Neonatal Nurse Practitioner Exam Respiratory Management

Question 1

What is the primary goal of surfactant replacement therapy in premature neonates?

Accepted Answer

Decrease alveolar surface tension to prevent collapse

Answer

Surfactant reduces alveolar surface tension, preventing alveolar collapse and improving lung compliance in premature infants.

Question 2

Which ventilator parameter is most directly adjusted to correct hypercapnia in a ventilated neonate?

Accepted Answer

Tidal volume or respiratory rate

Answer

Increasing tidal volume or respiratory rate increases minute ventilation, which removes more CO2 and corrects hypercapnia.

Question 3

A term neonate has persistent tachypnea, grunting, and a chest X-ray showing fluid in the fissures. What is the most likely diagnosis?

Accepted Answer

Transient tachypnea of the newborn

Answer

Transient tachypnea of the newborn (TTN) classically presents with fluid in the interlobar fissures on CXR in term or late-preterm infants.

Question 4

What is the recommended initial FiO2 for resuscitation of a term neonate at birth in the US?

Accepted Answer

21%

Answer

Current NRP guidelines recommend starting resuscitation of term neonates with room air (21% FiO2) and titrating based on pulse oximetry.

Question 5

Which finding on blood gas is most consistent with respiratory acidosis in a neonate?

Accepted Answer

pH 7.20, PaCO2 65 mmHg

Answer

Respiratory acidosis is characterized by a low pH combined with elevated PaCO2, reflecting inadequate ventilation.

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