RNC-NIC Respiratory Care 2

Question 1

A 28-week neonate on CPAP has increasing oxygen requirements and work of breathing. Chest X-ray shows a diffuse 'ground-glass' appearance with air bronchograms. What is the most likely diagnosis?

Accepted Answer

Respiratory distress syndrome (RDS)

Answer

Ground-glass opacification with air bronchograms on CXR is the classic radiographic finding of RDS due to surfactant deficiency in premature infants.

Question 2

When administering surfactant therapy via the INSURE technique, what does the acronym stand for?

Accepted Answer

Intubate, give SURfactant, Extubate

Answer

INSURE stands for INtubate, give SURfactant, and Extubate, minimizing ventilator exposure in preterm infants.

Question 3

A term neonate born through thick meconium-stained fluid is vigorous at birth. What is the current recommended initial management?

Accepted Answer

Routine care without immediate tracheal suctioning

Answer

Current NRP guidelines recommend routine care for vigorous meconium-stained neonates; immediate tracheal suctioning is no longer recommended for vigorous infants.

Question 4

A 32-week neonate receiving conventional mechanical ventilation has a PaCO2 of 28 mmHg on ABG. What ventilator adjustment is most appropriate?

Accepted Answer

Decrease tidal volume or respiratory rate

Answer

Hypocarbia (PaCO2 < 35 mmHg) in neonates risks cerebral vasoconstriction and periventricular leukomalacia; decreasing minute ventilation is indicated.

Question 5

Which finding on a neonatal blood gas indicates a mixed respiratory and metabolic acidosis?

Accepted Answer

pH 7.20, PaCO2 55 mmHg, HCO3 16 mEq/L

Answer

A mixed acidosis shows both elevated PaCO2 (respiratory component) and reduced bicarbonate (metabolic component) with a low pH.

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

(RNC-NIC) Registered Nurse Certified in Neonatal Intensive Care Practice Test

RNC-NIC Respiratory Care 2