A neonatal patient has PPHN. What may develop as a consequence of this

Question at position 1

A neonatal patient has PPHN. What may develop as a consequence of this?

 

Mucosal edema

Pulmonary embolism

Cardiac tamponade

Cardiomegaly

 

 

Question at position 2

 

PPHN usually appears:

 

Between the 1st and 6th days of life

In utero during the last trimester

Within the first twelve hours of birth

Within one hour of birth

 

 

Question at position 3

 

Apneic episodes in a premature neonate can be caused by all of the following EXCEPT:

 

Immature airway receptors

Immature central nervous system 

Immature chemoreceptors

Epiglottitis 

 

 

Question at position 4

 

A newborn’s 5-minute Apgar score is 7. How should this be interpreted?

 

Moderate distress; administer supplemental oxygen

Severe distress; begin bag-mask resuscitation

Moderate distress; intubate the airway and suction the lungs

Normal adjustment to being born

 

 

Question at position 5

 

When a neonate has PPHN, what structure(s) does the blood flow through to bypass the lungs?

 

1. Ductus venosus

 

2. Foramen ovale

 

3. Hypogastric arteries

 

4. Ductus arteriosus

 

 

 

a) 1, 3

 

b) 2, 4

 

c) 2

 

d) 1, 2, 4

 

Question at position 6

 

Respiratory causes of persistent pulmonary hypertension of the newborn (PPHN) include:

 

1. Congenital heart disease

 

2. Hypoxia

 

3. Meconium aspiration syndrome (MAS)

 

4. Respiratory distress syndrome (RDS)

 

 

 

2, 3, 4

1, 3

2

3, 4

 

 

Question at position 7

 

Apnea of prematurity can be defined as:

 

1. Respiratory pause causing bradycardia

 

2. Cycles of short breathing pauses followed by faster breathing

 

3. No breathing for >20 seconds

 

4. Sudden apnea and death (crib death)

 

 

 

4

1, 3

2

3, 4

Question at position 8

 

A neonate in respiratory distress will often dilate his or her nostrils to:

 

Sneeze out amniotic fluid

Facilitate inspiration

Nurse more easily

Raise the intrapleural pressure

 

 

Question at position 9

 

Late clinical manifestations of an infant with respiratory distress include:

 

1. Elevated diaphragm

 

2. Decreased respiratory rate

 

3. CO2 retention

 

4. Lethargy

 

a) 2, 3

 

b) 1, 2, 3, 4

 

c) 1, 2, 3

 

d) 1, 4

 

 

 

Question at position 10

 

Early clinical manifestations of an infant with respiratory distress include:

 

1. Cyanosis

 

2. Substernal retractions

 

3. Expiratory grunting

 

4. Apnea

 

a) 2, 4

 

b) 1, 2, 3

 

c) 1, 3

 

d) 2, 3, 4

 

Question at position 11

 

A premature infant is suspected of having persistent pulmonary hypertension of the newborn. How is this diagnosis confirmed?

 

 

 

Pulmonary angiography

Chest radiography

Arterial blood gas analysis

Echocardiography 

 

 

Question at position 12

 

A premature infant has two pulse oximeters placed: one on the right hand and one on the left foot. The respiratory therapist notes that the reading on the right hand is consistently 12% greater than the reading on the left foot. Which of the following is the best interpretation of this finding?

 

The infant likely has pneumonia

The infant has left-sided intra-pulmonary shunting

The infant has persistent pulmonary hypertension of the newborn

The infant is in septic shock with systemic capillary shunting

 

 

Question at position 13

 

A neonatal patient is found to have grunting on expiration. What physiologic effect does this produce?

 

Decreased PaCO2

Increased vital capacity 

Increased PAO2

Closes the ductus arteriosus

Question at position 14

 

An infant in respiratory distress will often generate a high negative intrapleural pressure during inspiration. In comparison to an adult, this will result in all of the following EXCEPT:

 

Intercostal retractions

Cyanosis of dependent thoracic areas

“seesaw” breathing pattern

Alveolar hyperinflation

 

 

Question at position 15

 

A newborn is flaccid and apneic, has a cyanotic body and a heart rate of 85/min, and shows no reaction to stimulation. Her Apgar score would be:

 

 

 

2

5

1

8

Question at position 16

 

A premature infant is found to be “bobbing” her head. This is important because it can be a sign of which of the following?

 

Respiratory distress

Septic shock

Hypoxemia

Intracranial hemorrhage 

 

 

Question at position 17

 

Which of the following can trigger apnea in the premature infant?

 

 

 

1. Micrognathia

 

2. Intracranial hemorrhage

 

3. REM sleep

 

4. Hypothermia

 

a) 2, 3, 4

 

b) 1, 2, 3, 4

 

c) 2

 

d) 3, 4

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