Question Answer
1. Which of the following phases of human lung development occurs from 17 to 26 weeks of gestation, and is characterized by the formation of a capillary network around airway passages? CANALICULAR
2. Regarding postnatal lung growth, by approximately what age do most of the alveoli that will be present in the lungs for life develop? 1.5 YEARS
3. Which of the following mechanisms appear to explain why oligohydramnios is associated with lung hypoplasia? MECHANICAL RESTRICTION OF CHEST WALL INTERFERENCE WITH FETAL BREATHING FAILURE TO PRODUCE FETAL LUNG LIQUID
4. What is the purpose of the material secreted by the type II pneumocyte? TO REDUCE SURFACE TENSION
5. Which of the following vascular networks is the major source of fetal lung liquid? PULMONARY CIRCULATION
6. Which of the following events or conditions is the most important risk factor for preterm birth? PRIOR PRETERM DELIVERY
7. What is the generally accepted as a safe limit for alcohol consumption during pregnancy to avoid the development of fetal alcohol syndrome? NO SAFE RANGE OF ALCOHOL IS SAFE
8. Which of the following conditions are associated with preeclampsia? PROTEINURIA GENERALIZED EDEMA HYPERTENSION
9. Which of the following maternal and/or fetal conditions are associated with pregestational diabetes? PRECLAMPSIA FETAL DEATH KETOACIDOSIS
10. Which of the following drugs is recommended to treat a group B Streptococcus infection for a patient who is allergic to penicillin? Clindamycin (CLEOCIN)
11. What is the main potential problem associated with the premature rupture of membranes? FETAL INFECTION
12. Which of the following maternal or fetal conditions can be determined or assessed via amniocentesis? MATERNAL Rh ISOIMMUNIZATION TRISOMY 21
13. Which of the following maternal complications are associated with cesarean section? INTRAOPERATIVE BLADDER OR BOWEL INJURIES ENDAMYOMETRITIS
14. How should the therapist interpret amniotic fluid of 5 cm? OLIGOHYDRAMNIOS
A fetus is undergoing a stress test. Contractions are stimulated by IV infusion of oxytocin into the mother. The fetal PO2 drops below 12mmHg and causes the fetal heart to slow. Which of the following conditions is likely indicated by this occurrence? UTEROPLACENTAL INSUFFICIENCY
16. How should the therapist interpret a fetal biophysical profile score of 7? FETUS APPEARS TO BE NORMAL
17. In lieu of obtaining a scalp blood gas sample, what can the therapist do to conduct intrapartum assessment of the fetus? FETAL SCALP STIMULATION
18. Which of the following medications are used as tocolytics? MAGNESIUM SULFATE INDOMETHACIN LA
19. A team has been summoned to the delivery room to perform neonatal resuscitation. Because no perinatal history is available, which of the following information would be useful for the resuscitation team to know in preparation for this event? PRESENCE OR ABSENCE OF MECONIUM GESTATIONAL AGE OF INFANT # OF BABIES EXPECTED
20. What measures can the therapist take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate? DRY INFANT’S SKIN REMOVE WET LINENS FROM INFANT WRAP INFANT IN PREWARMED BLANKET
The head of a neonate contaminated with meconium emerges at birth, the HR monitor reads 120bpm, and the Dr. notices that the infant has good muscle tone and a strong respiratory effort. What should the physician do at this time to provide the airway care? DO NOT PERFORM TRACHEAL SUCTION ON INFANT
22. A preterm neonate with a heart rate of 55bpm is receiving positive-pressure ventilation immediately after delivery. What should the therapist do at this time? APPLY CARDIAC COMPRESSIONS AND MAINTAIN PPV
23. A term infant is displaying acrocyanosis. What should the therapist do at this time? DO NOTHING AS THIS CONDITION IS OFTEN TRANSIET
24. Know how to evaluate a 1 min Apgar score? HR: none/0 <100bpm/1 >100bpm/2 RR: none/0 weak irreg/1 strong cry/2 skin color: pale/blue/0 pink body/blue ext/1 all pink/2 Reflex: no response/0 grimace/1 cough/cry/sneeze 2 Muscle tone: limp/0 some/1 well flexed/2
25. Which of the following actions constitutes appropriate stimulation of a neonate? FLICKING BOTTOM OF INFANTS FEET DRYING WITH TOWEL
26. Baby Cutie is born weighing 4,000 g. How many pounds does Baby Cutie weigh? 4000. *Move decimal left 3 to turn g into kg then multiply by 2.2 4 x 2.2 = 8.8 lbs.
