Test Bank For Neonatal and Pediatric Respiratory Care by Perretta

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Test Bank For Neonatal and Pediatric Respiratory Care by Perretta

Chapter 3 Resuscitation of the Newborn During Transition to Extrauterine Life

Multiple Choice

1. What stage of labor does the cervix reach complete dilatation?

A. Active phase

B. Latent phase

C. Deceleration phase

D. Transition phase

ANS: C

2. All of the following statements about fetal heart rate monitoring are true except:

A. It is used to estimate a fetus’s tolerance of labor process.

B. It is used to make decisions on the method and speed of the delivery.

C. It improves neonatal outcomes.

D. It has become the standard method of care in the United States.

ANS: C

3. A sinusoidal heart rate is indicative of:

A. Uteroplacental insufficiency

B. umbilical cord compression

C. A change in vagal tone after brief hypoxia episodes

D. Severe fetal hypoxia, acidosis, or anemia

ANS: D

4. Transition to the extrauterine world consists of all of the following rapid, physiological events except:

A. Establishment of respirations

B. Vasoconstriction of the pulmonary vasculature and increase in pulmonary vascular resistance

C. Transition of fetal circulation to adult circulation

D. Expansion of the lungs

ANS: B

5. A newborn presents at delivery with meconium-stained amniotic fluid and is handed to the resuscitation team. She is crying, has central cyanosis, and is moving spontaneously. Which of the following is the most appropriate first action for the team to take to resuscitate?

A. Dry, stimulate, and suction the mouth and nose.

B. Auscultate the lungs to evaluate aspiration of meconium.

C. Intubate and suction the trachea to remove meconium.

D. Place the baby on the mother’s chest.

ANS: A

6. Randomized controlled trials have suggested all of the following statements regarding induced hypothermia are true except:

A. Infants with moderate-to-severe hypoxic encephalopathy may be protected against brain injury.

B. Strict guidelines must be implemented within 12 to 24 hours following birth.

C. Infants with moderate-to-severe ischemic encephalopathy should be offered therapeutic hypothermia in a timely manner.

D. Registered respiratory therapists must be aware of their institutional policies to provide appropriate follow-up care.

ANS: B

7. What actions are usually enough to stimulate a newborn to breathe?

A. Positioning, drying, and suctioning

B. Positioning, drying, and slapping the newborn’s buttocks

C. Positioning, drying, and vigorously rubbing the newborn’s back

D. Positioning, drying, and flicking the newborn’s arm

ANS: A

8. What is the course of action when a newborn presents with secondary apnea?

A. Place in sniffing position.

B. Place on apnea monitor.

C. Initiate positive pressure ventilation.

D. Administer medications to increase heart rate.

ANS: C

9. Baby Carter presents with gasping, his heart rate is greater than 100 bpm, and the presence of secondary apnea is seen. Initially, what is the best approach when managing this newborn?

A. Biphasic positive airway pressure therapy

B. Positive pressure ventilation via resuscitation bag and mask

C. Oxygen therapy

D. Positioning, drying, and vigorously rubbing the newborn’s back

ANS: B

10. If a newborn weighs 2.5 kg, where should the endotracheal tube be taped?

A. 7.5 cm at the upper lip

B. 8.5 cm at the upper lip

C. 7.0 cm at the upper lip

D. 8.0 cm at the upper lip

ANS: B

11. What chest compression method is recommended by the Neonatal Resuscitation Program, and gives a greater peak systolic pressure when performing CPR on newborns?

A. Two-finger technique (compressing the chest with two fingers as the second hand supports the back)

B. One finger technique (compressing the chest with one finger as the second hand supports the back)

C. Two-thumb encircling-hand technique (two thumbs with fingers encircling the chest and supporting the back)

D. Two-thumb encircling-hold technique (two thumbs with fingers encircling the chest and supporting the back)

ANS: C

12. What is the compressions-to-ventilation ratio that a registered respiratory therapist should use during neonatal resuscitation?

A. 2:1

B. 3:1 

C. 20:2

D. 15:2

ANS: B

13. What route may be used to administer epinephrine 1:10,000 (0.1 mg/mL) to increase heart rate?

A. Subcutaneously

B. Intravenously only

C. Endotracheally only

D. Intravenously and endotracheally

ANS: D

14. What does the acronym APGAR stand for?

A. Assessment, pulse, grimace, appearance, resonance

B. Appearance, pulse, grimace, activity, respirations

C. Assessment, pulse, ground-glass appearance, asthma, respirations

D. Assessment, projection, grimace, auditory, respirations

ANS: B

15. Withholding and discontinuing resuscitation efforts may be appropriate in all of the following circumstances except:

A. When the birth weight is less than 400 grams

B. When gestational age is less than 28 weeks

C. When parental agreement is obtained 

D. When there is an undetectable heart rate after 10 minutes of CPR

ANS: B

16. Which of the following statements are true regarding disadvantages of self-inflating bags?
I. Inability to know if a good seal is being obtained
II. A reservoir attachment needed to achieve 100% FiO₂
III. Ability to provide 100% FiO₂ free- flowing dependably
IV. Inability to provide 100% FiO₂ free-flowing dependably

A. I, III, IV

B. II, III, IV

C. I, II, IV

D. I and II

ANS: C