MEDNAX NNP EXAM 2026/2027 QUESTIONS
AND CORRECT ANSWERS GRADED A+
Which of the following components increases pulmonary blood flow?
Acidosis
Alkalosis
Hypercarbia
Alkalosis
Alkalosis shifts the oxyhemoglobin dissociation curve to the left and improves
pulmonary blood flow. By modifying hemoglobin oxygen affinity, carbon dioxide
facilitates respiratory gas exchange in the lungs. At the lungs, carbon dioxide is
given up by red blood cells into the alveoli. Carbon dioxide concentration falls,
thereby shifting the oxyhemoglobin dissociation curve to the left; the increase in
hemoglobin oxygen affinity enhances uptake of oxygen from the alveoli and
enhances pulmonary flow.
In premature infants, an association has been found between intraventricular
hemorrhage (IVH) and the occurrence of:
Cardiac malformation
Pneumonia
Pneumothorax
Pneumothorax
,Which of the following leads to decreased pulmonary blood flow?
Left to right shunting
Pulmonary hyperinflation
Release of mediator substances (bradykinin, prostaglandins)
Pulmonary hyperinflation
The effect of mean airway pressure (mean Paw) on oxygenation probably is related
to optimization of lung volume and prevention of atelectasis, thus improving V/Q
relationships. However, Paw sometimes causes overdistention of airways and
alveoli, leading to an increase in dead space and right-to-left shunting of blood in
the lungs; and if a very high Paw is transmitted to the intrathoracic structures,
cardiac output could fall secondary to decreased venous return and increased
pulmonary vascular resistance, and thus despite an adequate PaO2 and oxygen
content, oxygen transport (arterial oxygen content multiplied by cardiac output)
could decrease.
Clinical findings present in an infant diagnosed with pulmonary hypertension
include:
Increased pulmonary blood flow
Increased pulmonary vascular contractility
Left to right shunting
Increased pulmonary vascular contractility
Pulmonary interstitial emphysema (PIE), seen predominantly in premature infants
who require prolonged use of assisted ventilation, often is a sequelae of:
Barotrauma
,Inadequate ventilation
Pulmonary hypoplasia
Barotrauma
The major contributor to risk for pulmonary hemorrhage among preterm infants is:
Patent ductus arteriosus (PDA)
Pneumothorax
Pulmonary interstitial emphysema (PIE)
Patent ductus arteriosus (PDA)
On a conventional ventilator, which of the following changes will have the greatest
impact on increasing the mean airway pressure?
Increasing frequency (rate)
Increasing peak end expiratory pressure (PEEP)
Increasing the peak inspiratory pressure (PIP)
Increasing peak end expiratory pressure (PEEP)
he most direct impact on mean airway pressure (mean Paw) comes from positive
end expiratory pressure (PEEP) because it is applied throughout the respiratory
cycle. PEEP is the baseline pressure, the lowest level to which airway pressure
falls. It is used to take advantage of Laplace's law, by maintaining some degree of
alveolar inflation during expiration, thus reducing the pressure necessary to further
inflate the alveolus during inspiration. There is a 1:1 relationship between PEEP
and mean Paw; for every 1-cm H2O increase in PEEP, there is a 1-cm H2O
increase in mean Paw.
, Which is the most common type of apnea in the preterm infant?
Central apnea
Mixed apnea
Obstructive apnea
Mixed apnea
The best way to maintain lung expansion using a conventional ventilator is to
increase the:
Inspiratory time
Peak inspiratory pressure (PIP)
Positive end-expiratory pressure (PEEP)
Peak inspiratory pressure (PIP)
Conventional ventilation with distending pressure is used to recruit atelectatic
alveoli. Alternative therapies of high frequency ventilation and with nasal
continuing positive airway pressure have also used.
Mechanisms of action of methylxanthines, used in the treatment of apnea of
prematurity, include:
Decreases CO2 sensitivity
Decreases diaphragmatic activity
Increases minute ventilation
Increases minute ventilation
AND CORRECT ANSWERS GRADED A+
Which of the following components increases pulmonary blood flow?