27. Which method of estimating gestational uses physical and neurological findings NEW BALLARD SCORE
28. Baby Cissy is evaluated with an APGAR of 6. What intervention would you perform? STIMULATE
29. The gestational age of a newborn has been evaluated to be 34 weeks. The newborn’s birth weight is greater than the 90th percentile. How should the therapist classify this infant? LARGE FOR GESTATIONAL AGE
30. A physical examination is being performed on a newborn, and the therapist notices that the infant’s arms do not move symmetrically. Which of the following situations could account for this problem? AN INJURY TO THE INFANT’S BRACHIAL PLEXUS MAY HAVE OCCURRED DURING BIRTH
31. Which of the following neonatal skin presentation at birth is associated with a high hematocrit value or polycythemia and neonatal hyperviscosity syndrome? REDDISH BLUE APPEARANCE
REDDISH BLUE APPEARANCE BECAUSE NEWBORNS HAVE RELATIVELY THIN & WEAK MUSCULATURE AND A LESS RIGID THORAX
1. Which of the following statements refers to the diagnostic procedure called transillumination? DIRECT A LIGHT SOURCE TOWARD THE IPSILATERAL SURFACE OF THE PATIENT’S THORAX
34. A neonate is found to have a bounding pulse. Which of the following conditions may contribute to his finding? PATENT DUCTUS ARTERIOSUS AND LEFT TO RIGHT SHUNT
35. For the purpose of assessing right –to –left shunting, as in the case of persistent pulmonary hypertension, which of the following sites would render postductal blood? LEFT ARM, LEFT LEG, RIGHT LEG
36. Which of the following conditions can cause abdominal distention? ASCITES ENTEROCOLITIS
37. Which of the following conditions are associated with scaphoid abdomen? PRUNE BELLY GASTROSCHISIS CONGENITAL DIAPHRAGMATIC HERNIA
38. Normal capillary refill time for a newborn should be less than 3 SECONDS
39. Signs of respiratory distress in a newborn include all of the following except VESICULAR BREATH SOUNDS
40. The umbilical cord normally consist of 1 ARTERY AND 2 VEINS (walsh 55)
41. When clearing a neonates airway the RRT should limit each pass to 3-5 SECONDS
42. Baby Bubby presents with his lower extremities first. This is called FOOTING OR INCOMPLETE BREECH
43. Congenital heart defects with R-L shunting are indicated when the pre-ductal PO2 monitor reads as least ____ than the post-ductal PO2. 15 mmHg
1. While stabilizing a preterm neonate before resuscitation, the therapist notices the infant display laryngeal spasm, bradycardia, and a delayed onset of spontaneous breathing. What could have caused these events to occur? Performing aggressive pharyngeal suctioning
2. The therapist working with a neonate, observes that the newborn has adequate ventilator efforts and a heart rate of 120 bpm. However, at the same time, the infant demonstrates cyanosis of the lips and mucous membranes. What should the therapist do? Direct 100% oxygen at a flow of 8 L/minute about one-half inch above the infant’s nose and mouth.
RT supervisor is observing a staff member perform BMV on an infant being resuscitated. The supervisor notices that the RRT places his fingers on the anterior margin of the infant’s mandible, and lifts the face into the mask. What should the supervisor do? Take no action because the therapist is correctly performing valve mask ventilation.
