MCN 568 respiratory UPDATED ACTUAL
Exam Questions and CORRECT Answers
nasal flaring - CORRECT ANSWER - Early sign of respiratory distress. May be present in
intubated, ventilated patients
Grunting - CORRECT ANSWER - Commonly seen in early RDS and transient tachypnea.
A physiologic response (partial closure of the glottis during expiration) to end-expiratory
alveolar collapse. Grunting helps maintain functional residual capacity and therefore
oxygenation
Retractions - CORRECT ANSWER - Intercostal, subcostal, and sterna retractions are
present with decreased lung compliance or increased airway resistance and may persist during
mechanical ventilation if support is inadequate
tachypnea - CORRECT ANSWER - a respiratory rate >60 implies the inability to generate
an adequate tidal volume and may persist during mechanical ventilation
cyanosis - CORRECT ANSWER - central cyanosis indicates hypoxemia. cyanosis is
difficult to appreciate in the presence of anemia. acrocyanosis is common shortly after birth and
is not a reflection of hypoxemia.
abnormal breath sounds - CORRECT ANSWER - inspiratory stridor, expiratory wheezing,
and rales should be appreciable. Unfortunately, unilateral pneumothorax may excape detection
on auscultation.
blood gases - CORRECT ANSWER - management of ventilation, oxygenation, and
changes of acid-base-status is most accurately determined by arterial blood has studies
arterial blood gas studies - CORRECT ANSWER - the most standardized and accepted
measure of respiratory status, especially for the oxygenation of low birthweight infants. invasive
monitoring that requires arterial puncture or indwelling arterial line.
,normal blood gas values for term infant - CORRECT ANSWER - Pao2- 80-95
Paco2- 35-45
pH-7.32-7.38
HCO3-24-26
BE/BD-+-3.0
normal blood gas values for preterm (30-36 weeks) - CORRECT ANSWER - Pao2- 60-80
Paco2- 35-45
pH- 7.30-7.35
HCO3-22-25
BE/BD- +-3.0
normal blood gas values for preterm <30 weeks - CORRECT ANSWER - Pao2- 45-60
Paco2- 38-50
pH- 7.27-7.32
HCO3- 19-22
BE/BD- +- 4.0
Dexamethasone indication - CORRECT ANSWER - treatment of airway edema prior to
extubation. Used in infants with BPD/CLD to facilitate weaning from the ventilator. improves
compliance, decreases inflammation
dexamethasone action - CORRECT ANSWER - synthetic glucocorticoid. prevents or
suppresses inflammatory and immune response. may reduce edema and scar tissue formation.
dexamethasone adverse effects - CORRECT ANSWER - W/ long term use, increased
susceptibility to infection, osteoporosis, growth retardation, hyperglycemia, F/E imbalance,
cataracts, myopathy, GI perforation and hemorrhage, HTN, and acute adrenal insufficiency.
, albuterol - CORRECT ANSWER - Bronchodilator administered via inhalation
albuterol indication - CORRECT ANSWER - used to reduce airway resistance and
increase lung compliance in infants, particularly those with BPD. Infants with severe BPD can
have airway smooth muscle hypertrophy and airway hyperreactivity. Also used as a treatment for
bronchospasms.
albuterol adverse effects - CORRECT ANSWER - tachycardia, hypertension, and
dysrhythmias. May Need to hold for increased heart rate.
surfactant actions - CORRECT ANSWER - intended to replace the missing or inactivated
natural surfactant of the infant. Surface tension reduction and stabilization of the alveolar air-
water interface are the basic functions. air-water interface stability imparts lower alveolar surface
tension and prevents atelectasis, or alternating areas of atelectasis and hyperinflation.
principal proteins of surfactant and are hydrophobic - CORRECT ANSWER - SP-B and
SP-C
involved in surface tension reduction, tubular myelin formation, and type II cell functions -
CORRECT ANSWER - SP-B
involved in surface tension reduction and film stability - CORRECT ANSWER - SP-C
hydrophilic; their mRNA is detected earlier than 20-24 weeks - CORRECT ANSWER -
SP-A and SP-D
required for tubular myelin formation and play a role in host defense but has little or no surface-
active properties - CORRECT ANSWER - SP-A
Exam Questions and CORRECT Answers
nasal flaring - CORRECT ANSWER - Early sign of respiratory distress. May be present in
intubated, ventilated patients
Grunting - CORRECT ANSWER - Commonly seen in early RDS and transient tachypnea.
