NPS NPS Respiratory Management 2

Question 1

What is the primary advantage of nasal CPAP (nCPAP) over mechanical ventilation for preterm neonates with mild-moderate RDS?

Accepted Answer

Avoidance of intubation and reduced BPD risk

Answer

nCPAP avoids the trauma of intubation and reduces the incidence of bronchopulmonary dysplasia by recruiting alveoli non-invasively.

Question 2

During neonatal resuscitation, the initial FiO2 for a term newborn should be:

Accepted Answer

21% (room air)

Answer

Current NRP guidelines recommend starting resuscitation of term newborns with room air (21% O2), titrating upward based on pulse oximetry.

Question 3

A neonate develops a sudden deterioration on mechanical ventilation. The NPS performs a DOPE assessment. What does 'D' stand for?

Accepted Answer

Displacement of the ETT

Answer

The DOPE mnemonic for sudden deterioration on a ventilator stands for Displacement, Obstruction, Pneumothorax, and Equipment failure.

Question 4

What is the minimum recommended positive end-expiratory pressure (PEEP) for mechanically ventilated neonates with RDS?

Accepted Answer

4–6 cmH2O

Answer

A PEEP of 4–6 cmH2O is recommended for neonates with RDS to maintain functional residual capacity and prevent alveolar collapse between breaths.

Question 5

Meconium aspiration syndrome (MAS) is characterized by which pathophysiological mechanism?

Accepted Answer

Airway obstruction, surfactant inactivation, and chemical pneumonitis

Answer

MAS causes a ball-valve airway obstruction, inactivates surfactant, triggers chemical pneumonitis, and often leads to pulmonary hypertension.

NPS - Neonatal Pediatric Specialist Practice Test