C-NPT : NCC Certified - Neonatal Pediatric Transport Exam

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NCC Certified - Neonatal Pediatric Transport
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Question: 569
Which of the following is the most important factor in determining oxygen consumption in neonates during transport?
emoglobin concentration entilation-perfusion matching
wer: A
anation: Metabolic rate is the most important factor in determining ox umption in neonates during transport. A higher metabolic rate leads to ased oxygen demand and utilization, which can be affected by factors tivity level, ambient temperature, and the presence of illness or stress.
stion: 570
ng a pediatric transport, the most important factor to consider when orming a physical examination is:
natomic abnormalities evelopmental/behavioral status hysiologic stability
Metabolic rate
H
V
Ans
Expl ygen
cons
incre such
as ac
Que
Duri perf
1. A
2. D
3. P
Answer: C
Explanation: The most important factor to consider when performing a physical examination during a pediatric transport is the patient's physiologic stability. Ensuring the patient's vital signs, respiratory status, and cardiovascular function are appropriately maintained is the top priority. While anatomic abnormalities
and developmental/behavioral status are also important aspects of the assessment, the patient's physiologic stability takes precedence during critical transport situations.
Question: 571
reventing dehydration voiding fluid overload
orrecting electrolyte abnormalities onitoring urine output
wer: B
anation: Avoiding fluid overload is the most important factor in taining fluid and electrolyte balance during neonatal transport. Excess administration can lead to complications such as pulmonary edema, rolyte disturbances, and cardiovascular compromise. Preventing dration, correcting electrolyte abnormalities, and monitoring urine out lso important, but the primary focus should be on preventing fluid oad.
stion: 572
Which of the following is the most important factor in maintaining fluid and electrolyte balance during neonatal transport?
1. P
2. A
3. C
4. M
Ans Expl
main ive
fluid elect
dehy put
are a overl
Que
A child presents with severe dehydration, lethargy, and altered mental status. The most appropriate fluid management is:
1. Isotonic fluid bolus
2. Hypotonic fluid maintenance
3. Isotonic fluid maintenance
Answer: A
stion: 573
monia caused by Streptococcus pneumoniae is characterized by: obar consolidation
iffuse interstitial infiltrates ultifocal nodular opacities
wer: A
anation: Pneumonia caused by Streptococcus pneumoniae, the most mon bacterial cause of pneumonia in children, is characterized by loba olidation on imaging. Diffuse interstitial infiltrates are more typical of monias, while multifocal nodular opacities are seen in some atypical monias.
stion: 574
Explanation: The most appropriate fluid management for a child presenting with severe dehydration, lethargy, and altered mental status is an isotonic fluid bolus. This helps rapidly restore intravascular volume and improve perfusion. Hypotonic fluid maintenance is typically used for ongoing fluid replacement, while isotonic fluid maintenance is more appropriate for a child with normal hydration status.
Que
Pneu
1. L
2. D
3. M
Ans Expl
com r
cons viral
pneu pneu
Que
A 6-month-old infant is brought to the emergency department with a 3-day history of fever, cough, and increased work of breathing. Physical examination reveals tachypnea, retractions, and diffuse wheezing throughout the lung fields. Chest radiograph shows hyperinflation and peribronchial cuffing. The most appropriate initial management is:
1. Supplemental oxygen
2. Intravenous antibiotics
3. Bronchodilator therapy Answer: C
chodilator therapy, as this can help relieve airway obstruction and imp ratory mechanics. Supplemental oxygen and intravenous antibiotics m upportive measures, but are not the primary treatment for uncomplicat chiolitis.
stion: 575
onate is receiving dopamine for cardiovascular support during transpo ch of the following parameters should be monitored most closely?
eart rate lood pressure rine output
wer: A
anation: When a neonate is receiving dopamine during transport, the meter that should be monitored most closely is the heart rate. Dopami mpathomimetic agent that can increase heart rate, and this is one of the ary adverse effects to watch for. Blood pressure and urine output are a
Explanation: The presentation of an infant with fever, cough, increased work of breathing, and radiographic findings of hyperinflation and peribronchial cuffing is consistent with bronchiolitis. The appropriate initial management is
bron rove
respi ay
be s ed
bron
Que
A ne rt.
Whi
1. H
2. B
3. U
Ans Expl
para ne is
a sy
prim lso
important to monitor, but heart rate is the most critical parameter when a neonate is on dopamine infusion.
Question: 576
During transport, the most important principle of mechanical ventilation support is:
1. Maintaining appropriate tidal volume
2. Achieving high peak inspiratory pressures
3. Allowing for spontaneous breathing efforts Answer: C
ng transport is allowing for spontaneous breathing efforts by the patien elps maintain patient-ventilator synchrony and preserves the patient' ratory drive, which is essential for successful weaning and extubation
ntaining appropriate tidal volume and avoiding excessively high peak ratory pressures are also important, but allowing for spontaneous brea primary goal.
stion: 577
is the primary goal of thermal management during neonatal transpor
aintaining normothermia ducing therapeutic hypothermia reventing hyperthermia acilitating passive cooling
wer: A
anation: The primary goal of thermal management during neonatal
Explanation: The most important principle of mechanical ventilation support duri t.
This h s
respi .
Mai
inspi thing
is the
Que
What t?
1. M
2. In
3. P
4. F
Ans Expl
transport is to maintain normothermia, as both hypothermia and hyperthermia can have significant physiological impacts and adverse outcomes in the neonate.
Question: 578
intravenous access in a neonate during transport?
