Kettering NPS ACTUAL EXAM REVIEW 150
QUESTIONS AND CORRECT ANSWERS COVERING
RECENT MOST TESTED QUESTIONS GUARANTEE
A+ GRADE
Which of the following should the neonatal/pediatric specialist recommend for an 8 year-old child
with cerebral atrophy and poor cognitive skills in order to promote bronchial hygiene while delivering
a bronchodilator?
a. intermittent positive pressure breathing
b. intrapulmonary percussive ventilation
c. external chest wall percussive device
d. in-exsufflator - correct answer -b. intrapulmonary percussive ventilation
A 9 year-old boy was diagnosed with congenital muscular dystrophy at age 3 after having frequent
falls, difficulty getting up from a sitting position and walking on his toes. He also has learning
disabilities and difficulty with psychomotor coordination. After an episode of influenza, he has an
ineffective cough and is retaining secretions. Which of the following should the neonaatal/pediatric
specialist recommend to assist with airway clearance?
a. Cool aerosol
b. PEP device
c. In-exsufflator
d. IPPB therapy - correct answer -c. in-exsufflator
An 11-year-old patient on mechanical ventilation has a size 6 mm ID cuffed endotracheal tube in
place. The neonatal/pediatric specialist uses a cufflator to measure the cuff pressure and notes that
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 large tube
d. Change to a smaller tube - correct answer -c. change to a large tube
,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. Re Intubate the patient
c. Administer heliox therapy
d. Administer racemic epinephrine - correct answer -b. re-intubate the patient
A 2-year-old patient with a severe case of laryngotracheobronchitis was extubated earlier in the
morning. The patient received aerosolized racemic epinephrine Q6h throughout the day. During her
initial assessment, the night shift neonatal/pediatric specialist notes that the patient has mild to
moderate inspiratory stridor. Vital signs: blood pressure is 80/40 mm Hg, heart rate is 100/min,
respiratory rate is 28/min, temperature is 37 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. Re Intubate the patient - correct answer -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 VAP. Which of the following
should the specialist recommend to reduce this 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 - correct answer -a. 1 and 2 only
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 endotracheal tube
b. Tracheostomy tube
c. Laryngeal mask airway
d. Carlen's tube - correct answer -b. tracheostomy tube
A 28-week gestational-age neonate requires endotracheal intubation. The infant weighs 1 kg. The
appropriate length of insertion for the endotracheal tube is
a. 5.5 cm
b. 6.5 cm
c. 7.5 cm
d. 8.5 cm - correct answer -b. 6.5 cm
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. 3 mm
b. 4 mm
c. 5 mm
d. 6 mm - correct answer -c. 5 mm
Which of the following should the neonatal/pediatric specialist anticipate when using an endotracheal
tube that was too large for an 8-year-old child? 1. Decreased perfusion of airway wall, 2. Tracheal
necrosis, 3. Vocal cord damage, 4. Increased airway resistance
a. 1 and 4 only
b. 2 and 4 only
c. 1, 2 and 3 only
d. 1, 2, 3 and 4 - correct answer -c. 1, 2 and 3 only
A neonatal/pediatric specialist is re-taping an endotracheal tube on a 4-year-old child in the PICU.
Following the procedure the specialist notes that the PETCO2 monitor reads zero. Which of the
following should the specialist recommend?
a. Chest x-ray
, b. Suction the endotracheal tube
c. Advance the endotracheal tube
d. Remove the endotracheal tube - correct answer -d. remove the endotracheal tube
A 7-year-old child requires frequent nasotracheal suctioning because of copious secretions and a weak
cough. The facilitate this procedure, the neonatal/pediatric specialist should insert a
a. Nasotracheal airway
b. Nasopharyngeal airway
c. Replogle tube
d. Coude catheter - correct answer -b. nasopharyngeal airway
While suctioning an 11-year-old child receiving mechanical ventilation for pneumonia, the
neonatal/pediatric specialist notes the presence of tenacious secretions that are difficult to remove.
The ventilator utilizes a heated wick-style humidifier. The suction pressure is set at 85 mm Hg. The
specialist should
a. Replace the humidifier with an artificial nose
b. Suction the child more frequently
c. Increase the suction pressure
d. instill normal saline into the airway prior to suctioning - correct answer -c. increase the suction
pressure
A blood sample is drawn from the umbilical artery catheter of a term infant breathing room air, and
the following values are reported: pH 7.28, PaCO2 49 torr, PaO2 70 torr, HCO3- 20 mEq/L, BE -4. The
neonatal/pediatric specialist should interpret these results as
a. Normal, all values are within expected ranges
b. Compensated respiratory acidosis
c. Compensated metabolic acidosis
d. Uncompensated respiratory acidosis - correct answer -a. normal, all values are within expected
ranges
QUESTIONS AND CORRECT ANSWERS COVERING
RECENT MOST TESTED QUESTIONS GUARANTEE
A+ GRADE
Which of the following should the neonatal/pediatric specialist recommend for an 8 year-old child
with cerebral atrophy and poor cognitive skills in order to promote bronchial hygiene while delivering
a bronchodilator?
