wheezing and respiratory distress.
9. Clinical signs of severe respiratory distress in a pediatric patient include all EXCEPT:
o A. Nasal flaring, grunting, retractions
o B. Tachypnea and tachycardia
o C. Pink skin color and normal mental status
o D. Cyanosis and lethargy
o Answer: Pink skin and normal mental status are signs of adequate oxygenation
and perfusion. All other options are signs of distress/impending failure.
10. The "classic triad" of symptoms for Croup (Laryngotracheobronchitis) is:
o A. Fever, drooling, inspiratory stridor
o B. Barking cough, inspiratory stridor, hoarseness
o C. Expiratory wheeze, prolonged expiration, cough
, o D. Sudden fever, sore throat, exudative tonsils
o Answer: This triad distinguishes croup from other upper airway disorders like
epiglottitis (A).
Category 2: Mechanical Ventilation Principles & Management
11. The primary goal of mechanical ventilation is:
o A. To normalize ABGs
o B. To provide adequate ventilation and oxygenation while minimizing injury
o C. To eliminate the work of breathing completely
o D. To treat the underlying disease
o Answer: Ventilation is a supportive therapy. The goal is to support gas exchange
and buy time for healing, while preventing ventilator-induced lung injury (VILI).
12. Which ventilator mode provides a set number of mandatory breaths per minute, but
the patient can trigger additional breaths that are also fully supported?
o A. Assist/Control (A/C)
o B. Synchronized Intermittent Mandatory Ventilation (SIMV)
o C. Pressure Support Ventilation (PSV)
o D. Continuous Positive Airway Pressure (CPAP)
o Answer: In A/C, every patient effort above the set rate triggers a full ventilator
breath. All breaths (mandatory and assisted) look the same.
13. In SIMV mode, what characterizes the patient-triggered breaths between mandatory
breaths?
o A. They are pressure-supported (if set) or unsupported (flow-by).
o B. They are always full volume-controlled breaths.
o C. They are identical to the mandatory breaths.
o D. They are not allowed.
o Answer: SIMV delivers mandatory breaths at a set rate. Between these, the
patient can breathe spontaneously at their own rate and volume, often with an
added pressure support level.
