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Book 4 UNIT 1

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
A damped pressure tracing may be caused by each of the following findings except
Special intravenous tubing is needed for direct blood pressure monitoring.
A narrowed pulse pressure may suggest certain congenital heart defects.
The reference range for direct blood pressure measurements is different than the reference range for indirect blood pressure measurements.
When a direct blood pressure monitoring waveform shows slow decrease in pressure during diastole, it may indicate increased systemic vascular resistance.
The transducer for direct blood pressure measurement should be level with the
Direct blood pressure measurement is used for each of the following reasons except
Book 4 UNIT 2

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
Blood glucose screening test results should be checked immediately after any exchange transfusion.
When an umbilical arterial catheter is used in an exchange transfusion, it is used only to withdraw blood from the baby
No baby should undergo more than one exchange transfusion.
Packed red blood cells (hematocrit level > 70%) of appropriate group and type should be used for an exchange transfusion
A reduction exchange transfusion is different from an exchange transfusion for hyperbilirubinemia because
What is the preferred age of donor blood used for an exchange transfusion?
A term, 4,000-g (8 lb 13 oz) baby with tachypnea who has been treated for hypoglycemia and has a venous hematocrit level of 68% should be considered for a reduction exchange transfusion.
Phototherapy lights should be used after every exchange transfusion for babies with hyperbilirubinemia
All preterm babies should be transfused with packed red blood cells if their hematocrit level is less than or equal to 25%.
Capillary blood from a heel stick sample is the preferred way to test a baby's hematocrit level.
Which of the following findings is a possible sign of anemia in a stable, growing, preterm baby?
Which of the following babies is at lowest risk for polycythemia?
A 1,800-g (3 lb 15Y2 oz), preterm baby is severely anemic and requires a transfusion of packed red blood cells. How much blood would you give?
Book 4 Unit 3

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
Which of the following is an appropriate way to provide nutrition to babies who need continuous positive airway pressure (CPAP) for acute respiratory disease who have achieved cardiovascular stability?
For which of the following babies would CPAP be most appropriate?
All babies with respiratory disease should receive CPAP.
High-flow nasal cannula can be used to deliver a consistent level of CPAP.
Which of the following statements best describes the purpose of CPAP?
Which of the following indicates the general range of pressure used with nasal CPAP when used in the treatment of respiratory distress syndrome?
A baby with respiratory distress syndrome is receiving nasal CPAP at 8 cm H20 pressure and an inspired oxygen concentration (F102) of 60%. Arterial blood gas results at these settings reveal that Pao2 = 94, Paco2 = 45 mm Hg, and pH level = 7.32. Which of the following next steps is the most appropriate one to take to adjust the baby's CPAP and oxygen therapy?
Book 4 Unit 4

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
Which of the following measurements cannot be adjusted independently on most infant ventilators?
Which of the following measurements is least reliable for determining the need for mechanical ventilation?
Which of the following statements is correct when determining ventilator settings for a baby with respiratory distress syndrome when compared to a baby with normal lung findings?
In which of the following cases is mechanical ventilation most indicated?
Which of the following statements is correct when determining ventilator settings for a term baby with meconium aspiration when compared to a preterm baby with respiratory distress syndrome?
Which of the following measurements is least likely to suggest a blocked endotra­ cheal tube?
Book 4 Unit 5

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
Which of the following statements about natural surfactant is accurate?
Which of the following statements best describes the action of natural surfactant when it is injected through an endotracheal tube?
Which of the following statements about surfactant deficiency is accurate?
Which of the following babies is at lowest risk for developing respiratory distress syndrome?
Preterm babies who have been stressed in utero have a incidence of respiratory distress syndrome
Which of the following methods of surfactant administration is appropriate?
All commercial surfactants contain the same components.
Betamethasone or dexamethasone administered to a pregnant woman. plus surfactant administered to the preterm baby, is more beneficial than surfactant administered alone.
By 32 weeks' gestation, approximately 60% of fetuses are producing adequate surfactant to prevent respiratory distress syndrome.
All surfactant components are produced by the lung at the same time during gestation.
Studies have shown that the earlier surfactant is used, the more effective it is.
Book 4 Unit 6

