KETTERING NPS EXAM WITH QUESTIONS AND
CORRECT ANSWERS
A 24-year-old female is admitted to Labor & Delivery in early labor. While reviewing the
past medical history, the neonatal-pediatric specialist notes that the patient is para 2
and gravida 3. The correct interpretation of these findings is
A.third pregnancy and two previous live births.
B.first pregnancy and three previous live births.
C.second pregnancy and three previous live births.
D.third pregnancy and three previous live births. - CORRECT ANSWER A.third
pregnancy and two previous live births.
While preparing equipment for flexible fiberoptic bronchoscopy, the neonatal-pediatric
specialist should check the
1. patency of scope lumen.
2. set suction pressure.
3. function of optical fibers.
A.1 and 2 only
B.2 and 3 only
C.1 and 3 only
D.1, 2, and 3 - CORRECT ANSWER D.1, 2, and 3
An infant is receiving 55% oxygen via oxygen hood. An arterial blood gas drawn from an
umbilical artery line reveals the following results:
pH7.36
PaCO232 torr
PaO245 torr
BE-6
These results are most consistent with
A.ventilation/perfusion mismatch.
B.intrapulmonary shunting.
C.hypoventilation.
D.venous admixture. - CORRECT ANSWER A.ventilation/perfusion mismatch.
While suctioning an 8-year-old child, the vacuum pressure suddenly stops. This could
be the result of
1. a mucus plug in the catheter.
2. a disconnected connecting tube.
3. a full collection bottle.
4. high vacuum regulator setting.
A.3 only
,B.1 and 4 only
C.1, 2 and 3 only
D.2, 3 and 4 - CORRECT ANSWER C.1, 2 and 3 only
What is the estimated tidal volume for a time-cycled ventilator if the flowrate is 7 L/min.
and the inspiratory time is 0.7 seconds?
A.50 mL
B.80 mL
C.110 mL
D.150 mL - CORRECT ANSWER B.80 mL
When the neonatal-pediatric specialist refrains from discussing patient information in the
hospital cafeteria, he is respecting the principle of
A.veracity.
B.confidentiality.
C.justice.
D.beneficence. - CORRECT ANSWER B.confidentiality.
A full-term, 10-hour-old newborn has a blood pressure of 68/44 mmHg in the left arm
and 44/28 mmHg in the left leg. This data indicates the presence of
A.Tetralogy of Fallot.
B.patent ductus arteriosus.
C.coarctation of the aorta.
D.transposition of the great vessels. - CORRECT ANSWER C.coarctation of the aorta.
The chest X-ray of a 32-week gestational-age infant indicates the endotracheal tube is
at the level of C-4. The neonatal-pediatric specialist should
A.maintain current tube position.
B.withdraw the tube.
C.advance the tube.
D.repeat the chest X-ray. - CORRECT ANSWER C.advance the tube.
During oral endotracheal intubation of a 9-year-old child, the neonatal-pediatric
specialist has difficulty visualizing the laryngeal structures. The specialist should
A.ask an assistant to apply cricoid pressure.
B.rotate the laryngoscope 90 degrees to right.
C.advance the laryngoscope an additional 4 cm.
D.use a nasotracheal approach. - CORRECT ANSWER A.ask an assistant to apply
cricoid pressure.
A 15-year-old near-drowning victim arrives in the emergency department with a
laryngeal mask airway in place. Following successful resuscitation, the patient will
require mechanical ventilation for several days, and the physician asks the neonatal-
pediatric specialist to replace the LMA with an oral endotracheal tube. The specialist
should
A.remove the LMA, then insert the ET tube.
,B.insert the ET tube through the LMA, then remove the LMA.
C.deflate the cuff on the LMA, insert the ET tube next to the LMA.
D.insert a nasotracheal tube, then remove the LMA. - CORRECT ANSWER B.insert the
ET tube through the LMA, then remove the LMA
An adolescent patient with a drug overdose is being mechanically ventilated at the
following settings.
ModeVC, A/C
FIO20.30
Rate16 b/min.
Flow15 L/min.
Tidal volume600 mL
Pressure limit40 cm H2O
The high pressure alarm sounds with each breath and wide fluctuations are noticed on
the pressure manometer. In this situation the most appropriate action would be to
A.sedate the patient.
B.increase the pressure limit.
C.increase the flow rate.
D.decrease the tidal volume. - CORRECT ANSWER C.increase the flow rate.
A 12-year-old gunshot victim has irreversible brain damage and his parents have
consented to organ donation. The neonatal-pediatric specialist should care for this child
by maintaining
A.cardiac output at 2 L/min
B.mean arterial pressure at 65 mmHg.
C.PaCO2 at less than 20 torr.
D.PaO2 at 120 torr. - CORRECT ANSWER D.PaO2 at 120 torr.
