NPS Assessment Test Questions and
Answers
B. intrauterine growth retardation (also low birth weight and preterm birth)
Central nervous system dysfunction: alcohol consumption
teratogenic effects: alcohol consumption
lower intellectual level: maternal malnutrition or diabetes - ANSWER-An infant born to a
mother who smoked cigarettes during pregnancy is at a greater risk of
A. central nervous system dysfunction
B. intrauterine growth retardation
C. teratogenic effects
D. lower intellectual level
B. 8 Fr - ANSWER-Which of the following suction catheters would be most appropriate
to use for a pediatric patient with a size 6 mm ID ETT?
A. 6 Fr
B. 8 Fr
C. 10 Fr
D. 12 Fr
C. remove and replace the ETT( the tube is obstructed, airway emergency!) -
ANSWER-While suctioning a 10-year old child receiving mechanical ventilation, the
neonatal/ pediatric specialist is unable to pass the suction catheter through the ETT.
The specialist should
A. attempt to insert a smaller catheter
B. increase the suction pressure
C. remove and replace the ETT
D. deflate and reinflate the ETT cuff
B. suction the airway, deflate the cuff, remove the tube at peak inspiration, encourage
the patient to cough, administer oxygen, and observe the patient for complications. -
ANSWER-The neonatal/ pediatric specialist is preparing to extubate a 14- year old
patient who required mechanical ventilation because of a sever exacerbation of asthma.
The specialist has obtained the equipment necessary for the procedure. in what
sequence should the specialist perform the procedure?
A. suction the airway, deflate the cuff, encourage the patient to cough, remove the tube
during exhalation, observe the patient for complications, and administer oxygen.
B. suction the airway, deflate the cuff, remove the tube at peak inspiration, encourage
the patient to cough, administer oxygen, and observe the patient for complications.
C. Deflate the cuff, suction the airway, remove the tube while suctioning, encourage the
patient to cough, administer oxygen, and observe the patient for complications.
,D. Deflate the cuff, suction the airway, remove the tube at peak inspiration, encourage
the patient to cough, and observe t
D. flexible fiberoptic bronchoscope - ANSWER-The pediatric pulmonologist is preparing
to intubate a child with laryngotracheal stenosis. Which of the following devices would
be most appropriate for this potentially difficult intubation?
A. Laryngeal mask airway
B. Laryngoscope with miller blade
C. Laryngoscope with Macintosh blade
D. Flexible fiberoptic bronchoscope
C. Change to a larger tube. (cuff pressure should not exceed 20 cm H2O, if it is higher
then the tube needs to be changed to a larger tube size) - ANSWER-An 11- year old
patient on mechanical ventilation has a size 6 mm ID cuffed ETT in place. The
neonatal/pediatric specialist uses a cufflator to measure the cuff pressure and notes that
the cuff pressure is 24 cm H2O. The specialist should
A. Maintain the current cuff pressure
B. reinflate the cuff with minimal leak technique
C. Change to a larger tube
D. Change to a smaller tube
B. reintubate the patient (airway emergency!) - ANSWER-A 5-year old patient with
epiglottitis was intubated for airway management. Following extubation, the neonatal/
pediatric specialist notes the presence of marked inspiratory stridor. The specialist
should
A. provide cool mist aerosol
B. Reintubate the patient
C. administer heliox therapy
D. administer racemic epinephrine
C. Helium- Oxygen gas mixture - ANSWER-A 2-year old patient with a severe case of
laryngotracheobronchitis was extubated earlier in the morning. The patient received
aerosolized racemic epinephrine Q6HR throughout the day. During her initial
assessment, the night shift neonatal/ pediatric specialist notes that the patient has mild
to moderated inspiratory stridor. Vital signs: BP 80/40 mmHg, HR 100/min, RR 28/min,
temp 37 degrees C, and SpO2 is 93% on 30% oxygen by cool aerosol. Which of the
following should the specialist recommend?
