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Exam 22: Neonatal Pulmonary Disorders

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Question 1

Multiple Choice

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The therapist is reviewing the chest radiograph of a newborn, preterm infant and observes diffuse, fine, reticulogranular densities, which provide a ground-glass appearance. On the basis of these radiographic findings, which of the following conditions should the therapist suspect is present?

A) Persistent pulmonary hypertension of the newborn
B) Respiratory distress syndrome
C) Bronchopulmonary dysplasia
D) Pulmonary interstitial emphysema

E) A) and B)
F) A) and C)

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Question 2

Multiple Choice

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While reviewing the chest X-ray of a newborn recently delivered via cesarean section, the therapist observes the following features: Pulmonary vascular congestion Prominent perihilar streaking Fluid in the interlobular fissures Hyperexpansion Flat diaphragm Which of the following conditions does this patient likely have?

A) RDS
B) Persistent pulmonary hypertension of the newborn
C) Transient tachypnea of the newborn
D) Barotrauma

E) C) and D)
F) A) and B)

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Question 3

Multiple Choice

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What is the significance of an infant with RDS demonstrating a grunt during each exhalation?

How should the therapist interpret the lack of supernatant foam appearing during the shake test?

What ventilator settings should a therapist select for a newborn with respiratory distress syndrome? I. PIP 25 to 30 cm H₂O II. PEEP 4 to 6 cm H₂O III. VT 5 to 6 mL/kg IV. Frequency 20 to 40 breaths per minute

When should a therapist consider CPAP for a newborn with respiratory distress?

Which of the following risk factors contribute to the pathogenesis of BPD? I. Lung immaturity II. Respiratory failure III. Oxygen supplementation IV. Positive-pressure ventilation

Which of the following medications should the therapist recommend for an infant with apnea of prematurity experiencing episodes of apnea?

A neonate diagnosed with a pneumothorax was treated with a chest tube. After 36 hours, the therapist noticed that bubbling is present in the chest tube system. What should the therapist do at this time?

Which of the following is the most common bacteria isolated in early-onset infection in term and near-term infants?

Which of the following blood gas parameters should the therapist target when managing patients with PPHN on mechanical ventilation? I. Preductal SpO₂ maintained between 90% and 99% II. PaCO₂ 40 to 50 mm Hg III. pH 7.35 to 7.45 IV. PaO₂ >95 mm Hg

Which of the following is the most common bacteria isolated in preterm infants?

Blood samples are simultaneously obtained from both the right radial artery and the umbilical artery, and the arterial partial pressure of oxygen (PaO₂) value from the right radial artery is 20 mm Hg greater than that analyzed from the umbilical artery sample. On the basis of this finding, which of the following conditions does the neonate likely have?

Which of the following are considered mechanical ventilation strategies used for infants with pulmonary hemorrhage?

Which of the following therapeutic interventions is generally needed to treat transient tachypnea of the newborn (TTN) ?

The therapist is contemplating the possibility of intubating and suctioning a nonvigorous newborn with MAS. Which of the following clinical parameters confirms the indication for the procedure?

What is the greatest risk factor for respiratory distress syndrome (RDS) ?

What radiographic features is the therapist likely to see on a typical chest X-ray of an infant with MAS?

How should the therapist interpret a lecithin-to-sphingomyelin (L:S) ratio of 2:1?

What is the typical type of airway obstruction that occurs with MAS?