quiz 5

Question 1

Signs of a diaphragmatic hernia include all of the following, EXCEPT:

Select one:

a. a scaphoid or concave abdomen.
b. bilaterally absent breath sounds.
c. noted increased work of breathing.
d. audible bowel sounds in the chest.

Answer 1

b. bilaterally absent breath sounds.

Question 2

After inserting an orogastric tube in a newborn, you should:

Select one:

a. leave the 20-mL syringe attached.
b. perform intubation within 2 minutes.
c. connect the tube to continuous suction.
d. leave the tube open to allow air to vent.

Answer 2

d. leave the tube open to allow air to vent.

Question 3

If a newborn requires epinephrine and peripheral venous access is unsuccessful, you should:

Select one:

a. cannulate the umbilical vein.
b. defer drug therapy and transport.
c. perform intubation immediately.
d. inject the drug directly into a vein.

Answer 3

a. cannulate the umbilical vein.

Question 4

Epinephrine is indicated during newborn resuscitation if:

Select one:

a. the heart rate does not increase above 80 beats/min after 30 to 60 seconds of effective positive pressure ventilation.
b. the newborn is bradycardic and thick secretions are hindering your ability to provide effective positive pressure ventilations.
c. the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions.
d. profound central cyanosis persists despite 30 seconds of effective positive pressure ventilation with 100% supplemental oxygen.

Answer 4

c. the heart rate remains below 60 beats/min after 30 seconds of effective ventilation and an additional 30 seconds of chest compressions.

Question 5

To assess a newborn’s preductal oxygen saturation, you should place the pulse oximeter probe on the:

Select one:

a. left hand.
b. right foot.
c. left foot.
d. right hand.

Answer 5

d. right hand.

Question 6

Signs of hypovolemia in the newborn include all of the following, EXCEPT:

Select one:

a. persistent pallor.
b. weak central pulses
c. persistent acrocyanosis.
d. persistent bradycardia.

Answer 6

c. persistent acrocyanosis.

Question 7

If hypovolemia is suspected or confirmed, you should administer ____ mL of normal saline to a 6-pound newborn over a period of ____.

Select one:

a. 18, 10 to 20 minutes
b. 27, 5 to 10 minutes
c. 33, 10 to 20 minutes
d. 55, 5 to 10 minutes

Answer 7

b. 27, 5 to 10 minutes

Question 8

Naloxone may be indicated for a newborn with respiratory depression if:

Select one:

a. the mother is not a chronic narcotic user.
b. the newborn’s heart rate is less than 120/min.
c. there is evidence that the mother abuses narcotics.
d. transport time to the hospital is longer than 10 minutes.

Answer 8

a. the mother is not a chronic narcotic user.

Question 9

Naloxone is NOT indicated for use in newborns:

Select one:

a. who weigh less than 5.5 lbs. Incorrect
b. who are born to narcotic-addicted mothers.
c. unless the umbilical vein has been cannulated.
d. with shallow breathing and persistent bradycardia.

Answer 9

b. who are born to narcotic-addicted mothers.

Question 10

A shift of heart tones and severe respiratory distress despite positive pressure ventilations is indicative of:

Select one:

a. a pneumothorax.
b. a diaphragmatic hernia.
c. Pierre Robin sequence.
d. a pericardial tamponade.

Answer 10

a. a pneumothorax.

Question 11

A newborn is at GREATEST risk for meconium aspiration if he or she:

Select one:

a. is large for his or her gestational age.
b. requires positive pressure ventilations.
c. has respiratory depression at the time of birth.
d. is born at more than 42 weeks gestation.

Answer 11

d. is born at more than 42 weeks gestation.

Question 12

In contrast to primary apnea, secondary apnea:

Select one:

a. is characterized by profound tachycardia.
b. commonly follows a brief period of hypoxia.
c. is usually unresponsive to stimulation alone.
d. necessitates immediate endotracheal intubation.

Answer 12

c. is usually unresponsive to stimulation alone.

Question 13

Mortality and morbidity are high among infants who are delivered at 24 weeks’ gestation, usually because of:

Select one:

a. congenital heart defects.
b. infection and hypothermia.
c. respiratory and neurologic problems.
d. metabolic and immune deficiencies.

Answer 13

c. respiratory and neurologic problems.

Question 14

Respiratory distress in a premature infant is MOST often the result of:

Select one:

a. a pneumothorax.
b. surfactant deficiency.
c. pneumonia at birth.
d. intracranial hemorrhage.

Answer 14

b. surfactant deficiency.

Question 15

In which of the following situations would a newborn MOST likely experience a seizure?

Select one:

a. Hyperglycemia
b. Post-term gestation
c. Maternal aspirin use
d. 33 weeks gestation

Answer 15

d. 33 weeks gestation

Question 16

A subtle seizure in the newborn is characterized by:

Select one:

a. eye deviations.
b. repetitive jerking.
c. flexion of the arms.
d. tonic limb extension.

Answer 16

a. eye deviations.

Question 17

Which of the following is often observed in a newborn with jitteriness, but not with a seizure?

Select one:

a. Deviation or fixation of the eyes
b. Autonomic phenomenon, such as tachycardia
c. Lack of a stimulus prior to the onset of the jitteriness
d. Resolution after application of gentle pressure to a limb

Answer 17

a. Deviation or fixation of the eyes

Question 18

The single MOST common cause of seizures in both term and preterm infants is:

Select one:

a. intracranial hemorrhaging.
b. hypoxic-ischemic encephalopathy.
c. congenital or developmental defects.
d. a severe derangement in electrolytes.

Answer 18

b. hypoxic-ischemic encephalopathy.

Question 19

Which of the following anticonvulsant medications would MOST likely be administered to a newborn with seizures in the prehospital setting?

Select one:

a. Dilantin
b. Depakote
c. Lorazepam
d. Phenobarbital

Answer 19

c. Lorazepam

Question 20

A fluid bolus in an infant consists of ______mL/kg of normal saline IV given over 5 to 10 minutes.

Select one:

a. 10
b. 15
c. 5
d. 20

Answer 20

a. 10