A. levalbuterol (Xopenex)
B. prostacyclin (flolan)
C. Helium- Oxygen gas mixture
D. Reintubate the patient
A. 1 and 2 only (also routine oral care, avoid routine circuit changes, MDI instead of
SVN, and a hi-lo tube) - ANSWER-A 3-year old patient is on mechanical ventilation after
nearly drowning in his grandmother's backyard pool. He developed a kidney infection
and has been on antibiotics for four days. The neonatal/pediatric specialist is also
,concerned about the development of ventilator- associated pneumonia. Which of the
following should the specialist recommend to reduce the risk?
1. keep head of bed elevated 30-45 degrees
2. closed suction catheters
3. change ventilator circuits every 72 hours
4. use SVN for bronchodilators instead of MDI
A. 1 and 2 only
B. 3 and 4 only
C. 1,2, and 4 only
D. 1.3. and 4 only
B. Tracheostomy tube - ANSWER-A 10-year old girl was involved in a personal
watercraft accident and suffered a C-3 fracture requiring mechanical ventilation. Nine
days following intubation, the pediatric intensivist asks the neonatal/ pediatric specialist
for a recommendation regarding an artificial airway for this patient. the specialist should
recommend a/an
A. uncuffed ETT
B. Tracheostomy tube
C. LMA
D. Carlen's tube
B. 6.5 cm (27-29 wks, 900-1000 grams)
5.5 cm for 23-24 wks or 500-600 grams
6.0 cm for 25-26 wks or 700-800 grams - ANSWER-A 28-week gestation-age neonate
requires endotracheal intubation. the inflant weighs 1kg. the appropriate length of
insertion for the ETT is
A. 5.5 cm
B. 6.5 cm
C. 7.5 cm
D. 8.5 cm
C. 5mm
Tube size= age in years +16, divided by 4 - ANSWER-The neonatal/pediatric specialist
is preparing for the intubation of a 4-year old near drowning victim. the appropriate
endotracheal tube size for this child is
A. 3mm
B. 4mm
C. 5mm
D. 6mm
C. 1,2,and 3 only - ANSWER-Which of the following should the neonatal/pediatric
specialist anticipate when using an endotracheal tube that was too large for an 8-year
old child?
, 1. Decreased perfusion of airway wall
2. Tracheal necrosis
3. Vocal cord damage
4. increased airway resistance
A. 1 and 4 only
B. 2 and 3 only
C. 1,2, and 3 only
D, 1,2,3, and 4
D. remove the ETT (an ETCO2 of zero means the tube is not in the trachea) -
ANSWER-A neonatal/pediatric specialist is re-taping an ETT on a 4-year old child in the
PICU. Following the procedure the specialist notes that the PETCO2 monitor reads
zero. Which of the following should the specialist recommend?
A. chest x-ray
B. suction the ETT
C. advance the ETT
D. remove the ETT
B. NPA - ANSWER-A 7-year old child requires frequent nasotracheal suctioning
because of copious secretions and a weak cough. To facilitate this procedure, the
neonatal/pediatric specialist should insert a
A. nasotracheal airway
B. NPA
C. replogle airway
D. coude catheter
C. increase the suction pressure. - ANSWER-While suctioning an 11-year child
receiving mechanical ventilation for PNA, the neonatal/pediatric specialist notes the
presence of tenacious secretions that are difficult to remove. The ventilator utilizes a
heated wick-style humidifier. the suction pressure is set at 85 mmHg. The specialist
should
A. replace the humidifier with an artificial nose
B. suction the child more frequently
C. increase the suction pressure
D. instill normal saline into the airway prior to suctioning
D. 1, 3, and 4 only - ANSWER-Which of the following statements are true regarding
capillary blood samples?
