Kettering Neonatal/Pediatric Specialist (NPS) Practice Exam

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• Which device is most appropriate for intubation in a child with laryngotracheal stenosis?
• A 29-week gestation neonate exhibits severe cyanosis, bradycardia, and hypotension. What should the neonatal/pediatric specialist recommend?
• A child presenting with failure to thrive might indicate which underlying issue?
• What is the most important indicator of an infant's nutritional status?
• Which adjustment should be made for a child with cerebral palsy and sleep apnea exhibiting elevated PaCO2 during nocturnal bilevel noninvasive ventilation?
• During a neonatal assessment, what finding could indicate a potential pneumothorax?
• The presence of nodular, irregular bubbles on a chest x-ray accompanied by lucencies in a premature newborn indicates which condition?
• Which test would best evaluate blood type incompatibility between the mother and the fetus?
• What is the I:E ratio for a ventilator set at a rate of 20 breaths/minute with an inspiratory time of 0.6 seconds?
• What recommendation should be made for a 2-year-old patient with mild inspiratory stridor after extubation?
• What type of artificial airway should be recommended for a 10-year-old girl with a C-3 fracture requiring mechanical ventilation after 9 days of intubation?
• What action should be taken when a preterm neonate shows increased respiratory effort while on mechanical ventilation?
• A 9-year-old boy with congenital muscular dystrophy requires assistance with airway clearance after experiencing an ineffective cough. Which recommendation should the specialist make?
• According to Nagele's rule, what is the due date for a woman whose last menstrual period began on October 26?
• What type of breath allows the patient to control all variables during mechanical ventilation?
• If a premature neonate is ventilated at a respiratory rate of 30/minute and an inspiratory time of 0.5 seconds, what is the resulting I:E ratio?
• What finding should a specialist document upon observing one side of a newborn's body is red and the other side is pale?
• How should a neonatal/pediatric specialist interpret umbilical arterial blood gas results indicating pH 7.28 and PaCO2 49 torr from a term infant on room air?
• In a 16-year-old patient on mechanical ventilation, what is the vascular resistance of the systemic circulation if given MAP, CVP, and CO?
• What condition should a specialist suspect for a child with a sweat chloride level of 88 mEq/L?
• What should be the principal focus during resuscitation of a neonate delivered via emergency C-section?
• A Glasgow Coma Scale of 10 indicates which level of head injury?
• For an infant requiring ventilation due to meconium aspiration, what is the maximum recommended initial pressure for ventilation?
• When a child is set to receive 50% oxygen therapy, how should the air entrainment port on the nebulizer be set?
• A 2-year-old with inspiratory stridor and recent cold symptoms shows subglottic swelling. What condition should the specialist suspect?
• In the case of an unrestrained 2-year-old with a severe closed head injury on mechanical ventilation, what should be increased to improve oxygen levels?
• A peak inspiratory pressure of 35 cmH2O in neonatal ventilation increases the risk of which complications?
• After a child aspirates gummy bears and is suctioned, what should the neonatal/pediatric specialist do next?
• An infant with meconium aspiration requires mechanical ventilation. Which initial ventilator settings are appropriate?
• During suctioning of an 11-year-old child, which action should the specialist take if secretions are difficult to remove and suction pressure is at 85 mm Hg?
• After extubation, a specialist notices marked inspiratory stridor in a 5-year-old patient. What should be the immediate action?
• After the assessment of a child who suffered multiple lacerations and is hypotensive, what should the neonatal/pediatric specialist recommend?
• Which of the following statements regarding capillary blood samples is TRUE?
• For a pediatric patient on mechanical ventilation with given blood gas results, what is the partial pressure of alveolar oxygen?
• When is it most critical to assess for signs of respiratory distress in pediatric patients?
• Which suction catheter is appropriate for a pediatric patient with a 6 mm ID endotracheal tube?
• During a high-risk delivery with a breech presentation, which type of breech is described when the buttocks present first?
• In the case of a 15-year-old asthma patient in moderate distress with no improvement, which delivery method should be selected for heliox therapy?
• What is a key diagnostic tool for a suspected case of appendicitis in children?
• Which mode of transport should be recommended for a premature infant requiring transfer to a NICU 120 miles away?
• For a preterm neonate with specific symptoms and signs of distress, which treatment options would be appropriate?
• In treating a newborn with hypoplastic left heart syndrome, which therapy should be recommended to balance vascular resistance?
• In mechanical ventilation, what conclusion can be drawn if peak inspiratory pressure increases but plateau pressure remains constant?
• In assessing a 9-year-old child on VC/SIMV who is in distress, what should be recommended to improve comfort during breathing through the endotracheal tube?
