NEONATAL AND PEDIATRIC

Question 1

is the age of the infant computed from the date of birth

Answer 1

Chronologic age

Question 2

is the age of the infant computed from the date of conception

Answer 2

Gestational age

Question 3

Term infants are born between?

Answer 3

37 and 42
weeks of gestational age

Question 4

preterm infants (premature or “preemies”) are born at fewer than

Answer 4

37 weeks of gestational age

Question 5

postterm infants are born at

Answer 5

43 or more weeks of
gestational age

Question 6

GRAVIDA is a pregnant woman, PARA is a woman who delivers a live infant,
and ABORTION is the delivery of a dead infant or embryo.

Question 7

Infants born prematurely are more susceptible to develop?

Answer 7

• RDS
• pulmonary interstitial emphysema (PIE),
• intraventricular hemorrhage (IVH)
• bronchopulmonary dysplasia (BPD).

Question 8

Post-term infants are more susceptible to:

Answer 8

• severe perinatal asphyxia
• meconium aspiration
• persistent pulmonary hypertension of the newborn (PPHN).

Question 9

caused by a failure to re-absorb
fetal lung fluid after birth.

Answer 9

transient tachypnea
of the newborn (TTN)

Question 10

is a simple, quick, and reliable means to assess and document the newborn’s status immediately after birth.

Answer 10

Apgar score

Question 11

Those who are adjusting well to extrauterine life usually have 1-minute scores ____________

Answer 11

7 to 10 but may still show:
- acrocyanosis
- irregular respirations
- hypotonia

Question 12

Moderately depressed infants with 1-minute scores of __________

Answer 12

4 to 6 may need more than routine care and often require an increased FIo2 with BVM ventilation.

Question 13

Infants who have 1-minute scores of ___________

Answer 13

0 to 3 are:
- severely depressed
- need extensive medical resuscitation
that may include intubation and mechanical ventilation.

Question 14

The simplest resuscitation required for newborns:

Answer 14

clearing the airway and drying the skin

Question 15

Allows for the evaluation of the
L/S ratio to assess pulmonary lung maturity.

Answer 15

Amniocentesis

Question 16

A healthy fetus has a minimum of an increase in heart rate of at least:

Answer 16

15 beats/minute

Question 17

Low birthweight (LBW): _____
Very low birthweight (VLBW): _____
Extremely low birthweight (ELBW): ______

Answer 17

• less than 2500 g
• less than 1500 g
• less than 1000 g

Question 18

• weight is appropriate for the gestational age: ______
• smaller than expected, the weight falls below the 10th percentile for the gestational age: _____
• heavier than expected, the birthweight is above the 90th percentile for the gestational age: ______

Answer 18

• Appropriate for gestational age (AGA)
• Small for gestational age (SGA)
• Large for gestational age (LGA)

Question 19

Gestational age is assigned by

Answer 19

• maternal dates
• fetal ultrasound
• gestational assessment examination.

Question 20

• Hyperthermia is a core body temperature of more than 37.5° C or 99.5° F.
• Hyperthermia in the newborn usually is caused by environmental factors.

Question 21

• Hypothermia is a core body temperature of less than 36.5° C or 97.7° F.
• Hypothermia is a more common and
  significantly more serious sign of INFECTION in the newborn than in the older child or adult.

Question 22

The most common methods to measure temperature are:

Answer 22

axillary and rectal temperatures.

Question 23

The normal pulse rate for newborns is between

Answer 23

100 and 160 beats/minute.

Question 24

The normal respiratory rate for
neonates and infants is between:

Answer 24

30 and 60 breaths/minute

Question 25

TACHYPNEA can be caused by - hypoxemia, - metabolic and respiratory acidosis, - CCHD, - anxiety, - pain, - hyperthermia and - crying.

Question 26

BRADYPNEA can be caused by - certain medications (e.g., narcotics), - hypothermia, and - central nervous system diseases,

Question 27

Respiratory rates that exceed 60 breaths/minute but normalize over the next several hours may indicate TTN (Transient tachypnea of newborn)

Question 28

Apnea may be accompanied by - cyanosis, - bradycardia, - pallor, and - hypotonia.

Question 29

Gasping respiratory efforts are never to be considered normal respiratory patterns in newborns.

Question 30

Usually, a term neonate’s systolic blood pressure should be no higher than 70 mm Hg, with diastolic pressure no higher than 50 mm Hg.

Question 31

Normal pulse pressure (the difference between systolic and diastolic blood pressure) in a term infant is between 15 and 25 mm Hg

Question 32

Difference in blood pressure between upper and lower extremities can be an indication of a CCHD such as

Answer 32

Coarctation of the aorta

Question 33

The infant should be unclothed and in a ______ position initially in a quiet environment.

