NPS EXAM REVIEW QUESTIONS AND
ANSWERS
What drugs are used to induce labor and when we would induce labor? - ANSWER-
Pitocin or oxytocin; used when mother has hypertension
What is the action of a tocolytic agent and what are the 2 most commonly used? -
ANSWER-Inhibits contractions
mag sulfate = anti-convulsant
tributaline = beta sympathomimemtic - relaxes smooth muscle
Describe the 4 different types of fetal presentations - ANSWER-Normal
Breech
Assisted Delivery
C-Section
Describe the 3 types of decelerations that can occur during fetal heart rate monitoring. -
ANSWER-Early or Normal
Late - HR decreases after contraction
Variable - no correlation between HR and contractions
What is maternal bleeding? - ANSWER-any vaginal bleeding after first trimester
What is PROM and what is it's affect on the neonate? - ANSWER-Rupture of amniotic
sack prior to 37 weeks gestation; infections
What are placental problems and what are the effects on the neonate? - ANSWER-
Placenta previa - low implantation of placenta
Why would corticosteroids be administered to the mother before birth? - ANSWER-to
stimulate surfactant production
What is the most important thing to do if an infant is born with meconium staining? -
ANSWER-Suction the airway
Describe Dubowitz Method. - ANSWER-7 physical and 6 neurologal findings; higher the
score the higher the gestation
Describe New Ballard Score. - ANSWER-Modified Dubowitz method; used for less than
28 weeks gestation and low birth weight of 1500 grams or less
What 5 factors are evaluated in the Apgar Score? - ANSWER-Done at 1 minute and
again at 5 minutes, and sometimes again at 10 minutes
,Appearance
Pulse
Grimace
Activity
Respirations
Each category scored from 0-2 points
What treatment would be indicated for a neonate with an Apgar score of 1? - ANSWER-
3 or less = Bad = resuscitation
4-6 = stimulate, PPV
7-10 = routine care, monitor
What is the significance of a high Silverman-Anderson Score? - ANSWER-Low score is
good; opposite of APGAR
How do we know if a neonate has a PDA? - ANSWER-pre and post ductal
pre - radial
post - umbilical line
If post is 15 or more lower = shunting = PDA
What happens to an infant's O2 consumption as the infant loses heat? - ANSWER-
decreases
Identify the four mechanisms by which infants lose heat to the environment. - ANSWER-
conduction
convection
evaporation
radiation
What are the four methods used to measure an infant's temperature? - ANSWER-
axillary
rectal
tympanic
What condition is associated with hypothermia? - ANSWER-low birth weight,
prematurity; if baby hypothermic for too long - can go apneic
Explain the difference between central cyanosis and acrocyanosis. - ANSWER-Central
cyanosis = due to hypoxemia; central part of body is cyanotic
Acrocyanosis = cyanosis of hands and feet; peripheral vasoconstriction
What is the normal respiratory rate for a term infant? - ANSWER-30-60 bpm
apnea = greater than 20 seconds without breathing
,A respiratory rate of 5 in a neonate would be described how, and what would be the
causes of this? - ANSWER-bradypnea; drugs given to mom
A respiratory rate of 80 in the neonate would be described how, and what would be the
cause of this? - ANSWER-tachypnea; hypoxemia; respiratory acidosis; heart defects
What pathologies in the neonate would cause unequal or asymmetrical chest
movement? - ANSWER-pneumothorax, atelectasis, ET tube in wrong position
What is the significance of MARKED subssternal and intrasternal retractions
accompanied by tachypnea? - ANSWER-Sign of distress!! Very Severe!!
