Question 1

Significant progress has been made in developing therapies to slow the progression of necrotizing enteroColitis.

Accepted Answer

As of my last update, while there have been advances in understanding the pathophysiology and management of necrotizing enterocolitis (NEC), significant progress in developing therapies specifically aimed at slowing its progression has been limited. Current treatments mainly focus on supportive care and surgical intervention when necessary, rather than targeted therapies to slow disease progression.

Question 2

What laboratory tests are essential to diagnose the presence of necrotizing enteroColitis
I.Complete blood Count
II.Basic metabolic panel
III.C-reactive protein
IV.Electrolyte panel
V.Clotting function
VI.Abdominal radiograph
VII.Blood cultures

Accepted Answer

The laboratory tests that are essential to diagnose the presence of necrotizing enterocolitis are a complete blood count, basic metabolic panel, C-reactive protein, electrolyte panel, and abdominal radiograph. Clotting function and blood cultures may also be helpful but are not essential for diagnosis. Therefore, options A, C, and D are unnecessary since they include tests that are not essential for diagnosis. Option B includes all the necessary tests.

Question 3

What settings on a Conventional ventilator are frequently adjusted by a registered respiratory therapist when managing the pulmonary Complications of necrotizing enteroColitis
I.Increase in positive end-expiratory pressure
II.Increase in peak airway pressure
III.Decrease in positive end-expiratory pressure
IV.Decrease in peak airway resistance pressure

Accepted Answer

When managing the pulmonary complications of necrotizing enterocolitis, the registered respiratory therapist will frequently adjust the settings on a conventional ventilator. In this case, an increase in positive end-expiratory pressure (PEEP) and an increase in peak airway pressure are often necessary to improve oxygenation and prevent alveolar collapse. Therefore, options I and II are correct. Decreasing PEEP and peak airway pressure can worsen oxygenation and lead to further lung damage, so options III and IV are not appropriate choices in this case. Therefore, the best choice is option C.

Question 4

Vascular endothelial growth factor medication is effective in halting development of retinopathy of prematurity in which of the following situations
I.As a rescue therapy when surgery does not produce adequate regression
II.In Combination therapy with laser surgery
III.As solitary treatment
IV.As a preventative to low birth weight in infants

Accepted Answer

Vascular endothelial growth factor medication is effective in halting development of retinopathy of prematurity as a rescue therapy when surgery does not produce adequate regression, in combination therapy with laser surgery, and as solitary treatment. It is not used as a preventative to low birth weight in infants.

Question 5

Which of the following can a registered respiratory therapist employ to most effectively assess the quality of lung inflation in a patient with necrotizing enteroColitis

Accepted Answer

Evaluating pressure-volume loops can provide the most detailed information about the quality of lung inflation in a patient with necrotizing enterocolitis. This is because pressure-volume loops can provide information about compliance, resistance, and overall lung function. Monitoring breath sounds and peak inspiratory pressure can also be helpful, but they do not provide the same level of detail as pressure-volume loops. Evaluating flow-volume loops is not necessary for assessing lung inflation in a patient with necrotizing enterocolitis.

Question 6

Which of the following are options to treat a patient who presents with patent ductus arteriosus with pulmonary edema on chest radiograph
I.Consider high-frequency oscillatory ventilation.
II.Increase positive end-expiratory pressure.
III.Administer exogenous surfactant.
IV.Administer oxygen.

Accepted Answer

Options I, II, III, and IV are all viable treatments for a patient with patent ductus arteriosus (PDA) and pulmonary edema. High-frequency oscillatory ventilation can improve oxygenation and ventilation while minimizing lung injury. Increasing positive end-expiratory pressure (PEEP) can help keep the alveoli open and reduce the work of breathing. Administering exogenous surfactant can improve lung compliance and gas exchange in infants with respiratory distress syndrome, which can coexist with PDA. Administering oxygen can help alleviate hypoxemia associated with pulmonary edema.

Question 7

Mechanically ventilated patients with a patent ductus arteriosus present what additional challenge for registered respiratory therapists

Accepted Answer

Pulmonary edema is a common complication in patients with a patent ductus arteriosus (PDA) due to increased pulmonary blood flow, which can lead to fluid accumulation in the lungs, posing an additional challenge for respiratory therapists.

Question 8

What factors can alter cerebral blood flow
I.Patent ductus arteriosus with shunting
II.Hypoxemia
III.Coagulopathy
IV.Alkalosis
V.Adrenal sufficiency

Accepted Answer

Patent ductus arteriosus with shunting, hypoxemia, and coagulopathy can all affect cerebral blood flow. Shunting can alter blood flow dynamics, hypoxemia can lead to vasodilation and increased flow, and coagulopathy can affect blood viscosity and flow.

