RNC-NIC Respiratory Care 3

Question 1

A premature neonate develops a sudden deterioration with decreased breath sounds on the right, hypotension, and bradycardia. Transillumination of the chest is positive on the right. What is the immediate intervention?

Accepted Answer

Emergency needle decompression at the second intercostal space, midclavicular line

Answer

Tension pneumothorax is a life-threatening emergency requiring immediate needle decompression at the 2nd intercostal space, midclavicular line, without waiting for imaging.

Question 2

Which of the following is the correct target SpO2 range for a premature neonate less than 32 weeks gestational age receiving supplemental oxygen?

Accepted Answer

90-95%

Answer

Current evidence supports targeting SpO2 of 90-95% in extremely preterm neonates to balance the risks of retinopathy of prematurity and mortality.

Question 3

A neonate with congenital diaphragmatic hernia (CDH) is intubated at birth. Which ventilation strategy is most appropriate?

Accepted Answer

Gentle ventilation with permissive hypercapnia and low pressures

Answer

Gentle ventilation with permissive hypercapnia avoids barotrauma to the hypoplastic lungs in CDH; aggressive ventilation worsens outcomes.

Question 4

When setting up a neonatal ventilator, which tidal volume range is considered lung-protective for a preterm neonate?

Accepted Answer

4-6 mL/kg

Answer

Tidal volumes of 4-6 mL/kg are recommended for lung-protective ventilation in preterm neonates to minimize volutrauma.

Question 5

A 26-week neonate receiving CPAP has FiO2 requirements of 0.45. Which clinical criteria would support transition to mechanical ventilation?

Accepted Answer

FiO2 greater than 0.40 with increased work of breathing and apnea

Answer

Failure criteria for CPAP include increasing FiO2 needs (>0.40-0.50), recurrent apnea, and signs of respiratory failure, indicating need for intubation.

(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 3