NeoNatal EXAM Questions with Verified
Solutions
. Before intubation, the chest radiograph of a premature newborn reveals low lung
volumes and diffuse ground-glass opacification of the lungs. These radiographic
findings are most characteristic of ______________. - ANS-Respiratory distress
syndrome
. Left lower lobe collapse (atelectasis) is associated with which of the following
radiographic findings? I. Loss of the left-side heart border II. Loss of the left
hemidiaphragm border III. Increased retrocardiac density IV. "Spine sign" - ANS-II, III,
and IV only
. Normal transition to extrauterine life depends on the pulmonary vascular system -
ANS-Changing from high pulmonary vascular resistance to low pulmonary vascular
resistance
A condition in which blood flow out of the right ventricle is obstructed because of atresia
of the pulmonary valve is more consistent with which of the following defects? - ANS-
Pulmonary atresia with intact ventricular septum
A conventional jet nebulizer with a dead volume of 1 mL is filled with a 3-mL solution of
albuterol. What percent of the medication is available for nebulization?
a.
33%
b.
50%
c.
75%
d.
100% - ANS-c
A fetus is undergoing a contraction stress test. Uterine contractions are stimulated by
the intravenous infusion of oxytocin into the mother. The fetal PO2 drops below 12 mm
Hg and causes the fetal heart rate to slow. Which of the following conditions is likely
indicated by this occurrence? - ANS-Uteroplacental insufficiency
A mother has just given birth to a 42-week infant who is small for his gestational age. A
chest radiograph of this neonate reveals coarse, patchy opacities secondary to
atelectasis from bronchial obstruction alternating with areas of hyperinflation. Which of
,the following clinical disorders does this infant likely have? - ANS-Meconium aspiration
syndrome
A mother states that she found her 18-month-old child choking near an open can of
peanuts. Which set of chest radiographs would most likely suggest airway obstruction? -
ANS-Frontal inspiratory and frontal forced expiratory
A neonate is found to have a bounding pulse. Which of the following conditions may
contribute to this finding? - ANS-Left-to-right shunt
A newborn does not appear to respond to the extrauterine environment. Both the cry
and respiratory effort are weak. Which of the following methods should the therapist use
to stimulate the newborn? - ANS-Gently rub the back.
A pediatric patient with pneumonia has an infiltrate in the lower half of the right lung.
The right heart border is obliterated. In which lobe(s) of the right lung is the infiltrate
located? - ANS-Right middle lobe
A physical examination is being performed on a newborn, and the therapist notices that
the infant's arms do not move symmetrically. Which of the following situations could
account for this problem? - ANS-An injury to the infant's brachial plexus may have
occurred during birth.
A pneumothorax is suspected on the left in a child's portable radiograph from the
intensive care unit. Which of the following may better image and confirm a suspected
pneumothorax? I. Cross-table lateral II. Upright frontal III. Left-side-down decubitus IV.
Right—down decubitus - ANS-I, II, and IV only
A pregnant woman at 30 weeks of gestation with premature rupture of membranes has
been admitted to the hospital with preterm labor. The physician has ordered
betamethasone. When does the maximal benefit of antenatal corticosteroid occur to
reduce RDS? - ANS-After 48 hours
A pregnant woman has been diagnosed with pregestational diabetes. Of which of the
following adverse fetal outcomes should the therapist be aware at the time of delivery -
ANS-Malformations of the cardiovascular system
A pregnant woman is coming for an early prenatal evaluation and wants to know if she
can listen to the baby's heartbeat. How early can the fetal heartbeat be detected? -
ANS-Day 22
A respiratory therapist has been ordered to obtain a blood gas sample from a
nonintubated premature baby. After selecting the best site to obtain the sample, what
should the RT suggest to ameliorate the pain associated with the procedure?
a.
Administer a small dose of fentanyl
, b.
Inject lidocaine at the injection site
c.
Give a pacifier dipped in 24% sucrose
d.
Administer a lidocaine drip - ANS-C
A respiratory therapist is evaluating a chest radiograph of a patient taken 2 days after
being admitted for significant respiratory distress and right middle lobe pneumonia.
Although the therapist notices a dramatic clinical improvement in the patient, the chest
X-ray appears to be more radiopaque than the one on admission. What could explain
this situation? - ANS-Incorrect exposure of the image receptor may have happened.
A therapist is called to the labor and delivery room to assist in the resuscitation of a 32-
week newborn. What FiO2 should be used to start positive pressure ventilation? - ANS-
30% and then adjusted using clinical assessment and preductal pulse oximetry
A therapist is called to the labor and delivery room to assist in the resuscitation of a term
newborn. If necessary, what FiO2 should be used to start positive pressure ventilation?
- ANS-21% and make changes utilizing preductal oximetry
A therapist is examining an AP chest radiograph of a neonate and notices a structure
projecting away from the mediastinum toward the right upper lung. This structure looks
like a sail with a sharp inferior margin and lateral margins with wavy contours. Which of
the following structures is the therapist observing? - ANS-Thymus
A therapist is monitoring a child on the mechanical ventilator who is hemodynamically
stable. The PetCO2 is 48 mm Hg. If accurate, what should be the PaCO2?
a.
43 to 48 mm Hg
b.
45 to 48 mm Hg
c.
50 to 53 mm Hg
d.
Exactly the same as PetCO2 - ANS-a
A therapist is resuscitating a term newborn. The heart rate falls to 55 beats per minute.