1. Peripheral venipuncture
2. Intraosseous access
anation: The most appropriate method for obtaining intravenous acces ate during transport is umbilical venous catheterization. This provides ble central venous access, which is preferred over peripheral venipunc traosseous access in the neonatal population during transport.
stion: 579
ch of the following is the most appropriate treatment for a neonate wit on pneumothorax during transport?
eedle decompression hest tube insertion upplemental oxygen
wer: A
anation: Needle decompression is the most appropriate treatment for a ate with tension pneumothorax during transport. Needle decompressio
Umbilical venous catheterization Answer: C
Expl s in a
neon
relia ture
or in
Que
Whi h
tensi
1. N
2. C
3. S
Ans Expl
neon n is
a rapid, life-saving procedure that can relieve the increased intrapleural pressure and allow the lung to re-expand. Chest tube insertion is a more definitive treatment, but it is not the appropriate first-line intervention during transport. Supplemental oxygen alone is not sufficient to manage a tension pneumothorax.
A child presents with fever, tachycardia, and hypotension. The most likely type of shock is:
1. Cardiogenic
2. Distributive (septic)
wer: B
anation: The combination of fever, tachycardia, and hypotension is m istent with distributive (septic) shock. Septic shock is caused by an whelming systemic inflammatory response to infection, leading to dilation and decreased peripheral vascular resistance. Cardiogenic sho o impaired cardiac function, while hypovolemic shock is caused by
/blood loss.
stion: 581
onate is receiving dopamine for cardiovascular support during transpo ch of the following adverse effects should the transport team monitor for
ypotension achycardia yperglycemia
wer: B
Hypovolemic Ans
Expl ost
cons over
vaso ck is
due t fluid
Que
A ne rt.
Whi ?
1. H
2. T
3. H
Ans
Explanation: One of the primary adverse effects to monitor for with dopamine administration in neonates during transport is tachycardia. Dopamine is a sympathomimetic agent that can increase heart rate. Hypotension and hyperglycemia are also potential side effects, but tachycardia is the most common cardiovascular adverse effect to watch for.
Which of the following principles is most important to consider when providing mechanical ventilation support during neonatal transport?
1. Maintaining a high respiratory rate
2. Avoiding excessive tidal volumes
wer: B
anation: Avoiding excessive tidal volumes is the most important princ nsider when providing mechanical ventilation support during neonata port. Delivering large tidal volumes can lead to volutrauma and lung y, which is particularly detrimental in fragile neonatal lungs.
stion: 583
onate is experiencing hypothermia during transport. Which of the wing interventions should be the initial priority?
ctively warm the neonate using a radiant warmer assively rewarm the neonate by covering with blankets dminister warm intravenous fluids
wer: B
anation: The initial priority in a neonate experiencing hypothermia is
Delivering a high fraction of inspired oxygen Ans
Expl iple
to co l
trans injur
Que A ne follo
1. A
2. P
3. A
Ans
Expl to
passively rewarm the neonate by covering them with blankets. Actively warming the neonate using a radiant warmer or administering warm intravenous fluids can be dangerous, as it can lead to rapid rewarming and complications. Passive rewarming is the safest and most appropriate initial intervention.
A pediatric patient with a suspected pneumothorax is most appropriately managed with:
1. Needle aspiration
2. Chest tube insertion
wer: A
anation: The most appropriate initial management for a suspected mothorax in a pediatric patient is needle aspiration. This allows for th decompression of the pleural space and relief of respiratory distress.
tube insertion may be necessary if the pneumothorax persists or recu hould not be the first-line intervention. Supplemental oxygen is also rtant, but does not directly address the underlying pneumothorax.
stion: 585
-year-old child with a history of asthma presents with acute onset of ezing, chest tightness, and difficulty breathing. Albuterol nebulizer ment provides minimal relief. The most appropriate next step is:
dminister intramuscular epinephrine crease the dose of oral corticosteroids
itiate noninvasive positive pressure ventilation
Supplemental oxygen Ans
Expl
pneu e
rapid
Chest rs,
but s impo
Que
A 12
whe treat
1. A
2. In
3. In
Answer: B
Explanation: In a child with an acute asthma exacerbation that is unresponsive to initial bronchodilator therapy, the next appropriate step is to increase the dose of oral corticosteroids, which can help reduce airway inflammation and obstruction. Intramuscular epinephrine is typically reserved for anaphylaxis, and noninvasive ventilation should be considered only for severe, life-
threatening exacerbations.
Question: 586
What is the most common cause of spatial changes in neonates during transport?
issue edema
rgan displacement wer: A
anation: Fluid shifts are the most common cause of spatial changes in ates during transport. Alterations in fluid balance, such as fluid mulation or depletion, can lead to changes in the distribution of body s, which can affect organ positions and the overall body habitus.
stion: 587
onate is experiencing cardiopulmonary arrest during transport. Which ollowing principles of resuscitation should guide the transport team's ns?
ollow NRP guidelines
rioritize advanced airway management dminister high-dose epinephrine immediately
Fluid shifts
T
O
Ans Expl
neon accu fluid
Que
A ne of
the f actio
1. F
2. P
3. A
Answer: A
Explanation: During a neonatal cardiopulmonary arrest in transport, the transport team should follow the Neonatal Resuscitation Program (NRP) guidelines. This includes the basic principles of airway, breathing, and circulation management, as well as the appropriate medication administration and timing. Advanced airway management and high-dose epinephrine are not the first-line actions according to NRP.

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