KETTERING NPS EXAM UPDATED
QUESTIONS AND CORRECT ANSWERS.
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 - ANS 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
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 - ANS B. 8 Fr
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
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,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 - ANS C. remove and replace the ETT( the tube is
obstructed, airway emergency!)
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 - ANS 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.
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 - ANS D. flexible fiberoptic bronchoscope
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
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,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 - ANS 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)
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 - ANS B. reintubate the patient (airway emergency!)
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 - ANS C. Helium- Oxygen gas mixture
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 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, 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 - ANS A. 1 and 2 only (also routine oral care, avoid routine circuit changes,
MDI instead of SVN, and a hi-lo tube)
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 - ANS B. Tracheostomy tube
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 - ANS 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
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
QUESTIONS AND CORRECT ANSWERS.
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 - ANS 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
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 - ANS B. 8 Fr
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
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,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 - ANS C. remove and replace the ETT( the tube is
obstructed, airway emergency!)
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 - ANS 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.
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 - ANS D. flexible fiberoptic bronchoscope
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
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,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 - ANS 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)
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 - ANS B. reintubate the patient (airway emergency!)
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 - ANS C. Helium- Oxygen gas mixture
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 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, 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 - ANS A. 1 and 2 only (also routine oral care, avoid routine circuit changes,
MDI instead of SVN, and a hi-lo tube)
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 - ANS B. Tracheostomy tube
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 - ANS 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
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
