NPS NPS Respiratory Management 1 — Questions and Answers
Question 1: What is the target oxygen saturation range recommended for preterm neonates less than 32 weeks gestation?
- 85–89%
- 91–95% (Correct answer)
- 96–99%
- 100%
Correct answer: 91–95%
Current evidence supports targeting SpO2 of 91–95% in preterm neonates <32 weeks to balance risks of retinopathy of prematurity and mortality.
Question 2: Which ventilation mode delivers a set tidal volume regardless of changes in lung compliance in mechanically ventilated neonates?
- Pressure-controlled ventilation (PCV)
- Volume-guaranteed ventilation (VG) (Correct answer)
- High-frequency oscillatory ventilation (HFOV)
- Synchronized intermittent mandatory ventilation (SIMV)
Correct answer: Volume-guaranteed ventilation (VG)
Volume-guaranteed ventilation delivers a clinician-set tidal volume by adjusting inspiratory pressure breath-by-breath, protecting against volutrauma as compliance changes.
Question 3: A neonate on HFOV has a rising PaCO2. Which ventilator parameter should be increased?
- Mean airway pressure (MAP)
- Frequency (Hz)
- Amplitude (ΔP) (Correct answer)
- Inspired oxygen (FiO2)
Correct answer: Amplitude (ΔP)
Amplitude (ΔP) determines tidal volume delivery in HFOV; increasing amplitude improves CO2 elimination and lowers PaCO2.
Question 4: What tidal volume range is recommended for lung-protective ventilation in ventilated neonates?
- 2–3 mL/kg
- 4–6 mL/kg (Correct answer)
- 7–9 mL/kg
- 10–12 mL/kg
Correct answer: 4–6 mL/kg
A tidal volume of 4–6 mL/kg is recommended for neonatal lung-protective ventilation to minimize volutrauma while maintaining adequate CO2 clearance.
Question 5: Which finding on chest X-ray is classic for neonatal respiratory distress syndrome (RDS)?
- Hyperinflation with flattened diaphragms
- Diffuse ground-glass opacity with air bronchograms (Correct answer)
- Lobar consolidation
- Pleural effusions
Correct answer: Diffuse ground-glass opacity with air bronchograms
Neonatal RDS classically shows diffuse ground-glass opacification with air bronchograms due to surfactant deficiency causing widespread alveolar atelectasis.
Question 6: A term neonate presents with tachypnea, mild hypoxia, and a chest X-ray showing fluid in the horizontal fissure and perihilar streaking. What is the most likely diagnosis?
- Meconium aspiration syndrome
- Transient tachypnea of the newborn (TTN) (Correct answer)
- Neonatal pneumonia
- Pneumothorax
Correct answer: Transient tachypnea of the newborn (TTN)
TTN results from delayed resorption of fetal lung fluid and presents with tachypnea and perihilar streaking/fissure fluid on CXR, typically resolving within 24–72 hours.
NPS NPS Respiratory Management 1
What is the target oxygen saturation range recommended for preterm neonates less than 32 weeks gestation?