C-NPT Exam 462 Questions with 100% Correct
Answers.
What is the most common acquired paralysis in a previously healthy child? - Correct
Answer Guillian Barre Syndrome
What is the most important electrolyte to replace in a dehydrated 4 week old infant with
gastric outlet obstruction? - Correct Answer Potassium
A child has a midline cyst in the neck that moves with swallowing. what is the most likely
diagnosis? - Correct Answer Thyrolglossal duct cyst
How much time does a full term neonate spend in waking state? - Correct Answer 30%
A caregiver brings a 16 month old into the ER for severe vomiting and diarrhea.
Hypovolemic shock is suspected. No cardiac abnormalities are suspected. What is the
appropriate initial bolus dose of an isotonic crystalloid solutions? - Correct Answer 20
ml/kg over 5-20 min may repeat
A newborn with meningomyelocele has surgery to close the defect but develops
hydrocephalus. What procedure is most commonly done to correct this? - Correct Answer
Ventriculoperitoneal shunt (VP)
An infant with hypertonia is born with up slanting palpebral fissures, bilateral epicanthic
fold, macroglossia, and a single transverse palmar crease. What is the most likely
diagnosis? - Correct Answer Trisomy 21
What is another name for Trisomy 21? - Correct Answer Down syndrome
What is a common cause of deaths in infants? - Correct Answer SIDS (sudden infant
death syndrome)
A 4 week old infant is brought in with a fever, poor feeding, and irritability. Physical exam
shows temp 39.4 and right otitis media with a bulging TM. The rest of the exam is normal.
Appropriate labs are obtained. What antibiotic is the best treatment in this scenario? -
Correct Answer Ampicillin and ceftriaxone
,An infant is born with agenesis of the forearm resulting in the left hand originating at the
elbow, low sloping shoulders, cardiac anomalies, a bifid thumb, and chest wall
deformities. What is the most likely diagnosis? - Correct Answer Holt Oram Syndrome
A 35 year old G3P2002 presents at 39 weeks with sever abd pain and vag bleeding. FHR
100. Stat section is performed. The neonatal team is handed a limp term infant with HR of
40 and no spontaneous breathing. The infant is aggressively resuscitated, including PPV,
intubation, UVC, EPI, Normal Saline bolus, and emergency released blood. The OB
confirms that a uterine rupture was the Etiology of the bleeding prior to delivery. The first
ABG was 6.9, 35,130, base excess -20. And lactate 16. At one hour of age she is
breathing spontaneously and has normal heart rate. She is lethargic but responsive and
has overactive deep tendon reflexes. What is the most appropriate next course of action?
- Correct Answer Therapeutic Hypothermia
What are the initial respiratory signs and symptoms of septic shock? - Correct Answer
Hyperventilation
A newborn is noted to have a reducible welling of the scrotum, what is the most likely
cause of this finding? - Correct Answer Failure of processus vaginalis to involute
A 1 week old infant born at 39 weeks by vag delivery had no complications at delivery. The
parents complain that the child's breathing sounds funny and seems to get worse when he
coughs or feeds. His breathing is described at high pitched and noisy but does get better
when he sleeps. What is the best initial management of this infant? What is this a sign of? -
Correct Answer Reassurance and supportive care
Tracheomalacia
What is the most common childhood abd malignancy? - Correct Answer Wilms Tumor
What capillary refill time in neonates would make you suspect that the term infant has
decreased intravascular volume? - Correct Answer 4-5 seconds
a 5 month old male is brought in with lethargy, a weak cry, and poor feeding. there have
been no fevers, congestion, vomiting or diarrhea. The infant has not had a bowel
movement in 3 days. normally, the patient takes 6 oz per feeding but only has been taking
2 oz. The mother is concerned the infant has been unable to hold his head up and has
been less active. PMH is unremarkable, normal delivery , neonatal screening and
vaccinations to date all normal. Exam shows no fever, normal VS, and no obvious
distress. The child is alert, mucosa is clear, and the anterior fontanelle is flat. The
cardiopulmonary exam is normal. Abd is soft without masses. Neurologic exam shows
,reactive pupils, decreased tone, and decreased gag. There is notable head lag and
diminished deep tendon relexes. What test would be most helpful in making the
diagnosis? - Correct Answer stool for botulinum toxins
With what condition will gastrografin enema NOT be therapeutically helpful? - Correct
Answer Hirschsprung disease
An 18 month old female is admitted with a left upper lobe pneumonia and the blood culture
is positive for staph A. After 24 hours the child becomes acutely hypoxic, tachypneic, and
hypotensive. On the way to see the pt, what equipment should be requested at the
bedside? - Correct Answer Large bore needle and chest tube set up