When is transillumination of the chest recommended? - ANSWER-bright light placed
against chest wall; halo = normal
bright illumination = pneumothorax
How does a pneumothorax respond to transillumination? - ANSWER-bright illumination
What does a decrease in transillumination
indicate? - ANSWER-halo = normal
What pulse location should be used in an infant less than one year, and infant greater
than one year, and during delivery of the newborn? - ANSWER-Less than one= brachial
greater than one = carotid
during delivery = umbilical pulsation
Bounding Pulse = PDA, AV Fistula, Tetralogy of Fallot
What is the normal heart rate for a term infant? - ANSWER-Full term = 100-160 bpm
What term would describe a heart rate of 55 and what would cause this? - ANSWER-
bradycardia = less than 100; give oxygen
What term would describe a heart rate of 210 and what would cause this? - ANSWER-
tachycardia = pain, crying
Write a brief description for pulsus
alternans. - ANSWER-alteration of strong and weak beats
Write a brief description for pulsus paradoxus. - ANSWER-weaker pulse during
inspiration and stronger pulse during expiration
What pathologies would cause the trachea to shift toward the affected side? -
ANSWER-atelectasis, fibrosis
, Describe resonance. - ANSWER-normal percussion
Describe flat or dull percussion note. - ANSWER-less air than normal
Describe tympany. - ANSWER-more air than normal
Describe hyperresonance. - ANSWER-extra air
How would the breath sounds change with consolidation? - ANSWER-increased
How would the breath sounds change with Hyaline Membrane Disease? - ANSWER-
decreased
How would the breath sounds change with an occluded ET tube? - ANSWER-no breath
sounds
How would the breath sounds change with a pneumothorax? - ANSWER-unequal
What pathologies would be associated with coarse rales? - ANSWER-secretions
What pathologies would be associated with medium rales? - ANSWER-secretions
What pathologies would be associated with fine rales? - ANSWER-secretions
What pathologies would be associated with wheezes? - ANSWER-asthma, RDS, BPD
unilateral = foreign object obstruction
What pathologies would be associated with stridor? - ANSWER-high pitched; upper
airway, croup, Epiglotitis
What is the significance of the 1st and 2nd heart sounds; S1 and S2? - ANSWER-
Normal; beyond that is not normal
What is normal blood pressure for the term infant? - ANSWER-60/40
What diagnostic test should be recommended in the presence of a heart murmur? -
ANSWER-echocardiogram
Bowel sounds in the chest indicates what? - ANSWER-Diaphragmatic hernia
What are the four critical life functions listed in order of priority? - ANSWER-1.
Ventilation - inhale O2, exhale CO2
2. Oxygenation - getting O2 into the blood
3. Circulation - heart beating to move blood around to get O2 to all parts of body
4. Perfusion - blood pressure; pressures to perfuse tissue to deliver oxygen to body
cells
ANSWERS
What drugs are used to induce labor and when we would induce labor? - ANSWER-
Pitocin or oxytocin; used when mother has hypertension
What is the action of a tocolytic agent and what are the 2 most commonly used? -
ANSWER-Inhibits contractions
mag sulfate = anti-convulsant
tributaline = beta sympathomimemtic - relaxes smooth muscle
Describe the 4 different types of fetal presentations - ANSWER-Normal
Breech
Assisted Delivery
C-Section
Describe the 3 types of decelerations that can occur during fetal heart rate monitoring. -
ANSWER-Early or Normal
Late - HR decreases after contraction
Variable - no correlation between HR and contractions
What is maternal bleeding? - ANSWER-any vaginal bleeding after first trimester
What is PROM and what is it's affect on the neonate? - ANSWER-Rupture of amniotic
sack prior to 37 weeks gestation; infections
What are placental problems and what are the effects on the neonate? - ANSWER-
Placenta previa - low implantation of placenta
Why would corticosteroids be administered to the mother before birth? - ANSWER-to
stimulate surfactant production
What is the most important thing to do if an infant is born with meconium staining? -
ANSWER-Suction the airway
Describe Dubowitz Method. - ANSWER-7 physical and 6 neurologal findings; higher the
score the higher the gestation
Describe New Ballard Score. - ANSWER-Modified Dubowitz method; used for less than
28 weeks gestation and low birth weight of 1500 grams or less
What 5 factors are evaluated in the Apgar Score? - ANSWER-Done at 1 minute and
again at 5 minutes, and sometimes again at 10 minutes
,Appearance
Pulse
Grimace
Activity
Respirations
Each category scored from 0-2 points
What treatment would be indicated for a neonate with an Apgar score of 1? - ANSWER-