A 16-month-old child with croup has been receiving continuous aerosol via ultrasonic
nebulizer. The patient progress notes indicate that no distress or stridor has been noted
in the past two days and that the patient has gained weight since admission. Chest X-
ray reveals bilateral fluffy infiltrates. Auscultation reveals bilateral fine rales. The
neonatal-pediatric specialist should recommend
A.a stat albuterol treatment.
B.suctioning the patient.
C.discontinuing the aerosol therapy.
D.oral endotracheal intubation. - CORRECT ANSWER C.discontinuing the aerosol
therapy.
Radiographic evaluation of a newborn infant's chest reveals air loops in the left chest
with a shift of the mediastinum to the right. This is suggestive of
A.IRDS.
B.gastroschisis.
C.tracheoesophageal fistula.
D.diaphragmatic hernia. - CORRECT ANSWER D.diaphragmatic hernia.
, Advantages of electronic charting over manual charting include
1. automation of day-to-day procedures.
2. improved accuracy of charting.
3. standardization of care.
4. less costly.
A.1 and 2 only
B.3 and 4 only
C.1, 2, and 3 only
D.2, 3, and 4 only - CORRECT ANSWER C.1, 2, and 3 only
Measurement of a child's VD/VT ratio may help establish the diagnosis of
A.ARDS.
B.pneumonia.
C.pulmonary embolism.
D.pulmonary edema. - CORRECT ANSWER C.pulmonary embolism.
Following two hours of early labor, the obstetrician determines that the baby is in the
breech position. The baby's heart rate suddenly shows variable decelerations with each
contraction and bradycardia. Which of the following is the most likely cause?
A.normal response to labor
B.prolapsed cord
C.infection
D.congenital malformation - CORRECT ANSWER B.prolapsed cord
A child is receiving postural drainage and percussion for left lower lobe pneumonia.
Which lobe would the neonatal-pediatric specialist be draining when the patient is most
likely to become hypoxic?
A.Right upper lobe
B.Right lower lobe
C.Left upper lobe
D.Left lower lobe - CORRECT ANSWER A.Right upper lobe
When initiating nasal CPAP for a 2600 g infant, the neonatal-pediatric specialist should
select which of the following items?
1. volume measuring device.
2. blended gas source.
3. humidification device.
A.2 and 3 only
B.1 and 2 only
C.1 and 3 only
D.1, 2, and 3 - CORRECT ANSWER A.2 and 3 only
CORRECT ANSWERS
A 24-year-old female is admitted to Labor & Delivery in early labor. While reviewing the
past medical history, the neonatal-pediatric specialist notes that the patient is para 2
and gravida 3. The correct interpretation of these findings is
A.third pregnancy and two previous live births.
B.first pregnancy and three previous live births.
C.second pregnancy and three previous live births.
D.third pregnancy and three previous live births. - CORRECT ANSWER A.third
pregnancy and two previous live births.
While preparing equipment for flexible fiberoptic bronchoscopy, the neonatal-pediatric
specialist should check the
1. patency of scope lumen.
2. set suction pressure.
3. function of optical fibers.
A.1 and 2 only
B.2 and 3 only
C.1 and 3 only
D.1, 2, and 3 - CORRECT ANSWER D.1, 2, and 3
An infant is receiving 55% oxygen via oxygen hood. An arterial blood gas drawn from an
umbilical artery line reveals the following results:
pH7.36
PaCO232 torr
PaO245 torr
BE-6
These results are most consistent with
A.ventilation/perfusion mismatch.
B.intrapulmonary shunting.
C.hypoventilation.
D.venous admixture. - CORRECT ANSWER A.ventilation/perfusion mismatch.
While suctioning an 8-year-old child, the vacuum pressure suddenly stops. This could
be the result of
1. a mucus plug in the catheter.
2. a disconnected connecting tube.
3. a full collection bottle.
4. high vacuum regulator setting.
A.3 only
,B.1 and 4 only
C.1, 2 and 3 only
D.2, 3 and 4 - CORRECT ANSWER C.1, 2 and 3 only
What is the estimated tidal volume for a time-cycled ventilator if the flowrate is 7 L/min.
and the inspiratory time is 0.7 seconds?
A.50 mL
B.80 mL
C.110 mL
D.150 mL - CORRECT ANSWER B.80 mL
When the neonatal-pediatric specialist refrains from discussing patient information in the
hospital cafeteria, he is respecting the principle of
A.veracity.
B.confidentiality.
C.justice.
D.beneficence. - CORRECT ANSWER B.confidentiality.
A full-term, 10-hour-old newborn has a blood pressure of 68/44 mmHg in the left arm
and 44/28 mmHg in the left leg. This data indicates the presence of
A.Tetralogy of Fallot.
B.patent ductus arteriosus.