4. What appears to be the reason for the infrequent need to administer chest compressions and cardiopulmonary resuscitative drugs to neonates in the delivery room. The delivery of adequate ventilation is the primary factor in effective resuscitation of a neonate.
5. What ratio of chest compressions and positive-pressure breaths must the therapist administer to a newborn during cardiopulmonary resuscitation? 3:1
RRT has been performing CPR on a neonate for about 90 seconds, applying ventilation with 100% oxygen and chest compression. The infant has maintained a spontaneous heart rate of 40 bpm. What should the therapist recommend at this time? Administering epinephrine
7. Which of the following mediations is used to reverse respiratory depression induced by opioid overdose? Naloxone (Narcan)
8. Which of the following features characterize a self-inflating neonatal resuscitation bag? Maximum stroke volume (Vt of 200 -300 ml) One way valve preventing rebreathing of exhaled gas. Reservoir to achieve high O2 concentration Pressure relief valve preventing excess pressure.
9. Be able to adjust a non-self-inflating bag before ventilating your patient A neonate receiving Ve f 2L/min, what flow should the therapist set the non-self inflating bag to? a flow rate of at least 2-3x the pt’s Ve is sufficient to fill the bag and flush reservoir tube (allows exhaled gas to be flushed out) Debby gave ranges of 2-4, 4-6, 8-10, 10-12. If the patient is on 2L, then we multiply 2 by 2 and 3 to get 4-6L/min
10. What are the advantages of a non-self- inflating resuscitation system? 100% O2 can be delivered. And Vt can be controlled
11. In ventilating an infant, once a seal is ensured between the mask and infant’s face and chest movement is present, ventilate the infant for____? 15-30sec
12. Ventilation of an infant should be perform at a rate of ___ with enough pressure to provide an easy rise/fall of the chest 40-60 bpm
13. Chest compression are indicated when the heart remain less than ___ despite 30 sec of effective positive – pressure ventilation 60/min
14. In the 2-finger technique to perform chest compression tip of 2 finger are used to depress the sternum while the other had support the baby’s _____. Back
15. In a newborn Ellana, RRT will deliver ____ compression and ___ ventilation each minute. 90 compressions /30 ventilation
16. Which of the following clinical presentations signify respiratory distress? Head bobbing Central cyanosis Retractions
17. Which of the following conditions are components of respiratory failure? Impaired oxygenation Inadequate ventilation
18. Why do infants and children have higher oxygen demands than adults? Because they have higher metabolic rates
19. Within the context of respiratory failure, what is the role of arterial blood gas anaylsis? It may be used to confirm the clinical impression
20. How should the therapist intervene on noticing the presence of agonal respirations displayed by a pediatric patient? As if the patient has respiratory arrest
21. How will an infant physiologically attempt to maintain blood pressure? Increase heart rate Improve cardiac contractility Increase peripheral vascular tone
22. Someone who loses a significant volume of blood because of hemorrhage is likely to develop Decompensated shock
23. What is the next pathophysiologic development that is likely to occur in a patient experiencing respiratory failure and shock? Cardiac arrest
24. A therapist walks into the room of a pediatric patient and notices the child sitting upright, and leaning forward by the bedside table; what position has the patient assumed? The tripod position
25. What should be the initial step taken by the therapist when confronted with a seriously injured child? Rapid cardiopulmonary assessment
26. For the purpose of airway support, how should the therapist position an infant who is in respiratory distress? With the infant’s head and neck in a neutral position
27. Baby sweet cakes is found pulseless after initial assessment, RRT Dominique will being CPR at a rate of _____. 100/min
28. Baby sweet check will be given CPR. Ventilatory ratio by RRT at 30:2
29. Baby sweet cheeks needs to be evaluated at_____? 5 cycle
30. What site is used to check the pulse of a child? Carotid
31. Which of the following causes of upper airway obstruction may require an artificial airway? Laryngotracheobronchitis Epiglotitis Subglottic stenosis
32. The therapist is about to perform endotracheal intubation on a 2 yr-old. What size endotracheal tube needs to be used? 4.5 mm I.D.
