Deck 12: Assessment of the Neonatal and Pediatric Patient

Question 1

What do the L/S ratio and phosphatidylinositol (PI) and phosphatidylglycerol (PG) levels assess?

A) Cardiovascular maturation
B) Lung maturation
C) Renal system maturation
D) Overall level of fetal maturation

Answer 1

Lung maturation

Question 2

What Apgar parameter usually deteriorates first in a hypoxic infant?

A) Respiratory effort
B) Heart rate
C) Muscle tone
D) Skin color

Answer 2

Skin color

Question 3

Which of the following are typical causes of tachypnea in the newborn?
1) Hypothermia
2) Hypoxemia
3) Respiratory acidosis
4) Pain

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

Answer 3

2, 3, and 4

Question 4

What is the significance of "grunting" in an infant?

A) A low functional residual capacity (FRC)
B) Increased airway resistance
C) Significant secretion retention
D) High compliance

Question 5

What does the Ballard examination of a newborn infant assess?

A) Lung maturation
B) Transition from fetal to extrauterine circulation
C) Gestational age
D) Cerebral function

Question 6

What effect does abdominal distention have on respiration?

A) Impedes diaphragm movement.
B) Decreases the work of breathing.
C) Does not have any impact on respiration.
D) Improves expiration and lung stabilization.

Question 7

What is the upper limit for normal systolic blood pressure in the term newborn?

A) 60 mm Hg
B) 70 mm Hg
C) 80 mm Hg
D) 90 mm Hg

Question 8

Which of the following is part of the biophysical evaluation of a fetus performed by ultrasound?

A) Reactive heart rate
B) Fetal brain development
C) Fetal gastrointestinal function
D) Body size

Question 9

What range of gestational age in weeks is considered term?

A) 32 to 36
B) 34 to 40
C) 37 to 42
D) 38 to 44

Question 10

An infant's entire right hemithorax "lights up" during transillumination. What does this signify?

A) Normal lung tissue
B) Significant pleural effusion
C) Significant pneumothorax
D) Intensity of the light is set too high

Question 11

What is indicated by a capillary refill greater than 3 s in the infant?

A) Normal cardiopulmonary function
B) Respiratory failure
C) Circulatory failure
D) Renal failure

Question 12

What is the likely diagnosis of leukopenia in an infant?

A) Overwhelming infection
B) Chronic infection
C) Acute infection
D) Local infection

Question 13

What is the normal leukocyte count for newborns?

A) 5000 to 15,000/mm³
B) 9000 to 30,000/mm³
C) 15,000 to 40,000/mm³
D) 21,000 to 35,000/mm³

Question 14

Which of the following is a common cause of hypothermia in an infant?

A) Infection
B) Heart failure
C) Atelectasis
D) Liver disease

Question 15

Which of the following conditions is associated with an infant born early in gestation?

A) Meconium aspiration
B) Respiratory distress syndrome (RDS)
C) Persistent pulmonary hypertension
D) Perinatal asphyxia

Question 16

Why is it so important to quickly identify a low blood glucose level in a newborn?

A) Because of worry about impaired pulmonary function
B) Because it is detrimental to brain development
C) Because it results in rapid renal deterioration
D) Because it can result in blindness through retinal detachment

Question 17

You are looking in the chart of your patient, and in the maternal history, you see the following: G3, P2, Ab0. Which of the following statements is true?

A) The mother is in her third pregnancy.
B) The mother is in her second pregnancy.
C) The mother has delivered three healthy children.
D) The mother has had one abortion.

Question 18

What is the upper limit of the normal range for the heart rate in the newborn?

A) 120 beats/min
B) 140 beats/min
C) 160 beats/min
D) 180 beats/min

Question 19

Infants who need extensive medical resuscitation at birth will have Apgar scores in the range of:

A) 9 to 10.
B) 6 to 8.
C) 4 to 6.
D) 0 to 3.

Question 20

What is indicated by the presence of retractions in the newborn?

A) A compliant chest wall
B) Stiff lungs
C) Reduced airway resistance
D) Heart failure

Question 21

A child presents at the emergency department with difficulty breathing and a harsh, barking cough. The history reveals a runny nose over the past few days. What is the most likely diagnosis?

A) Croup
B) Epiglottitis
C) Asthma
D) Bronchopulmonary dysplasia (BPD)

Question 22

What parameter demonstrates the largest difference when capillary blood is compared with arterial blood?

A) PO₂
B) PCO₂
C) pH
D) HCO₃^-

Question 23

What differentiates pneumonia from transient tachypnea of the newborn (TTN) on chest radiograph?

A) Rapid resolution of TTN
B) TTN will have a ground-glass appearance
C) Silhouette sign
D) Diffuse streakiness and fluid in the major and minor fissures

Question 24

Which of the following clinical findings suggests the need for a chest radiograph in the infant?
1) Cyanosis
2) Unexplained tachypnea
3) Normal breath sounds in a postterm newborn
4) Worsening clinical status

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

Question 25

Which of the following is the most likely cause of airway patency compromise in a child with a tracheostomy tube that just underwent a flexible bronchoscopy?

A) Pneumothorax
B) Copious secretions in the airway
C) Asthma
D) Pneumonia

Question 26

A newborn presents with a murmur and a 6% difference in oxygen saturation between the preductal and postductal SpO₂. What is the most likely diagnosis?

A) Epiglottitis
B) Patent ductus arteriosus
C) Croup
D) Pneumonia

Question 27

What is the normal range for PaO₂ at birth?

A) 40 to 60 mm Hg
B) 50 to 70 mm Hg
C) 60 to 80 mm Hg
D) 70 to 90 mm Hg

Question 28

What clinical problem is associated with low serum levels of calcium and phosphorus?

A) Acute hypoxia
B) Liver failure
C) Poor nutrition
D) Renal failure

Question 29

Which of the following conditions is a result of a bacterial disease?

A) Asthma
B) Croup
C) Epiglottitis
D) Respiratory distress syndrome (RDS)

Question 30

Which of the following conditions is most likely to cause a falsely low tcPO₂ reading?

A) Alkalosis
B) Hypertension
C) Hypovolemia
D) Hyperthermia

Question 31

A 4-year-old presents to the emergency room with difficulty breathing, a dry cough, and audible inspiratory and expiratory wheezing. The parents report the child was playing outside with siblings prior to the difficulty breathing. The symptoms have been progressively worsening. What is the most likely diagnosis?

A) Epiglottitis
B) Asthma
C) Croup
D) Pneumonia

Question 32

Which lung volumes can be measured easily in newborns?
1) Thoracic gas volume
2) Residual volume
3) Functional residual capacity
4) Crying vital capacity

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