Neonatal & Pediatric Final Exam 2024 Graded A

Which of the following statements describe truncus arteriosus? A. The pulmonary artery arises from the left ventricle, and the aorta stems from the right ventricle. B. A large VSD allows total mixing of blood from the two ventricles. C. If SVR decreases relative to PVR, blood flow will be shunted from right to left, bypassing the lungs. D. All of the above - D. All of the above What factor is responsible for closure of the foramen ovale? A. Increased PaO2 B. Increased pressure on the left side of the heart C. Blood flowing through the lungs D. High pulmonary vascular resistance - B. Increased pressure on the left side of the heart What is the incidence of respiratory distress syndrome (RDS) among infants born at less than 28 weeks of gestation? A. 30% to 40% B. 40% to 50% C. 60% to 80% D. 80% - C. 60% to 80% What radiographic features is the therapist likely to see on a typical chest X-ray of an infant with MAS? A. Ground-glass appearance B. Complete whiteout C. Decreased lung volume D. Patchy areas of atelectasis - D. Patchy areas of atelectasis The therapist is treating a child with TOF who appears to be having a "tet" spell. What should the therapist suggest to treat this event? A. Beta blockers B. Knee-chest position to increase SVR C. Morphine sulfate D. All of the above - D. All of the above The therapist is setting pulse oximetry to determine the presence of right-to-left shunt in an infant suspected of having a heart defect. Where should the therapist place the pulse ox probe to obtain the most accurate measure of preductal oxygen saturation? A. Any finger of the right hand B. Any finger of the left hand C. Left earlobe D. Lower extremities - A. Any finger of the right hand Which of the following physiologic mechanisms need to be in place to ensure adequate systemic perfusion in infants with hypoplastic left heart syndrome (HLHS)? A. Presence of an ASD B. Presence of a mitral regurgitation C. Adequate left atrial function D. Presence of a PDA - D. Presence of a PDA Blood samples are simultaneously obtained from both the right radial artery and the umbilical artery, and the arterial partial pressure of oxygen (PaO2) value from the right radial artery is 20 mm Hg greater than that analyzed from the umbilical artery sample. On the basis of this finding, which of the following conditions does the neonate likely have? A. PPHN B. MAS C. Neonatal pneumonia D. RDS - A. PPHN What ventilator settings should a therapist select for a newborn with respiratory distress syndrome? A. PIP 25-30 cm H2O B. PEEP 3-6 cm H2O C. VT 5-6 mL/kg D. Frequency 60 breaths per minute - B. PEEP 3-6 cm H2O 0. Why does meconium staining occur predominantly in infants older than 36 weeks of gestational age? A. Because these infants can generate strong inspiratory efforts B. Because infants this age have significant cardiac outputs C. Because these infants demonstrate strong peristalsis D. Because these newborns have weak anal sphincter tone - C. Because these infants demonstrate strong peristalsis 1. Which of the following clinical manifestations is consistent with an atrial septal defect (ASD)? A. An ASD often causes congestive heart failure (because of decreased pulmonary blood flow). B. The right ventricle may become hypertrophic (right ventricular hypertrophy). C. Most patients with an ASD are symptomatic in the neonatal intensive care unit, presenting with right atrial enlargement. D. Chest radiographs are usually abnormal. - B. The right ventricle may become hypertrophic (right ventricular hypertrophy). What is the typical type of airway obstruction that occurs with MAS? A. Ball valve B. Complete C. No obstruction D. Airway inflammation - A. Ball valve How should the therapist interpret a preductal-to-postductal PaO2 difference of 8 mm Hg in a neonate? A. Unreliable data B. Absence of ductal shunting C. Presence of ductal shunting D. Inconclusive data - . Absence of ductal shunting Which of the following congenital cardiac anomalies is classified as conotruncal, associated with a "boot-shaped" appearance of the heart? A. Tetralogy of Fallot B. Transposition of the great vessels C. Coarctation of the aorta D. Atrioventricular canal defect - A. Tetralogy of Fallot Which of the following medications should the therapist recommend for an infant with apnea of prematurity experiencing episodes of apnea? A. Caffeine B. Benzodiazepines C. Antibiotics D. Doxapram - A. Caffeine Which of the following therapeutic interventions is generally needed to treat transient tachypnea of the newborn (TTN)? A. Endotracheal intubation B. 30%-40% oxygen hood C. Bronchial hygiene therapy D. Bronchodilator therapy - B. 30%-40% oxygen hood Which of the following blood gas parameters should the therapist target when managing patients with PPHN? A. SaO2 95% B. PaCO2 35-45 mm Hg C. pH 7.35-7.45 D. All of the above - D. All of the above Eight hours after being born, a baby presents with cyanosis despite administration of adequate ventilation, tachypnea, and retractions. Which of the following conditions should the therapist suspect is affecting this newborn? A. RDS B. BPD C. PPHN D. GBS pneumonia - C. PPHN