3 or less = Bad = resuscitation
4-6 = stimulate, PPV
7-10 = routine care, monitor
What is the significance of a high Silverman-Anderson Score? - ANSWER-Low score is
good; opposite of APGAR
How do we know if a neonate has a PDA? - ANSWER-pre and post ductal
pre - radial
post - umbilical line
If post is 15 or more lower = shunting = PDA
What happens to an infant's O2 consumption as the infant loses heat? - ANSWER-
decreases
Identify the four mechanisms by which infants lose heat to the environment. - ANSWER-
conduction
convection
evaporation
radiation
What are the four methods used to measure an infant's temperature? - ANSWER-
axillary
rectal
tympanic
What condition is associated with hypothermia? - ANSWER-low birth weight,
prematurity; if baby hypothermic for too long - can go apneic
Explain the difference between central cyanosis and acrocyanosis. - ANSWER-Central
cyanosis = due to hypoxemia; central part of body is cyanotic
Acrocyanosis = cyanosis of hands and feet; peripheral vasoconstriction
What is the normal respiratory rate for a term infant? - ANSWER-30-60 bpm
apnea = greater than 20 seconds without breathing
,A respiratory rate of 5 in a neonate would be described how, and what would be the
causes of this? - ANSWER-bradypnea; drugs given to mom
A respiratory rate of 80 in the neonate would be described how, and what would be the
cause of this? - ANSWER-tachypnea; hypoxemia; respiratory acidosis; heart defects
What pathologies in the neonate would cause unequal or asymmetrical chest
movement? - ANSWER-pneumothorax, atelectasis, ET tube in wrong position
What is the significance of MARKED subssternal and intrasternal retractions
accompanied by tachypnea? - ANSWER-Sign of distress!! Very Severe!!
When is transillumination of the chest recommended? - ANSWER-bright light placed
against chest wall; halo = normal
bright illumination = pneumothorax
How does a pneumothorax respond to transillumination? - ANSWER-bright illumination
What does a decrease in transillumination
indicate? - ANSWER-halo = normal
What pulse location should be used in an infant less than one year, and infant greater
than one year, and during delivery of the newborn? - ANSWER-Less than one= brachial
greater than one = carotid
during delivery = umbilical pulsation
Bounding Pulse = PDA, AV Fistula, Tetralogy of Fallot
What is the normal heart rate for a term infant? - ANSWER-Full term = 100-160 bpm
What term would describe a heart rate of 55 and what would cause this? - ANSWER-
bradycardia = less than 100; give oxygen
What term would describe a heart rate of 210 and what would cause this? - ANSWER-
tachycardia = pain, crying
Write a brief description for pulsus
alternans. - ANSWER-alteration of strong and weak beats
Write a brief description for pulsus paradoxus. - ANSWER-weaker pulse during
inspiration and stronger pulse during expiration
What pathologies would cause the trachea to shift toward the affected side? -
ANSWER-atelectasis, fibrosis
, Describe resonance. - ANSWER-normal percussion
Describe flat or dull percussion note. - ANSWER-less air than normal
Describe tympany. - ANSWER-more air than normal
Describe hyperresonance. - ANSWER-extra air
How would the breath sounds change with consolidation? - ANSWER-increased
How would the breath sounds change with Hyaline Membrane Disease? - ANSWER-
decreased
How would the breath sounds change with an occluded ET tube? - ANSWER-no breath
sounds
How would the breath sounds change with a pneumothorax? - ANSWER-unequal
What pathologies would be associated with coarse rales? - ANSWER-secretions
What pathologies would be associated with medium rales? - ANSWER-secretions
What pathologies would be associated with fine rales? - ANSWER-secretions
What pathologies would be associated with wheezes? - ANSWER-asthma, RDS, BPD
unilateral = foreign object obstruction
What pathologies would be associated with stridor? - ANSWER-high pitched; upper
airway, croup, Epiglotitis
What is the significance of the 1st and 2nd heart sounds; S1 and S2? - ANSWER-
Normal; beyond that is not normal
What is normal blood pressure for the term infant? - ANSWER-60/40
What diagnostic test should be recommended in the presence of a heart murmur? -
ANSWER-echocardiogram
Bowel sounds in the chest indicates what? - ANSWER-Diaphragmatic hernia
What are the four critical life functions listed in order of priority? - ANSWER-1.
Ventilation - inhale O2, exhale CO2
2. Oxygenation - getting O2 into the blood
3. Circulation - heart beating to move blood around to get O2 to all parts of body
4. Perfusion - blood pressure; pressures to perfuse tissue to deliver oxygen to body
cells
