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A 10-year-old boy is to perform hyperinflation therapy with an incentive spirometer
following abdominal surgery. Preoperative spirometry documented a vital capacity of
2400 mL and an inspiratory capacity of 1400 mL. The neonatal/pediatric specialist
should set the initial volume goal on the incentive spirometer at - CORRECT ANSWER:
700
A 10-year-old child develops ARDS following smoke inhalation and requires mechanical
ventilation in the VC, A/C mode. The following information is available:
Set VT:525 mLMandatory rate:15/minActual rate:15/minInspiratory time:0.8
secFIO2:0.90Peak Pressure:30 cm H2OPlateau Pressure:25 cm H2OPEEP:15 cm H2O
Following a recruitment maneuver, the neonatal/pediatric specialist notes that the SpO2
rises to 91% for several minutes before falling to 82%. The specialist should -
CORRECT ANSWER: repeat the recruitment maneuver
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 - CORRECT
ANSWER: tracheostomy tube
children over 8 require cuffed ETT
Carlen's tube also known as a endobronchial tube and can be used for independent
lung ventilation
,A 12-year-old 37 kg child requires mechanical ventilation following a skateboard
accident in which he suffered blunt chest trauma.Vital signs reveal:Heart rate:
76/minuteRespiratory rate: 14/minBlood pressure: 98/70 mm HgSpO2: 88%The current
ventilator settings are:
VT:300 mLMandatory rate:14/minuteFIO2:0.70PEEP:5 cm H2O
The most recent ABG results are:
pH:7.36PaCO2:40 torrPaO2:58 torrHCO3-:22 mEq/L
The neonatal/pediatric specialist should increase the - CORRECT ANSWER: increase
the PEEP
A 12-year-old child is evaluated for sleep apnea. During polysomnography, he has
multiple episodes in which his chest movement increases but his nasal air flow ceases.
The neonatal/pediatric specialist should interpret these findings as - CORRECT
ANSWER: obstructive sleep apnea
A 13-year-old patient is in the ICU following an ATV accident during which he suffered
head trauma and a broken femur. Following insertion of a pulmonary artery catheter, his
cardiac output is 6.0 L/min as determined by thermal dilution. His body surface area is
estimated at 1.5 m2. The patient's cardiac index is - CORRECT ANSWER: cardiac
index = CQ/body serface area
6/1.5=4l/min/m2
A 14-day-old, 44-week gestation-age neonate with meconium aspiration receives
mechanical ventilation. Currently, the infant requires a mean airway pressure of 20 cm
H2O and 100% oxygen to maintain a PaO2 of 40 torr. Which of the following should the
neonatal/pediatric specialist recommend based on this patient's Oxygen Index (OI)? -
CORRECT ANSWER: initiate ECMO
MAP*fio2 / pao2 *100 = Oxygen index
A 14-year-old boy was involved in a snowmobile accident and admitted to the trauma
unit. The patient has been successfully weaned from mechanical ventilation and is
currently on oxygen via high flow nasal cannula. He has a chest tube that has been
,clamped for 24 hours and the neonatal/pediatric specialist is asked to evaluate the
patient. The patient's heart rate is 102/min and respiratory rate is 32/min. The most
recent chest x-ray demonstrates a right basilar infiltrate with obliteration of the right
costophrenic angle. The specialist should - CORRECT ANSWER: release the clamp on
the chest tube
A 14-year-old patient in the Cardio Vascular ICU is monitored with a pulmonary artery
catheter following a mitral-valve replacement. Which of the following hemodynamic
values should the neonatal/pediatric specialist monitor in order to evaluate the function
of the left side of the heart? - CORRECT ANSWER: pcwp
pap, map is lung problem pulmonary hypertension
A 14-year-old patient receives volume-control ventilation with a hygroscopic condenser
humidifier following multiple trauma. Twelve hours after initiation of mechanical
ventilation, the neonatal/pediatric specialist notes an increase in the viscosity of the
patient's secretions. The specialist should - CORRECT ANSWER: change to a heated
wick humidifier
A 15-year-old child receives mechanical ventilation following a motor vehicle accident.
The following information is available:
Set VT:525 mLPeak Pressure:30 cm H2OPlateau Pressure:25 cm H2OPEEP:5 cm
H2OTubing Compliance:1 mL/cm H2O
What is the child's static lung compliance? - CORRECT ANSWER: 25
tv/plat-peep
corrected tv is pip-peep
A 15-year-old patient who suffered trauma in a skateboard accident receives
mechanical ventilation. The neonatal/pediatric specialist notes evidence of auto-PEEP
, while observing the flow-time airway graphic. The specialist should - CORRECT
ANSWER: increase flow, decrease iT, increase ET
A 15-year-old patient with asthma presents to the ED in moderate distress. Three hours
of treatment have failed to improve the patient's condition and the physician orders
heliox therapy. Which of the following should the neonatal/pediatric specialist select for
delivery of this therapy? - CORRECT ANSWER: non-rebreather mask
A 16-year-old girl receives mechanical ventilation following abdominal surgery.
Hemodynamic values are as follows:MAP: 94 mm HgCVP: 4 mm HgMPAP: 15 mm
HgPCWP: 10 mm HgQT: 5 L/minThe physician asks the neonatal/pediatric specialist to
determine the vascular resistance of the systemic circulation. Which of the following
would the specialist report to the physician? - CORRECT ANSWER: 1440 dynes
map-cvp
94-4=90/5= 18*80= 1440
A 2-week-old term infant receives mechanical ventilation with pressure control
ventilation. The neonatal/pediatric specialist has the peak inspiratory pressure set
appropriately but must decrease the PaCO2 for this patient. The specialist should
increase the - CORRECT ANSWER: Respiratory Rate
A 2-year-old boy presents to the ED with intercostal and suprasternal retractions, and
struggles to breathe. Auscultation reveals a high-pitched, continuous expiratory sound
over the right lower lobe. His mother states she heard him coughing "really hard" in the
den where his older sister was counting the money from her piggy bank. The mother is
concerned that the child swallowed a coin. Which of the following should the
neonatal/pediatric specialist recommend to determine the cause of the respiratory
distress? - CORRECT ANSWER: bronchoscopy
A 2-year-old patient with a severe case of laryngotracheobronchitis was extubated
earlier in the morning. The patient received aerosolized racemic epinephrine Q6H