1. Indications for intubating a newborn may include all of the following except:
B. initiation of nasal CPCP.
2. A neonate has the following signs and readings 1 min after birth: heart rate of 80/min, no respiratory effort, some flex- ion of extremities, grimace response to stimulation, blue limbs and pink body. The Apgar score is:
A. 3.
B. 4.
C. 5.
D. 6.
B. 4.
3. Resuscitation should ______ while the Apgar scoring is being assessed, and scoring should continue every 5 min up to 20 min if the score is less than____ .
A. continue; 7
4. A therapist is asked to intubate a 3,500-gm neonate. The appropriate supplies include a size ___ laryngoscope blade , and a size ___ endotracheal (ET) tube.
B. 1; 4; uncuffed
5. The delivery room physician asks a therapist to intubate a 800-gm neonate. Since the therapist is busy suctioning and providing bag/mask ventilation, the therapist should ask a nurse to obtain a size __ blade and a size __ endotracheal tube.
A. 00; 2.5
B. 00; 3.0
C. 1; 3.0
D. 1; 4.0
A. 00; 2.5
6. If the neonatal endotracheal tube has a vocal cord marking, it should be guided visually until the marking is:
C. at or slightly below the vocal cords.
7. When the vocal cord marking is not avail- able on the ET tube, a useful rule to esti- mate the initial depth of intubation (cm marking at the lips) is to:
D. add 6 to the infant’s weight in kilograms.
8. Prophylactic use of surfactant is indicated for all of the following neonatal conditions except:
D. less than 2,000 g birth weight.
9. Therapeutic (rescue) use of surfactant is indicated in neonates with all of the following signs except:
C. apnea.
10. Surfactants may be manufactured by all of the following methods except:
B. extraction from stem cells.
In regards to administration and use of surfactant,
D. A and B only.
12. A full-term neonate has the following umbilical artery blood gases: pH 7.42, PCO2 36 mm Hg, PO2 50 mm Hg, FIO2 60% via oxyhood. Mild cyanosis is noted. The therapist should proceed with:
A. nasal continuous positive airway pressure on 60% FIO2.
13. In egards to nasal continuous positive airway pressure (N-CPAP) therapy,
A. N-CPAP is provided by a ventilator.
B. the initial CPAP level should be 2 to 3 cm H2O.
C. N-CPAP is used to provide ventilation and oxygenation.
D. N-CPAP devices do not need supplemental humidification.
A. N-CPAP is provided by a ventilator.
. In pressure controlled ventilation, a pre- set__ is used to deliver the tidal volume, and the delivered ___ is variable in conditions of changing compliance or airflow resistance.
A. pressure; volume
15. In volume-controlled ventilation, a preset___ is used to deliver the tidal volume, and the delivered ___ is variable in conditions of changing compliance or airflow resistance.
B. volume; pressure
16. A positive response to surfactant replace- ment would lead to a sudden ___ in lung compliance and ___ of the lungs, unless the pressure is reduced immediately.
D. increase; overinflation
17. In volume-controlled ventilation, the initial tidal volume for neonates is typically set at:
D. 2 mL/kg.
18. Baby Johnson, a 28-week-gestation neo- nate, is being ventilated by a mechanical ventilator without a separate frequency control. Which of the following ventilator controls has the least direct influence on the ventilator frequency?
A. FIO2 control
19. As a therapist is doing routine ventilator check in the NICU, she notices that the in- spired gas temperature at the proximal air- way adaptor is 34°C. The therapist should:
A. increase the temperature to a range between 34°C and 37°C and document.
20. Hazards and complications associated with “rain-out” in the ventilator circuit include all of the following except:
A. increased lung compliance.
21. A neonate has been admitted to the NICU for acute respiratory distress. As a thera- pist is setting up the ventilator, the other RCP states that the baby is “hard to bag.” Based on this information, the initial peak inspiratory pressure (PIP) on the ventilator should be set from:
A. 10 to 20 cm H2O.
22. A therapist receives an order to initiate mechanical ventilation for Baby Nix, a 32-week-gestation neonate transferred to NICU following delivery. Since the therapist has not evaluated the lung compliance, the therapist should initiate mechanical ventilation with an approxi- mate tidal volume range of:
B. 3 to 7 mL/kg.
A neonate who is being mechanically ventilated has the following ventilator settings: inspiratory time 0.4 sec, inspira- tory flow rate 6 L/min, FIO2 35%, peak inspiratory pressure 15 cm H2O. Calculate the approximate tidal volume delivered by the ventilator.
C. 40 mL
A medical resident asks the therapist to differentiate the values between a capil- lary blood sample and an arterial sample. The therapist should explain that the blood gas values obtained from a capillary sample are comparable to that obtained from an arterial sample with the exception of:
D. PO2.
Baby Brown, a neonate in the NICU, has the following blood gas values obtained from the umbilical artery: pH 7.34, PaCO2 44 mm Hg, PaO2 56 mm Hg, FIO2 21%. This blood gas report shows: