RCP 601

NEONATAL AND PEDIATRIC RESPIRATORY C= ARE

TEST 1, UNITS 1 & 2 &= nbsp; &nbs= p; &= nbsp; &nbs= p; &= nbsp; &nbs= p; NAME___________________________

JUNE 7, 2010

ANSWER THE FOLLOWING MULTIPLE CHOICE QUESTIONS WITH THE BEST ANSWER ON THE ANSWER SHEET PROVIDED. (2 PTS EACH)

1.&n= bsp; In fetal circulation the organ that is responsible for enriching the fetal blo= od with oxygen is (are) the:

A) Placenta

B) Uterus

C) Fetus’ lungs

D) Fetus’ liver

2.&n= bsp; The placenta is a:

A) Low resistance and low pressure organ

B) Low resistance and high pressure organ

C) High resistance and low pressure organ

D) High resistance and high pressure organ

3.&n= bsp; Which of the following blood vessels in fetal circulation has the highest oxygen saturation?

A) Umbilical artery

B) Umbilical vein

C) Pulmonary artery

D) Superior vena cava

4.&n= bsp; The oxygen saturation found in the umbilical vein in fetal circulation is about= :

A) 80%

B) 92%

C) 96%

D) 99%

5.&n= bsp; The last stage of fetal lung development is the:

A) Canalicular stage

B) Embryonic stage

C) Pseudoglandular stage

D) Saccular stage

6.&n= bsp; The initial lung bud emerges from the:

A) Trachea

B) Pharynx

C) Esophagus

D) Larynx

7.&n= bsp; In relation to lung growth, which of the following is a TRUE statement?

A) Gas exchange surface area grows proportionally with an increase in oxygen consumption and body surface area

B) The surface area of gas exchange increases inversely with age=

C) Normal lung growth is a continuous process that extends into adulthood<= /span>

D) Normal structural development is complete before the first breath

8.&n= bsp; The fetal heart is structurally developed by:

A) 4 weeks gestation

B) 8 weeks gestation

C) 16 weeks gestation

D) 20 weeks gestation

9.&n= bsp; In fetal circulation:

A) Pulmonary pressures are higher than systemic pressures and pulmonary vascular resista= nce is higher than systemic vascular resistance

B) Pulmonary pressures are higher than systemic pressures and pulmonary vascular resista= nce is lower than systemic vascular resistance

C) Pulmonary pressures are lower than systemic pressures and pulmonary vascular resistan= ce is higher than systemic vascular resistance

D) Pulmonary pressures are lower than systemic pressures and pulmonary vascular resistan= ce is lower than systemic vascular resistance

10.&= nbsp; Most umbilical cords (about 97%) have:

A) One umbilical artery and one umbilical vein

B) One umbilical arteries and two umbilical veins

C) Two umbilical arteries and one umbilical vein

D) Two umbilical arteries and two umbilical veins

11.&= nbsp; In fetal circulation, the umbilical artery branches off the:=

A) Subclavian artery

B) Common carotid artery

C) Internal iliac artery

D) Renal artery

12.&= nbsp; How is most of the fetal blood entering via the umbilical vein shunted to the inferior vena cava?

A) Through the foramen ovale

B) Through the superior vena cava

C) Through the ductus venosus

D) Through the ligamentum arteriosum

13.&= nbsp; The ductus arteriosus is found between the:

A) Pulmonary artery and inferior vena cava

B) Pulmonary artery and umbilical vein

C) Aorta and pulmonary vein

D) Aorta and pulmonary artery

14.&= nbsp; The hemoglobin in a fetus:

A) Is found in higher concentrations and has a higher affinity for oxygen

B) Is found in lower concentrations and has a higher affinity for oxygen

C) Is found in higher concentrations and has a lower affinity for oxygen

D) Is found in lower concentrations and has a lower affinity for oxygen

15.&= nbsp; The term used for a large amount of amniotic fluid is:

A) Polyhydramnios

B) Polyedematous

C) Oligohydramnios

D) Oligoedematous

16.&= nbsp; Which of the following maternal ages would most likely lead to the most complications?

