Deck 37: Respiratory Distress Syndrome

Question 1

What special environmental concerns are there with a neonate with RDS in order to avoid compromising his/her oxygenation?

A) Keeping a normal body temperature
B) Placing a bilirubin light on the neonate
C) Keeping the infant cool
D) Humidifying the inhaled oxygen

Answer 1

Keeping a normal body temperature

Question 2

The neonate with RDS would have a phosphatidylglycerol (PG) level that is:

A) present.
B) absent.
C) above normal.
D) below normal.

Answer 2

absent.

Question 3

Management of a neonate with RDS may include:
1) emergency tracheostomy.
2) instilling surfactant into the lungs.
3) mechanical ventilation.
4) supplemental oxygen.

A)3, 4
B)2, 3
C)2, 3, 4
D)1, 3, 4

Answer 3

2, 3, 4

Question 4

The respiratory pattern of a neonate with RDS will have which of these characteristics?
1) Respiratory rate of about 50/min
2) Respiratory rate of >60/min
3) Cyclical breathing pattern
4) Hard and deep breaths

A)1, 3
B)2, 3
C)1, 4
D)2, 4

Question 5

In assessing a patient with RDS, the respiratory therapist would expect to find:
1) intercostal retractions.
2) acrocyanosis.
3) flaring nostrils.
4) wheezing.

A)1, 3
B)1, 2, 4
C)2, 3, 4
D)1, 2, 3

Question 6

The INSURE method of surfactant administration includes:
1) respiratory support.
2) insertion of a feeding tube.
3) extubation.
4) intubation.

A)1, 3
B)1, 3, 4
C)2, 3, 4
D)1, 2, 3

Question 7

A patient with RDS has alveolar hypoxia and pulmonary vasoconstriction. How will this affect his blood flow?
1) Blood shunts through the foramen ovale
2) Increased systemic blood flow
3) Blood shunts through the ductus arteriosus
4) Decreased blood flow to the gut

A)2, 4
B)1, 3
C)1, 2, 3
D)2, 3, 4

Question 8

A patient has RDS. What clinical manifestations are associated with the more negative intrapleural pressures needed during inspiration?
1) Seesaw breathing movement
2) Vesicular breath sounds
3) Pulmonary edema
4) Dependent thoracic areas are cyanotic

A)1, 4
B)2, 4
C)1, 2, 3
D)2, 3, 4

Question 9

The standard of care to evaluate the oxygenation status of a premature infant with RDS is by:

A) capillary blood gas (CBG).
B) arterial blood gas (ABG).
C) capnography.
D) pulse oximetry.

Question 10

It is likely that a neonate with RDS will have which of the following chest radiograph findings?

A) Airway dilation and distortion
B) Fluffy infiltrates in the bases of the lungs
C) Ground-glass appearance
D) Cardiomegaly

Question 11

A premature infant with RDS is receiving mechanical ventilation. In managing the patient's oxygenation, the respiratory therapist should strive to keep the PaO₂ at:

A) between 25 and 50.
B) between 40 and 70.
C) between 80 and 100.
D) 95 or greater.

Question 12

Which of the following is usually seen in the lungs of a neonate with RDS?

A) Alveolar collapse (atelectasis)
B) Segmental atelectasis
C) Lobar atelectasis
D) Pulmonary fibrosis

Question 13

Which of the following amniotic fluid lab findings would indicate mature fetal lungs?

A) S:A ratio is <55.
B) PG is absent.
C) L:S ratio is 2:1.
D) L:S ratio is 1:2.

Question 14

The hyaline membrane seen in the alveoli of a neonate with RDS is similar to the anatomic alteration found in what other pulmonary disease?

A) Bacterial pneumonia
B) Pulmonary fibrosis
C) Acute respiratory distress syndrome (ARDS)
D) Meconium aspiration syndrome (MAS)

Question 15

What vascular anatomic alteration could occur as a consequence of hypoxia in a patient with RDS?

A) Closure of the ductus arteriosus
B) Transient pulmonary hypertension
C) Increased flow through the ductus venosus
D) Airway mucosal edema

Question 16

A mother is about to deliver a 25 weeks' gestation infant. What therapeutic intervention should the respiratory therapist be prepared to give to minimize the risk for RDS?

A) Mask CPAP
B) Airway suctioning
C) Exogenous surfactant
D) Mechanical ventilation

Question 17

What is the primary cause of RDS in the newborn?

A) Underdevelopment of alveolar type I cells
B) Deficiency or abnormality of pulmonary surfactant
C) Hypoxia causing pulmonary hypoperfusion
D) Excessive amniotic fluid in the lungs

Question 18

Which of the following are associated with an increased risk for developing RDS?
1) Low-birth weight infant
2) Prenatal asphyxia
3) Maternal bleeding
4) First-born twin

A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3

Question 19

Respiratory distress syndrome (RDS) primarily affects infants who are:

A) preterm with insufficient surfactant.
B) full-term.
C) postterm with too much surfactant.
D) preterm with too much surfactant.