AND VERIFIED ANSWERS | GRADED A+| PASS ON FIRST ATTEMPT |
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 - ANSWER D. Flow is not adequate
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. - ANSWER D. initiate a CPAP trial.
1
,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. - ANSWER C. 15 cm H2O.
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. - ANSWER D. prepare to extubate the neonate.
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
2
,A. mandatory rate.
B. FIO2.
C. PEEP.
D. I:E ratio. - ANSWER A. mandatory rate.
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 - ANSWER C. initiate mechanical ventilation
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
3
, B. 1 and 3 only
C. 2 and 3 only
D. 1, 2, and 3 - ANSWER B. 1 and 3 only
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. - ANSWER A. resume ventilation at the previous settings.
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 - ANSWER 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
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?
4
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 - ANSWER D. Flow is not adequate
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. - ANSWER D. initiate a CPAP trial.
1
,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. - ANSWER C. 15 cm H2O.
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. - ANSWER D. prepare to extubate the neonate.
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
2
,A. mandatory rate.
B. FIO2.
C. PEEP.
D. I:E ratio. - ANSWER A. mandatory rate.
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 - ANSWER C. initiate mechanical ventilation
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
3
, B. 1 and 3 only
C. 2 and 3 only
D. 1, 2, and 3 - ANSWER B. 1 and 3 only
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. - ANSWER A. resume ventilation at the previous settings.
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 - ANSWER 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
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?
4