33. Why are some pediatric endotracheal tubes available without cuffs? Because in some infant’s the ET creates a seal against the cricoid cartilage.
34. Where in the upper airway of an infant should the laryngoscope blade be placed to expose the glottis during endotracheal intubation? The epiglottis is directed lifted with the tip of the laryngoscope blade
35. Which of the following statements describe the laryngeal mask airway (LMA)? The potential for aspiration is greater than with translaryngeal intubation. The LMA is a good alternative as an emergency airway when PPV is needed
36. When should Sellick’s maneuver be performed? When the patient is at risk for regurgitation or aspiration during intubation
37. How should the therapist determine the depth of insertion of an endotracheal tube in an infant during the intubation procedure? At the point where the single heavy black line just move beyond the glottis
38. Which of the following forms of endotracheal intubation will a neonate with Pierre Robin syndrome likely undergo? Anterior commissure intubation
39. Which of the following areas of an infant’s upper airway are most prone to develop edema as a result of endotracheal intubation? Subglottic region
40. How do arched and angled tracheostomy tubes compare with each other? Angle tube is longer
41. Where does the fetal oxyhemoglobin dissociation curve reside in comparison with the normal adult oxyhemoglobin dissociation curve? Fetal oxyhemoglobin dissociation curve is shifted to the left
42. When weaning an infant receiving oxygen from a nasal cannula attached to a low-flow flowmeter set at 100%, what range represents the recommended oxygen flow reduction from the flowmeter? 0.1 to 0.2 L/min.
43. Which of the following devices would be most appropriate to use for a 3-year-old patient who experiences immediate postextubation hypoxemia? Face tent
44. An infant requires both a precise high FIO2 and maintenance of a neutral thermal environment. Which of the following systems can best achieve these goals? (Egan) Oxyhood or warmed O2 blending system w/o incubator Heat incubator w/automatic O2 controlling system
45. Clogging of an isolette incubator air inlet filter will result in which of the following? (Egan) Increase Oxygen
46. A neutral thermal environment should be maintain? (Egan) Gases should be directed away from the infant’s face High input flow >10-15 L/min should be avoided Minimum flow of 7L/min must be maintained
47. While attending to a neonatal patient in the neonatal intensive care unit (NICU), the therapist notices that a transcutaneous electrode is affixed to the upper chest of the neonate. What should the therapist do at this time? The therapist should do nothing because the transcutaneous electrode is properly placed
1. Another name for respiratory distress syndrome (RDS) is: HYALINE MEMBRANE DISEASE
2. What are the major factors in the pathophysiology of RDS (Egan) QUALITATIVE SURFACTANT DEFICIENCY INCREASED SMALL AIRWAY COMPLIANCE PRESENCE OF DUCTUS ARTERIOSUS decrease alveolar surface area
3. Which of the following factors is associated with an increase in the incidence of RDS? (Egan) MATERNAL DIABETES
4. What diagnostic parameter is most often used to confirm the diagnosis of RDS? (Egan) CXR
5. What is the maximum PIP that should be used with mechanical ventilation of larger premature infants to prevent volutrauma? (Egan) 30 cmH20
6. Survanta rescue treatment of infants with evidence of RDS should occur (Rau) WITHIN 8 HRS. OF BIRTH
7. How much Survanta should be administered for prophylactic treatment of a 700 gram newborn? (Rau) 4ml/kg=dose; 700 gram=0.7kg ; 0.7kg x 4ml = 2.8ml
8. Which of the following is not shown on an X-ray for TTN?(Walsh) ROUND DIAPHRAGM
9. Which of the following therapeutic interventions are generally needed to treat TTN?(Walsh) 40% OXYHOOD
