1.No safe range to drink alcohol.
 
2. Smoking mothers have babies that tend to be about 200g lighter than infants born of mothers who do not smoke
 
3. Which condition a woman with a long history of smoking who is in the last part of the third trimester of her pregnancy is at high risk of developing?
– premature rupture of membranes
– placental abruption
– placenta previa
– SIDS
 
4. What three conditions are associated with preeclampsia?
– proteinuria
– generalized edema
– hypertension
 
5. What risk factors delivery should the healthcare team be aware at the time of delivery of a newborn from a mother diagnosed with pregestational diabetes?
microcephaly
 
6. What metabolic disturbances should be considered from a baby that is very large for gestational age whose mother is diagnosed with gestational diabetes?
– hypocalcemia
– hyperkalemia
– hypoglycemia
 
7. What microorganism often affects pregnancy outcome?
                Group B sterptococcus
 
8. What is the main potential problem associated with the premature rupture of membranes?
                fetal infection
 
9. What condition is responsible for up to 40% of the preterm births in the USA?
                premature rupture of membranes
 
10. When does the maximal benefit of antenatal corticosteroid occur to reduce RDS?
                after 48 hours
 
11. What condition is a significant problem in postterm pregnancy?
                meconium aspiration
12. What medication will be the most appropriate to induce labor for a woman who is 41-weeks pregnant and at high risk for complication in the postpartum period?
 
13. What is the most common invasive procedure to assess the fetal condition?
                amniocentesis
 
14. What is the best course of action for a pregnant woman whose non stress test reported two accelerations in fetal heart rate, each of at least 15 beats per minute and lasting at least 15 seconds, associated with maternal perception of fetal movement over a period of 20 minutes?
No action is required because this reactive non-stress test is associated with normal uteroplacental function
 
15. What condition would occur in a fetus that is undergoing a contraction stress test, the uterine contractions are stimulated by the intravenous infusion of oxytocin into the mother, the fetal PO2 drops below 12 mm Hg and causes the fetal heart rate to slow?
                uteroplacental insufficiency
 
16. What other intrapartum assessment of the fetus can be done instead of obtaining a scalp blood gas sample?
                fetal scalp stimulation
 
17. What FiO2 should be used to start positive pressure ventilation in the labor and delivery room to assist in the resuscitation of a term newborn according to the 2011 NRP guidelines?
 
18. What condition could cause a newborn to have hypoxemia due to hypothermia?
                Hypoglycemia
 
19. What to do to prevent injury and atelectasis, and also avoid interfering with the infant’s ability to establish adequate ventilation, while stabilizing a preterm neonate before resuscitation?
 
 
20. What factors are taken into consideration when assessing the gestational age of a neonate
– previous maternal pregnancies
– prenatal ultrasound evaluations
– gestational duration based on the last menstrual cycle
 
21.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?
A. Small for gestational age
B. Very large for gestational age
C. Large for gestational age
D. Average for gestational age
 
22.An infant arrives in the newborn nursery with an axillary body temperature of 95.6° F. Which of the following events may be responsible for this infant’s temperature?
A. The neonate was in an infant warmer in the delivery room.
B. The newborn has protracted diarrhea.
C. The delivery room temperature was low.
D. The infant was swaddled in numerous blankets.
 
23.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?
A. An injury to the infant’s brachial plexus may have occurred during birth.
B. The infant experienced nuchal cords during birth.
C. The baby was born via cesarean section.
D. The infant may have been born breach.


 
24.The therapist notices that an infant presents with irregular areas of dusky skin alternating with areas of pale skin, On the basis of this observation, which of the following conditions should the therapist anticipate this patient having?
A. Polycythemia
B. Renal insufficiency
C. Situs inversus with dextrocardia
D. Hypotension
              
25.Which of the following neonatal skin presentations at birth is associated with a high hematocrit value or polycythemia and neonatal hyperviscosity syndrome?
A. Mottling
B. Vemix
C. Reddish blue appearance
D. Lanugo
 
 
26.Why are chest retractions more prominent among neonates than among older children and adults?
A. Because neonates generate a greater subatmospheric intrapleural pressure.
B. Because airway resistance through the smaller caliber airways is higher.
C. Because neonates have a much higher respiratory rate.
D. Because newborns have relatively thin and weak musculature, and a less rigid thorax.
 
