NBRC Neonatal and Pediatric Respiratory Care 1 — Questions and Answers
Question 1: Which condition in premature infants results from surfactant deficiency?
- Transient tachypnea of the newborn (TTN)
- Respiratory distress syndrome (RDS) (Correct answer)
- Bronchopulmonary dysplasia (BPD)
- Meconium aspiration syndrome
Correct answer: Respiratory distress syndrome (RDS)
Neonatal RDS (hyaline membrane disease) results from surfactant deficiency in premature infants, leading to diffuse alveolar collapse and respiratory failure.
Question 2: The primary treatment for neonatal RDS is:
- Systemic corticosteroids after birth
- Exogenous surfactant replacement therapy (Correct answer)
- High-frequency oscillatory ventilation immediately
- Inhaled nitric oxide
Correct answer: Exogenous surfactant replacement therapy
Exogenous surfactant administered intratracheally stabilizes alveoli and dramatically improves oxygenation and survival in neonates with RDS.
Question 3: Normal SpO2 targets for premature neonates receiving supplemental oxygen to reduce retinopathy of prematurity (ROP) risk are:
- 85–89%
- 91–95% (Correct answer)
- 96–99%
- 100%
Correct answer: 91–95%
Current guidelines recommend targeting SpO2 of 91–95% in premature neonates to balance ROP risk (excess oxygen) against necrotizing enterocolitis and mortality risk (insufficient oxygen).
Question 4: Bronchopulmonary dysplasia (BPD) is defined as oxygen dependency at:
- 7 days of life
- 28 days of life (Correct answer)
- 3 months of corrected age
- 6 months of corrected age
Correct answer: 28 days of life
BPD is defined as oxygen requirement at 28 days of life and reflects chronic lung injury from mechanical ventilation, oxygen toxicity, and inflammation in premature infants.
Question 5: Meconium aspiration syndrome (MAS) occurs when:
- Premature birth causes surfactant deficiency
- Meconium-stained amniotic fluid is inhaled, causing airway obstruction and inflammation (Correct answer)
- Group B streptococcus causes neonatal pneumonia
- Persistent pulmonary hypertension develops without meconium
Correct answer: Meconium-stained amniotic fluid is inhaled, causing airway obstruction and inflammation
MAS results from aspiration of meconium-stained amniotic fluid, causing chemical pneumonitis, mechanical obstruction, and surfactant inactivation, often in term or post-term infants.
Question 6: Neonatal nasal CPAP is most commonly used to treat which condition?
- Neonatal RDS and apnea of prematurity (Correct answer)
- Congenital diaphragmatic hernia
- Tracheoesophageal fistula
- Pierre Robin sequence
Correct answer: Neonatal RDS and apnea of prematurity
Nasal CPAP reduces the need for invasive mechanical ventilation in preterm infants with RDS by maintaining alveolar patency, and also reduces apnea of prematurity episodes.
NBRC Neonatal and Pediatric Respiratory Care 1
Which condition in premature infants results from surfactant deficiency?