1. The heel should be warmed with a wet cloth
2. Capillary PO2 values correlate well with arterial PO2 values
3. Capillary pH values correlate well with arterial pH values
4. capillary PCO2 values correlate well with arterial PCO2 values
A. 1 and 2 only
B. 3 and 4 only
Answers
B. intrauterine growth retardation (also low birth weight and preterm birth)
Central nervous system dysfunction: alcohol consumption
teratogenic effects: alcohol consumption
lower intellectual level: maternal malnutrition or diabetes - ANSWER-An infant born to a
mother who smoked cigarettes during pregnancy is at a greater risk of
A. central nervous system dysfunction
B. intrauterine growth retardation
C. teratogenic effects
D. lower intellectual level
B. 8 Fr - ANSWER-Which of the following suction catheters would be most appropriate
to use for a pediatric patient with a size 6 mm ID ETT?
A. 6 Fr
B. 8 Fr
C. 10 Fr
D. 12 Fr
C. remove and replace the ETT( the tube is obstructed, airway emergency!) -
ANSWER-While suctioning a 10-year old child receiving mechanical ventilation, the
neonatal/ pediatric specialist is unable to pass the suction catheter through the ETT.
The specialist should
A. attempt to insert a smaller catheter
B. increase the suction pressure
C. remove and replace the ETT
D. deflate and reinflate the ETT cuff
B. suction the airway, deflate the cuff, remove the tube at peak inspiration, encourage
the patient to cough, administer oxygen, and observe the patient for complications. -
ANSWER-The neonatal/ pediatric specialist is preparing to extubate a 14- year old
patient who required mechanical ventilation because of a sever exacerbation of asthma.
The specialist has obtained the equipment necessary for the procedure. in what
sequence should the specialist perform the procedure?
A. suction the airway, deflate the cuff, encourage the patient to cough, remove the tube
during exhalation, observe the patient for complications, and administer oxygen.
B. suction the airway, deflate the cuff, remove the tube at peak inspiration, encourage
the patient to cough, administer oxygen, and observe the patient for complications.
C. Deflate the cuff, suction the airway, remove the tube while suctioning, encourage the
patient to cough, administer oxygen, and observe the patient for complications.
,D. Deflate the cuff, suction the airway, remove the tube at peak inspiration, encourage
the patient to cough, and observe t
D. flexible fiberoptic bronchoscope - ANSWER-The pediatric pulmonologist is preparing
to intubate a child with laryngotracheal stenosis. Which of the following devices would
be most appropriate for this potentially difficult intubation?
A. Laryngeal mask airway
B. Laryngoscope with miller blade
C. Laryngoscope with Macintosh blade
D. Flexible fiberoptic bronchoscope
C. Change to a larger tube. (cuff pressure should not exceed 20 cm H2O, if it is higher
then the tube needs to be changed to a larger tube size) - ANSWER-An 11- year old
patient on mechanical ventilation has a size 6 mm ID cuffed ETT in place. The
neonatal/pediatric specialist uses a cufflator to measure the cuff pressure and notes that
the cuff pressure is 24 cm H2O. The specialist should
A. Maintain the current cuff pressure
B. reinflate the cuff with minimal leak technique
C. Change to a larger tube
D. Change to a smaller tube
B. reintubate the patient (airway emergency!) - ANSWER-A 5-year old patient with
epiglottitis was intubated for airway management. Following extubation, the neonatal/
pediatric specialist notes the presence of marked inspiratory stridor. The specialist
should
A. provide cool mist aerosol
B. Reintubate the patient
C. administer heliox therapy
D. administer racemic epinephrine
C. Helium- Oxygen gas mixture - ANSWER-A 2-year old patient with a severe case of
laryngotracheobronchitis was extubated earlier in the morning. The patient received
aerosolized racemic epinephrine Q6HR throughout the day. During her initial
assessment, the night shift neonatal/ pediatric specialist notes that the patient has mild
to moderated inspiratory stridor. Vital signs: BP 80/40 mmHg, HR 100/min, RR 28/min,
temp 37 degrees C, and SpO2 is 93% on 30% oxygen by cool aerosol. Which of the
following should the specialist recommend?