• In the case of a 14-year-old with meconium aspiration needing 100% oxygen, what is the recommended next step?
• Following stimulation and suctioning, a full-term infant shows mild respiratory distress and cyanosis. What initial treatment should be started?
• What is the primary concern for a newborn with polysyndactyly?
• A 32-year-old woman in labor shows concerning vital signs, including low blood pressure. What should the specialist consider?
• What is the cardiac index for a 13-year-old patient with a cardiac output of 6.0 L/min and a body surface area of 1.5 m2?
• After 12 hours on volume-control ventilation, what should the neonatal/pediatric specialist do if there is an increase in secretion viscosity?
• What action should be taken for a woman in active labor with a fetal oxygen saturation level of 50%?
• A 6-day-old neonate with profound cyanosis has an egg-shaped heart shadow on an x-ray. What treatment is recommended?
• Which condition is characterized by a failure to thrive and is associated with malnutrition due to inadequate protein intake?
• A child with asthma is evaluated and shows symptoms three days a week. How should the asthma be classified?
• In a case of severe airway obstruction post-extubation in a child, what immediate intervention may be necessary?
• An 8-year-old child recovering from blunt chest trauma shows diminished breath sounds on one side. What is the next recommended step for evaluation?
• What action should be taken if a cuff pressure is measured at 24 cm H2O in a size 6 mm ID cuffed endotracheal tube?
• In order to determine the length of an orogastric tube in a premature neonate, the specialist should measure the distance from the:
• How can the static lung compliance for a 15-year-old child on mechanical ventilation be determined with given data?
• What should a specialist do if a pediatric patient exhibits inability to maintain adequate oxygen levels post-extubation?
• Which of the following best describes the importance of monitoring blood gases in pediatric patients on mechanical ventilation?
• An infant born to a mother who smoked during pregnancy is at a greater risk of which condition?
• What condition presents with an inability to tolerate feedings due to excessive vomiting in infants?
• What should be set as the mean airway pressure when initiating high frequency oscillatory ventilation for a preterm infant?
• What is an indicator that a child's respiratory condition might be serious enough to need hospitalization?
• What is a likely cause of stertor in a 10-year-old child's assessment?
• Which airway device should be inserted to facilitate nasotracheal suctioning in a child with copious secretions?
• In assessing a neonate’s response to positive pressure ventilation, what finding might suggest that the intervention is effective?
• According to the American Heart Association, high-quality CPR includes which of the following?
• What should a neonatal/pediatric specialist do if they are unable to pass a suction catheter through the endotracheal tube of a 10-year-old child?
• What standard is used by neonatal/pediatric specialists to assess preoperative spirometry results?
• What should a neonatal/pediatric specialist do if the PETCO2 monitor reads zero after re-taping an endotracheal tube?
• In cases of suspected apnea in preterm infants, what is the preferred initial intervention?
• What is the target range for pre-ductal SpO2 four minutes after delivery for a term infant?
• To reduce the risk of Ventilator-Associated Pneumonia (VAP) in a 3-year-old patient, which two methods should be recommended?
• A 2-year-old with respiratory distress may have swallowed an object. What should be the next step to determine the cause?
• After an ATV accident, a 13-year-old's cardiac output is 6.0 L/min. What does this indicate about their cardiac performance?
• A 2-week-old infant on pressure control ventilation needs a decrease in PaCO2. What should the specialist increase?
• What complication should the neonatal/pediatric specialist anticipate when using an endotracheal tube that is too large for a child?
• Which of the following is a potential consequence of using an oversized endotracheal tube on a pediatric patient?
• A 39-week-gestation newborn shows signs of shock and thermal instability. What infection should be suspected?
• During positive pressure ventilation of a premature neonate, if the chest is not rising, which action is appropriate?
• If a newborn's heart reveals S3 and S4 heart sounds, what further evaluation should the specialist recommend?
• A 3-year-old child presents with wheezing after playing with crayons. What procedure should be recommended?
• What cleaning procedure should be recommended for the nebulizer to control infection at home?
• After a recruitment maneuver in a 10-year-old with ARDS, if SpO2 falls back down, what should be the next step?
• Which procedure would help differentiate between persistent pulmonary hypertension of the newborn (PPHN) and right-to-left shunting from a congenital heart defect?
• During fetal scalp monitoring, a primigravida woman has a scalp pH of 7.10 at 39 weeks of gestation. What should be done next?
• A newborn term infant is receiving oxygen by oxyhood and has a SpO2 of 72%. What is the appropriate action for the neonatal/pediatric specialist?
• What should be monitored closely for a pediatric patient transitioning from voluntary to assisted mechanical ventilation?