A physiologic response (partial closure of the glottis during expiration) to end-expiratory
alveolar collapse. Grunting helps maintain functional residual capacity and therefore
oxygenation
Retractions - CORRECT ANSWER - Intercostal, subcostal, and sterna retractions are
present with decreased lung compliance or increased airway resistance and may persist during
mechanical ventilation if support is inadequate
tachypnea - CORRECT ANSWER - a respiratory rate >60 implies the inability to generate
an adequate tidal volume and may persist during mechanical ventilation
cyanosis - CORRECT ANSWER - central cyanosis indicates hypoxemia. cyanosis is
difficult to appreciate in the presence of anemia. acrocyanosis is common shortly after birth and
is not a reflection of hypoxemia.
abnormal breath sounds - CORRECT ANSWER - inspiratory stridor, expiratory wheezing,
and rales should be appreciable. Unfortunately, unilateral pneumothorax may excape detection
on auscultation.
blood gases - CORRECT ANSWER - management of ventilation, oxygenation, and
changes of acid-base-status is most accurately determined by arterial blood has studies
arterial blood gas studies - CORRECT ANSWER - the most standardized and accepted
measure of respiratory status, especially for the oxygenation of low birthweight infants. invasive
monitoring that requires arterial puncture or indwelling arterial line.
,normal blood gas values for term infant - CORRECT ANSWER - Pao2- 80-95
Paco2- 35-45
pH-7.32-7.38
HCO3-24-26
BE/BD-+-3.0
normal blood gas values for preterm (30-36 weeks) - CORRECT ANSWER - Pao2- 60-80
Paco2- 35-45
pH- 7.30-7.35
HCO3-22-25
BE/BD- +-3.0
normal blood gas values for preterm <30 weeks - CORRECT ANSWER - Pao2- 45-60
Paco2- 38-50
pH- 7.27-7.32
HCO3- 19-22
BE/BD- +- 4.0
Dexamethasone indication - CORRECT ANSWER - treatment of airway edema prior to
extubation. Used in infants with BPD/CLD to facilitate weaning from the ventilator. improves
compliance, decreases inflammation
dexamethasone action - CORRECT ANSWER - synthetic glucocorticoid. prevents or
suppresses inflammatory and immune response. may reduce edema and scar tissue formation.
dexamethasone adverse effects - CORRECT ANSWER - W/ long term use, increased
susceptibility to infection, osteoporosis, growth retardation, hyperglycemia, F/E imbalance,
cataracts, myopathy, GI perforation and hemorrhage, HTN, and acute adrenal insufficiency.
, albuterol - CORRECT ANSWER - Bronchodilator administered via inhalation
albuterol indication - CORRECT ANSWER - used to reduce airway resistance and
increase lung compliance in infants, particularly those with BPD. Infants with severe BPD can
have airway smooth muscle hypertrophy and airway hyperreactivity. Also used as a treatment for
bronchospasms.
albuterol adverse effects - CORRECT ANSWER - tachycardia, hypertension, and
dysrhythmias. May Need to hold for increased heart rate.
surfactant actions - CORRECT ANSWER - intended to replace the missing or inactivated
natural surfactant of the infant. Surface tension reduction and stabilization of the alveolar air-
water interface are the basic functions. air-water interface stability imparts lower alveolar surface
tension and prevents atelectasis, or alternating areas of atelectasis and hyperinflation.
principal proteins of surfactant and are hydrophobic - CORRECT ANSWER - SP-B and
SP-C
involved in surface tension reduction, tubular myelin formation, and type II cell functions -
CORRECT ANSWER - SP-B
involved in surface tension reduction and film stability - CORRECT ANSWER - SP-C
hydrophilic; their mRNA is detected earlier than 20-24 weeks - CORRECT ANSWER -
SP-A and SP-D
required for tubular myelin formation and play a role in host defense but has little or no surface-
active properties - CORRECT ANSWER - SP-A
