Deck 6: Disease of Full-Term Infants

Question 1

What is a reCommended setting for Conventional mechanical ventilation for an infant who is born with Complications as a result of meConium aspiration syndrome

A)Synchronized intermittent mandatory ventilation, respiratory rate less than 50 breaths/minute, 6-8 mL/kg, I-time 0.33 seCond, and positive end expiratory pressure 8 cm H₂O
B)Synchronized intermittent mandatory ventilation, respiratory rate less than 60 breaths/minute, 4-10 mL/kg, I-time 0.33 seCond, and positive end expiratory pressure 8 cm H₂O
C)Synchronized intermittent mandatory ventilation, respiratory rate less than 50 breaths/minute, 4-7 mL/kg, I-time 0.50 seCond, and positive end expiratory pressure 5 cm H₂O
D)Synchronized intermittent mandatory ventilation, respiratory rate less than 50 breaths/minute, 4-6 mL/kg, I-time 0.50 seCond, and positive end expiratory pressure 3 cm H₂O

Answer 1

C

Question 2

Nitric oxide does all of the following except:

A)Enzyme regulation
B)Platelet inhibition
C)Neurotransmission
D)Has a half-life greater than 30 minutes

Answer 2

D

Question 3

Which cardiopulmonary disease is also associated with pulmonary hypertension

A)MeConium aspiration syndrome
B)Pulmonary hypoplasia
C)Hypoplastic left heart syndrome
D)Bronchopulmonary dysplasia

Answer 3

D

Question 4

Which of the following are Complications to extraCorporeal life support
I)Pneumothorax
II)Infection
III)Seizures
IV)Hypotension
V)Tachycardia
VI)Hemolysis

A)I, III, IV, and VI
B)I, II, III, and VI
C)II, III, VI, and VII
D)II, IV, V, and VI

Question 5

What is an unacceptable oxygenation index that would suggest the need for extraCorporeal membrane oxygenation

A)20
B)Greater than 30
C)Greater than 40
D)20-35

Question 6

What parameter should be changed if PaCO₂ is high during high-frequency oscillatory ventilation

A)Increase ΔP
B)Decrease ΔP
C)Increase Paw
D)Decrease Paw

Question 7

What is the most Common underlying diagnosis of persistent pulmonary hypertension of the newborn

A)MeConium aspiration syndrome
B)Pneumonia
C)Sepsis
D)Congenital diaphragmatic hernia

Question 8

What process must occur to stimulate a newborn to breathe

A)Decrease in PaO₂
B)Increase in PaCO₂
C)Decrease in PaCO₂
D)Increase in PaO₂

Question 9

Neonatal extraCorporeal membrane oxygenation selection criteria include which of the following
I)Oxygenation index greater than 55
II)Oxygenation index greater than 40
III)No major cardiac defect
IV)Reversible lung disease
V)Gestation age greater than 30 weeks
VI)Mechanical ventilation less than 10 days
VII)No bleeding Complications

A)II, III, IV, and VII
B)I, III, V, and VII
C)II, IV, VI, and VII
D)I, V, VI, and VII

Question 10

A change from fetal circulation to adult circulation requires which of the following scenarios to occur

A)An increase in pulmonary vascular resistance and a significant decrease in systemic vascular resistance
B)A decrease in pulmonary vascular resistance and a significant increase in systemic vascular resistance
C)A decrease in pulmonary vascular resistance and a decrease in systemic vascular resistance
D)An increase in pulmonary vascular resistance and a significant increase in systemic vascular resistance

Question 11

What risk factors increase the likelihood of an infant being born with persistent pulmonary hypertension in the newborn

A)Female baby, vaginal delivery, and birth weight greater than 90th percentile
B)Male baby, gestational age greater than 41 weeks, and cesarean delivery prior to onset of labor
C)Male baby, gestational age less than 41 weeks, and elective cesarean delivery
D)Female baby, NSAID drug use, and cesarean delivery prior to onset of labor

Question 12

Risk factors to pulmonary hypertensive crisis include which of the following
I)Hypoxemia
II)Hyperventilation
III)Inadequate afterload of the left ventricle
IV)Noxious stimulation
V)Hypoventilation
VI)Inadequate preload of the right ventricle
VII)Hypotension

