Neonate Final Exam Questions With Answers 2023 (Already Graded A+)

Neonate Final Exam Questions With Answers 2023 (Already Graded A+) During the assessment of a 2-day-old infant born at 32 weeks' gestation, the following data are available: Heart rate: 122 beats/minute Respiratory rate: 50 breaths/minute, irregular with frequent periods of apnea lasting 15-25 seconds. SPO2: 86-91% Which of the following should the respiratory therapist recommend? - ANSWER Initiation of nasal CPAP at 6 cm H2O What diagnostic parameter is most often used to confirm the diagnosis of RDS? - ANSWER CXR A respiratory therapist is reviewing the electronic medical record of a laboring mother who is 100% effaced and whose cervix is 6-cm dilated. The results of the L:S was 2.5. The respiratory therapist should conclude: - ANSWER The diagnosis of respiratory distress syndrome is unlikely. Which of the following is a risk factor for meconium aspiration syndrome? - ANSWER Post term delivery Decrease in surfactant levels - ANSWER Causes atelectasis Which of the following best describes the pathophysiologic effects associated with meconium aspiration syndrome? - ANSWER Chemical pneumonitis An infant with persistent pulmonary hypertension is intubated and receiving continuous mechanical ventilatory support. The infant's pre-ductal SPO2 ranges from 95% to 98%. Which of the following should the respiratory therapist recommend? - ANSWER Maintaining current therapy Which of the following is an acute complication of RDS? - ANSWER Intraventricular hemorrhage Which of the following strategies should a respiratory therapist recommend for an infant admitted to the neonatal ICU with meconium aspiration syndrome? - ANSWER Surfactant replacement therapy Which of the following is effective in accelerating fetal lung development when a preterm delivery is eminent? - ANSWER Administration of antenatal steroids Which of the following best describes the position an infant should be placed during surfactant administration? - ANSWER Supine A respiratory therapist is reviewing the electronic medical record of a preterm infant who is intubated and receiving mechanical ventilation in the neonatal ICU. The progress note specifies the infant received prophylactic surfactant therapy. Which of the following should the respiratory therapist conclude? - ANSWER Surfactant was administered immediately following birth. Rescue surfactant is administered to: - ANSWER Preterm infants with identifiable respiratory distress syndrome. A respiratory therapist is reviewing the chest radiograph of an infant diagnosed with RDS. Which of the following findings should the respiratory therapist expect? - ANSWER Ground-glass appearance of the lungs Which of the following organisms accounts for most causes of early-onset pneumonia? - ANSWER Group B streptococcus Respiratory Distress Syndrome is 1. Mostly seen in premature neonates 2. Normally presenting shortly after birth 3. Associated with grunting of the neonate 4. Hyperinflation and perihilar streaking is seen on chest radiograph - ANSWER 1, 2 and 3 only Which of the following physiologic consequences would develop if the liquid-gas interface were without surfactant? - ANSWER Every breath would require a considerable amount of pressure to expand the lung with each inspiration. A respiratory therapist is providing 40% oxygen at 1 L/min by heated high-flow nasal cannula to a newborn admitted to the neonatal ICU with meconium aspiration syndrome. The SPO2 is 99%. Which of the following should the respiratory therapist do? - ANSWER Maintain current therapy. Early-onset pneumonia occurs within the first: - ANSWER 7 days of life. Acrocyanosis is scored as what value on the APGAR assessment? - ANSWER 1 A respiratory therapist assesses an infant born at 38 weeks' gestation, 5 minutes after birth. The infant's thorax is pink. Acrocyanosis is present. A bluish discoloration is noted on the hands and feet. Which of the following would the respiratory therapist do? - ANSWER Continue with assessment What is the primary vasopressor used in resuscitation of the newborn? - ANSWER Epinephrine Explanation: Epinephrine is recommended for heart <60 after 30 seconds of positive pressure with oxygen and chest compressions What is the definition of the sniffing position? - ANSWER Head position in which the patient is supine and the neck is slightly distended Appropriate stimulation of a newborn includes which of the following? choose all that apply? g with a warm towel ing the bottom of the feet y rubbing the back y shaking the shoulders - ANSWER g with a warm towel ing the bottom of the feet y rubbing the back The APGAR score includes which of the following criteria? choose all that apply? - ANSWER x irritability rate What assessment tool is used for the evaluation of the newborn in the delivery room? - ANSWER APGAR A newborn infant is born with secretions and needs to be suctioned. What suction pressure (negative) should be applied to accomplish this safely? - ANSWER 80-100 mmHg An infant is in the delivery room post birth. The neonate is in respiratory distress and needs to be suctioned. How long should suction be applied to the airway