QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES / 2024 KETTERING NPS PRACTICE TEST QS AND
ANSWERS (BRAND NEW!)
A 6-day-old term neonate presents to the ED with profound cyanosis and hypoxia. The infant initially
did well at birth and has been home with his parents. The chest x-ray reveals an egg-shaped heart
shadow. Which of the following should the neonatal/pediatric specialist recommend to the ED
physician?
a. Indomethacin
b. Diuretic therapy
c. Balloon atrial septostomy
d. Pulmonary artery banding - ANSWER>>>>-c. balloon atrial septostomy
A three-year-old child presents to the ED. Her mother states that the child was coloring with her
older sibling when she started coughing violently. The mother noted several broken crayons on the
floor when the children were playing. Presently the child's forceful coughing has ceased with only
occasional coughs remaining. Auscultation reveals wheezing in the right upper lobe with vesicular
sounds in all other lobes. The neonatal/pediatric specialist should recommend a
a. Chest x-ray
b. Lateral neck x-ray
c. Flexible bronchoscopy
d. Rigid bronchoscopy - ANSWER>>>>-d. rigid bronchoscopy
The neonatal/pediatric specialist attends a high-risk delivery in which the newborn's buttocks and
lower extremities present first. This fetal presentation is best referred to as
a. Complete breech
b. Frank breech
c. Incomplete breech
d. Transverse lie - ANSWER>>>>-a. complete breech
Protruding intestines contained within a translucent membrane or sac best describes which of the
following conditions?
,a. Gastroschisis
b. Omphalocele
c. Myelomeningocele
d. DiGeorge Syndrome - ANSWER>>>>-b. omphalocele
A glasgow coma scale of 10 indicates
a. No head injury
b. Mild head injury
c. Moderate head injury
d. Severe head injury - ANSWER>>>>-c. moderate head injury
Which of the following should the neonatal/pediatric specialist suspect in a 1-year-old child with a
gradual onset of symptoms?
a. Foreign body aspiration
b. Asthma
c. Respiratory syncytial virus
d. epiglottitis - ANSWER>>>>-c. respiratory syncytial virus
Which of the following should the neonatal/pediatric specialist recommend for a newborn with
hyperbilirubinemia? 1. Phototherapy 2. Vitamin E 3. Nasal CPAP 4. Exchange transfusion
a. 1 and 2 only
b. 3 and 4 only
c. 1, 2 and 3 only
d. 1, 2 and 4 only - ANSWER>>>>-d. 1, 2 and 4 only
Which of the following procedures would be helpful to differentiate between persistent pulmonary
hypertension of the newborn (PPHN) and right-to-left shunting resulting from a congenital heart
defect?
a. Oxygen challenge (hyperoxia) test
b. Silverman-Anderson score
c. Hyperoxia-Hyperventilation Test
,d. Fiberoptic Transillumination - ANSWER>>>>-c. hyperoxia-hyperventilation test
During assessment of an infant's nutritional status, the neonatal/pediatric specialist notes that the
infant has a protruding belly with edematous face and limbs. This condition is best described as
a. Potter Syndrome
b. Scaphoid abdomen
c. Kwashiorkor
d. Marasmus - ANSWER>>>>-c. Kwashiorkor
A feeding tube is inserted through the nose of a full-term newborn. When evaluating the post-
procedure x-ray, the neonatal/pediatric specialist notes that the tube is coiled in the newborn's
mediastinum. This would indicate a/an
a. Diaphragmatic hernia
b.Esophageal atresia
c. Traceo-esophageal fistula
d. Choanal atresia - ANSWER>>>>-b. esophageal atresia
Which of the following should the neonatal/pediatric specialist recommend for an 8 year-old child
with cerebral atrophy and poor cognitive skills in order to promote bronchial hygiene while delivering
a bronchodilator?
a. intermittent positive pressure breathing
b. intrapulmonary percussive ventilation
c. external chest wall percussive device
d. in-exsufflator - ANSWER>>>>-b. intrapulmonary percussive ventilation
A 9 year-old boy was diagnosed with congenital muscular dystrophy at age 3 after having frequent
falls, difficulty getting up from a sitting position and walking on his toes. He also has learning
disabilities and difficulty with psychomotor coordination. After an episode of influenza, he has an
ineffective cough and is retaining secretions. Which of the following should the neonatal/pediatric
specialist recommend to assist with airway clearance?
a. Cool aerosol
b. PEP device
, c. In-exsufflator
d. IPPB therapy - ANSWER>>>>-c. in-exsufflator
A 9-year-old child aspirates while eating gummy bears with her twin sister. She was laying on her left
side at the time of aspiration. The child is in no apparent distress. The neonatal/pediatric specialist
quickly suctions the child. What should the specialist do next?
a. Sit the patient up and perform the Heimlich maneuver
b. Order a chest x-ray
c. Perform back blows
d. Roll the patient to the right side for postural drainage - ANSWER>>>>-d. roll the patient to the
right side for postural drainage
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 - ANSWER>>>>-c. non-rebreather mask
A neonatal/pediatric specialist is called to the ED to administer a bronchodilator to a 7-year-old child
with asthma. The child is on oxygen via nasal cannula at 2L/min. Pulse oximetry reveals a saturation
of 84%. The specialst finds the end of the oxygen tubing under the chair of the mother at the
bedside. The specialist reattaches the tubing and notes that the SpO2 is now 93%. The specialist
should
a. Maintain the current oxygen flow
b. Change the device to a non-rebreather mask
c. Increase the oxygen flow
d. Contact the ED physician - ANSWER>>>>-a. maintain the current oxygen flow
Which of the following could cause a loss of pressure during delivery of nasal CPAP to a neonate? 1.
Baby is crying 2. Insufficient flow 3. Obstruction 4 misplaced nasal prongs
a. 1 and 2 only