Neonatal Nurse Practitioner Exam Respiratory Management 2

Question 1

Which condition is characterized by a persistent right-to-left shunt through the ductus arteriosus and foramen ovale in a term neonate?

Accepted Answer

Persistent pulmonary hypertension of the newborn (PPHN)

Answer

PPHN involves elevated pulmonary vascular resistance causing right-to-left shunting through fetal channels, bypassing the lungs.

Question 2

Inhaled nitric oxide (iNO) is used in neonates primarily to:

Accepted Answer

Selectively dilate pulmonary vasculature

Answer

iNO selectively dilates pulmonary vasculature without systemic effects, reducing pulmonary hypertension and improving oxygenation.

Question 3

A preterm infant on CPAP has a sudden desaturation with decreased breath sounds on the right. What is the priority action?

Accepted Answer

Obtain chest X-ray and prepare for needle decompression

Answer

Sudden unilateral desaturation with absent breath sounds suggests pneumothorax, requiring urgent chest X-ray and possible needle decompression.

Question 4

Which drug is first-line for pharmacologic treatment of apnea of prematurity?

Accepted Answer

Caffeine citrate

Answer

Caffeine citrate is the preferred first-line methylxanthine for apnea of prematurity due to its superior safety profile and once-daily dosing.

Question 5

What does a pre-ductal SpO2 greater than post-ductal SpO2 by more than 10% indicate in a neonate?

Accepted Answer

Right-to-left ductal shunting consistent with PPHN

Answer

A significant pre-to-post-ductal SpO2 gradient indicates right-to-left shunting through the ductus arteriosus, consistent with PPHN.

Neonatal Nurse Practitioner Exam Practice Test