NPS Exam Review with Complete
Solutions
What are the four critical life functions listed in order of priority? - ANS-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
What is the first step in patient assessment? - ANS-Check the chart
What would be the next steps in patient assessment? - ANS-History and Physical Exam
and check radiographs
Which of the four critical life functions are the first priority? - ANS-Ventilation
What is the definition of an emergency? - ANS-When one or more of the life functions
are being threatened.
What assessments would measure how well a patient is ventilating? - ANS-RR, breath
sounds, tidal volume, chest movement; vital signs
How would you know that a patient is having a problem with oxygenation? - ANS-
HEART RATE! This is the first thing to change if you're not oxygenating. Color,
sensorium
How will you know if a patient is circulating? - ANS-what kind of pulse, capillary refill,
cardiac output
What is the main parameter to know if someone is perfusing? - ANS-blood pressure
What other ways can perfusion be measured? - ANS-temperature, sensorium, urine
output
What is the most common life function problem? - ANS-oxygenation
What is the first drug given to everybody? - ANS-oxygen
What items should be reviewed in a patient's chart before giving respiratory therapy
treatments? - ANS-everything
,What is the age of a fetus neonate, infant, child, adolescent? - ANS-Fetus = Before birth
Neonate = 0-1 month
Infant = 1 month to 1 year
Child = 1 year to puberty
Adolescent = puberty to adult
What are the most important electrolytes and what is their function? - ANS-sodium,
chloride, potassium
What is the normal neonatal electrolyte value for sodium, chloride, and potassium? -
ANS-Sodium = 133-149 mEq/L
Chloride = 87-114 mEq/L
Potassium = 5.3-6.4 mEq/L
What is the normal urine output level for an infant? - ANS-2 mL/kg per hour
What values are included in the CBC and what are the normal values? - ANS-RBC =
4.1-5.7 mm3 WBC = 6,800-14,300 mm3 (neonates may have a higher normal WBC)
Hematocrit = 37.4-56.1%
Hemoglobin = 12.7-18.6
g/dL
low on RBC = low on hemoglobin = oxygenation affected
RBC x 3 = hemoglobin
Hemoglobin x 3 = hematocrit (know this)
What is the normal type of hemoglobin? - ANS-Hemoglobin A
What is a Coomb's test? - ANS-incomapatabilty; RH Factor; give Rogham
What does bilirubin help to evaluate? - ANS-peaks during pregnancy, after delivery
rises after few days and then falls; if baby jaundice = bilirubin problem
What is the normal value for bilirubin for a full term infant at birth? - ANS-4-5 mg/dL at
birth
How is hyper bilirubin treated? - ANS-phototherapy
What is the normal glucose level for a term infant? - ANS-55-115 mg/dL
What is the most common cause of hyperglycemia in the newborn? - ANS-infection or
sepsis
,What are 3 causes of hypoglycemia in the newborn? - ANS-happens when mom is
diabetic; prematurity, hypothermia, shock, sepsis
What procedure is required to obtain fluid for L/S ratio measurement? - ANS-
amniocentesis; very invasive
What is the significance of an L/S Ratio of 1:1? - ANS-Anything less than
2:1 = not mature lungs = increased risk for RDS
How long does it take to get the results of the Shake Test? - ANS-15 minutes
What is the significance of the presence of bubbles in the Shake Test Fluid? - ANS-
presence of mature surfactant
What information is obtained from evaluation of PG and PC levels? - ANS-lung maturity
levels
PG is best and most reliable indicator of lung maturity
What factors in the maternal history would indicate a high risk pregnancy? - ANS-
current age - less than 16 or older than 40; prenatal care; smoking; caffeine; fetal
alcohol syndrome; nutrition; diabetes; how many previous live births
What size of babies will diabetic mothers deliver? - ANS-Big babies; they look full term,
but they aren't
What is the significance of a Group B Strep Infection in the mother? - ANS-Can pass
right on to baby during delivery. Baby will be in distress.