With what is Klumpke paralysis mainly associated? - Correct Answer Traction lesion of C8
and T1 spinal nerves
A newborn after having undergone a very difficult delivery is found to have an abnormal
left arm. The left arm appears to be hanging by the side and rotated medially. The forearm
is extended and pronated. The infant dose not appear to move his arm and has no
gripping action. What is the diagnosis? - Correct Answer Erb Duchenne palsy
________________ is due to paralysis of the upper brachial plexus. This injury is most
common during childbirth. - Correct Answer Erb Palsy
Where is an IO line usually inserted? - Correct Answer one finger breath below the tibial
tuberosity
In comparison to the vocal cords, where is the LMA usually placed? - Correct Answer
superior
Which is treated with fresh frozen plasma and platelets? - Correct Answer Disseminated
intravascular coagulation
What will most likely result from an injury to the middle meningeal artery? - Correct
Answer Epidural hemorrhage
During ventilation of an infant with congenital diaphragmatic hernia, what precaution
should be exercised? - Correct Answer Lower Ventilatory pressure
, A pt. with Crigler-Najjar syndrome develops kernicterus. what treatment should be
considered? - Correct Answer Plasma Exchange
What is the most common origin of arterial anomaly of origin in tetralogy of Fallot? -
Correct Answer LAD to RCA
A 2 week old female is brought to the Er with a cough, conjunctivitis, nasal congestion,
and an infiltrate on CXR. What is the most likely etiologic agent? - Correct Answer
Chlamydia
_________ is the drug of choice for chlamydia. - Correct Answer Erythromycin
A 2 year old female has been brought to your facility in cardiac arrest. As a member of the
code team, what device will best assist you the in the care of this pt? - Correct Answer
Pediatric emergency tape
Cabin altitudes of ______ feet can alter night vision. - Correct Answer 5000 feet
Inability of tissue cells to accept or utilize oxygen. Causes: CO poisoing, phosgene gas,
cyanide poisoning, alcohol, narcotics.
What type of hypoxia is this?
a. histotoxic hypoxia
b. hypemic hypoxia
c. hypoxic hypoxia
d. stagnant hypoxia - Correct Answer A. Histotoxic hypoxia
-Gravitational forces
-Temperature extremes
-Prolonged PPV
-hyperventilation
-heart failure
Causes of what type of hypoxia?
a. histotoxic hypoxia
b. hypemic hypoxia
Answers.
What is the most common acquired paralysis in a previously healthy child? - Correct
Answer Guillian Barre Syndrome
What is the most important electrolyte to replace in a dehydrated 4 week old infant with
gastric outlet obstruction? - Correct Answer Potassium
A child has a midline cyst in the neck that moves with swallowing. what is the most likely
diagnosis? - Correct Answer Thyrolglossal duct cyst
How much time does a full term neonate spend in waking state? - Correct Answer 30%
A caregiver brings a 16 month old into the ER for severe vomiting and diarrhea.
Hypovolemic shock is suspected. No cardiac abnormalities are suspected. What is the
appropriate initial bolus dose of an isotonic crystalloid solutions? - Correct Answer 20
ml/kg over 5-20 min may repeat
A newborn with meningomyelocele has surgery to close the defect but develops
hydrocephalus. What procedure is most commonly done to correct this? - Correct Answer
Ventriculoperitoneal shunt (VP)
An infant with hypertonia is born with up slanting palpebral fissures, bilateral epicanthic
fold, macroglossia, and a single transverse palmar crease. What is the most likely
diagnosis? - Correct Answer Trisomy 21
What is another name for Trisomy 21? - Correct Answer Down syndrome
What is a common cause of deaths in infants? - Correct Answer SIDS (sudden infant
death syndrome)
A 4 week old infant is brought in with a fever, poor feeding, and irritability. Physical exam
shows temp 39.4 and right otitis media with a bulging TM. The rest of the exam is normal.
Appropriate labs are obtained. What antibiotic is the best treatment in this scenario? -
Correct Answer Ampicillin and ceftriaxone
,An infant is born with agenesis of the forearm resulting in the left hand originating at the
elbow, low sloping shoulders, cardiac anomalies, a bifid thumb, and chest wall
deformities. What is the most likely diagnosis? - Correct Answer Holt Oram Syndrome
A 35 year old G3P2002 presents at 39 weeks with sever abd pain and vag bleeding. FHR
100. Stat section is performed. The neonatal team is handed a limp term infant with HR of
40 and no spontaneous breathing. The infant is aggressively resuscitated, including PPV,
intubation, UVC, EPI, Normal Saline bolus, and emergency released blood. The OB
confirms that a uterine rupture was the Etiology of the bleeding prior to delivery. The first
ABG was 6.9, 35,130, base excess -20. And lactate 16. At one hour of age she is
breathing spontaneously and has normal heart rate. She is lethargic but responsive and
has overactive deep tendon reflexes. What is the most appropriate next course of action?