Question 9

You are caring for a mechanically ventilated neonate at risk of developing intraventricular hemorrhage.Choose the best practice guidelines for this patient. I.Synchronized mode of ventilation
II.Adjust peak inspiratory pressure to maintain pH 7.45-7.55, PaCO₂ 40-45 mm Hg, and tidal volume within normal limits.
III.Adjust peak inspiratory pressure to maintain pH 7.25 to 7.35, PaCO₂ 40-55 mm Hg, and tidal volume within normal limits.
IV.Tidal volume 6-8 mL/kg
V.Respiratory rate 30-60 breaths/minute
VI.I-time 0.3-0.4 seCond
VII.Positive end-expiratory pressure 5-10 cm H₂O

Accepted Answer

The best practice guidelines for a mechanically ventilated neonate at risk of developing intraventricular hemorrhage include:

I. Synchronized mode of ventilation
Neonates should receive synchronized ventilation to prevent asynchrony between the infant's respiratory efforts and the ventilator.

III. Adjust peak inspiratory pressure to maintain pH 7.25 to 7.35, PaCO₂ 40-55 mm Hg, and tidal volume within normal limits.
Maintaining optimal arterial blood gas values and normal tidal volume can help prevent intraventricular hemorrhage.

V. Respiratory rate 30-60 breaths/minute
The respiratory rate should be adjusted to maintain appropriate blood gas levels and oxygenation while minimizing the risk of barotrauma.

VI. I-time 0.3-0.4 second
The inspiratory time should be set to allow adequate time for gas exchange while minimizing the risk of lung injury.

Therefore, the best choice of practice guidelines for this patient is B.

Question 10

What three risk factors are associated with necrotizing enteroColitis in term infants
I.Umbilical catheters
II.Exchange transfusions
III.Polycythemia
IV.Hyperoxia at time of delivery
V.Increase in interstitial fluid pressure

Accepted Answer

Necrotizing enterocolitis (NEC) in term infants can be associated with specific risk factors different from those in preterm infants. Umbilical catheters, exchange transfusions, and polycythemia are among the risk factors associated with NEC in term infants. Umbilical catheters can introduce infection or cause vascular injury, exchange transfusions may introduce proinflammatory agents or cause hemodynamic instability, and polycythemia can lead to increased blood viscosity and reduced blood flow to the intestines, contributing to the development of NEC.

Question 11

Which of the following can be used in the management of an infant with necrotizing enteroColitis
I.DeCompression of bowel
II.Replacement of blood products
III.IV antibiotics
IV.Total parenteral nutrition
V.IV prostaglandin inhibitor

Accepted Answer

I, II, III, and IV are correct. Decompression of the bowel can relieve pressure and may help in managing necrotizing enterocolitis (NEC). Replacement of blood products may be necessary due to blood loss or anemia. IV antibiotics are used to treat or prevent infection, which is a critical aspect of managing NEC. Total parenteral nutrition (TPN) provides necessary nutrients while bypassing the gut to allow it to heal. IV prostaglandin inhibitors are not typically used in the management of NEC, making options involving V incorrect.

Question 12

What percentage of infants who develop necrotizing enteroColitis require surgical intervention

Accepted Answer

Approximately 20% to 40% of infants who develop necrotizing enterocolitis (NEC) require surgical intervention. This intervention may involve removal of the dead tissue in the intestine or the creation of a temporary colostomy. It is important for healthcare providers to monitor infants closely for signs of NEC and intervene early to prevent the need for surgery.

Question 13

Which of the following statements is true regarding fatalities in patients diagnosed with necrotizing enteroColitis

Accepted Answer

The answer of Which of the following statements is true...

Question 14

How many hours does it take the ductus arteriosus to close Completely in a healthy term baby

Accepted Answer

The ductus arteriosus typically takes up to 72 hours to close completely in a healthy term baby. This process is part of the normal physiological changes that occur as the newborn adjusts from fetal to neonatal circulation.

Question 15

What is the goal of ventilatory support for a patient with necrotizing enteroColitis

Accepted Answer

The answer of What is the goal of ventilatory support...

Question 16

Which of the following are not clinical signs of necrotizing enteroColitis I.Bradypnea II.Tachypnea III.Increase work of breathing IV.Apnea V.Ascites VI.Cyanosis

Accepted Answer

The answer of Which of the following are not clinical...