Define Para. - ANS-Number of pregnancies resulting in live birth
Define Gravida. - ANS-Number of pregnancies
What is the difference between pre-eclampsia and eclampsia and when does this
occur? - ANS-Pre-eclampsia = high blood pressure; pregnancy induced hypertension;
protein in urine
Full Eclampsia = high blood pressure resulting in seizures or coma
Occurs when mother has hypertension; mag sulfate is used to lower blood pressure,
rest, diet, salt restrictions
Why are C-sections done and why is the infant at greater risk with this type of delivery?
- ANS-If mom is high risk, General Anesthesia can cause fetal depression
What drugs are used to induce labor and when we would induce labor? - ANS-Pitocin or
oxytocin; used when mother has hypertension
, What is the action of a tocolytic agent and what are the 2 most commonly used? - ANS-
Inhibits contractions
mag sulfate = anti-convulsant
tributaline = beta sympathomimemtic - relaxes smooth muscle
Describe the 4 different types of fetal presentations - ANS-Normal
Breech
Assisted Delivery
C-Section
Describe the 3 types of decelerations that can occur during fetal heart rate monitoring. -
ANS-Early or Normal
Late - HR decreases after contraction
Variable - no correlation between HR and contractions
What is maternal bleeding? - ANS-any vaginal bleeding after first trimester
What is PROM and what is it's affect on the neonate? - ANS-Rupture of amniotic sack
prior to 37 weeks gestation; infections
What are placental problems and what are the effects on the neonate? - ANS-Placenta
previa - low implantation of placenta
Why would corticosteroids be administered to the mother before birth? - ANS-to
stimulate surfactant production
What is the most important thing to do if an infant is born with meconium staining? -
ANS-Suction the airway
Describe Dubowitz Method. - ANS-7 physical and 6 neurologal findings; higher the
score the higher the gestation
Describe New Ballard Score. - ANS-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? - ANS-Done at 1 minute and again at
5 minutes, and sometimes again at 10 minutes
Appearance
Pulse
Grimace
Activity
Respirations
Solutions
What are the four critical life functions listed in order of priority? - ANS-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
What is the first step in patient assessment? - ANS-Check the chart
What would be the next steps in patient assessment? - ANS-History and Physical Exam
and check radiographs
Which of the four critical life functions are the first priority? - ANS-Ventilation
What is the definition of an emergency? - ANS-When one or more of the life functions
are being threatened.
What assessments would measure how well a patient is ventilating? - ANS-RR, breath
sounds, tidal volume, chest movement; vital signs
How would you know that a patient is having a problem with oxygenation? - ANS-
HEART RATE! This is the first thing to change if you're not oxygenating. Color,
sensorium
How will you know if a patient is circulating? - ANS-what kind of pulse, capillary refill,
cardiac output
What is the main parameter to know if someone is perfusing? - ANS-blood pressure
What other ways can perfusion be measured? - ANS-temperature, sensorium, urine
output
What is the most common life function problem? - ANS-oxygenation
What is the first drug given to everybody? - ANS-oxygen
What items should be reviewed in a patient's chart before giving respiratory therapy
treatments? - ANS-everything
,What is the age of a fetus neonate, infant, child, adolescent? - ANS-Fetus = Before birth
Neonate = 0-1 month
Infant = 1 month to 1 year
Child = 1 year to puberty
Adolescent = puberty to adult
What are the most important electrolytes and what is their function? - ANS-sodium,
chloride, potassium
What is the normal neonatal electrolyte value for sodium, chloride, and potassium? -
ANS-Sodium = 133-149 mEq/L
Chloride = 87-114 mEq/L
Potassium = 5.3-6.4 mEq/L
What is the normal urine output level for an infant? - ANS-2 mL/kg per hour
What values are included in the CBC and what are the normal values? - ANS-RBC =
4.1-5.7 mm3 WBC = 6,800-14,300 mm3 (neonates may have a higher normal WBC)
