NPS procedures, equip, and emergency care NBRC NPS
Complete Questions With Complete Solutions
10 minutes after delivery, a 28 week, 1880g newborn has pre-
ductal SpO2 of 80%. This should be interpreted as:
A. normal
B. excessive
C. acceptable
D. hypoxemic Correct Answers D. hypoxemic
1 min = 60-65%
2 min = 65-70%
3 min = 70-75%
4 min = 75-80%
5 min = 80-85%
10 min = 85-95%
20 minutes into resuscitation of a premature newborn, blood gas
results are:
pH 7.20, PaCO2 39, PaO2 65, HCO2 16
You should recommend... Correct Answers Administer
sodium bicarbonate
A 10 year old receiving mechanical ventilation requires
transportation to another medical facility in a non-pressurized
aircraft. Using a galvanic feul cell O2 analyzer, the analyzed
FiO2 on the ground is 0.40. During transport the analyzed FiO2
reads 0.28. You should:
,A. Leave FiO2
B. replace the fuel cell on the analyzer
C. adjust the gain control on the analyzer
D. re-calibrate the analyzer Correct Answers D. re-calibrate
the analyzer
Galvanized fuel cell analyzer can be affected by changes in
altitude - FIRST step is re-calibration - if that doesn't work, then
change fuel cell
A 10-year old child has been intubated and connected to EtCO2
monitoring. The monitor displays an EtCO2 of 3 torr. This
would most likely indicate:
A. ET tube is in the esophagus
B. ET tube is in right mainstem bronchus
C. pulmonary edema is present
D. a pulmonary embolus has occured Correct Answers A. ET
tube is in esophagus - low EtCO2 after intubation
Sudden decrease in EtCO2 might indicate increased ventilation
or decreased perfusion/deadspace disease ex. PE, hypovolemia,
BPD
Increase EtCO2 = obstruction or hypoventilation
Norm PaCO2 = 40
Norm EtCO2 = 30-35
A 14-year-old patient is receiving volume-control ventilation
with a hygroscopic condenser humidifier following multiple
,trauma. Twelve hours after initiation of mechanical ventilation,
the neonatal/pediatric specialist notes an increase in the viscosity
of the patient's secretions. The specialist should
A. administer a short acting bronchodilator.
B. suction the patient frequently.
C. change to a heated wick humidifier.
D. administer a mucolytic. Correct Answers C. change to a
heated wick humidifier.
hygroscopic condenser humidifier = HME
a 15-year old arrives in the ED with an LMA in place. To
replace the LMA with an ET tube, you would:
A. remove LMA, then insert ET tube
B. insert ET tube through LMA, then remove LMA
C. Deflate cuff of LMA, insert ET tube next to LMA, then
remove LMA
D. insert a nasotracheal tube, then remove LMA Correct
Answers B. insert ET tube through LMA, then remove LMA
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?
A. Nasal cannula
B. High-flow cannula
C. Non-rebreather mask
, D. Air entrainment mask Correct Answers C. Non-rebreather
mask
a 16-year old patient underwent thoracotomy five days ago and
is resting comfortably, with stable vital signs. No bubbling has
been seen in the water seal chamber of his chest drainage system
for the past 36 hours. You should recommend:
A. removing the chest tube
B. clamping the chest tube
C. adding water to the chamber
D. increasing suction pressure Correct Answers B. clamping
the chest tube
suction control = first bottle - to suction
water-seal = middle bottle - there should be little to no bubbling
in this bottle. Continuous bubbling indicates an air leak in the
system or pleural/pulmonary space.
collection = last bottle - to patient
Tube is clamped FIRST for 24 hours before removal, then CXR
is obtained to determine if there is re accumulation of fluid/air
when removing patient should utilize valsalva maneuver, deap
breth, then bear down
A 2000g infant has been intubated and the ET tube is taped at 10
cm at the lips. Upon auscultation, you are unable to hear breath
sounds in all lung fields. Which of the following is the most
appropriate response?