Question 17

When does a patent ductus arteriosus usually present in an infant

Accepted Answer

The answer of When does a patent ductus arteriosus usually...

Question 18

When managing a mechanically ventilator patient with intraventricular hemorrhage, what values should a registered respiratory therapist be most Concerned with
I.PaCO₂
II.PaO₂
III.pH
IV.HCo₃

Accepted Answer

When managing a mechanically ventilated patient with intraventricular hemorrhage, the primary concerns are PaCO₂ and pH. PaCO₂ levels are crucial because hypercapnia (high CO₂ levels) can increase intracranial pressure (ICP), worsening the patient's condition. Similarly, maintaining an appropriate pH is essential for ensuring proper cerebral perfusion and avoiding further brain injury. While PaO₂ and HCO₃ are important in overall patient management, PaCO₂ and pH are most critical in the context of intraventricular hemorrhage.

Question 19

What are steps the health-care team can implement to minimize the risk of intraventricular hemorrhage
I.Delay Cord clamping 30 to 120 seConds after delivery.
II.Immediate delivery
III.Prenatal steroids
IV.Pressure Control ventilation only
V.Monitor hemodynamic values.
VI.Pressure Control ventilation and Controlled mandatory ventilation

Accepted Answer

Delaying cord clamping, monitoring hemodynamic values, and using pressure control ventilation and controlled mandatory ventilation can all help minimize the risk of intraventricular hemorrhage. Prenatal steroids and immediate delivery may also be beneficial, but they are not included in the best choice answer because they were not listed in the same options as the other strategies in the question.

Question 20

How is patent ductus arteriosus treated
I.Surgical ligation
II.Decrease in fluid intake
III.Indomethacin
IV.IV ibuprofen
V.Treating hypoxemia

Accepted Answer

Patent ductus arteriosus (PDA) can be treated with various methods including surgical ligation, pharmacological closure with medications like indomethacin or IV ibuprofen, and addressing contributing factors such as hypoxemia. Decreasing fluid intake can also be part of the management to reduce the workload on the heart.

Quiz 8: Common Neonatal Complications: Multisystem Complications

Significant progress has been made in developing therapies to slow the progression of necrotizing enteroColitis.

What laboratory tests are essential to diagnose the presence of necrotizing enteroColitis I.Complete blood Count II.Basic metabolic panel III.C-reactive protein IV.Electrolyte panel V.Clotting function VI.Abdominal radiograph VII.Blood cultures

Which of the following can a registered respiratory therapist employ to most effectively assess the quality of lung inflation in a patient with necrotizing enteroColitis

Which of the following are options to treat a patient who presents with patent ductus arteriosus with pulmonary edema on chest radiograph I.Consider high-frequency oscillatory ventilation. II.Increase positive end-expiratory pressure. III.Administer exogenous surfactant. IV.Administer oxygen.

Mechanically ventilated patients with a patent ductus arteriosus present what additional challenge for registered respiratory therapists

What factors can alter cerebral blood flow I.Patent ductus arteriosus with shunting II.Hypoxemia III.Coagulopathy IV.Alkalosis V.Adrenal sufficiency

What three risk factors are associated with necrotizing enteroColitis in term infants I.Umbilical catheters II.Exchange transfusions III.Polycythemia IV.Hyperoxia at time of delivery V.Increase in interstitial fluid pressure

Which of the following can be used in the management of an infant with necrotizing enteroColitis I.DeCompression of bowel II.Replacement of blood products III.IV antibiotics IV.Total parenteral nutrition V.IV prostaglandin inhibitor

What percentage of infants who develop necrotizing enteroColitis require surgical intervention

Which of the following statements is true regarding fatalities in patients diagnosed with necrotizing enteroColitis

How many hours does it take the ductus arteriosus to close Completely in a healthy term baby

What is the goal of ventilatory support for a patient with necrotizing enteroColitis

Which of the following are not clinical signs of necrotizing enteroColitis I.Bradypnea II.Tachypnea III.Increase work of breathing IV.Apnea V.Ascites VI.Cyanosis

When does a patent ductus arteriosus usually present in an infant

When managing a mechanically ventilator patient with intraventricular hemorrhage, what values should a registered respiratory therapist be most Concerned with I.PaCO₂ II.PaO₂ III.pH IV.HCo₃

How is patent ductus arteriosus treated I.Surgical ligation II.Decrease in fluid intake III.Indomethacin IV.IV ibuprofen V.Treating hypoxemia