A) 14 years old

B) 21 years old

C) 28 years old

D) 34 years old

17.&= nbsp; One of the most common drugs used for tocolysis is:

A) Calcium chloride

B) Potassium sulfate

C) Sodium chlorate

D) Magnesium sulfate

18.&= nbsp; Hypertension, edema and proteinuria are all signs of:

A) Dystocia

B) Toxemia

C) Polyhydramnios

D) Tocolysis

19. Anten= atal steroids to promote lung maturity in potentially premature deliveries are m= ost effective when given at:

A) 12-16 weeks gestation

B) 17-20 weeks gestation

C) 24-32 weeks gestation

D) 33-38 weeks gestation

20.&= nbsp; Meconium staining is usually caused by:

A) Prematurity

B) Cesarean section delivery

C) An asphyxiating event to the fetus

D) Multiple gestations

21.&= nbsp; Late decelerations in fetal heart rate are usually caused by:<= /p>

A) Fetal anemia

B) Umbilical cord compression

C) Fetal head compression

D) Uteroplacental insufficiency

22.&= nbsp; Betamethasone and dexamethasone are drugs used to:

A) Steroids used to promote lung maturity

B) Steroids used to stop labor

C) Beta adrenergics used to induce labor

D) Vasodilators used to increase placental blood flow

23.&= nbsp; Normal neonatal heart rate for a term infant should be:

A) 60-100

B) 80-120

C) 100-140

D) 120-160

24. You n= otice a neonate on a 60% oxyhood while doing rounds. The neonate’s pulse oximeter= is reading 97% and seems to be a reliable reading.&nb= sp; You would:

A) Increase oxygen to 70%

B) Decrease oxygen to 50%

C) Leave oxygen at 60%

D) Change the baby to a nasal CPAP unit at 60% oxygen

25.&= nbsp; Which of the following would be a normal blood pressure for a 2000 gram neonate?<= o:p>

A) 50/30

B) 90/60

C) 110/70

D) 120/80

ANSWER THE FOLLOWING QUESTIONS WITH A CONCISE ANSWER.

26. For e= ach of the following occurrences that occur during fetal lung development, list the approximate gestational age at which they occur. (3 pts)

&nbs= p; Lung bud appears-

&nbs= p; Diaph= ragm is complete-

&nbs= p; Mature carotid bodies available-

27. You a= re assisting in the delivery of a 22-week gestation neonate. What kind of developmental problem= s will you anticipate in this neonate? (5 pts)

28. Appro= ximately what percent of cardiac output goes to the lungs in the fetus and why does = any blood flow go to the lungs? (= 2 pts)

29. List = and describe some of the important changes that occur during the infant’s transition from fetal circulation to adult circulation. (5 pts)

30.&= nbsp; Discuss the causes of the closure of the ductus arteriosus. (3 pts)

31.&= nbsp; What causes blood to shunt through the foramen ovale? (2 pts)

32.&= nbsp; At what age do the number alveoli in a human stop increasing? Remember your units. (2 pts)

33.&= nbsp; Describe why the pressure needed by an infant’s first breath ahs to be so high? (2 pts)

34.&= nbsp; List four maternal risk factors which might lead to cardiopulmonary problems for= the neonate. (4 pts)

35.&= nbsp; Describe the following and discuss why they can be dangerous for the fetus. (4 pts)

&nbs= p; Place= ntal abruption-

&nbs= p; Cord prolapse-

36.&= nbsp; Name two beta-mimetic drugs used for tocolysis.= (2 pts)

37.&= nbsp; List three things for which fetal ultrasound can be used. (3 pts)

38.&= nbsp; List and describe six signs of respiratory distress that can be seen in the neonate. (6 pts)

39.&= nbsp; List and describe five differences between the cardiopulmonary system of an adult and an infant.

(5 pts)

= ;

40.&= nbsp; Describe how to auscultate a neonate. = (2 pts)

BONUS: