Neonatal Respiratory Care Exam II
ACTUAL QUESTIONS AND CORRECT
ANSWERS
List 5 methods by which noise can increase in the NICU? - CORRECT
ANSWERS✅✅Alarms
Talking or laughing by bedside
Suctioning/Mechanical vent
Radios
Printers
3 responses by the infant to noise - CORRECT ANSWERS✅✅Startles
Apnea and/or bradycardia
Color changes
3 ways that a baby communicates stress in the NICU - CORRECT ANSWERS✅✅Arching
backward
Frantic activity
Loss of muscle tone
Changes in HR
Irritability
Finger splaying
2 Indications for airway clearance in the newborn - CORRECT ANSWERS✅✅1. Premature
neonate prone to atelectasis b/c lack of surfactant
2. Secretions have greater impact b/c aw diameter
3. Retained secretions due to: atelectasis, RDS, BPD, intubation
4. Aspiration due to meconium
When should percussion to the chest not be done on a neonate? - CORRECT
ANSWERS✅✅If the patient is fragile and does not tolerate well
,What are some indications that the infant has bronchoconstriction requiring a bronchodilator -
CORRECT ANSWERS✅✅Bronchoconstriction
Wheezing
Retractions
Decrease chest expansion/breath sounds
Hypercapnia
Increasing FiO2 req.
Describe how a SVN can be used along with a flow-inflating bag to administer a
bronchodilator treatment - CORRECT ANSWERS✅✅Aerosolized drug with SVN and
flow-inflating bag with manometer and blender
SVN powered with 4-7 LPM
Bag at same rate/PIP as ventilator
When using a SVN and a bag to administer a bronchodilator tx, what problems could arise
during tx? - CORRECT ANSWERS✅✅Increase in Vt
Increase Ppeak
Potential for auto-PEEP
Extubation
Infection by SVN
Reaction to drugs
What are 3 indications for suctioning through an ETT? - CORRECT ANSWERS✅✅Suction
*ONLY* when indicated
1. Worsening chest expansion
2. Coarse rhonchi or crackles
3. Mucus in ETT
4. Graphics showing secretions
, Given pressure, flow, and volume scalar, what on the graph would indicate resistance to
exhalation possibly from secretions in the ETT? - CORRECT ANSWERS✅✅1. Volume
scalar shows longer time for exhalation and emptying of the lung
2. If exhalation is too long, it can cause breath stacking
What change in expiration would occur in a flow volume curve to indicate resistance to
expiration and possible need to suction? - CORRECT ANSWERS✅✅Prolonged expiratory
time
Where should the FiO2 be set when performing ETT suction? - CORRECT
ANSWERS✅✅FiO2 0.10 above current FiO2 (45% to 55%)
FiO2=1.0 if prolonged bradycardia
Should normal saline be used to suction through ETT? - CORRECT ANSWERS✅✅Yes,
but just a few drops of NS for lubricant for nasal suctioning
Give the size suction catheter to use for a 2.5, 3.0, 3.5, and 4.0 ETT - CORRECT
ANSWERS✅✅2.5 = 5 or 6 french
3.0 = 6 to 8 french
3.5 = 8 french
4.0 = 8 or 10 french
If a newborn has an oral ETT and the cm mark is at the top of the tube is 12 cm, how many
cm should the suction catheter be inserted? - CORRECT ANSWERS✅✅16 cm (add 4 cm
for the adapter length)
Why is it important not to hit the carina with the suction catheter each time the catheter is
passed down the ETT? - CORRECT ANSWERS✅✅Hitting the carina can cause
bradycardia and desaturation
What action to take while suctioning through a 2.5 ETT with a 5.0 Fr catheter: Heart rate
drops from 146 to 128 and SpO2 drops from 96% to 90%? - CORRECT
ANSWERS✅✅Stop suctioning, withdraw catheter
Bag with current FiO2 until stable
ACTUAL QUESTIONS AND CORRECT
ANSWERS
List 5 methods by which noise can increase in the NICU? - CORRECT
ANSWERS✅✅Alarms
Talking or laughing by bedside
Suctioning/Mechanical vent
Radios
Printers
3 responses by the infant to noise - CORRECT ANSWERS✅✅Startles
Apnea and/or bradycardia
Color changes
3 ways that a baby communicates stress in the NICU - CORRECT ANSWERS✅✅Arching
backward
Frantic activity
Loss of muscle tone
Changes in HR
Irritability
Finger splaying
2 Indications for airway clearance in the newborn - CORRECT ANSWERS✅✅1. Premature
neonate prone to atelectasis b/c lack of surfactant
2. Secretions have greater impact b/c aw diameter
3. Retained secretions due to: atelectasis, RDS, BPD, intubation
4. Aspiration due to meconium
When should percussion to the chest not be done on a neonate? - CORRECT
ANSWERS✅✅If the patient is fragile and does not tolerate well
,What are some indications that the infant has bronchoconstriction requiring a bronchodilator -
CORRECT ANSWERS✅✅Bronchoconstriction
Wheezing
Retractions
Decrease chest expansion/breath sounds
Hypercapnia
Increasing FiO2 req.
Describe how a SVN can be used along with a flow-inflating bag to administer a
bronchodilator treatment - CORRECT ANSWERS✅✅Aerosolized drug with SVN and
flow-inflating bag with manometer and blender
SVN powered with 4-7 LPM
Bag at same rate/PIP as ventilator
When using a SVN and a bag to administer a bronchodilator tx, what problems could arise
during tx? - CORRECT ANSWERS✅✅Increase in Vt
Increase Ppeak
Potential for auto-PEEP
Extubation
Infection by SVN
Reaction to drugs
What are 3 indications for suctioning through an ETT? - CORRECT ANSWERS✅✅Suction
*ONLY* when indicated
1. Worsening chest expansion
2. Coarse rhonchi or crackles
3. Mucus in ETT
4. Graphics showing secretions
, Given pressure, flow, and volume scalar, what on the graph would indicate resistance to
exhalation possibly from secretions in the ETT? - CORRECT ANSWERS✅✅1. Volume
scalar shows longer time for exhalation and emptying of the lung
2. If exhalation is too long, it can cause breath stacking
What change in expiration would occur in a flow volume curve to indicate resistance to
expiration and possible need to suction? - CORRECT ANSWERS✅✅Prolonged expiratory
time
Where should the FiO2 be set when performing ETT suction? - CORRECT
ANSWERS✅✅FiO2 0.10 above current FiO2 (45% to 55%)
FiO2=1.0 if prolonged bradycardia
Should normal saline be used to suction through ETT? - CORRECT ANSWERS✅✅Yes,
but just a few drops of NS for lubricant for nasal suctioning
Give the size suction catheter to use for a 2.5, 3.0, 3.5, and 4.0 ETT - CORRECT
ANSWERS✅✅2.5 = 5 or 6 french
3.0 = 6 to 8 french
3.5 = 8 french
4.0 = 8 or 10 french
If a newborn has an oral ETT and the cm mark is at the top of the tube is 12 cm, how many
cm should the suction catheter be inserted? - CORRECT ANSWERS✅✅16 cm (add 4 cm
for the adapter length)
Why is it important not to hit the carina with the suction catheter each time the catheter is
passed down the ETT? - CORRECT ANSWERS✅✅Hitting the carina can cause
bradycardia and desaturation
What action to take while suctioning through a 2.5 ETT with a 5.0 Fr catheter: Heart rate
drops from 146 to 128 and SpO2 drops from 96% to 90%? - CORRECT
ANSWERS✅✅Stop suctioning, withdraw catheter
Bag with current FiO2 until stable