27.Why is it difficult to localize auscultation findings of the thorax of a newborn?
A. Because the neonate’s chest is small and sounds are difficult to differentiate.
B. Because the newborn’s pulmonary compliance is low.
C. Because the neonate’s tidal volume is so small.
D. Because the newborn infant is frequently crying.
 
28.Which of the following statements refers to the diagnostic procedure called transillumination?
A. Place a light source between the surface of the bed and the patient’s back, and orient the patient in a supine position.
B. Insert a fiberoptic light sourne down a patient’s endotracheal tube and beyond the tube’s distal tip.
C. Position a beam of light against a patient’s chest wall in a well-lit room.
D. Direct a light source toward the ipsilateral surface of the patient’s thorax.
 
29.A neonate is found to have a bounding pulse. Which of the following conditions may contribute t this finding?
I. Patent ductus arteriosus
II. Hypoplastic left-sided heart syndrome
Ill. Coarctation of the aorta
IV. Left-to-right shunt

 

A. I and II only
B. I, Ill, and IV only
C. II and Ill only
D. I and IV only
 
30.What condition would be responsible for the therapist observing a pulse oximeter indicating decreased perfusion while central blood pressure remains normal?
A. Volume depletion with compensatory peripheral vasoconstriction
B. Hypoplastic right-sided heart syndrome
C. Hypervolemia with compensatory peripheral vasodilation
D. Hypoplastic left-sided heart syndrome
 
 
31.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?
I. Right arm
II. Left arm
Ill. Right leg
IV. Left leg

 

A. I only
B. II, III, and IV only
C. 1,III, and IV only
D. II only
               
33. What would cause a preterm neonate to have a grunting cry
                Respiratory Distress
 
34.Which of the following information represent components of patient history for a new pediatric patient?
I. Chief complaint
II. History of present illness
III. Past medical history
IV. Occupational history

 

A. I and II only
B. III and IV only
C. I, II, and III only
D. I, II, III, and IV
 
35.Which of the following components comprise the history of present illness section of a patient’s medical history?
I. Frequency and duration of symptoms
II. Symptoms exhibited by parents
III. Onset of symptoms
IV. Symptoms resulting in hospitalizations

 

A. I and III only
B. II, III, and IV only
C. I, II, and IV only
D. I, II, and III only
 
 
 
36.Which of the following components comprise the past medical history section of the patient’s medical history?
I. Birth weight
II. Previous mechanical ventilation
Ill. Recurrence of symptoms based on season
IV. Emergency department visits

 

A. II only
B. I, II, Ill, and IV
C. I, II, and IV only
D. II and IV only
 
37.Which of the following components of a patient’s medical history is intended to determine the presence of symptoms not identified in the history of present illness and that may be related or contribute to the child’s underlying condition?
A. Chief complaint
B. History of present illness
C. Review of systems
D. Past medical history
 
38.A child who demonstrates head bobbing, nasal flaring, and grunting is exhibiting the signs of
        A. Respiratory distress
        B. Acidemia
        C. Hypercapnia
        D. Hypoxemia
39.Which of the following pulmonary diseases are not chest wall deformities, but are characterized by an increased anteroposterior diameter?
I. Pectus excavatum
II. Severe asthma
III. Pneumonia
IV. Cystic fibrosis

 

A I and III only
B. II and IV only
C. II, III, and IV only
D. I, II, Ill, and IV
40.During a physical examination of a child’s chest, the therapist perceives increased tactile fremitus over the patient’s right lower lobe. Which of the following conditions may cause this physical
A. Pulmonary consolidation
B. Aspirated foreign object
C. Mucous plug
D. Pneumothorax         
 