What is the best course of action? - ANS-Administer IV or ET epinephrine
A therapist is resuscitating a term newborn. What should be the rate of ventilation? -
ANS-40 to 60 breaths per minute
A therapist is viewing a chest X-ray of a pediatric patient who recently emerged from
general anesthesia after upper abdominal surgery. The right hemidiaphragm is
Solutions
. Before intubation, the chest radiograph of a premature newborn reveals low lung
volumes and diffuse ground-glass opacification of the lungs. These radiographic
findings are most characteristic of ______________. - ANS-Respiratory distress
syndrome
. Left lower lobe collapse (atelectasis) is associated with which of the following
radiographic findings? I. Loss of the left-side heart border II. Loss of the left
hemidiaphragm border III. Increased retrocardiac density IV. "Spine sign" - ANS-II, III,
and IV only
. Normal transition to extrauterine life depends on the pulmonary vascular system -
ANS-Changing from high pulmonary vascular resistance to low pulmonary vascular
resistance
A condition in which blood flow out of the right ventricle is obstructed because of atresia
of the pulmonary valve is more consistent with which of the following defects? - ANS-
Pulmonary atresia with intact ventricular septum
A conventional jet nebulizer with a dead volume of 1 mL is filled with a 3-mL solution of
albuterol. What percent of the medication is available for nebulization?
a.
33%
b.
50%
c.
75%
d.
100% - ANS-c
A fetus is undergoing a contraction stress test. Uterine contractions are stimulated by
the intravenous infusion of oxytocin into the mother. The fetal PO2 drops below 12 mm
Hg and causes the fetal heart rate to slow. Which of the following conditions is likely
indicated by this occurrence? - ANS-Uteroplacental insufficiency
A mother has just given birth to a 42-week infant who is small for his gestational age. A
chest radiograph of this neonate reveals coarse, patchy opacities secondary to
atelectasis from bronchial obstruction alternating with areas of hyperinflation. Which of
,the following clinical disorders does this infant likely have? - ANS-Meconium aspiration
syndrome
A mother states that she found her 18-month-old child choking near an open can of
peanuts. Which set of chest radiographs would most likely suggest airway obstruction? -
ANS-Frontal inspiratory and frontal forced expiratory
A neonate is found to have a bounding pulse. Which of the following conditions may
contribute to this finding? - ANS-Left-to-right shunt
A newborn does not appear to respond to the extrauterine environment. Both the cry
and respiratory effort are weak. Which of the following methods should the therapist use
to stimulate the newborn? - ANS-Gently rub the back.
A pediatric patient with pneumonia has an infiltrate in the lower half of the right lung.
The right heart border is obliterated. In which lobe(s) of the right lung is the infiltrate
located? - ANS-Right middle lobe
A physical examination is being performed on a newborn, and the therapist notices that
the infant's arms do not move symmetrically. Which of the following situations could
account for this problem? - ANS-An injury to the infant's brachial plexus may have
occurred during birth.
A pneumothorax is suspected on the left in a child's portable radiograph from the
intensive care unit. Which of the following may better image and confirm a suspected
pneumothorax? I. Cross-table lateral II. Upright frontal III. Left-side-down decubitus IV.
Right—down decubitus - ANS-I, II, and IV only
A pregnant woman at 30 weeks of gestation with premature rupture of membranes has
been admitted to the hospital with preterm labor. The physician has ordered
betamethasone. When does the maximal benefit of antenatal corticosteroid occur to
reduce RDS? - ANS-After 48 hours
A pregnant woman has been diagnosed with pregestational diabetes. Of which of the
following adverse fetal outcomes should the therapist be aware at the time of delivery -
ANS-Malformations of the cardiovascular system
A pregnant woman is coming for an early prenatal evaluation and wants to know if she
can listen to the baby's heartbeat. How early can the fetal heartbeat be detected? -
ANS-Day 22
A respiratory therapist has been ordered to obtain a blood gas sample from a
nonintubated premature baby. After selecting the best site to obtain the sample, what
should the RT suggest to ameliorate the pain associated with the procedure?
a.
Administer a small dose of fentanyl
, b.
Inject lidocaine at the injection site
c.
Give a pacifier dipped in 24% sucrose
d.
Administer a lidocaine drip - ANS-C
A respiratory therapist is evaluating a chest radiograph of a patient taken 2 days after
being admitted for significant respiratory distress and right middle lobe pneumonia.
Although the therapist notices a dramatic clinical improvement in the patient, the chest
X-ray appears to be more radiopaque than the one on admission. What could explain
this situation? - ANS-Incorrect exposure of the image receptor may have happened.
A therapist is called to the labor and delivery room to assist in the resuscitation of a 32-
week newborn. What FiO2 should be used to start positive pressure ventilation? - ANS-
30% and then adjusted using clinical assessment and preductal pulse oximetry
A therapist is called to the labor and delivery room to assist in the resuscitation of a term
newborn. If necessary, what FiO2 should be used to start positive pressure ventilation?
- ANS-21% and make changes utilizing preductal oximetry
A therapist is examining an AP chest radiograph of a neonate and notices a structure
projecting away from the mediastinum toward the right upper lung. This structure looks
like a sail with a sharp inferior margin and lateral margins with wavy contours. Which of
the following structures is the therapist observing? - ANS-Thymus
A therapist is monitoring a child on the mechanical ventilator who is hemodynamically
stable. The PetCO2 is 48 mm Hg. If accurate, what should be the PaCO2?
a.
43 to 48 mm Hg
b.
45 to 48 mm Hg
c.
50 to 53 mm Hg
d.
Exactly the same as PetCO2 - ANS-a
A therapist is resuscitating a term newborn. The heart rate falls to 55 beats per minute.
What is the best course of action? - ANS-Administer IV or ET epinephrine
A therapist is resuscitating a term newborn. What should be the rate of ventilation? -
ANS-40 to 60 breaths per minute
A therapist is viewing a chest X-ray of a pediatric patient who recently emerged from
general anesthesia after upper abdominal surgery. The right hemidiaphragm is