10. What radiographic finding is common in infants with transient tachypnea? (Egan) HYPERINFLATION
11. What treatment usually causes improvement in the initial treatment of transient tachypnea of the newborn (Egan) O2 WITH LOW FiO2
12. What treatment may improve lung fluid clearnance in the infant with transient tachypnea? (Egan) FREQUENT TURNING OF THE INFANT
13. What is associated with ball-valve obstruction in meconium aspiration syndrome? (Egan) VOLUTRAUMA
14. Which of the following blood gas alteration is usually seen in meconium aspiration syndrome? (Egan) HYPOXEMIA WITH MIXED RESPIRATORY AND METABOLIC ACIDOSIS
15. The aspiration of meconium can also cause what type of lung tissue damage or response? CHEMICAL PNEUMONITIS
16. What is the common root of Persistent Pulmonary Hypertension in the newborn INCREASED PVR
17. In transition to exauterine life, what caused the bold to flow through the lungs? INCREASED PaO2
18. What drug can be used to dilate the pulmonary vessels, thus treat PPHTN TOLAZOLINE (Tolazine)
19. Which factor is not associated with the new description of BPD? USE OF HFV
20. What clinical finding is typically seen with BPD infants? HYPOXEMIA AND HYPERCAPNIA
21. Which of the following therapies has little effect on long-term outcome such as mortality and duration of oxygen therapy in infants with BPD? STEROIDS
22. Which of the following is NOT associated with causing apnea in premature infants? GENDER
23. Treatment of the premature infant with apnea includes all of the following except? TRANSFUSION
24. Which of the following is NOT associated with causing apnea in premature infants? PLACE INFANT IN TRENDELENBURG
25. Clinical findings associated with congenital diaphragmatic hernia include HEPATOMEGALY
26. Which of the following maternal characteristics is NOT associated with an increase in frequency of SIDS? HISTORY OF ASTHMA
27. Which of the following infant characteristics is associated with an increased risk of SIDS? PRETERM BIRTH
28. How do you diagnose GERD ESOPHAGEAL pH TESTING GASTRIC SCINTISCANNING UPPER GI CONTRAST STUDIES
29. The following diseases are commonly associated with bronchiolitis most likely to result in respiratory failure except PNEUMONIA
30. Which of the following groups of infants should receive passive immunization for RSV? CHRONIC LUNG DISEASE INFANTS BORN < 32 WEEKS GESTATIONAL AGE INFANTS WITH CONGENITAL HEART DISEASE
31. Which of the following is the reason why ribavirin is administered for 12-18 hours per day for treatment (Rau) THE DRUG HAS A SHORT HALF LIFE IN RESPIRATORY SECRETIONS
32. What is the leading cause of death among patients with cystic fibrous? LUNG DISEASE
33. What therapy has been shown to reduce the incidence of bronchiectatic exacerbations in the patient with cystic fibrosis? INHALED TOBRAMYCIN
34. Cystic fibrosis (CF) is associated with chronic airway infection, often with: (Rau) PSEUDOMONAS AERUGINOSA
35. Dornase Alpha (Pulmozyme) is used to treat? (Rau) ABNORMALLY TENACIOUS DNA-CONTAINING SPUTUM
36. The usual dose of Dornase Alpha (Pulmozyme) is? (Rau) 2.5 mg DAILY
37. What medication can be used to close the PDA? INDOMETHACIN
38. A premature infant is experiencing episodes of apnea and cyanosis. The RRT should recommend THEOPHYLLINE (theo-dur)
39. How do you treat TGV RASHKIND PROCEDURE
40. Where specifically does the diaphragmatic hernia occur? BOCHDALEK FORAMEN
41. What would the CXR reveal for a TGV? HEART WILL BE EGG SHAPED
42. An acute bacterial infection causing significant edema and inflammation to the tissue around a child’s glottis often leading to dysphasia and severe respiratory distress is known as which of the following? EPIGLOTITIS
