RNC-NIC Respiratory Care 5

Question 1

A neonate on synchronized intermittent mandatory ventilation (SIMV) begins to actively fight the ventilator. Which condition should the nurse first assess for?

Accepted Answer

Pneumothorax, tube malposition, obstruction, or other acute deterioration

Answer

Neonate-ventilator asynchrony and agitation should prompt immediate assessment for acute complications such as pneumothorax, tube displacement, or obstruction before sedation.

Question 2

A blood gas from a ventilated preterm neonate shows pH 7.18, PaCO2 62 mmHg, HCO3 22 mEq/L. How should this be classified?

Accepted Answer

Respiratory acidosis

Answer

The low pH with elevated PaCO2 and normal bicarbonate indicates uncompensated respiratory acidosis, likely due to hypoventilation.

Question 3

Which clinical sign is most indicative of adequate chest rise during bag-mask ventilation in a neonate?

Accepted Answer

Visible symmetric chest wall movement similar to normal breathing

Answer

Adequate bag-mask ventilation produces visible, symmetric chest rise that mimics normal tidal breathing, indicating appropriate tidal volume delivery.

Question 4

A nurse notes that a 30-week neonate's endotracheal tube has copious thick secretions. Which suctioning practice is correct for an intubated neonate?

Accepted Answer

Suction only when clinically indicated with catheter no larger than half the ETT internal diameter

Answer

ETT suctioning should be performed only when clinically indicated and with a catheter no more than half the ETT internal diameter to avoid airway trauma.

Question 5

Which parameter in HFOV primarily controls CO2 elimination?

Accepted Answer

Amplitude (ΔP)

Answer

In HFOV, amplitude (ΔP) determines the oscillatory volume (DCO2) and is the primary control for CO2 elimination.

(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 5