RRT RRT Neonatal and Pediatric Respiratory Care 2 — Questions and Answers
Question 1: What is the recommended tidal volume for neonatal mechanical ventilation using lung-protective strategy?
- 2–4 mL/kg IBW
- 4–6 mL/kg IBW (Correct answer)
- 6–8 mL/kg IBW
- 8–10 mL/kg IBW
Correct answer: 4–6 mL/kg IBW
Neonatal lung-protective ventilation targets tidal volumes of 4–6 mL/kg IBW to minimize volutrauma in the immature, surfactant-deficient lung.
Question 2: Bronchopulmonary dysplasia (BPD) in premature infants is most associated with:
- Maternal diabetes
- Prolonged mechanical ventilation and oxygen exposure in preterm lungs (Correct answer)
- Congenital infection
- Meconium aspiration
Correct answer: Prolonged mechanical ventilation and oxygen exposure in preterm lungs
BPD results from mechanical ventilation-induced barotrauma/volutrauma and oxygen toxicity in the immature lung, causing abnormal alveolar and vascular development.
Question 3: In pediatric resuscitation, what is the correct compression-to-ventilation ratio for two-rescuer CPR?
- 30:2
- 15:2 (Correct answer)
- 30:1
- 5:1
Correct answer: 15:2
Two-rescuer pediatric CPR uses a 15:2 ratio to provide more frequent ventilations, as pediatric arrests are more often respiratory in origin.
Question 4: Which inhaled medication is first-line for acute bronchiolitis in a hospitalized infant?
- Albuterol nebulization
- Racemic epinephrine
- Ribavirin
- Supportive care with nasal suctioning and hydration (no bronchodilators) (Correct answer)
Correct answer: Supportive care with nasal suctioning and hydration (no bronchodilators)
Current AAP guidelines recommend only supportive care for bronchiolitis; bronchodilators, corticosteroids, and antibiotics are not routinely recommended.
Question 5: What is the correct ETT size formula for uncuffed tubes in pediatric patients older than 1 year?
- Age/4 + 3.5
- Age/4 + 4 (Correct answer)
- Age/3 + 3
- Weight/10 + 2
Correct answer: Age/4 + 4
The formula (Age/4) + 4 estimates uncuffed ETT size in children over 1 year, though cuffed tubes are increasingly preferred in modern practice.
Question 6: Persistent pulmonary hypertension of the newborn (PPHN) is best treated with which intervention?
- High-flow nasal cannula oxygen only
- Inhaled nitric oxide (iNO) and optimized ventilation (Correct answer)
- Oral sildenafil alone
- CPAP without supplemental oxygen
Correct answer: Inhaled nitric oxide (iNO) and optimized ventilation
iNO selectively dilates pulmonary vasculature, reducing right-to-left shunting in PPHN, and is used alongside optimized ventilation and oxygenation.
RRT RRT Neonatal and Pediatric Respiratory Care 2
What is the recommended tidal volume for neonatal mechanical ventilation using lung-protective strategy?