Below are 5 free sample exam questions for the Care of the Extremely Low Birth Weight Neonate exam.
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Sample Questions
- A one-week old former 27 weeks gestational age infant has a large patent ductus arteriosus (PDA). What is the optimal fluid management for this infant?
- a. Give less fluids than normal
- b. Give more fluids than normal
- c. Give normal amount of fluids
- A three day old 28 weeks gestational age infant is on a conventional ventilator and is ready to be extubated. A gas that shows the following: pH 7.54 / pCO2 29 / pO2 75 / HCO3 26. What is this infant at risk for most, given these blood gas results?
- a. Hyperglycemia
- b. Intraventricular hemorrhage
- c. Patent ductus arteriosus
- Which of the following interventions is most useful when engaging with the vision sense?
- a. Developmentally appropriate visual recording
- b. High contrast colored mobiles
- c. Parental gaze
- A former 24 weeks gestational age infant is now 3 months old and requires CPAP. A recent echocardiogram reveals a small patent ductus arteriosus with left to right shunting. Which the following is the best way to reduce the development of cor pulmonale?
- a. Diuretic administration
- b. PDA closure with medication
- c. Prevent hypoxemia
- A two week old former 25 weeks gestational age infant develops necrotizing enterocolitis and shock. A cortisol level is drawn and is found to be low and hydrocortisone is started due to suspected:
- a. Adrenal insufficiency
- b. Hyperpituitarism
- c. Hypothyroidism
Scroll down or click here to see the answer key.
Answer Key
1. a. Give less fluids than normal. Fluid restricting premature infants does not close a PDA, but it may reduce the risk of the PDA re-opening, particularly if the infant is undergoing pharmacological treatment.
2. b. Intraventricular hemorrhage. Low carbon dioxide levels cause cerebral vasoconstriction, which in turn may cause intraventricular hemorrhage. Research has also shown brain injury in term infants with prolonged hypocapnia; avoidance of hypocapnia is recommended whenever possible.
3. c. Parental gaze. This is the most important way to engage with an infant’s sense of vision, although highly contrasted mobiles can be helpful if not used all the time (due to sensory overload). Visual recordings are never appropriate for infants.
4. c. Prevent hypoxemia. . Cor pulmonale is right ventricular heart failure, commonly caused by bronchopulmonary dysplasia and pulmonary hypertension in premature infants. Preventing hypoxemia reduces the amount of pulmonary hypertension and heart muscle remodeling that develops, ultimately lessening the risk of cor pulmonale. Diuretic administration may lessen the effects of pulmonary edema, but this serves to help assist with reducing hypoxemia, rather than directly decreasing the risk of cor pulmonale. A PDA is not generally able to be successfully treated medically (with drugs) at three months of life.
5. a. Adrenal insufficiency. . Infants, particularly premature infants, tend to become adrenally insufficient while under stress. They can develop hypotension that is not responsive to vasopressors and giving them hydrocortisone helps them overcome this adrenal insufficiency.