Complete Questions With Complete Solutions
10 minutes after delivery, a 28 week, 1880g newborn has pre-
ductal SpO2 of 80%. This should be interpreted as:
A. normal
B. excessive
C. acceptable
D. hypoxemic Correct Answers D. hypoxemic
1 min = 60-65%
2 min = 65-70%
3 min = 70-75%
4 min = 75-80%
5 min = 80-85%
10 min = 85-95%
20 minutes into resuscitation of a premature newborn, blood gas
results are:
pH 7.20, PaCO2 39, PaO2 65, HCO2 16
You should recommend... Correct Answers Administer
sodium bicarbonate
A 10 year old receiving mechanical ventilation requires
transportation to another medical facility in a non-pressurized
aircraft. Using a galvanic feul cell O2 analyzer, the analyzed
FiO2 on the ground is 0.40. During transport the analyzed FiO2
reads 0.28. You should:
,A. Leave FiO2
B. replace the fuel cell on the analyzer
C. adjust the gain control on the analyzer
D. re-calibrate the analyzer Correct Answers D. re-calibrate
the analyzer
Galvanized fuel cell analyzer can be affected by changes in
altitude - FIRST step is re-calibration - if that doesn't work, then
change fuel cell
A 10-year old child has been intubated and connected to EtCO2
monitoring. The monitor displays an EtCO2 of 3 torr. This
would most likely indicate:
A. ET tube is in the esophagus
B. ET tube is in right mainstem bronchus
C. pulmonary edema is present
D. a pulmonary embolus has occured Correct Answers A. ET
tube is in esophagus - low EtCO2 after intubation
Sudden decrease in EtCO2 might indicate increased ventilation
or decreased perfusion/deadspace disease ex. PE, hypovolemia,
BPD
Increase EtCO2 = obstruction or hypoventilation
Norm PaCO2 = 40
Norm EtCO2 = 30-35
A 14-year-old patient is receiving volume-control ventilation
with a hygroscopic condenser humidifier following multiple
,trauma. Twelve hours after initiation of mechanical ventilation,
the neonatal/pediatric specialist notes an increase in the viscosity
of the patient's secretions. The specialist should
A. administer a short acting bronchodilator.
B. suction the patient frequently.
C. change to a heated wick humidifier.
D. administer a mucolytic. Correct Answers C. change to a
heated wick humidifier.
hygroscopic condenser humidifier = HME
a 15-year old arrives in the ED with an LMA in place. To
replace the LMA with an ET tube, you would:
A. remove LMA, then insert ET tube
B. insert ET tube through LMA, then remove LMA
C. Deflate cuff of LMA, insert ET tube next to LMA, then
remove LMA
D. insert a nasotracheal tube, then remove LMA Correct
Answers B. insert ET tube through LMA, then remove LMA
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?
A. Nasal cannula
B. High-flow cannula
C. Non-rebreather mask
, D. Air entrainment mask Correct Answers C. Non-rebreather
mask
a 16-year old patient underwent thoracotomy five days ago and
is resting comfortably, with stable vital signs. No bubbling has
been seen in the water seal chamber of his chest drainage system
for the past 36 hours. You should recommend:
A. removing the chest tube
B. clamping the chest tube
C. adding water to the chamber
D. increasing suction pressure Correct Answers B. clamping
the chest tube
suction control = first bottle - to suction
water-seal = middle bottle - there should be little to no bubbling
in this bottle. Continuous bubbling indicates an air leak in the
system or pleural/pulmonary space.
collection = last bottle - to patient
Tube is clamped FIRST for 24 hours before removal, then CXR
is obtained to determine if there is re accumulation of fluid/air
when removing patient should utilize valsalva maneuver, deap
breth, then bear down
A 2000g infant has been intubated and the ET tube is taped at 10
cm at the lips. Upon auscultation, you are unable to hear breath
sounds in all lung fields. Which of the following is the most
appropriate response?