5 y.o. brought to ED w/labored breathing and high fever. Exam reveals marked insp stridor. The child is listless/dad says he has had a sore throat. The boy responds very quietly with short answers.A lateral neck x-ray shows a thumb sign.What treatment? INTUBATION BY ANESTHESIOLOGIST
44. A 4 yr. old child with LTB presents in the ED with moderate stridor and harsh breath sounds. The RRT should recommend which of the following? AMINOPHYLLINE (RE= RACEMIC EPINEPHRINE)
45. Which of the following is an acute viral disease affecting the trachea and small airways which often can cause a fever, barking cough, grunting and wheezing? CROUP
46. The causative agent for epiglotitis is? H. INFLUENZA
PFO using Catheter-base procedure 47. This is a permanent implantation? 48. The catheter is inserted into the _____? TRUE/GROIN
1. Which of the following physiologic effects are generally associated with the use of CPAP for the treatment of respiratory distress syndrome (RDS)? STABALIZE CHEST WALL INCREASE FRC
2. Which of the following outcomes are advantages of CPAP over mechanical ventilation in infants? FEWER RESPIRATORY RELATED NOSOCOMIAL INFECTIONS LOWER INCIDENCE OF INTRAVENTRICULAR HEMORRHAGE FEWER CASES OF RETINOPATHY OF PREMATURE
3. Where in the CPAP delivery system should the pressure-relief/pop off valve be situated? AS CLOSE TO THE PATIENT’S AIRWAY AS POSSIBLE
4. Which of the following features are often components of CPAP systems incorporated within infant ventilators? HIGHLY RESPONSIVE DEMAND FLOW SYSTEMS APNEA BACK UP BREATHS LEAK COMPENSATION CAPABILITIES
5. How is the positive pressure level established in a bubble CPAP system? THE TERAPIST IMMERSES THE DISTAL END OF THE EXPIRATORY LIMB A CERTAIN DISTANCE BELOW THE WATER SURFACE
6. Which form of CPAP is associated with a “thoracic wiggle”? B-CPAP (BUBBLE CPAP)
7. Which is the set flow in an Infant Flow CPAP system based on? The flow of gas through the solenoid valve
8. Which of the following CPAP systems delivers a more consistent pressure, lowers work of breathing, is less sensitive to leaks, and is more effective at alveolar recruitment compared with other forms of CPAP? IF-CPAP
9. Which of the following anatomic structures has been shown to break down because of the use of nasal masks associated with IF-CPAP? PHILTRUM
10. What FIO2 should a patient receive when CPAP is initiated? THE INFANT SHOULD RECEIVE THE SAME FiO IT WAS RECEIVING IMMEDIATELY BEFORE CPAP
11. Which of the following ventilator settings are preset during time-cycled, pressure-limited ventilation? INSPIRATORY TIME RR, I:E RATIO
12. During volume-controlled ventilation, which of the following factors influences the peak inspiratory pressures? PULMONARY COMPLIANCE
13. Which of the following modes of ventilation attempt to maintain a minimal target tidal volume with a constant pressure by manipulating the inspiratory flow? PRVC
14. Karen NPS, RRT is about to mechanically ventilate a neonate with a ventilator that delivers the volume guarantee mode. Which of the ventilator settings does she need to set for this mode? VT, INSPIRATORY TIME, INSPIRATORY FLOW
15. Tyson NPS, RRT is initiating mechanical ventilation for a 12-year-old patient who has status asthmaticus. Which of the following modes of ventilation is most appropriate for this patient at this time? TIME OR PATIENT TRIGGERED PRESSURE CONTROL VENTILATION
16. When airway pressure release ventilation is used, what physiologic process occurs as the higher pressure is released and the lower is achieved? EXHALATION OF CO2
17. A patient is about to be switched form a conventional mode of ventilation to inverse ratio ventilation. What should the therapist recommend for this patient before instituting this mode? SEDATE AND PARALYZE THE PATIENT