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
Hypoxicischemic encephalopathy (HIE) is a term used to describe neonates with encephalopathy at birth that is caused by hypoxia-ischemia around the time of delivery. Which one of the following findings is supportive of a hypoxic-ischemic event as the cause of the encephalopathy?
HIE can be classified as mild, moderate, or severe on the basis of the degree of encephalopathy. Which of the following findings would be seen in a newborn with moderate encephalopathy?
Therapeutic hypothermia is the only neuroprotective treatment currently available to neonates with HIE. How soon should therapeutic hypothermia be initiated for optimal brain protection?
A baby is born after emergent cesarean delivery for placental abruption. Therapeutic hypothermia would not be indicated in which one of the following clinical scenarios?
A newborn with HIE has been found to be eligible for therapeutic hypothermia. You are arranging for transfer to your referral cooling center. Which of the following statements regarding the supportive management of newborns with HIE is correct?
You are considering initiating passive cooling for a newborn with severe HIE. Which one of the following statements regarding passive cooling is correct?
Book 4 Unit 7

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
A term baby with short bowel syndrome recently returned to your nursery from a regional perinatal center. Which of the following measurements is least important for you to monitor in this baby?
Two weeks ago, a 1,500-g (3 lb 5 oz), preterm baby returned to your hospital after 3 weeks in a regional perinatal center. The parents live in your town and have visited the baby once in the past 2 weeks. What would you do?
   
Yes No
 
 
 
Which of the following babies is at highest risk for developing hydrocephalus?
All of the following statements about retinopathy of prematurity are correct except
A preterm baby requires assisted ventilation and several weeks of intensive care at a regional perinatal center. Now the baby is stable, weighs 1,500 g (3 lb 5 oz), has no respiratory distress, and is returning to your nursery for further weight gain. Which of the following things should be done for this baby?
   
Yes No
 
 
 
 
 
 
A 4,540-g (10 lb) baby has seizures that are controlled with a certain drug dose. By the time the baby reaches 9,070 g (20 lb), he should be receiving twice as much medication
When a preterm baby reaches 1,500 g (3 lb 5 oz) and her respiratory disease has resolved, it is safe to assume the baby will not have an apneic spell.
Nipple feedings should be used for any baby who has a gag reflex and can suck on a nipple.
Babies with chronic lung disease can grow completely new, healthy lung tissue.
After a baby with hydrocephalus has a shunt placed, it is no longer necessary to measure the baby's head circumference .
It is a good sign if a baby with congenital heart disease gains 60 g (2 oz) or more per day for several days in a row.
Babies who require caffeine to control apneic spells may have the drug stopped and be sent home the next day, as long as they have reached a weight of 1,800 g (3 lb 15Yz oz).
Any baby with short bowel syndrome will need an ostomy (colostomy or ileostomy) for the rest of their life.
All of the following findings are common causes of anemia in preterm babies except
Which of the following things should you do when supplementing a baby's nipple feedings with tube feedings given through a nasogastric or an orogastric tube?
All of the following steps are important in weaning a baby from an incubator except
Indicate which of the following things should be routinely checked for a hospitalized baby with congenital heart disease and congestive heart failure:
   
Yes No
 
 
 
 
 
 
Book 4 Unit 8

Select the one best answer to each question (unless otherwise instructed). Record your answers on the test.
Parents have full autonomy over their children.
The principle of respect for autonomy does not apply to newborns.
Newborns receive more rights than a fetus but less than those of a toddler.
All infants born at 22 weeks' gestation die and should not be resuscitated.
The neurological outcome of neonates with trisomy 18 is so poor that they should not be resuscitated
Anencephalic newborns do not have any rights, because they lack the capacity for eventual higher order thinking.
Unilateral decisions, when justified, do not need the permission of a surrogate decision maker.
Opioid analgesia is appropriate to give in end-of-life scenarios as long as the intent is to lessen the degree of suffering.
Mrs and Mr Francis present to your hospital at 22 weeks and 3 days of gestation. The estimation of gestational age is accurate, given that this was an in vitro fertil­ization pregnancy. You are the neonatologist on service. Mrs Francis is currently stable, but the attending physician for maternal-fetal medicine (MFM) fears she will deliver in the next 48 hours. This is a much desired pregnancy. Your hospital has a policy against resuscitation at less than 23 weeks' gestation, but you think a hospital across town may offer resuscitation at this gestational age. What is your obligation to this couple?
You are resuscitating a neonate of unconfirmed gestational age born to a mother who received no prenatal care. The neonate appears "fetoid" (very immature skin with fused eyes) and has not responded to intubation and positive pressure ventila­tion. You are the pediatrician on call, and the neonatologist is enroute to the hospi­tal. You firmly believe further resuscitative interventions will not save this neonate's life. You have been resuscitating this infant for 20 minutes without a response. What is your next best course of action?