with each pass? - ANSWER 3-5 seconds In the delivery room it is an anticipated high risk delivery. To ensure that the RT can deliver blow by oxygen, CPAP and positive pressure ventilation, which of the following is needed? - ANSWER Flow inflating resuscitator When providing positive pressure ventilation to an newborn, what rate should the breaths be delivered? - ANSWER 40-60 A newly delivered infant needs positive pressure ventilation. What pressure (in cmH2O) should the RT not exceed to start? - ANSWER 20 A neonate has deteriorated and needs chest compressions. At what rate should the chest compressions be delivered? - ANSWER 120 A neonate is being monitored with a transcutaneous monitor during mechanical ventilation. The PTCO2 is reading 137 mmHg and PTCCO2 is reading 0 mmHg. Which of the following explains these findings? - ANSWER The electrode has become detached An infant receiving mechanical ventilation acutely develops cyanosis and a sudden drop in blood pressure. A pneumothorax is suspected but the patient's chest cannot be auscultated due to the noise level in the room. The RT should - ANSWER Transilluminate the chest A capillary blood gas sample has been obtained from a neonate. The infant is currently receiving 0.25 LPM nasal O2. The results of the CBG are as follows pH 7.35 PaCO2 44mmHg PaO2 45 mmHg What recommendation should the RT suggest? - ANSWER Further evaluation at this time Which of the following is an advantage to using a pulse oximeter? 1.Does not pick up artifact with motion 2.Can be used with poor perfusion situations 3.It can be used when the patient is hypothermic 4.It is easy to use - ANSWER 4.It is easy to use The capnograph, as opposed to the pulse oximeter, is the best monitor to insure adequate ventilation during a pediatric conscious sedation (PCS) procedure in the E.D.? True or False - ANSWER True The following ABG is drawn on a 38 week gestational age infant receiving 35% oxygen. pH 7.34 PCO2 32 mmHg PO2 68 mmHg What should the therapist recommend? A.Maintaining the FIO2 B.Decreasing the FIO2 C.Instituting nasal CPAP D.Initiating mechanical ventilation - ANSWER A.Maintaining the FIO2 A respiratory therapist prepared to draw a capillary blood gas on an infant born at 30 weeks' gestation. Which of the following sites should the respiratory therapist select to obtain the sample? - ANSWER The posterolateral aspect of the foot The therapist has been asked to measure preductal oxygen saturation. Where could the therapist place the pulse oximeter probe? - ANSWER Right hand An oxygen challenge test is performed on a term neonate. The SpO2 from the right hand is 99% and the left foot is 89%. Which of the following is most appropriate to recommend? A.Suction the neonate B.Obtain an ABG sample C.Measure the SpO2 on the left hand D.Obtain an echocardiogram - ANSWER D.Obtain an echocardiogram A neonate has a blood pressure of 80/40 mmHg. This is considered - ANSWER Normal What measures can the therapist take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate? I. Dry the infant's skin. II. Wrap the infant in pre-warmed blankets. III. Remove wet linens from around the infant. IV. Measure the neonate's body temperature. a.I, II, and IV only b.I, II, and III only c.I and II only d.IV only - ANSWER b.I, II, and III only As the head of a neonate contaminated with meconium emerges at birth, the heart rate monitor indicates 120 beats/minute, and the physician notices that the infant has good muscle tone and a strong respiratory effort. What should the physician do at this time to provide airway care? a.Perform tracheal suctioning only at this time. b.Intubate the infant immediately. c.Only routine monitoring of respiratory vital signs is needed at this time. d.Perform pharyngeal and tracheal suctioning immediately. - ANSWER c.Only routine monitoring of respiratory vital signs is needed at this time. The respiratory therapist is evaluating a child with suspected foreign body aspiration. The radiographer gently adds pressure to the abdomen during expiration to take the chest radiograph. If an obstruction is confirmed, what changes should the RT expect to see? a.The size of both lungs will decrease. b.The size of the affected lung will decrease. c.The size of the unaffected lung will increase. d.The size of the affected lung will remain the same or the lung will be hyper-expanded. - ANSWER d.The size of the affected lung will remain the same or the lung will be hyper-expanded. While percussing the thorax of a child during a physical examination, the therapist hears a dull percussion note over the child's right lung. Which of the following conditions may cause this physical finding? I. Atelectasis II. Pneumothorax III. Pleural effusion IV. Consolidation a.I, II, III, and IV b.I, III, and IV only c.I and II only d.II, III, and IV only - ANSWER b.I, III, and IV only Which of the following are criteria to order a chest radiograph in a pediatric patient who does not have chest symptoms? I. Fever II. Oxygen saturation < 95% III. White blood cell count > 20,000/mm3 IV. Creatinine > 2 mg/dL a.I and IV only b.III only c.II and III only d.I, II, and III only - ANSWER d.I, II, and III only