Bryant NPS, RRT is conducting a ventilator check for Baby Cutie and makes these notes on the vent flow sheet: Peep: 5 cmH20, PIP: 25 cmH20., f: 15 bpm and FIO2 35. On the basis of these observations, what should the therapist recommend for this neonate? WEANING FROM MECHANICAL VENTILATION
19. Retractions, ventilator asynchrony, and pressure fluctuations on the manometer around the baseline PEEP setting may be signs of ________? (Pilbeam) INSUFFICIENT FLOW
20. _______ is not a set parameter in mechanical ventilation with TCPL. (Pilbeam) MECHANICAL VT
21. According to the U.S. Food Drug Administration, which of the following mechanical ventilator rates constitutes high-frequency ventilation (HFV)? > 150 BPM
22. What is the relationship between the tidal volume and the dead space volume in the context of high-frequency ventilation? VD VOLUME IS GREATER THAN VT
23. Which of the following statements best describes the relationship between tidal volume and frequency during HFJV of pediatric and neonatal patients? NEONATES NEED HIGHER FREQUENCIES AND LOWER VT
24. During HFOV, which of the following factors has a direct influence on a neonate’s delivered tidal volume? OSCILLATORY AMPLITUDE & PEAK INSPIRATORY PRESSURE
25. What is the recommended inspiratory time percent setting for HFOV? 33%
26. What is the primary therapeutic goal when a patient with lungs prone to atelectasis receives HFV? TO OPTIMIZE LUNG INFLATION
27. For HFOV, any time the patient becomes disconnected form the ventilator circuit_______. ( Pilbeam) A RECRUITMENT MANEUVER SHOULD BE PERFORMED
28. For HFOV, the IT % control may assist in CO2 elimination. Other settings that alos critically influence PaCo2 include all of the following except- (Pilbeam) mPaw
29. According to University of Iowa protocols for 3100A, how do you set the frequency? 10 HZ FOR TERM INFANTS
30. According to University of Iowa protocols for 3100A, how do you set the power? IF CHEST WALL NEEDS TO BE VIBRATING, TURN UP THE POWER
31. Which of the following is not a common indication for ECMO? (Egan) PERSISTANT ALKALOSIS
32. What is the definition of ECMO per class lecture? PARTIAL OR COMPLETE CARDIOPULMONARY BYPASS WHICH TEMPORARILY SUPPORTS THE INFANT/CHILD WHILE REVERSIBLE LUNG DISEASE RESOLVES
33. What is the role of the Roller Pump? PROVIDES MECHANICAL PUMPING ACTION FOR THE CIRCUIT AND CARDIOVASCULAR SYSTEM
34. What is the role of the Heat Exchanger? RE-WARMS BLOOD TO BODY TEMPERATURE BEFORE RETURNING IT TO THE PATIENT. ALSO SERVES AS A BUBBLE FILTER
35. What is the role of the Reservoir Bladder? SERVES AS THE RIGHT ATRIUM; PROVIDES A RESERVOIR FOR THE PUMP AND KEEPS NEGATIVE PRESSURE FROM PULLING THE VESSEL INTO THE CANNULA
36. What is the role of the membrane oxygenator? SERVES AS THE GAS EXCHANGE ORGAN; ADDS OXYGEN TO THE BLOOD AND REMOVES CARBON DIOXIDE
37. In VA ECMO, the arterial cannula is inserted into the_____? RIGHT COMMON CAROTID ARTERY
38. The main goal of ECLS is to: PROVIDE ADEQUATE TISSUE OXYGEN DELIVERY
39. Sadie NPS RRT will set the amplitude of the 3100 A to see a _____. WIGGLE
40. In infant mechanical ventilation the frequency controls _____. PaCO2
__ is a mode of support designed to provide two levels of CPAP and allow spontaneous breathing at both levels when spontaneous effort is present. APRV
2. Since APRV can reduce airway pressures in patients with ALI/ARDS, it is also thought to be associated with a reduced risk of ventilator-associated lung injury. The primary reason or this is MAY RECRUIT CONSOLIDATED LUNG AREAS OVER TIME AND REPEATED OPENING AND CLOSING OF ALVEOLI
When changing from a conventional mode to APRV, the settings on the conventional ventilator can serve as a guide to the APRV settings. For setting initial P high, it is appropriate to use all of the following settings from conventional ventilation except: THE PATIENT’S CONVENTIONAL MODE PEEP PRESSURE
