Deck 31: Newborn and Early Childhood Respiratory Disorders

Question 1

Which of the following can trigger apnea in the premature infant?
1) Micrognathia
2) Intracranial hemorrhage
3) REM sleep
4) Hypothermia

A)2
B)3, 4
C)1, 2, 3
D)1, 2, 3, 4

Answer 1

1, 2, 3, 4

Question 2

Respiratory causes of persistent pulmonary hypertension of the newborn (PPHN) include:
1) congenital heart disease.
2) hypoxia.
3) meconium aspiration syndrome (MAS).
4) respiratory distress syndrome (RDS).

A)2
B)3, 4
C)1, 3
D)2, 3, 4

Answer 2

3, 4

Question 3

The most recent arterial blood gas results on your premature neonatal patient show that the PaO₂ is low. All of the following are possible causes of this, EXCEPT:

A) fatigue.
B)PPHN.
C)hyperventilation.
D)pulmonary shunting.

Answer 3

hyperventilation.

Question 4

Late clinical manifestations of an infant with respiratory distress include:
1) elevated diaphragm.
2) decreased respiratory rate.
3) CO₂ retention.
4) lethargy.

A)2, 3
B)1, 4
C)1, 2, 3
D)1, 2, 3, 4

Question 5

When a neonate has PPHN, what structure(s) does the blood flow through to bypass the lungs?
1) Ductus venosus
2) Foramen ovale
3) Hypogastric arteries
4) Ductus arteriosus

A)2
B)1, 3
C)2, 4
D)1, 2, 4

Question 6

Early clinical manifestations of an infant with respiratory distress include:
1) cyanosis.
2) substernal retractions.
3) expiratory grunting.
4) apnea.

A)1, 3
B)2, 4
C)2, 3, 4
D)1, 2, 3

Question 7

A premature neonate must generate a higher negative intrapleural pressure during inspiration than a term neonate. This will result in all of the following, EXCEPT:

A) cyanosis of dependent thoracic areas.
B)"seesaw" breathing pattern.
C)alveolar hyperinflation.
D)intercostal retractions.

Question 8

Your neonatal patient has PPHN. What may develop as a consequence of this?

A) Cardiomegaly
B)Pulmonary embolism
C)Mucosal edema
D)Cardiac tamponade

Question 9

Apnea of prematurity could be defined as:
1) respiratory pause causing bradycardia.
2) cycles of short breathing pauses followed by faster breathing.
3) no breathing for >20 seconds.
4) sudden apnea and death (crib death).

A)4
B)2
C)1, 3
D)3, 4

Question 10

A neonate in respiratory distress will often dilate his/her nostrils to:

A) facilitate inspiration.
B)nurse more easily.
C)sneeze out amniotic fluid.
D)raise its intrapleural pressure.

Question 11

Apneic episodes in a premature neonate can be caused by all of the following, EXCEPT:

A) epiglottitis.
B)immature central nervous system.
C)immature airway receptors.
D)immature chemoreceptors.

Question 12

A newborn is flaccid and apneic, has a cyanotic body and a heart rate of 85/min, and shows no reaction to stimulation. Her Apgar score would be:

A) 8.
B) 5.
C) 2.
D) 1.

Question 13

PPHN usually appears:

A) in utero during the last trimester.
B)within 1 hour of birth.
C)within the first 12 hours of birth.
D)between the 1st and 6th days of life.

Question 14

A newborn's 5-minute Apgar score is 7. How should this be interpreted?

A) Normal adjustment to being born
B)Moderate distress; intubate the airway and suction the lungs
C)Moderate distress; administer supplemental oxygen
D)Severe distress; begin bag-mask resuscitation

Question 15

Your neonatal patient is having expiratory grunting. What physiologic effect does this produce?

A) Increased vital capacity.
B)Increased PAO₂.
C)Decreased PaCO₂.
D)Closes the ductus arteriosus.