- Correct Answer Therapeutic Hypothermia
What are the initial respiratory signs and symptoms of septic shock? - Correct Answer
Hyperventilation
A newborn is noted to have a reducible welling of the scrotum, what is the most likely
cause of this finding? - Correct Answer Failure of processus vaginalis to involute
A 1 week old infant born at 39 weeks by vag delivery had no complications at delivery. The
parents complain that the child's breathing sounds funny and seems to get worse when he
coughs or feeds. His breathing is described at high pitched and noisy but does get better
when he sleeps. What is the best initial management of this infant? What is this a sign of? -
Correct Answer Reassurance and supportive care
Tracheomalacia
What is the most common childhood abd malignancy? - Correct Answer Wilms Tumor
What capillary refill time in neonates would make you suspect that the term infant has
decreased intravascular volume? - Correct Answer 4-5 seconds
a 5 month old male is brought in with lethargy, a weak cry, and poor feeding. there have
been no fevers, congestion, vomiting or diarrhea. The infant has not had a bowel
movement in 3 days. normally, the patient takes 6 oz per feeding but only has been taking
2 oz. The mother is concerned the infant has been unable to hold his head up and has
been less active. PMH is unremarkable, normal delivery , neonatal screening and
vaccinations to date all normal. Exam shows no fever, normal VS, and no obvious
distress. The child is alert, mucosa is clear, and the anterior fontanelle is flat. The
cardiopulmonary exam is normal. Abd is soft without masses. Neurologic exam shows
,reactive pupils, decreased tone, and decreased gag. There is notable head lag and
diminished deep tendon relexes. What test would be most helpful in making the
diagnosis? - Correct Answer stool for botulinum toxins
With what condition will gastrografin enema NOT be therapeutically helpful? - Correct
Answer Hirschsprung disease
An 18 month old female is admitted with a left upper lobe pneumonia and the blood culture
is positive for staph A. After 24 hours the child becomes acutely hypoxic, tachypneic, and
hypotensive. On the way to see the pt, what equipment should be requested at the
bedside? - Correct Answer Large bore needle and chest tube set up
With what is Klumpke paralysis mainly associated? - Correct Answer Traction lesion of C8
and T1 spinal nerves
A newborn after having undergone a very difficult delivery is found to have an abnormal
left arm. The left arm appears to be hanging by the side and rotated medially. The forearm
is extended and pronated. The infant dose not appear to move his arm and has no
gripping action. What is the diagnosis? - Correct Answer Erb Duchenne palsy
________________ is due to paralysis of the upper brachial plexus. This injury is most
common during childbirth. - Correct Answer Erb Palsy
Where is an IO line usually inserted? - Correct Answer one finger breath below the tibial
tuberosity
In comparison to the vocal cords, where is the LMA usually placed? - Correct Answer
superior
Which is treated with fresh frozen plasma and platelets? - Correct Answer Disseminated
intravascular coagulation
What will most likely result from an injury to the middle meningeal artery? - Correct
Answer Epidural hemorrhage
During ventilation of an infant with congenital diaphragmatic hernia, what precaution
should be exercised? - Correct Answer Lower Ventilatory pressure
, A pt. with Crigler-Najjar syndrome develops kernicterus. what treatment should be
considered? - Correct Answer Plasma Exchange
What is the most common origin of arterial anomaly of origin in tetralogy of Fallot? -
Correct Answer LAD to RCA
A 2 week old female is brought to the Er with a cough, conjunctivitis, nasal congestion,
and an infiltrate on CXR. What is the most likely etiologic agent? - Correct Answer
Chlamydia
_________ is the drug of choice for chlamydia. - Correct Answer Erythromycin
A 2 year old female has been brought to your facility in cardiac arrest. As a member of the
code team, what device will best assist you the in the care of this pt? - Correct Answer
Pediatric emergency tape
Cabin altitudes of ______ feet can alter night vision. - Correct Answer 5000 feet
Inability of tissue cells to accept or utilize oxygen. Causes: CO poisoing, phosgene gas,
cyanide poisoning, alcohol, narcotics.
What type of hypoxia is this?
a. histotoxic hypoxia
b. hypemic hypoxia
c. hypoxic hypoxia
d. stagnant hypoxia - Correct Answer A. Histotoxic hypoxia
-Gravitational forces
-Temperature extremes
-Prolonged PPV
-hyperventilation
-heart failure
Causes of what type of hypoxia?
a. histotoxic hypoxia
b. hypemic hypoxia
