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1.

What measures can the therapist take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate? I. Dry the infants skin. II. Wrap the infant in prewarmed blankets. III. Remove wet linens from around the infant. IV. Measure the neonates body temperature.

C) 2.

I, II, and III only

A preterm neonate with a heart rate of 55 beats/minute is receiving positivepressure ventilation immediately after delivery. What should the therapist do at this time?
A) 3.

Apply cardiac compressions and maintain positive-pressure ventilation.

A term infant is born displaying acrocyanosis. What should the therapist do at this time?
D) 4.

Do nothing, as this condition is often transient.

The therapist has completed a 1-minute Apgar score. The following evaluations were obtained: (1) the infant is pale; (2) the heart rate is 90 beats/minute; (3) the respiratory effort is irregular; (4) some muscle tone is noted; and (5) no response to nasal suctioning is found. On the basis of these findings, what Apgar score should be assigned to this neonate?
C)

5.

The therapist, working with a neonate, observes that the newborn has adequate ventilatory efforts and a heart rate of 120 beats/minute. However, at the same time, the infant demonstrates cyanosis of the lips and mucous membranes. What should the therapist do at this time?
A)

Direct 100% oxygen at a flow of 8 L/minute about one-half inch above

the infants nose and mouth.


6.

A respiratory therapy supervisor is observing a staff member perform bag mask ventilation on an infant who is being resuscitated. The supervisor notices that the therapist places his fingers on the anterior margin of the infants mandible, and lifts the infants face into the mask. What should the supervisor do at this time? Take no action because the therapist is correctly performing valve mask ventilation.
D) 7.

While performing positive-pressure mechanical ventilation on a neonate, the therapist notices that the infants thorax is not displaying bilateral expansion during each inspiration. Auscultation of the chest reveals diminished bilateral breath sounds. The infants heart rate is 85 beats/minute, and observation demonstrates central cyanosis. Which of the following events may have caused this clinical situation? I. Pneumothorax II. Poorly positioned or leaking mask III. Inappropriately sized endotracheal tube IV. Airway obstruction
C) 8.

I, II, and IV only

What appears to be the reason for the infrequent need to administer chest compressions and cardiopulmonary resuscitative drugs to neonates in the delivery rooms?
C)

The delivery of adequate ventilation is the primary factor in

effective resuscitation of a neonate.


9.

What ratio of chest compressions and positive-pressure breaths must the therapist administer to a newborn during cardiopulmonary resuscitation?
A) 10.

One compression for every three breaths

The therapist has been performing cardiopulmonary resuscitation on a neonate for about 90 seconds, applying ventilation with 100% oxygen and chest compressions. The infant has maintained a spontaneous heat rate of 40 beats/minute. What should the therapist recommend at this time?
D) 11.

Administering epinephrine

Which of the following actions constitutes appropriate stimulation of a neonate?

I. Gently slapping the infants buttocks II. Gently shaking the infants upper torso III. Flicking the bottoms of the infants feet IV. Drying with a towel
C)

III and IV only

12.

Which of the following factors are taken into consideration when assessing the gestational age of a neonate? I. Previous maternal pregnancies II. Prenatal ultrasound evaluations III. Postnatal findings based on physical and neurologic examinations IV. Gestational duration based on the last menstrual cycle
D) 13.

II, III, and IV only

The gestational age of a newborn has been evaluated to be 34 weeks. The newborns birth weight is greater than the 90th percentile. How should the therapist classify this infant?
C) 14.

Large for gestational age

The therapist notices that an infant presents with irregular areas of dusky skin alternating with areas of pale skin. On the basis of this observation, which of the following conditions should the therapist anticipate this patient having?
B) 15.

Hypotension

Which of the following neonatal skin presentations at birth is associated with a high hematocrit value or polycythemia and neonatal hyperviscosity syndrome?
C) 16.

Reddish blue appearance

Why are chest retractions more prominent among neonates than among older children and adults?

B) Because newborns have relatively thin and weak musculature, and a less rigid thorax. 17.

While performing a physical examination on a newborn infant, the therapist notices that the point of maximal cardiac impulse is to the left of the sternal border. Which of the following conditions can cause this situation?
A 18. C)

Right-sided pneumothorax

Which of the following statements refers to the diagnostic procedure called transillumination?
B)

Direct a light source toward the ipsilateral surface of the patients

thorax.

19.

For the purpose of assessing right-to-left shunting, as in the case of persistent pulmonary hypertension, which of the following sites would render postductal blood? I. Right arm II. Left arm III. Right leg IV. Left leg
A D)

II, III, and IV only

Feedback: 20.

Which of the following conditions can cause abdominal distention? I. Enterocolitis II. Ascites III. Congenital diaphragmatic hernia IV. Omphalocele
A) 21.

I and II only

Which of the following conditions are associated with scaphoid abdomen? I. Necrotizing enterocolitis

II. Gastroschisis III. Prune-belly syndrome IV. Sepsis


B) 22.

II and III only

While performing an examination of the abdomen of a neonate, the therapist is able to palpate the infants liver 1 to 2 cm below the right costal margin. Which of the following conditions can account for this development?
D) 23.

Normal liver position

After the umbilical cord has been cut in the delivery room during the delivery of a large for gestational age infant, the therapist notices that the umbilical cord is large and fat. Which of the following maternal conditions is likely present?
C)

Diabetes mellitus

24.

A newborn who presents as pale, mottled, floppy, with little interest in feeding, and slightly irritable most likely has which of the following conditions?
A)

Sepsis

25.

Which of the following white blood cell counts constitutes the condition leukopenia?
A)

Less than or equal to 3500/mm3