Answer 33

SUPINE

Question 34

Peripheral cyanosis of the hands and feet during the first 24 to 72 hours of life:

Answer 34

Acrocyanosis

Question 35

An infant with respiratory distress characteristically exhibits:

Answer 35

- tachypnea (discussed earlier), - retractions, - nasal flaring, and sometimes - grunting

Question 36

Retractions in the infant generally indicate:

Answer 36

- decrease in lung compliance, and a - serious increase in the work of breathing or - airway resistance, or both.

Question 37

It is a cardinal sign of respiratory distress and increased work of breathing in the infant.

Answer 37

Nasal flaring

Question 38

Is a sound heard at the end of expiration just before rapid inspiration

Answer 38

Grunting

Question 39

Capillary refill should be less than 3 seconds and will be greater than 3 seconds if the infant has a ________ or _________

Answer 39

low cardiac output or decreased peripheral perfusion.

Question 40

This can decrease blood flow to the skin and prolong capillary refill:

Answer 40

- acidosis, - hypoxemia, - hypoglycemia - hypothermia

Question 41

Is a technique often used in examining the chest of neonates and small infants, but not an older child or adult?

Answer 41

Transillumination

Question 42

In the presence of a pneumothorax or pneumomediastinum, the entire hemithorax lights up, dispersing the light in an irregular shape

Question 43

Leukopenia, particularly neutropenia is a more ominous sign. Usually, neutropenia indicates an infection and implies that the infant may be developing an _________

Answer 43

overwhelming infection

Question 44

A chronically ill infant with POOR NUTRITION has low levels of calcium and phosphorus and an increased risk for developing rickets.

Question 45

Any condition that decreases blood flow under the electrode, such as acidosis, shock, hypovolemia, or hypoglycemia, can cause tcpo2 to be falsely lower than Pao2.

Question 46

Three volumes can be measured easily in newborns independent of their cooperation: - FRC, - thoracic gas volume (TGV), and - crying vital capacity (CVC).

Question 47

Resistance is elevated in infants with:

Answer 47

MAS and BPD

Question 48

The most important clinical lung volume measurement is the:

Answer 48

FRC

Question 49

- In the older pediatric patient, the preferred position for taking x-ray films is upright: - most chest x-ray films are taken with the infant in the _________ position

Answer 49

Supine Position

Question 50

Chest radiographs should be done in infants who have:

Answer 50

- unexplained tachypnea, - cyanosis, - abnormal breath sounds, - malformations of the chest or airway, or an - overall generalized sick appearance.

Question 51

is a disease of inadequate surfactant production. The immature alveoli have increased surface tension and collapse. The chest radiograph of these infants is fairly typical. It includes a diffuse, hazy ground-glass appearance; air bronchograms extending out to the periphery of the lungs; and low lung volumes

Answer 51

RDS

Question 52

is primarily an airway disease. The stressed mature fetus passes meconium into the amniotic fluid and then with gasping respirations inhales the meconium-laden amniotic fluid into its lungs.

Answer 52

MAS

Question 53

The indications for umbilical artery catheterization include :

Answer 53

- source for frequent ABG sampling - continuous blood pressure monitoring - large-scale blood replacement

Question 54

- is usually a viral disease affecting the trachea and small airways in children - tends to appear in children between 3 months and 5 years old, but it can happen at any age - The child may have cold symptoms, such as a stuffy or runny nose, for a few days and may also have a fever. These symptoms progress to a loud, seal-like barking cough; rapid or difficult respiration; and grunting or wheezing while breathing.

Answer 54

CROUP

Question 55

- is usually a bacterial disease that causes significant edema and inflammation of the epiglottis - very uncommon because the Haemophilus influenzae type B (Hib) vaccine is a routine childhood immunization. - The disease was once most often seen in children aged 2 to 6 years

Answer 55

Epiglottitis

Question 56

- is a chronic airway disease that is caused by airway inflammation and hyperresponsiveness to irritants. - The typical symptoms include intermittent dry cough and expiratory wheezing.

Answer 56

Asthma

Question 57

First 2 weeks of pregnancy, when the female ovum and male sperm unite

Answer 57

Conception

Question 58

Pregnancy weeks 3 to 12, encompassing 4 to 8 weeks of embryo development. This is when the major organs such as the central nervous system and heart begin development.

Answer 58

Embryonic stage

Question 59

Encompasses the remaining weeks 13 to 40 for a full-term delivery. Most lung development occurs during this phase

Answer 59

Fetal development stage

Question 60

Toward the end of this phase, at about week 35, mature surfactant begins to appear

Answer 60

Saccular Phase