NPS NPS Respiratory Management 3

Question 1

What is the normal PaCO2 range targeted during mechanical ventilation of a neonate with RDS?

Accepted Answer

35–45 mmHg

Answer

Target PaCO2 of 35–45 mmHg is appropriate for term neonates; permissive hypercapnia (45–55 mmHg) may be acceptable in preterm infants on lung-protective ventilation.

Question 2

Which condition is the most common cause of air leak syndrome in mechanically ventilated neonates?

Accepted Answer

RDS with high PIP ventilation

Answer

Excessive peak inspiratory pressure (PIP) during mechanical ventilation for RDS is the most common cause of pulmonary air leak (pneumothorax, PIE) in neonates.

Question 3

A neonate with congenital diaphragmatic hernia (CDH) is intubated at birth. Why is bag-mask ventilation avoided in CDH?

Accepted Answer

It inflates herniated bowel, worsening lung compression

Answer

Bag-mask ventilation forces air into the stomach and herniated intestinal loops, further compressing the hypoplastic lung and worsening respiratory failure.

Question 4

What is the significance of a pulmonary interstitial emphysema (PIE) finding on chest X-ray in a ventilated preterm neonate?

Accepted Answer

It represents air dissecting into lung interstitium, a risk factor for tension pneumothorax

Answer

PIE represents air trapped in the pulmonary interstitium and perivascular sheaths, and can progress to pneumothorax, pneumomediastinum, or pneumopericardium.

Question 5

Which parameter primarily determines oxygenation in a neonate on high-frequency oscillatory ventilation (HFOV)?

Accepted Answer

Mean airway pressure (MAP)

Answer

Mean airway pressure (MAP) is the primary determinant of lung recruitment and oxygenation in HFOV, while amplitude controls CO2 elimination.

NPS - Neonatal Pediatric Specialist Practice Test

NPS - Neonatal Pediatric Specialist Practice Test

NPS NPS Respiratory Management 3