Deck 9: Abdominal Defects

Question 1

Potential benefits of gradual reduction of the bowel versus primary reduction include which of the following
I)Fewer days on the ventilator
II)Decrease in pulmonary barotrauma
III)Longer enteral feedings
IV)Decreased tissue perfusion
V)Decreased risk of infection

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

Answer 1

C

Question 2

Which of the following statements are true Concerning the potential outComes for infants with Confirmed Congenital diagrammatic hernia
I)Surgical intervention usually Corrects the hernia with few Consequences.
II)Death is probable.
III)Pulmonary Complications will arise.
IV)There will be gastrointestinal morbidities.
V)Quality of life will be improved.
VI)There will be little to no neurological defects.

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

Answer 2

C

Question 3

More than 50% of Congenital diagrammatic hernia survivors will Continue to be afflicted with gastrointestinal dysfunction.

Answer 3

True

Question 4

Which of the following are criteria for initiating extraCorporeal membrane oxygenation
I)Oxygenation index greater than 40 for 4 or more hours
II)Decrease in blood lactate levels
III)Increase in urine output
IV)PaO₂ less than 50 mm Hg on FiO₂ 1.0
V)pH less than 7.20 and peak inspiratory pressure less than 17 cm H₂O
VI)Preductal SpO₂ less than 85% or postductal SpO₂ less than 70%

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

Question 5

Which medications are the preferred drug of choice for pain management in patients with a Congenital diagrammatic hernia and respiratory failure
I)Fentanyl at 2-5 micrograms/kg
II)Midazolam drips at 60 micrograms/kg per hour
III)Pancuronium 0.1 mg/kg
VI)Vecuronium 0.1 mg/kg

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

Question 6

What are Complications associated with Congenital diaphragmatic hernia
I)Patent ductus arteriosus
II)Patent foramen ovale
III)Malrotation
IV)Pulmonary edema
V)Pulmonary hypoplasia

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

Question 7

A higher lung/head ratio denotes a larger problem with pulmonary dysfunction in infants with Congenital diaphragmatic hernia.

Question 8

What are the clinical Complications that Coexist with Congenital diaphragmatic hernia (CDH) Collectively known as CDH-syndrome
I)Pulmonary hypoplasia
II)Pulmonary hypertension
III)Patent ductus arteriosus
IV)Patent foramen ovale
V)Malnutrition

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

Question 9

What is one of the most noticeable physical findings in a newborn who presents with Congenital diagrammatic hernia

A)Scaphoid abdomen
B)Protruding belly
C)Concave chest
D)Paradoxical breathing

Question 10

Repair of the omphalocele can be delayed for months to years depending on the size of the defect.

Question 11

What clinical findings should a respiratory therapist expect in an infant with a Congenital diaphragmatic hernia
I)Breath sounds throughout lung region
II)Apnea
III)Hypotension
IV)Slow venous return
V)Heart sounds heard in anatomically Correct location
VI)Minimal response to positive pressure ventilation
VII)Significant positive response to supplemental oxygen

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

Question 12

Which of the following factors Contribute to surfactant dysfunction in patients with Congenital diaphragmatic hernia
I)Lung hypoplasia
II)SeCondary surfactant deficiency
III)High-frequency oscillatory ventilation
IV)Change in surfactant Composition as a direct result in ventilator-induced injury

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

Question 13

What does an iatrogenic lung injury mean

A)Lung injury caused by mechanical ventilation
B)Lung injury caused by improper cleanliness of health-care workers
C)Lung injury caused by improper CPR techniques carried out at bedside
D)Lung injury caused by improper chest physiotherapy causing bruising of the lung

Question 14

Delivery room management for Congenital diaphragmatic hernia Consists of which of the following
I)Expecting respiratory distress
II)No mask ventilation
III)Nasogastric tube placement
IV)0.50-1.0 FiO₂ application
V)Early administration of Continuous positive airway pressure

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

Question 15

What is the primary function of an inotrope

A)Helps to diuresis fluid
B)Improves cardiac Contractibility
C)Vasodilator
D)Phosphodiesterase inhibitor

Question 16

Which of the following procedures should a delivery room resuscitation team perform for a newborn with gastroschisis
I)Place the exposed bowel in a bowel bag.
II)Insert a nasogastric tube.
III)Keep bowel dry.
IV)Administer IV broad-spectrum antibiotics.
V)Bottle feed as tolerated.

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

Question 17

Respiratory management for an infant with Congenital diaphragmatic hernia should Consist of which of the following
I)Monitoring exhaled tidal volume
II)Arterial blood gas measurements
III)Monitoring spontaneous respiratory efforts
IV)Serial chest radiographs
V)Prompting weaning to decrease abdominal distention

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

Question 18

What is the half-life of inhaled nitric oxide

A)3 seConds
B)5 seConds
C)10 seConds
D)15 seConds

Question 19

Gentle ventilation Consists of maintaining which of the following parameters
I)Peak inspiratory pressure to maintain PaCO₂ 45-65 mm Hg
II)Ventilation pressures less than 25 cm H₂O
III)Postductal pH greater than 7.30
IV)Positive end-expiratory pressure 4-6 cm H₂O
V)Normoxemia
VI)25-30 breaths/minute
VII)I-time 0.3-0.4 seCond

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

Question 20

Which of the following statements are true Concerning the use of extraCorporeal membrane oxygenation (ECMO) for patients with Congenital diaphragmatic hernia
I)The higher oxygenation index, the worse a patient's ability to oxygenate, despite high levels of ventilatory support.
II)A low numerator when calculating oxygen index means high oxygen support.
III)A low denominator when calculating oxygen index means poor tissue oxygenation.
IV)Inhaled nitric oxide and ECMO are frequently used.

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

Question 21

High-frequency oscillatory ventilation may decrease alveolar surfactant production.