NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice
Questions & 100% Correct Answers 2026/2027
OBJECTIVE ASSESSMENT - EXAM
NPS Exam 2026/2027: Comprehensive Neonatal &
Pediatric Respiratory Care Study Guide with Practice
Questions & 100% Correct Answers 2026/2027
EDITION
150 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Neonatal Respiratory Care Assessment & Diagnostic Procedures
Pediatric Respiratory Care Pharmacology & Emergency Care
Mechanical Ventilation & Oxygen Therapy NPS Exam Preparation & Test-Taking
COVER PAGE - 1
, SECTION 1 | Neonatal Respiratory Care | Q1-Q25 | 2026/2027
NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice Questions & 100% Correct Answers
2026/2027
Q1 Question 1 of 150
A respiratory therapist is assessing a premature infant born at 28 weeks gestation who presents with
grunting, nasal flaring, and intercostal retractions at 4 hours of age. The therapist recognizes these
findings as classic signs of which neonatal respiratory condition?
A. Respiratory distress syndrome due to surfactant deficiency
B. Transient tachypnea of the newborn requiring observation only
C. Meconium aspiration syndrome requiring airway suctioning
D. Congenital diaphragmatic hernia requiring surgical repair
Correct Answer: A
Rationale:
Premature infants (less than 32 weeks) lack adequate surfactant production, leading to respiratory distress syndrome
(RDS) with classic signs of grunting, nasal flaring, and retractions. Transient tachypnea occurs in term infants, meconium
aspiration occurs after meconium-stained amniotic fluid, and congenital diaphragmatic hernia presents with a scaphoid
abdomen.
Q2 Question 2 of 150
A respiratory therapist is preparing to administer surfactant to a premature neonate with RDS. The
therapist knows that surfactant replacement therapy works by which mechanism?
A. Increasing alveolar surface tension to prevent collapse
B. Reducing alveolar surface tension to maintain alveolar patency and improve compliance
C. Stimulating surfactant production by type II pneumocytes only
D. Dilating bronchial smooth muscle to improve airflow
Correct Answer: B
Rationale:
Surfactant reduces alveolar surface tension, maintaining alveolar patency at end-expiration and improving lung
compliance in neonates with RDS. It does not increase surface tension (which would worsen atelectasis), and while it
may stimulate type II pneumocytes, its primary mechanism is surface tension reduction, not bronchodilation.
NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice Questions & 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 80% | Page 2 of 82
, Q3 Question 3 of 150
A respiratory therapist is caring for a term infant born through meconium-stained amniotic fluid who is
vigorous at birth with strong respiratory effort, good muscle tone, and heart rate above 100. Which
intervention is most appropriate?
A. Observation without routine intubation, with intervention only if respiratory distress develops
B. Routine intubation and tracheal suctioning regardless of infant status
C. Immediate administration of surfactant replacement therapy
D. Immediate initiation of positive pressure ventilation
Correct Answer: A
Rationale:
Current guidelines state that vigorous infants born through meconium-stained fluid do not require routine intubation and
tracheal suctioning. They should be observed closely, with intervention only if respiratory distress develops. Routine
intubation is reserved for non-vigorous infants.
Q4 Question 4 of 150
A respiratory therapist is caring for a term infant with meconium aspiration syndrome who has
developed persistent pulmonary hypertension of the newborn (PPHN). The therapist anticipates
administering which gas therapy to reduce pulmonary vascular resistance?
A. 100 percent oxygen at high flow rates
B. Inhaled nitric oxide at 20 ppm
C. Helium-oxygen mixture (heliox) at 70/30
D. Carbon dioxide in low concentrations
Correct Answer: B
Rationale:
Inhaled nitric oxide (iNO) at 20 ppm selectively dilates pulmonary vasculature, reducing pulmonary vascular resistance
and improving oxygenation in PPHN. It does not cause systemic hypotension. While oxygen is used, it is not selective for
pulmonary vasodilation, and heliox and carbon dioxide are not treatments for PPHN.
NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice Questions & 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 80% | Page 3 of 82
, Q5 Question 5 of 150
A respiratory therapist is assessing a 1-hour-old term infant with tachypnea, mild retractions, and a
benign chest radiograph showing fluid in the fissures. The infant's mother had a cesarean section
without labor. Which condition is most likely?
A. Respiratory distress syndrome due to prematurity
B. Meconium aspiration syndrome
C. Transient tachypnea of the newborn due to delayed fluid reabsorption
D. Congenital heart disease
Correct Answer: C
Rationale:
Transient tachypnea of the newborn (TTN) is common in term infants, especially after cesarean section without labor,
due to delayed reabsorption of fetal lung fluid. The chest radiograph shows fluid in the fissures and streaky perihilar
infiltrates. RDS occurs in preterm infants, meconium aspiration requires meconium exposure, and congenital heart
disease would have different findings.
Q6 Question 6 of 150
A respiratory therapist is caring for a neonate with congenital diaphragmatic hernia. Which physical
finding is most characteristic of this condition and helps distinguish it from other causes of respiratory
distress?
A. Bilateral crackles on auscultation with normal abdomen
B. Increased chest wall retractions with a distended abdomen
C. Symmetrical chest expansion with no abnormal sounds
D. Scaphoid abdomen with bowel sounds heard in the chest
Correct Answer: D
Rationale:
Congenital diaphragmatic hernia causes abdominal contents to herniate into the chest, producing a scaphoid (sunken)
abdomen and bowel sounds in the chest. Breath sounds are decreased on the affected side. The other options do not
describe this condition.
NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice Questions & 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 80% | Page 4 of 82
Questions & 100% Correct Answers 2026/2027
OBJECTIVE ASSESSMENT - EXAM
NPS Exam 2026/2027: Comprehensive Neonatal &
Pediatric Respiratory Care Study Guide with Practice
Questions & 100% Correct Answers 2026/2027
EDITION
150 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Neonatal Respiratory Care Assessment & Diagnostic Procedures
Pediatric Respiratory Care Pharmacology & Emergency Care
Mechanical Ventilation & Oxygen Therapy NPS Exam Preparation & Test-Taking
COVER PAGE - 1
, SECTION 1 | Neonatal Respiratory Care | Q1-Q25 | 2026/2027
NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice Questions & 100% Correct Answers
2026/2027
Q1 Question 1 of 150
A respiratory therapist is assessing a premature infant born at 28 weeks gestation who presents with
grunting, nasal flaring, and intercostal retractions at 4 hours of age. The therapist recognizes these
findings as classic signs of which neonatal respiratory condition?
A. Respiratory distress syndrome due to surfactant deficiency
B. Transient tachypnea of the newborn requiring observation only
C. Meconium aspiration syndrome requiring airway suctioning
D. Congenital diaphragmatic hernia requiring surgical repair
Correct Answer: A
Rationale:
Premature infants (less than 32 weeks) lack adequate surfactant production, leading to respiratory distress syndrome
(RDS) with classic signs of grunting, nasal flaring, and retractions. Transient tachypnea occurs in term infants, meconium
aspiration occurs after meconium-stained amniotic fluid, and congenital diaphragmatic hernia presents with a scaphoid
abdomen.
Q2 Question 2 of 150
A respiratory therapist is preparing to administer surfactant to a premature neonate with RDS. The
therapist knows that surfactant replacement therapy works by which mechanism?
A. Increasing alveolar surface tension to prevent collapse
B. Reducing alveolar surface tension to maintain alveolar patency and improve compliance
C. Stimulating surfactant production by type II pneumocytes only
D. Dilating bronchial smooth muscle to improve airflow
Correct Answer: B
Rationale:
Surfactant reduces alveolar surface tension, maintaining alveolar patency at end-expiration and improving lung
compliance in neonates with RDS. It does not increase surface tension (which would worsen atelectasis), and while it
may stimulate type II pneumocytes, its primary mechanism is surface tension reduction, not bronchodilation.
NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice Questions & 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 80% | Page 2 of 82
, Q3 Question 3 of 150
A respiratory therapist is caring for a term infant born through meconium-stained amniotic fluid who is
vigorous at birth with strong respiratory effort, good muscle tone, and heart rate above 100. Which
intervention is most appropriate?
A. Observation without routine intubation, with intervention only if respiratory distress develops
B. Routine intubation and tracheal suctioning regardless of infant status
C. Immediate administration of surfactant replacement therapy
D. Immediate initiation of positive pressure ventilation
Correct Answer: A
Rationale:
Current guidelines state that vigorous infants born through meconium-stained fluid do not require routine intubation and
tracheal suctioning. They should be observed closely, with intervention only if respiratory distress develops. Routine
intubation is reserved for non-vigorous infants.
Q4 Question 4 of 150
A respiratory therapist is caring for a term infant with meconium aspiration syndrome who has
developed persistent pulmonary hypertension of the newborn (PPHN). The therapist anticipates
administering which gas therapy to reduce pulmonary vascular resistance?
A. 100 percent oxygen at high flow rates
B. Inhaled nitric oxide at 20 ppm
C. Helium-oxygen mixture (heliox) at 70/30
D. Carbon dioxide in low concentrations
Correct Answer: B
Rationale:
Inhaled nitric oxide (iNO) at 20 ppm selectively dilates pulmonary vasculature, reducing pulmonary vascular resistance
and improving oxygenation in PPHN. It does not cause systemic hypotension. While oxygen is used, it is not selective for
pulmonary vasodilation, and heliox and carbon dioxide are not treatments for PPHN.
NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice Questions & 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 80% | Page 3 of 82
, Q5 Question 5 of 150
A respiratory therapist is assessing a 1-hour-old term infant with tachypnea, mild retractions, and a
benign chest radiograph showing fluid in the fissures. The infant's mother had a cesarean section
without labor. Which condition is most likely?
A. Respiratory distress syndrome due to prematurity
B. Meconium aspiration syndrome
C. Transient tachypnea of the newborn due to delayed fluid reabsorption
D. Congenital heart disease
Correct Answer: C
Rationale:
Transient tachypnea of the newborn (TTN) is common in term infants, especially after cesarean section without labor,
due to delayed reabsorption of fetal lung fluid. The chest radiograph shows fluid in the fissures and streaky perihilar
infiltrates. RDS occurs in preterm infants, meconium aspiration requires meconium exposure, and congenital heart
disease would have different findings.
Q6 Question 6 of 150
A respiratory therapist is caring for a neonate with congenital diaphragmatic hernia. Which physical
finding is most characteristic of this condition and helps distinguish it from other causes of respiratory
distress?
A. Bilateral crackles on auscultation with normal abdomen
B. Increased chest wall retractions with a distended abdomen
C. Symmetrical chest expansion with no abnormal sounds
D. Scaphoid abdomen with bowel sounds heard in the chest
Correct Answer: D
Rationale:
Congenital diaphragmatic hernia causes abdominal contents to herniate into the chest, producing a scaphoid (sunken)
abdomen and bowel sounds in the chest. Breath sounds are decreased on the affected side. The other options do not
describe this condition.
NPS Exam 2026/2027: Comprehensive Neonatal & Pediatric Respiratory Care Study Guide with Practice Questions & 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 80% | Page 4 of 82
