NeoNate week 2 (part 2)

1.

1 point

What is the most accurate classification of neonatal mechanical ventilation?

volume controlled, flow limited, time cycled

volume controlled, flow limited, volume cycled

pressure controlled, pressure limited, flow cycled

pressure controlled, pressure limited, time cycled

2.

1 point

An advantage to the use of negative pressure ventilation is:

reduced cardiopulmonary complications

allows the use of lower FiO2

better access to the patient

less cost to the patient

3.

1 point

How is hypercapnic respiratory failure identified?

a decreased PaO2

an increased PaCO2

a decreased bicarbonate

a decreased pH

4.

1 point

Determination of adequate levels of PIP is initially determined by:

patient weight and gestational age

FiO2 requirements

flow and inspiratory time to be used

chest excursion, breath sounds, and PaCO2

5.

1 point

The first parameter weaned from a mechanically ventilated infant should be:

flow

PIP

rate

FiO2

6.

1 point

Artificial surfactant is best administered:

directly instilled into the endotracheal tube

through the peripheral IV site

adding to the ventilator circuitry

nebulizer into the endotracheal tube

7.

1 point

Rescue surfactant is given:

as quickly as possible following delivery

before the onset of RDS symptoms

to any patient less than 32 weeks’ gestation

after the onset of RDS symptoms

8.

1 point

Which of the following is not true regarding partial liquid ventilation?

it reduces infection

improves lung compliance

improves pulmonary gas exchange

reduces lung injury

9.

1 point

Which of the following are clinical signs of failure to wean?
I. increased chest excursion
II. bradycardia
III. retractions
IV. tachycardia
V. pallor

III, IV, V

I, III, IV

II, III, IV, V

I, III, V

10.

1 point

While managing a patient receiving HFOV the respiratory care practitioner notices that the PaO2 is decreased. This can be corrected by all of the following except:

increasing the PEEP

increasing the PIP

increasing the amplitude

increasing the frequency

11.

1 point

What mode of ventilation should be instituted if the physician requests an increase in the spontaneous tidal volume during SIMV?

MMV

APRV

IRV

PSV

12.

1 point

The major advantage to HFV is:

improved oxygenation

reduced cost

improved ventilation

reduced barotrauma

13.

1 point

Which of the following parameters has the greatest influence on mean airway pressure?

inspiratory timw

PIP

PEEP

flow rate

14.

1 point

Which of the following describes the venoarterial route of ECLS?

Blood is taken from the right atrium and returned to the aortic arch

Blood is taken from the pulmonary vein and returned to the pulmonary artery

Blood is taken from the subclavian vein and returned to the subclavian artery

Blood is taken from the femoral vein and returned to the femoral artery

15.

1 point

Changing which of the following ventilatory parameters would not alter minute ventilation?

rate

PEEP

PIP

expiratory time

16.

1 point

The respiratory care practitioner receives blood gas results on a ventilated infant. The PaCO2 is 48 mmHg and previously it was 43 mmHg. A proper ventilator change would be:

increase the inspiratory time and flow

increase the rate by 5 BPM or the PIP by 2 cm H20

decrease the rate by 5 BPM and the PIP by 3 cm H20

decrease the flow rate and the FiO2

17.

1 point

Which of the following HFV methods requires the use of an adapted ETT?

HFOV

HFPPV

HFFI

HFJV

18.

1 point

Two criteria used to determine potential ECLS patients are:

level of hypoxemia and ventilatory support

patient age and weight

A-a gradient and the oxygen index

level of PaCO2 and pH

19.

1 point

What arterial blood gas change is most likely to be observed when the mean airway pressure is increased?

increased PaCO2

increased PaO2

decreased PaO2

decreased PaCO2

20.

1 point

Which of the following is not considered a hazard of mechanical ventilation?

diaphragmatic paralysis

barotrauma

intracranial hemorrhage

infection

21.

1 point

The main advantage in using volume-cycled ventilation with neonates is:

improvement in lung compliance

reduced barotrauma

reduction in airway resistance

delivery of a consistent tidal volume

22.

1 point

Which of the following modes of ventilation should not be used on a spontaneously breathing patient?

IMV

inverse ratio ventilation

APRV

SIMV

23.

1 point

All of the following are hazards of HVF except:

hyperinflation

necrotizing tracheobronchitis

air trapping

hypertension

24.

1 point

The most common complication of ECLS is:

bleeding

barotauma

machine failure

infection

25.

1 point

Which of the following would indicate a failure in CPAP?
I. PaO2 less than 50 mmHg with an FiO2 of 80% to 100% and CPAP of 10 to 12 cm H20
II. PaCO2 greater than 50 mmHg
III. Marked retractions
IV. frequent apnea spells
V. reduced FiO2 needs

I, III, IV

II, III, IV

I, II, III

I, II, V

26.

1 point

How is tidal volume increased during pressure-controlled ventilation?

increase the peep and the change in pressure by the same value

increase the PEEP

increase the delta P (change in pressure)

increase the expiratory time