Kettering NPS ACTUAL EXAM REVIEW 300
QUESTIONS AND CORRECT ANSWERS COVERING
RECENT MOST TESTED QUESTIONS GUARANTEE
A+ GRADE
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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -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 - 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 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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -C. 5mm
Tube size= age in years +16, divided by 4
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
QUESTIONS AND CORRECT ANSWERS COVERING
RECENT MOST TESTED QUESTIONS GUARANTEE
A+ GRADE
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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -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 - 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 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 - correct answer -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 - correct answer -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 - correct answer -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 - correct answer -C. 5mm
Tube size= age in years +16, divided by 4
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