41.While percussing the thorax of a child during a physical examination, the therapist hears a dull percussion note over the child’s right lung. Which of the following conditions may cause this physical finding?
I. Atelectasis
II. Pneumothorax
III. Pleural effusion
IV. Consolidation

 

A. I and II only
B. I, II, III, and IV
C. II, III, and IV only
D. I, II, and IV only
 
42.After placing a stethoscope over a small child’s trachea, the therapist hears expiratory stridor. Which of the following conditions is consistent this finding?
A. Laryngotracheobronchitis
B. Tracheomalacia
C. Asthma episode
D. Adenotonsillar hypertrophy
 
43.While auscultating a young child’s thorax, the therapist hears bilateral fine crackles. Which of the following conditions can produce these adventitious sounds?
A. Pulmonary edema
B. Asthma
C. Croup
D. Bronchitis
 
44.Which of the following white blood cell counts constitutes the condition leukopenia?
A. Less than or equal to 3500/mm
B. Greater than or equal to 25,000/mm
C. 10,000 to 20,000/mm
D. 5000 to 10,000/mm
 
45.Which of the following maternal complications are associated with cesarean section?
  1. Intraoperative bladder or bowel injuries
  2. Endomyometritis
  3. Failure to progress in labor
  4. Placenta previa
  1. I and II only
  2. II and III only
  3. III and IV only
  4. I, II, and III only
  
 
46.How should the therapise interpret an amniotic fluid index of 25 cm?
                Polyhydramnios
 
 
47.How should a therapist interpret a fetal biophysical profile score of  7?
                Fetus appears to be normal
 
48. What medications are used as tocolytics          

             magnesium sulfate
49.
What are some methods to prevent heat loss & cold stress on a preterm neonate prior to resuscitation

  dry infants skin, wrap the infant in prewarmed blankets, remove wet linens from around the infant
 
50. Know what are the current recommendations for infants with meconium
Therefore, current recommendationsfor infants with meconium are that
Ø  no intrapartum suctioning should occur;
Ø  infants who are vigorous at birth (strong respiratory effort, a heart rate of greater than 100 beats/min, good muscle tone) should not receive tracheal suctioning; and
Ø  infants who are not vigorous (no or poor respiratory effort, a heart rate of less than 100 beats/min, poor muscle tone) may receive direct laryngotracheal suctioning.
 
52.The therapist has been performing cardiopulmonary resuscitation on a neonate for about 90 seconds, applying ventilation with 100% oxygen and chest compressions. The infant has maintained a spontaneous heat rate of 40 beats/minute. What should the therapist recommend at this time?
Give Epinephrine
 
53. Examples to appropriately stimulate a newborn
flicking the bottoms of the feet and drying with a towel
54.What should the rate of ventilation be in a term newborn?
                40-60 breaths per minute
 

