NPS Guide Questions And
Answers GRADED A+ 2025-2026
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
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
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. 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
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 - ANS-C. 5mm
Tube size= age in years +16, divided by 4
Answers GRADED A+ 2025-2026
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
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
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. 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
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 - ANS-C. 5mm
Tube size= age in years +16, divided by 4