A)I, IV, V, VI, and VII
B)I, II, V, VI, and VII
C)II, III, IV, V, and VI
D)I, III, IV, V, and VI

Question 13

What drug increases systemic pressure and oxygenation in neonates with persistent pulmonary hypertension of the newborn

A)Inhaled nitric oxide
B)Prostacyclin
C)Norepinephrine
D)Sildenafil

Question 14

Sedation and paralytics are a reasonable care strategy when patients are unable to effectively ventilate and oxygenate, but its use should be limited.To what amount of time should sedation and paralytics be limited

A)12 hours
B)24 hours
C)36 hours
D)48 hours

Question 15

What is the percentage of full-term neonates with moderate-to-severe respiratory failure who utilize surfactant regiment

A)75%
B)80%
C)82%
D)85%

Question 16

What is the indication for immediate need of extraCorporeal membrane oxygenation therapy
I)Oxygenation index greater than 25
II)Oxygenation index greater than 40
III)A-aO₂ gradients greater than 600 after 4 hours inhaled nitric oxide therapy
IV)A-aO₂ gradients less than 600 after 4 hours inhaled nitric oxide therapy

A)I and III
B)II and III
C)I and IV
D)II and IV

Question 17

Baby Nolan presents with persistent pulmonary hypertension of the newborn and is failing assist Control ventilation.What are the reCommended initial high-frequency oscillator settings

A)Bias flow 8 Lpm, Hz 8, I-time 25%, Paw 1.5 cm H₂O above Controlled mandatory ventilation, and change in pressure for chest wiggle
B)Bias flow 10 Lpm, Hz 12, I-time 33%, Paw 3 cm H₂O above Controlled mandatory ventilation, and change in pressure for chest wiggle
C)Bias flow 15 Lpm, Hz 15, I-time 33%, Paw 3 cm H₂O above Controlled mandatory ventilation, and change in pressure for chest wiggle
D)Bias flow 18 Lpm, Hz 8, I-time 25%, Paw 3.0 cm H₂O above Controlled mandatory ventilation, and change in pressure for chest wiggle

Question 18

Which medication is useful for neonates who present with rebound hypoxemia and are not responsive to inhaled nitrous oxide

A)Dobutamine
B)Prostacyclin
C)Sildenafil
D)Magnesium sulfate

Question 19

In cases of persistent pulmonary hypertension of a newborn, what mode of ventilation maintains the same mean airway pressure and improves oxygenation and ventilation the fastest

A)Controlled mandatory ventilation
B)ExtraCorporeal membrane oxygenation
C)High-frequency oscillatory ventilation
D)High-frequency jet ventilation

Question 20

During high-frequency jet ventilation, what setting should be changed to Correct ventilation issues

A)Hz
B)ΔP
C)Peak inspiratory pressure
D)I-time %

Question 21

Which of the following options illustrate risk factors for transient tachypnea
I)C-section delivery
II)Maternal asthma
III)Maternal diabetes
IV)Female gender
V)Positive phosphatidylglycerol presence test of amniotic fluid
VI)Clamping of umbilical Cord immediately after birth
VII)Birth weight less than 200 grams
VIII.Aplastic anemia

A)IV, V, and VI
B)II, III, and VI
C)I, II, and III
D)I, III, and VI

Question 22

How does a patient present with meConium aspiration syndrome
I)Tachypnea
II)Hypoxemia
III)Respiratory alkalosis
IV)No apparent respiratory distress
V)Grunting

A)I, II, and V
B)II, III, and V
C)I, IV, and V
D)III, IV, and V

Question 23

Strategies to manage persistent pulmonary hypertension of the newborn Consist of which of the following
I)Oxygen therapy to maintain SPO₂ 90-120 mm Hg
II)Oxygen therapy to maintain SPO₂ 80-100 mm Hg
III)Pulmonary vasodilators
IV)HCT 35-45%
V)HCT 45-55%

A)I, III, and IV
B)II and III
C)II, III, and V
D)II, III, and IV