a. intermittent positive pressure breathing
b. intrapulmonary percussive ventilation
c. external chest wall percussive device
d. in-exsufflator - correct answer -b. intrapulmonary percussive ventilation
A 9 year-old boy was diagnosed with congenital muscular dystrophy at age 3 after having frequent
falls, difficulty getting up from a sitting position and walking on his toes. He also has learning
disabilities and difficulty with psychomotor coordination. After an episode of influenza, he has an
ineffective cough and is retaining secretions. Which of the following should the neonaatal/pediatric
specialist recommend to assist with airway clearance?
a. Cool aerosol
b. PEP device
c. In-exsufflator
d. IPPB therapy - correct answer -c. in-exsufflator
An 11-year-old patient on mechanical ventilation has a size 6 mm ID cuffed endotracheal tube in
place. The neonatal/pediatric specialist uses a cufflator to measure the cuff pressure and notes that
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 large tube
d. Change to a smaller tube - correct answer -c. change to a large tube
,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. Re Intubate the patient
c. Administer heliox therapy
d. Administer racemic epinephrine - correct answer -b. re-intubate the patient
A 2-year-old patient with a severe case of laryngotracheobronchitis was extubated earlier in the
morning. The patient received aerosolized racemic epinephrine Q6h throughout the day. During her
initial assessment, the night shift neonatal/pediatric specialist notes that the patient has mild to
moderate inspiratory stridor. Vital signs: blood pressure is 80/40 mm Hg, heart rate is 100/min,
respiratory rate is 28/min, temperature is 37 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. Re Intubate the patient - correct answer -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 VAP. Which of the following
should the specialist recommend to reduce this 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 - correct answer -a. 1 and 2 only
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 endotracheal tube
b. Tracheostomy tube
c. Laryngeal mask airway
d. Carlen's tube - correct answer -b. tracheostomy tube
A 28-week gestational-age neonate requires endotracheal intubation. The infant weighs 1 kg. The
appropriate length of insertion for the endotracheal tube is
a. 5.5 cm
b. 6.5 cm
c. 7.5 cm
d. 8.5 cm - correct answer -b. 6.5 cm
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. 3 mm
b. 4 mm
c. 5 mm
d. 6 mm - correct answer -c. 5 mm
Which of the following should the neonatal/pediatric specialist anticipate when using an endotracheal
tube that was too large for an 8-year-old child? 1. Decreased perfusion of airway wall, 2. Tracheal
necrosis, 3. Vocal cord damage, 4. Increased airway resistance
a. 1 and 4 only
b. 2 and 4 only
c. 1, 2 and 3 only
d. 1, 2, 3 and 4 - correct answer -c. 1, 2 and 3 only
A neonatal/pediatric specialist is re-taping an endotracheal tube on a 4-year-old child in the PICU.
Following the procedure the specialist notes that the PETCO2 monitor reads zero. Which of the
following should the specialist recommend?
a. Chest x-ray
, b. Suction the endotracheal tube
c. Advance the endotracheal tube
d. Remove the endotracheal tube - correct answer -d. remove the endotracheal tube
A 7-year-old child requires frequent nasotracheal suctioning because of copious secretions and a weak
cough. The facilitate this procedure, the neonatal/pediatric specialist should insert a
a. Nasotracheal airway
b. Nasopharyngeal airway
c. Replogle tube
d. Coude catheter - correct answer -b. nasopharyngeal airway
While suctioning an 11-year-old child receiving mechanical ventilation for pneumonia, the
neonatal/pediatric specialist notes the presence of tenacious secretions that are difficult to remove.
The ventilator utilizes a heated wick-style humidifier. The suction pressure is set at 85 mm Hg. The
specialist should
a. Replace the humidifier with an artificial nose
b. Suction the child more frequently
c. Increase the suction pressure
d. instill normal saline into the airway prior to suctioning - correct answer -c. increase the suction
pressure
A blood sample is drawn from the umbilical artery catheter of a term infant breathing room air, and
the following values are reported: pH 7.28, PaCO2 49 torr, PaO2 70 torr, HCO3- 20 mEq/L, BE -4. The
neonatal/pediatric specialist should interpret these results as
a. Normal, all values are within expected ranges
b. Compensated respiratory acidosis
c. Compensated metabolic acidosis
d. Uncompensated respiratory acidosis - correct answer -a. normal, all values are within expected
ranges