Hematocrit = 37.4-56.1%
Hemoglobin = 12.7-18.6
g/dL
low on RBC = low on hemoglobin = oxygenation affected
RBC x 3 = hemoglobin
Hemoglobin x 3 = hematocrit (know this)
What is the normal type of hemoglobin? - ANS-Hemoglobin A
What is a Coomb's test? - ANS-incomapatabilty; RH Factor; give Rogham
What does bilirubin help to evaluate? - ANS-peaks during pregnancy, after delivery
rises after few days and then falls; if baby jaundice = bilirubin problem
What is the normal value for bilirubin for a full term infant at birth? - ANS-4-5 mg/dL at
birth
How is hyper bilirubin treated? - ANS-phototherapy
What is the normal glucose level for a term infant? - ANS-55-115 mg/dL
What is the most common cause of hyperglycemia in the newborn? - ANS-infection or
sepsis
,What are 3 causes of hypoglycemia in the newborn? - ANS-happens when mom is
diabetic; prematurity, hypothermia, shock, sepsis
What procedure is required to obtain fluid for L/S ratio measurement? - ANS-
amniocentesis; very invasive
What is the significance of an L/S Ratio of 1:1? - ANS-Anything less than
2:1 = not mature lungs = increased risk for RDS
How long does it take to get the results of the Shake Test? - ANS-15 minutes
What is the significance of the presence of bubbles in the Shake Test Fluid? - ANS-
presence of mature surfactant
What information is obtained from evaluation of PG and PC levels? - ANS-lung maturity
levels
PG is best and most reliable indicator of lung maturity
What factors in the maternal history would indicate a high risk pregnancy? - ANS-
current age - less than 16 or older than 40; prenatal care; smoking; caffeine; fetal
alcohol syndrome; nutrition; diabetes; how many previous live births
What size of babies will diabetic mothers deliver? - ANS-Big babies; they look full term,
but they aren't
What is the significance of a Group B Strep Infection in the mother? - ANS-Can pass
right on to baby during delivery. Baby will be in distress.
Define Para. - ANS-Number of pregnancies resulting in live birth
Define Gravida. - ANS-Number of pregnancies
What is the difference between pre-eclampsia and eclampsia and when does this
occur? - ANS-Pre-eclampsia = high blood pressure; pregnancy induced hypertension;
protein in urine
Full Eclampsia = high blood pressure resulting in seizures or coma
Occurs when mother has hypertension; mag sulfate is used to lower blood pressure,
rest, diet, salt restrictions
Why are C-sections done and why is the infant at greater risk with this type of delivery?
- ANS-If mom is high risk, General Anesthesia can cause fetal depression
What drugs are used to induce labor and when we would induce labor? - ANS-Pitocin or
oxytocin; used when mother has hypertension
, What is the action of a tocolytic agent and what are the 2 most commonly used? - ANS-
Inhibits contractions
mag sulfate = anti-convulsant
tributaline = beta sympathomimemtic - relaxes smooth muscle
Describe the 4 different types of fetal presentations - ANS-Normal
Breech
Assisted Delivery
C-Section
Describe the 3 types of decelerations that can occur during fetal heart rate monitoring. -
ANS-Early or Normal
Late - HR decreases after contraction
Variable - no correlation between HR and contractions
What is maternal bleeding? - ANS-any vaginal bleeding after first trimester
What is PROM and what is it's affect on the neonate? - ANS-Rupture of amniotic sack
prior to 37 weeks gestation; infections
What are placental problems and what are the effects on the neonate? - ANS-Placenta
previa - low implantation of placenta
Why would corticosteroids be administered to the mother before birth? - ANS-to
stimulate surfactant production
What is the most important thing to do if an infant is born with meconium staining? -
ANS-Suction the airway
Describe Dubowitz Method. - ANS-7 physical and 6 neurologal findings; higher the
score the higher the gestation
Describe New Ballard Score. - ANS-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? - ANS-Done at 1 minute and again at
5 minutes, and sometimes again at 10 minutes
Appearance
Pulse
Grimace
Activity
Respirations