Acidosis
Alkalosis
Hypercarbia
Alkalosis
Alkalosis shifts the oxyhemoglobin dissociation curve to the left and improves
pulmonary blood flow. By modifying hemoglobin oxygen affinity, carbon dioxide
facilitates respiratory gas exchange in the lungs. At the lungs, carbon dioxide is
given up by red blood cells into the alveoli. Carbon dioxide concentration falls,
thereby shifting the oxyhemoglobin dissociation curve to the left; the increase in
hemoglobin oxygen affinity enhances uptake of oxygen from the alveoli and
enhances pulmonary flow.
In premature infants, an association has been found between intraventricular
hemorrhage (IVH) and the occurrence of:
Cardiac malformation
Pneumonia
Pneumothorax
Pneumothorax
,Which of the following leads to decreased pulmonary blood flow?
Left to right shunting
Pulmonary hyperinflation
Release of mediator substances (bradykinin, prostaglandins)
Pulmonary hyperinflation
The effect of mean airway pressure (mean Paw) on oxygenation probably is related
to optimization of lung volume and prevention of atelectasis, thus improving V/Q
relationships. However, Paw sometimes causes overdistention of airways and
alveoli, leading to an increase in dead space and right-to-left shunting of blood in
the lungs; and if a very high Paw is transmitted to the intrathoracic structures,
cardiac output could fall secondary to decreased venous return and increased
pulmonary vascular resistance, and thus despite an adequate PaO2 and oxygen
content, oxygen transport (arterial oxygen content multiplied by cardiac output)
could decrease.
Clinical findings present in an infant diagnosed with pulmonary hypertension
include:
Increased pulmonary blood flow
Increased pulmonary vascular contractility
Left to right shunting
Increased pulmonary vascular contractility
Pulmonary interstitial emphysema (PIE), seen predominantly in premature infants
who require prolonged use of assisted ventilation, often is a sequelae of:
Barotrauma
,Inadequate ventilation
Pulmonary hypoplasia
Barotrauma
The major contributor to risk for pulmonary hemorrhage among preterm infants is:
Patent ductus arteriosus (PDA)
Pneumothorax
Pulmonary interstitial emphysema (PIE)
Patent ductus arteriosus (PDA)
On a conventional ventilator, which of the following changes will have the greatest
impact on increasing the mean airway pressure?
Increasing frequency (rate)
Increasing peak end expiratory pressure (PEEP)
Increasing the peak inspiratory pressure (PIP)
Increasing peak end expiratory pressure (PEEP)
he most direct impact on mean airway pressure (mean Paw) comes from positive
end expiratory pressure (PEEP) because it is applied throughout the respiratory
cycle. PEEP is the baseline pressure, the lowest level to which airway pressure
falls. It is used to take advantage of Laplace's law, by maintaining some degree of
alveolar inflation during expiration, thus reducing the pressure necessary to further
inflate the alveolus during inspiration. There is a 1:1 relationship between PEEP
and mean Paw; for every 1-cm H2O increase in PEEP, there is a 1-cm H2O
increase in mean Paw.
, Which is the most common type of apnea in the preterm infant?
Central apnea
Mixed apnea
Obstructive apnea
Mixed apnea
The best way to maintain lung expansion using a conventional ventilator is to
increase the:
Inspiratory time
Peak inspiratory pressure (PIP)
Positive end-expiratory pressure (PEEP)
Peak inspiratory pressure (PIP)
Conventional ventilation with distending pressure is used to recruit atelectatic
alveoli. Alternative therapies of high frequency ventilation and with nasal
continuing positive airway pressure have also used.
Mechanisms of action of methylxanthines, used in the treatment of apnea of
prematurity, include:
Decreases CO2 sensitivity
Decreases diaphragmatic activity
Increases minute ventilation
Increases minute ventilation