A. levalbuterol (Xopenex)
B. prostacyclin (flolan)
C. Helium- Oxygen gas mixture
D. Reintubate the patient
A. 1 and 2 only (also routine oral care, avoid routine circuit changes, MDI instead of
SVN, and a hi-lo tube) - ANSWER-A 3-year old patient is on mechanical ventilation after
nearly drowning in his grandmother's backyard pool. He developed a kidney infection
and has been on antibiotics for four days. The neonatal/pediatric specialist is also
,concerned about the development of ventilator- associated pneumonia. Which of the
following should the specialist recommend to reduce the risk?
1. keep head of bed elevated 30-45 degrees
2. closed suction catheters
3. change ventilator circuits every 72 hours
4. use SVN for bronchodilators instead of MDI
A. 1 and 2 only
B. 3 and 4 only
C. 1,2, and 4 only
D. 1.3. and 4 only
B. Tracheostomy tube - ANSWER-A 10-year old girl was involved in a personal
watercraft accident and suffered a C-3 fracture requiring mechanical ventilation. Nine
days following intubation, the pediatric intensivist asks the neonatal/ pediatric specialist
for a recommendation regarding an artificial airway for this patient. the specialist should
recommend a/an
A. uncuffed ETT
B. Tracheostomy tube
C. LMA
D. Carlen's tube
B. 6.5 cm (27-29 wks, 900-1000 grams)
5.5 cm for 23-24 wks or 500-600 grams
6.0 cm for 25-26 wks or 700-800 grams - ANSWER-A 28-week gestation-age neonate
requires endotracheal intubation. the inflant weighs 1kg. the appropriate length of
insertion for the ETT is
A. 5.5 cm
B. 6.5 cm
C. 7.5 cm
D. 8.5 cm
C. 5mm
Tube size= age in years +16, divided by 4 - ANSWER-The neonatal/pediatric specialist
is preparing for the intubation of a 4-year old near drowning victim. the appropriate
endotracheal tube size for this child is
A. 3mm
B. 4mm
C. 5mm
D. 6mm
C. 1,2,and 3 only - ANSWER-Which of the following should the neonatal/pediatric
specialist anticipate when using an endotracheal tube that was too large for an 8-year
old child?
, 1. Decreased perfusion of airway wall
2. Tracheal necrosis
3. Vocal cord damage
4. increased airway resistance
A. 1 and 4 only
B. 2 and 3 only
C. 1,2, and 3 only
D, 1,2,3, and 4
D. remove the ETT (an ETCO2 of zero means the tube is not in the trachea) -
ANSWER-A neonatal/pediatric specialist is re-taping an ETT on a 4-year old child in the
PICU. Following the procedure the specialist notes that the PETCO2 monitor reads
zero. Which of the following should the specialist recommend?
A. chest x-ray
B. suction the ETT
C. advance the ETT
D. remove the ETT
B. NPA - ANSWER-A 7-year old child requires frequent nasotracheal suctioning
because of copious secretions and a weak cough. To facilitate this procedure, the
neonatal/pediatric specialist should insert a
A. nasotracheal airway
B. NPA
C. replogle airway
D. coude catheter
C. increase the suction pressure. - ANSWER-While suctioning an 11-year child
receiving mechanical ventilation for PNA, the neonatal/pediatric specialist notes the
presence of tenacious secretions that are difficult to remove. The ventilator utilizes a
heated wick-style humidifier. the suction pressure is set at 85 mmHg. The specialist
should
A. replace the humidifier with an artificial nose
B. suction the child more frequently
C. increase the suction pressure
D. instill normal saline into the airway prior to suctioning
D. 1, 3, and 4 only - ANSWER-Which of the following statements are true regarding
capillary blood samples?
1. The heel should be warmed with a wet cloth
2. Capillary PO2 values correlate well with arterial PO2 values
3. Capillary pH values correlate well with arterial pH values
4. capillary PCO2 values correlate well with arterial PCO2 values
A. 1 and 2 only
B. 3 and 4 only
