Neonatal Nurse Practitioner for Professional Flashcards

A term neonate with meconium aspiration syndrome (MAS) fails to improve on conventional ventilation. The ventilator strategy most likely to improve oxygenation while minimizing volutrauma is:

Answer: High-frequency oscillatory ventilation (HFOV) with lung recruitment strategy

HFOV provides consistent mean airway pressure for lung recruitment while delivering very small tidal volumes, reducing volutrauma in MAS.

Which retinopathy of prematurity (ROP) finding requires treatment within 72 hours to prevent retinal detachment?

Answer: Type 1 ROP: Zone I any stage with plus disease, or Zone II Stage 3 with plus disease

Type 1 ROP is the threshold for urgent treatment with laser photocoagulation or anti-VEGF therapy to prevent progression to detachment.

A neonate has neonatal abstinence syndrome (NAS) with a Finnegan score consistently above 8. After maximizing non-pharmacologic interventions, which first-line pharmacologic treatment is recommended?

Answer: Oral morphine or methadone titrated to symptom control

Opioid replacement with oral morphine or methadone is first-line pharmacotherapy for NAS due to opioid exposure, targeting the underlying receptor withdrawal.

A 36-week infant has a serum calcium of 6.2 mg/dL with jitteriness and prolonged QTc on EKG. The immediate treatment is:

Answer: IV 10% calcium gluconate infused slowly over 10–15 minutes with cardiac monitoring

Symptomatic hypocalcemia with EKG changes requires slow IV calcium gluconate with continuous cardiac monitoring to avoid bradycardia.

Which chromosomal abnormality is most commonly associated with duodenal atresia in the newborn?

Answer: Trisomy 21 (Down syndrome)

Approximately 30% of duodenal atresia cases are associated with Trisomy 21, making it the most common chromosomal association.

When counseling parents about the expected developmental trajectory of their 25-week infant at hospital discharge, which statement reflects evidence-based prognostic guidance?

Answer: Outcomes vary widely; most infants benefit from early intervention therapies with individualized follow-up

Outcomes at 25 weeks are highly variable; early intervention services improve outcomes, and individualized, honest counseling respects family autonomy.

A 3-week-old infant presents with fever, bulging fontanelle, and CSF findings of glucose 25 mg/dL, protein 320 mg/dL, and 480 WBC with 90% PMNs. The most likely causative organism is:

Answer: Group B Streptococcus (GBS)

Group B Streptococcus is the most common cause of late-onset neonatal meningitis (7–90 days), followed by E. coli.