C.coarctation of the aorta.
D.transposition of the great vessels. - CORRECT ANSWER C.coarctation of the aorta.
The chest X-ray of a 32-week gestational-age infant indicates the endotracheal tube is
at the level of C-4. The neonatal-pediatric specialist should
A.maintain current tube position.
B.withdraw the tube.
C.advance the tube.
D.repeat the chest X-ray. - CORRECT ANSWER C.advance the tube.
During oral endotracheal intubation of a 9-year-old child, the neonatal-pediatric
specialist has difficulty visualizing the laryngeal structures. The specialist should
A.ask an assistant to apply cricoid pressure.
B.rotate the laryngoscope 90 degrees to right.
C.advance the laryngoscope an additional 4 cm.
D.use a nasotracheal approach. - CORRECT ANSWER A.ask an assistant to apply
cricoid pressure.
A 15-year-old near-drowning victim arrives in the emergency department with a
laryngeal mask airway in place. Following successful resuscitation, the patient will
require mechanical ventilation for several days, and the physician asks the neonatal-
pediatric specialist to replace the LMA with an oral endotracheal tube. The specialist
should
A.remove the LMA, then insert the ET tube.
,B.insert the ET tube through the LMA, then remove the LMA.
C.deflate the cuff on the LMA, insert the ET tube next to the LMA.
D.insert a nasotracheal tube, then remove the LMA. - CORRECT ANSWER B.insert the
ET tube through the LMA, then remove the LMA
An adolescent patient with a drug overdose is being mechanically ventilated at the
following settings.
ModeVC, A/C
FIO20.30
Rate16 b/min.
Flow15 L/min.
Tidal volume600 mL
Pressure limit40 cm H2O
The high pressure alarm sounds with each breath and wide fluctuations are noticed on
the pressure manometer. In this situation the most appropriate action would be to
A.sedate the patient.
B.increase the pressure limit.
C.increase the flow rate.
D.decrease the tidal volume. - CORRECT ANSWER C.increase the flow rate.
A 12-year-old gunshot victim has irreversible brain damage and his parents have
consented to organ donation. The neonatal-pediatric specialist should care for this child
by maintaining
A.cardiac output at 2 L/min
B.mean arterial pressure at 65 mmHg.
C.PaCO2 at less than 20 torr.
D.PaO2 at 120 torr. - CORRECT ANSWER D.PaO2 at 120 torr.
A 16-month-old child with croup has been receiving continuous aerosol via ultrasonic
nebulizer. The patient progress notes indicate that no distress or stridor has been noted
in the past two days and that the patient has gained weight since admission. Chest X-
ray reveals bilateral fluffy infiltrates. Auscultation reveals bilateral fine rales. The
neonatal-pediatric specialist should recommend
A.a stat albuterol treatment.
B.suctioning the patient.
C.discontinuing the aerosol therapy.
D.oral endotracheal intubation. - CORRECT ANSWER C.discontinuing the aerosol
therapy.
Radiographic evaluation of a newborn infant's chest reveals air loops in the left chest
with a shift of the mediastinum to the right. This is suggestive of
A.IRDS.
B.gastroschisis.
C.tracheoesophageal fistula.
D.diaphragmatic hernia. - CORRECT ANSWER D.diaphragmatic hernia.
, Advantages of electronic charting over manual charting include
1. automation of day-to-day procedures.
2. improved accuracy of charting.
3. standardization of care.
4. less costly.
A.1 and 2 only
B.3 and 4 only
C.1, 2, and 3 only
D.2, 3, and 4 only - CORRECT ANSWER C.1, 2, and 3 only
Measurement of a child's VD/VT ratio may help establish the diagnosis of
A.ARDS.
B.pneumonia.
C.pulmonary embolism.
D.pulmonary edema. - CORRECT ANSWER C.pulmonary embolism.
Following two hours of early labor, the obstetrician determines that the baby is in the
breech position. The baby's heart rate suddenly shows variable decelerations with each
contraction and bradycardia. Which of the following is the most likely cause?
A.normal response to labor
B.prolapsed cord
C.infection
D.congenital malformation - CORRECT ANSWER B.prolapsed cord
A child is receiving postural drainage and percussion for left lower lobe pneumonia.
Which lobe would the neonatal-pediatric specialist be draining when the patient is most
likely to become hypoxic?
A.Right upper lobe
B.Right lower lobe
C.Left upper lobe
D.Left lower lobe - CORRECT ANSWER A.Right upper lobe
When initiating nasal CPAP for a 2600 g infant, the neonatal-pediatric specialist should
select which of the following items?
1. volume measuring device.
2. blended gas source.
3. humidification device.
A.2 and 3 only
B.1 and 2 only
C.1 and 3 only
D.1, 2, and 3 - CORRECT ANSWER A.2 and 3 only