1. There is no safe range
2. The birth weight of infants of women who smoke during pregnancy is about 200g less than that of infants of nonsmokers
3. premature rupture of membranes (PROM)
4. exacerbation of hypertension, proteinuria, and edema
5. diabetic Ketoacidosis, proliferative, retinopathy, and preeclampsia/eclampsia,
6. hypoglycemia, hypocalcaemia, hyperkalemia, hyperbilirybinmia, and idiopathic respiratory distress syndrome
7. infectious agents
8. smoking
9. group B streptococcus
10. occurs 48 hours after initiation of therapy and lasts for 7 days
11. oligohydranmios, macrosomia, meconium aspiration, and placental insufficiency
12. intravenous infusion of oxytocin
13. amniocentesis
14. continuously monitor the fetal heart rate while conducting a contraction stress test while uterine contractions are stimulated by intravenous infusion into mother of a dilate solution of oxytocin normally PO2 decreases with each contraction and rapidly returns to normal
15. uteroplacental insufficiency
16. fetal scalp stimulation
17. 21-1 room air
18. ?
19. avoid excessive suctioning of clear fluid from the nasopharynx
20. gestational duration based on the last menstrual cycle, prenatal ultrasound evaluation, postnatal findings based on physical and neurological examination
21. infant whose birth weight is more than the 19th percentile
22. normal value for axillary is 97.6 ± 1 F the temperature may be lower for an infant just arriving to the nursery if the delivery room was cold it might be higher if the room was warm
23. when an infant does not move his or her arms symmetrically it is a sign of a broken clavicle or injury to brachial plexus which is the nerves that control the movement and sensation in the shoulder, arm, forearm, and hand
24. mottling is irregular arms of dusky skin alternating with areas of pale skin it suggests hypotension or anemia in an extremely pale infant
25. reddish bluish appearance suggests high hematocrit value or polycythemia and neonatal hyper viscosity syndrome
26. because neonates have a compliant rib cage
27. the chest is small and sounds are hard to differentiate
28. It is used when there is a suspected pneumothorax transillumination means using a high energy flashlight or fiberoptic device in a dark room then place light on suspected side of chest a large pneumothorax reveals excessive pink irregular area of light or glowing area compared to the other side
29. patent ductus arteriosus and left to right shunt results from rapid runoff of blood into the low resistance pulmonary circulation
30. volume depletion with compensatory peripheral vasoconstriction
31. left hand and lower extremities
32. omphalocele is a birth defect in which an infant’s intestine or abdominal organs sstick out of the navel (a type of hernia)
33. respiratory distress syndrome
34. chief complaint or primary concern, list of present illness, med history, review of symptoms,, family history , and social and environmental history
35. Duration intensity severity and improvement/deterior actions of symptoms
36. HPI, MH, ROS, family history , and social and environmental histories
37. it attempts to identify symptoms that were not identified in the HPI and that may be related or contribute to child’s underlying condition
Information includes: family history, social and environmental histories, history of prematurity, birth weight, need for duration of O2 therapy , assisted ventilation or both, previous ER visits,, hospitalization, or both (also intensive care unit admissions and my need for assisted ventilation, previous surgeries, and immunization history
38. tachypnea, refractions, grunting, nasal flaring, and cyanosis
39. bronchopulmonary dysplasia
40. pulmonary consolidation
41. atelectasis consolidation, or pleural effusion
42. intrachoracic central airway obstruction occurring in a mass or vascular compression of trachea, tracheomalacia, and bronchomalacia
43. distal small airways, or aveolar collapse such as pneumonia or pulmonary edema
44. White blood cell count less than 3500/mm3
45. and increased risk of significant maternal blood loss, anesthesia complications, intaoper active bladder or bowel injuries, postoperative wound infection, endomopomeetritis, and thromboembolic events
46. Amniotic fluid index is calculated by measuring the depth of the largest vertical pocket of fluid in each of the four equal uterine quadrants. Oligohydramnios is too little amniotic fluid or AFL below 5cm, and polyhyddramnios is too much amniotic fluid or an AFl above 24cm both polyhydraminos and oligohydraminos are associated with cogential anomalies and fetal malformations
47. 8 to 10 is normal
48. magnesium sulfate B mimetic agent and inolonethacin (a prostaglandin inhibitor)
49. Deliver infant in warm, draft free area, use of conductive heat gaining mattresses, polyethylene wrap for infants 32 weeks of gestation or less,, rapidly drying infants skin removing wet linens
50. tracheal intubation , cyanotic, newborns not intrapartum suctioning should occur infants who are vigorus at birth (strong respiratory effort heart rate greater than 100 bpm good muscle tone) should not be tracheal suctioned
Infants who aren’t vigorus (no or poor respiratory effort HR less than 100 bpm poor muscle tone) may be larygotracehal suctioned
51. page 42 table 4-1
52. When heart rate remains below 60
53. clear airway with either bulb syringe or suction catheter positive pressure ventilation chest compressions thermal strategies
54. 40 to 60 breaths per minute