• A full-term infant presents with coughing and choking during feedings, and an x-ray indicates a coiled tube in the mediastinum. What should the specialist recommend?
• For a child with status asthmaticus receiving helium and oxygen, what could be the actual flow rate to the non-rebreathing mask if the flowmeter is set at 10L/min?
• A 3-year-old child shows signs of respiratory distress. What assessment would be most critical in determining the need for immediate intervention?
• What does the neonate/pediatric specialist recommend for a child on VC/SIMV ventilation who is facing increased breathing resistance?
• During a bronchoscopy, if a child begins to cough as the bronchoscope advances, what should the specialist recommend?
• A 3-year-old child exhibits poor air exchange and a high-pitched noise during inspiration while clutching their neck. This situation is best described as:
• What should a neonatal/pediatric specialist recommend for a 32-week gestation-age neonate with a SpO2 of 74% and a pH of 7.24?
• What is the appropriate endotracheal tube size for a 4-year-old near-drowning victim?
• A 12-year-old child is receiving mechanical ventilation after a skateboard accident. What should the neonatal/pediatric specialist increase to improve oxygenation?
• For a term infant on mechanical ventilation with specific blood gas results, what should the neonatal specialist increase?
• A neonate with central cyanosis has a heart rate that increases to 70/minute after 30 seconds of resuscitation. What should the specialist do next?
• What action should the neonatal/pediatric specialist take when a post-term neonate is born with weak respiratory efforts and a heart rate of 58/min?
• How should surfactant therapy be administered to a preterm neonate with IRDS?
• What condition is indicated by a child having increased chest movement but no nasal airflow during polysomnography?
• Which vital sign change would prompt immediate intervention during newborn resuscitation?
• For a neonate with IRDS on pressure control ventilation, how can the mean airway pressure be increased?
• What is the immediate management goal for a brain-dead near-drowning victim whose parents wish to donate organs?
• What are considered primary goals of a home care program?
• What should the pediatric specialist do after reattaching the oxygen tubing for a 7-year-old asthmatic child, who’s SpO2 improved to 93%?
• How should the specialist calculate the inspiratory time for a ventilator set at 25 breaths per minute with an I:E ratio of 1:3?
• What is the appropriate response when measured NO is above the set concentration during inhaled nitric oxide therapy?
• A parent's choice to withhold life support from an anencephalic infant illustrates which ethical principle?
• When a patient on CPAP has worsened respiratory distress, what action should be taken?
• What finding would indicate that a neonatal/pediatric specialist should perform an intervention after unable to maintain adequate endotracheal suctioning in a child?
• What should be monitored closely in a newborn diagnosed with neonatal abstinence syndrome?
• What is the priority action when managing a critically ill child with severe abdominal pain?
• A newborn exhibits a heart rate of 50/min and is limp after delivery. What intervention should be initiated?
• Which statement is TRUE regarding urine output for a full-term infant weighing 3kg?
• In mechanical ventilation management, what does a high PaCO2 indicate that might require adjustment to the ventilator settings?
• What do blood gas results of pH 7.07, PCO2 62 torr, and PO2 45 torr indicate in a 28-week gestation neonate receiving 40% oxygen?
• After changing the respiratory rate of a neonate receiving mechanical ventilation, which action should the neonatal/pediatric specialist consider if ABG results indicate stable values?
• What action should be taken when the high pressure alarm sounds during a therapeutic bronchoscopy?
• In cases of suspected pneumothorax in a child, which intervention is critical?
• A 4-year-old child presents with wheezing and hypoxia. What treatment should the specialist initiate?
• When setting an initial volume goal for an incentive spirometer for a child after abdominal surgery, what should it be based on?
• What is the most recommended intervention if a preterm neonate has linear lucencies in the chest x-ray and worsening blood gas results?
• Which assessment finding would indicate the need for immediate airway management in a pediatric patient?
• To enhance the effectiveness of albuterol for a child with asthma, which recommendation is best?
• During assessment, an infant shows a protruding belly with an edematous face and limbs. This condition is best described as?
• For a patient in the trauma unit with a chest tube clamped for 24 hours, what should the specialist recommend?
• What is the best first step in managing a patient with potential airway obstruction after extubation?
• For a 28-week gestational-age neonate, what is the appropriate length of insertion for the endotracheal tube?
• During mechanical ventilation in pressure control, under which condition will the preset inspiratory pressure not be reached?
• For a preterm neonate on mechanical ventilation who has blood gas results indicating an acidosis, which intervention should be implemented?
• For a neonate who fails to breathe spontaneously after a C-section due to placental abruption, which factor could be responsible?
• What is a suitable setting to encourage a child to achieve their full inspiratory capacity with an incentive spirometer?
