NPS Practice Questions

Question 1

A 1.5Kg NEONATE HAS JUST RECEIVED SURFACTANT REPLACEMENT THERAPY. THE PATIENTS HEART RATE SUDDENLY DROPS TO 78 AND THE SpO2 DROPS TO 80%. TRANSILLUMINATION OF THE CHEST REVEALS HYPERLUCENCY OVER THE RIGHT. WHAT SHOULD THE RESPIRATORY THERAPIST RECOMMEND NEXT?

A.CHEST X-RAY
B. SUCTIONING
C.NEEDLE DECOMPRESSION TO THE
AFFECTED SIDE
D. INCREASE FiO2

Answer 1

C.NEEDLE DECOMPRESSION TO THE
AFFECTED SIDE

Question 2

A term newborn is delivered and at one minute presents with a heart rate of 70, limp, pale, has some flexion of the extremities and an irregular respiratory effort. What is the APGAR score you would assign this infant?

A. 1
B. 5
C. 3
D. 7

Answer 2

C. 3

Question 3

MODERATE STRIDOR WITH RETRACTIONS IS NOTED POST EXTUBATION OF A 15-YEAR-OLD IN THE PEDIATRIC ICU. WHAT YOU RECOMMEND TO THE PHYSICIAN?

A.INTUBATION
B.INHALED CORTICOSTEROIDS
C.NEBULIZED RACEMIC EPINEPHRINE
D. COOL BLAND AEROSOL THERAPY

Answer 3

C.NEBULIZED RACEMIC EPINEPHRINE

Question 4

A 28-Kg, 7-YEAR-OLD CHILD WITH LUNG CONTUSIONS HAS DEVELOPED ARDS FROM HIS INJURIES. HE IS BEING MECHANICALLY VENTLATED WITH THESE SETTINGS: MANDATORY RATE: 18 PIP 30 PEEP +8 FiO2 60% EXHALED VT IS 170ML RECENT ABG IS AS FOLLOWS: pH 7.27 PCO2 62 PaO2 70 HCO3 29

YOUR RECOMMENDATION FOR CORRECTING THIS ABG IS TO:
A. INCREASE PEEP
B. INCREASE MANDATORY RATE
C. DECREASE PIP
D. INCREASE FiO2

Answer 4

B. INCREASE MANDATORY RATE

Question 5

WHICH OF THE FOLLOWING SHOULD THE RESPIRATORY THERAPIST USE TO DETERMINE THE GESTATIONAL AGE OF A NEONATE?

A. SILVERMAN
B. GLASGOW
C. APGAR
D. BALLARD

Answer 5

D. BALLARD

Question 6

A 700g NEONATE IS BEING MECHANICALLY VENTILATED WITH HFOV. THE CHEST XRAY REVEALS THE LUNGS ARE ONLY EXPANDED TO THE 6TH RIB. THE PATIENT HAS HAD INCREASED OXYGEN NEEDS FROM 0.30 FIO2 TO 0.60 FIO2. WHICH SETTING WOULD YOU ADJUST TO REACH PROPER EXPANSION AND BETTER OXYGENATE THE PATIENT?

A. deltaP
B. MEAN AIRWAY PRESSURE (MAP)
C. HERTZ
D. I-TIME (Ti)

Answer 6

B. MEAN AIRWAY PRESSURE (MAP)

Question 7

A 10-YEAR-OLD ASTHMATIC IN MODERATE RESPIRATORY DISTRESS IS ALREADY RECEIVING CONTINUOUS ALBUTEROL, CORTICOSTEROIDS AND MAGNESIUM SULFATE. THE PATIENT STILL HAS INCREASED WORK OF BREATHING AND DIMISHED BREATH SOUNDS WITH FAINT WHEEZING HEARD. WHAT WOULD BE YOUR NEXT RECOMMENDATION

A. HELIOX
B. HFCWO
C. NEBULIZED 3% HYPERTONIC SALINE
D. ECMO

Answer 7

A. HELIOX

Question 8

A 2-YEAR-OLD CHILD IS PRESENTING TO THE EMERGENCY DEPARTMENT DURING YOUR SHIFT WITH MODERATE RETRACTIONS, WHEEZING AND AN SpO2 of 87%. YOU RECOMMEND NEBULIZED ALBUTEROL AT THIS TIME. WHICH DELIVERY SYSTEM WOULD YOU USE?

A. MDI WITH HOLDING CHAMBER
B. SMALL VOLUME NEBULIZER WITH MOUTHPIECE
C. BLOW-BY SMALL VOLUME NEBULIZER WITH A MASK
D. SMALL VOLUME NEBULIZER WITH A MASK

Answer 8

D. SMALL VOLUME NEBULIZER WITH A MASK

Question 9

A NEONATE THAT HAS BEEN ADMITTED TO THE NEONATAL ICU IS PRESENTING WITH SIGNS OF PERSISTANT PULMONARY HYPERTENSION OF THE NEWBORN. THE NEONATALOGIST WOULD LIKE YOU TO INITIATE INHALED NITRIC OXIDE THERAPY. WHICH STARTING DOSE DO YOU RECOMMEND FOR THIS PATIENT?

A. 5PPM
B. 40PPM
C. 30PPM
D. 20PPM

Answer 9

D. 20PPM

Question 10

A CHEST X-RAY OF A 1200g NEONATE REVEALS SMALL CYSTIC RADIOLUCENCIES BILATERALLY. WHAT IS THIS INDICATIVE OF?

A. TENSION PNEUMOTHORAX
B. PULMONARY INTERSTITIAL EMPHYSEMA
C. TETRALOGY OF FALLOT
D. TRANSIENT TACYPNEA OF THE NEWBORN

Answer 10

B. PULMONARY INTERSTITIAL EMPHYSEMA