4. For HFOV the TI % control may assist in CO2 elimination. Other settings that also critically influence PaCo2 include all of the following except mPAW
5. Heliox therapy is helpful in treating spontaneously breathing patients in all of the following conditions except POST INTUBATION STRIDOR
6. The most commonly used concentration of heliox is_______________ 80% HELIUM 20% OXYGEN
7. Independent lung ventilation (ILV) is a technique that allows the gas flow to each lung to be controlled separately. It is also called unilateral lung ventilation. ILV is delivered by using a specialized double-lumen ET tube. TRUE
8. ILV is intended to increase functional residual capacity and increase effective ventilation in the more damaged lung, thereby reducing the possibility of barotrauma or volutrauma of the less damaged or more compliant lung. TRUE
9. Thoracoabdominal aortic aneurism surgical repair is a procedure that usually results in a unique form of lung injury: as a result, management of the postoperative course indicates the use of _____. ILV
10. Which of the following is false about the use of Peep in patients with ARDS? 10 cmH2O PEEP IS GOOD FOR MOST PATIENTS
11. In managing an asthmatic patient receiving volume-targeted IMV, you not the persistence of 6-8 cm H20 of auto-Peep. Which of the following would you recommend to the patient’s doctor? APPLY 4-5 cmH20 OF PEEP
12. A patient with a closed – head injury who requires ventilatory support has a ICP of 10 mm Hg. Which of the following approaches would you recommend for this patient? MAINTAIN NORMAL ABG
13. The goal in establishing a patient’s minute ventilation during ventilator support is to ensure removal of CO2, as judged by normalization of what? ARTERIAL pH
14. In CMV, adjustment of the inspiratory flow allows the RRT to manipulate which of the following parameters of ventilation I:E RATIO & INSPIRATORY TIME
15. When adjusting the FIO2 setting for a patient receiving mechanical ventilator support, what should your goal be? DECREASE THE FIO2 TO BELOW 50% ASAP
16. What two parameters are most commonly used for bedside assessment of respiratory muscle strength? VC & MIP
17. What variable begins in the inspiratory phase of a ventilator? TRIGGER
18. Which of the following variables ends the inspiratory phase? CYCLE
19. Which of the following variables begins a mandatory breath? TIME
20. A dual mode that features a pressure-controlled breath pattern with volume as a conditional variable is which of the following? PRVC
21. Which of the following control modes of ventilation consists of pressure –limited mandatory breaths that can be automatically adjusted between breaths to achieve a preset tidal volume? ADAPTIVE
22. Which of the following modes of ventilation requires the use of a special nasogastric tube that is fitted with an electrode array? NAVA (NEUTRALLY ADJUSTED VENT. ASSIST)
23. What is the Glasgow Coma Scale (GCS) score that requires intracranial pressure monitoring? <8
24. What is the CS when the returned tidal volume is 380 mL, the PEEP is 5 cm H2O, the PIP is 23 cm H2O, and the Pplat is 20 cm H20 STATIC = EX. VT ÷ PLAT – PEEP
25. What is the Raw when the PIP is 30 cm H2O, the Pplat is 20 cm H2O, and the set ventilator gas flow rate is 40 L/min? RAW= PIP-PLAT ÷ PF/SEC
26. An increase in the size of the “fish tail” in the following volume pressure loop indicate INCREASED WOB TO TRIGGER INSPIRATION (see SG for picture)
27. Using the graph below, please identify the problem represented by letter AIR LEAK (see SG for picture)
28. Using the graph below, please identify the problem represented. AIR TRAPPING (see SG for picture)
29. Using the graph below, please identify the problem represented. OVERDISTENTION (see SG for picture)
30. Which of the following is NOT a common purpose of using ventilator graphics? INSPIRATORY PAUSE