• A chest x-ray reveals irregular bubbles in a 1-month-old infant with poor oxygenation. What should the specialist recommend?
• For a child with asthma, what medication is commonly prescribed as a rescue inhaler?
• If a sputum sample shows an abnormal number of squamous cells, what is the appropriate next step a specialist should take?
• What is the Vd/Vt ratio calculated for a 7-year-old following surgery with current monitoring data of FiO2 0.40?
• A 3-year-old child receiving positive pressure ventilation shows coarse crackles in both upper lobes. What should the specialist recommend?
• What should be increased in a 4 kg infant receiving volume control ventilation who appears tachypneic?
• What is the best recommendation for a 3-year-old with an oxygen saturation of 87% currently on 50% oxygen via a simple mask?
• An infant born to a mother with diabetes is at high risk for which conditions?
• A full-term neonate receiving mechanical ventilation has a chest x-ray showing the endotracheal tube in the T3 position. What should the specialist recommend?
• In mechanical ventilation, what is indicated by a consistently low plateau pressure in a patient receiving adequate tidal volume?
• Which of the following should a specialist recommend for severe metabolic acidosis during lengthy pediatric resuscitation?
• During a CPAP trial, which action should the neonatal/pediatric specialist take if a 28-week-gestation neonate shows significant distress?
• What is the appropriate ventilator adjustment for a preterm neonate displaying significant respiratory effort?
• Which of the following is an appropriate treatment for a child exhibiting acute respiratory distress due to asthma exacerbation?
• If a feeding tube is coiled in the newborn's mediastinum upon post-procedure x-ray, this would indicate?
• A 5-year-old child shows signs of hoarseness and moderate stridor after a cold. What is the appropriate recommendation for this child?
• Following administration of nebulizer treatments for asthma, what information is crucial to monitor in a pediatric patient?
• In a motor vehicle accident case, which condition should the specialist suspect based on the pulmonary artery catheter readings?
• Which of the following should be recommended for a newborn with hyperbilirubinemia?
• Which of the following is a common sign of respiratory distress in a newborn?
• The chest x-ray of a premature neonate reveals bubbles in the hilar area. This finding is most consistent with what condition?
• A two-year-old child with a history of meconium ileus presents with severe respiratory symptoms. What is a likely diagnosis?
• With a biophysical profile score of 3, what should the specialist recommend for a 30-week pregnant woman?
• Which pharmaceutical agent should not be used during a bronchoscopy when a child is coughing?
• What indicates an "altered oxygenation" status in a neonate that requires immediate intervention?
• A 4-year-old child with stridor, drooling, and a fever is suspected of having what condition?
• What is the most appropriate action if a galvanic fuel cell cannot be calibrated while analyzing FiO2 for a neonate?
• Which factor could cause a loss of pressure during nasal CPAP delivery to a neonate?
• Protruding intestines contained within a translucent membrane or sac best describes which of the following conditions?
• What should be checked first if a child with a known respiratory condition presents with sudden respiratory distress?
• What is the maximum mean airway pressure value that should not be exceeded in a six-week-old neonate ventilated with pressure control?
• In a patient with an increasing peak inspiratory pressure, which assessment finding may suggest a need for intervention?
• What adjustment is necessary for the high pressure alarm before a fiberoptic bronchoscopy in a child receiving volume control ventilation?
• For a child with moderate to severe asthma, which medicine might be included in their action plan to relieve acute symptoms?
• What is the most critical step for a pediatric patient with a significant drop in oxygen levels during mechanical ventilation?
• What is the a/A ratio for a 26-week gestation-age neonate on mechanical ventilation with given PaO2 and PaCO2 levels?
• In a 1-year-old child with a gradual onset of symptoms, which condition should the neonatal/pediatric specialist suspect?
• For a pediatric patient, what is the maximum recommended flow rate for a nebulizer treatment?
• What should the neonatal/pediatric specialist do for a 28-week-gestation infant with RDS on mechanical ventilation if there is adequate oxygenation and ventilation?
• What should the neonatal/pediatric specialist do for a child with a head injury exhibiting hypoxic conditions on mechanical ventilation?
• Which method should the neonatal/pediatric specialist recommend for an 8-year-old child with cerebral atrophy to promote bronchial hygiene while delivering a bronchodilator?
• In managing a child on mechanical ventilation in the Assist/Control, Volume Control mode, how should the specialist increase minute ventilation?
• How would you describe a neonate with meconium staining, a heart rate of 110/minute, and strong respiratory effort?
• Which of the following would be most helpful in treating sinus bradycardia during a pediatric resuscitation?
• For a near-drowning victim on mechanical ventilation who is hypercapnic, what should be done to ventilator settings?