Deck 12: Neonatal and Pediatric Mechanical Ventilation

Question 1

What is the significance of a shorter tracheal length in infants and children?

A) The shorter length increases airway resistance.
B) Right mainstem intubation is more common.
C) The trachea is less stable than that in adults.
D) Airway dead space is increased in infants.

Answer 1

B

Question 2

What is the location of the larynx in infants as compared to adults?

A) Infants at C6 and adults at C2.
B) Infants and adult larynx are both at C4.
C) Infants at C1 and adults at C5.
D) Infants at C2 and adults at C1.

Answer 2

C

Question 3

Why must infants increase their respiratory rate and not their tidal volume when work of breathing increases?

A) Infants are obligate nose-breathers.
B) The large abdomen-to-thorax ratio inhibits the tidal volume.
C) Infants have more intracellular water.
D) The thorax is unstable.

Answer 3

D

Question 4

The growth process at puberty is driven by what two hormones?

A) Growth hormone and sex hormones
B) Growth hormone and thyroid hormone
C) Parathyroid hormone and growth hormone
D) Luteinizing hormone and growth hormone

Question 5

Which of the following is characteristic of volume ventilation?

A) Volume varies as compliance changes.
B) It is used to limit ventilator-induced lung damage.
C) It is used when minute ventilation control is desired.
D) It works well in the presence of a large air leak.

Question 6

A neonate is being ventilated via pressure-control mode. To assess changes in compliance or resistance, the therapist should monitor the:

A) peak pressure.
B) tidal volume.
C) inspiratory time.
D) plateau pressure.

Question 7

A therapist receiving a verbal order to initiate CPAP on a neonate must first assess the neonate for adequate:

A) apnea.
B) surfactant levels.
C) critical opening pressure.
D) spontaneous breathing.

Question 8

Which of the following is a hazard of CPAP?

A) Barotrauma
B) Increased cardiac output
C) Decreased intracranial pressure
D) Increased cerebral perfusion pressure

Question 9

If volume ventilation is used in the neonate, what tidal volume range is recommended?

A) 8 to 10 mL/kg
B) 6 to 8 mL/kg
C) 4 to 5 mL/kg
D) 3 to 4 mL/kg

Question 10

When ventilating a pediatric patient with a cuffed endotracheal tube, what size is appropriate for a 5 year old using Cole's formula?

A) 9.0
B) 5.0
C) 3.5
D) 7.5

Question 11

A neonatal patient on pressure ventilation with a PIP of 18 has a PaCO₂ of 57. What pressure setting will normalize the PaCO₂?

A) 26
B) 45
C) 20
D) 39

Question 12

The physician orders a pediatric patient to have a PaO₂ of 90 mm Hg. The patient is currently on an F_IO₂ of 0.45 with a PaO₂ of 72. What F_IO₂ will achieve the physician's order?

A) 0.32
B) 0.48
C) 0.55
D) 0.5

Question 13

What is the most prevalent phospholipid in surfactant?

A) Sphingomyelin
B) Phosphatidylcholine
C) Phosphatidylglycerin
D) Cholesterol

Question 14

What is the expected change in lung mechanics after the administration of surfactant?

A) Increased pressure
B) Increased flow rate
C) Increased compliance
D) Increased respiratory rate

Question 15

What is the recommended cuff pressure when using a cuffed tube to ventilate a pediatric patient?

A) 20 mm Hg
B) 20 cm H₂O
C) 25 cm H₂O
D) 25 mm Hg

Question 16

Which of the following should be used to guide the minute ventilation setting when ventilating a child?

A) mPaw
B) PaO₂
C) Anion gap
D) PaCO₂

Question 17

Which of the following changes will reduce the PaCO₂ in an infant on high-frequency oscillatory ventilation?

A) Decrease Hz
B) Decrease mPaw
C) Decrease amplitude
D) Decrease inspiratory time%

Question 18

When evaluating NAVA catheter placement, the screen shows blue on the first ECG line only. What is the appropriate action to take?

A) Push the catheter further in a bit.
B) Tape the catheter in place.
C) Pull the catheter out a bit.
D) Recalibrate the catheter.

Question 19

What oxygenation index qualifies an infant for ECMO?

A) 20
B) 40
C) 600
D) 10

Question 20

A patient on ECMO has fluid retention with reduced urine output. The patient is receiving platelets and is on inotropic medications to maintain the cardiac output. Which of the following would indicate recovery?

A) Increased platelet count
B) Pulmonary edema
C) Diuresis
D) Normal heart rate