RRT RRT Neonatal and Pediatric Respiratory Care 1 — Questions and Answers
Question 1: What is the most common cause of respiratory distress syndrome (RDS) in premature neonates?
- Meconium aspiration
- Surfactant deficiency (Correct answer)
- Congenital diaphragmatic hernia
- Transient tachypnea of the newborn
Correct answer: Surfactant deficiency
RDS in premature infants results from insufficient surfactant production by immature type II pneumocytes, causing progressive alveolar collapse.
Question 2: Which Apgar score component assesses a newborn's respiratory effort?
- Heart rate
- Grimace/reflex irritability
- Respiration (Correct answer)
- Color
Correct answer: Respiration
The Apgar score evaluates respiration (absent=0, slow/irregular=1, strong cry=2) at 1 and 5 minutes to assess transition to extrauterine life.
Question 3: Transient tachypnea of the newborn (TTN) is caused by:
- Surfactant deficiency
- Delayed clearance of fetal lung fluid (Correct answer)
- Meconium aspiration
- Congenital pneumonia
Correct answer: Delayed clearance of fetal lung fluid
TTN results from retained fetal lung fluid that was not adequately cleared during labor, causing mild respiratory distress that resolves within 24–72 hours.
Question 4: What is the primary treatment for meconium aspiration syndrome (MAS) with respiratory failure?
- Immediate aggressive suctioning below the vocal cords in all meconium-stained neonates
- Supportive care with supplemental oxygen, and surfactant or HFOV if severe (Correct answer)
- Prophylactic antibiotics and chest physiotherapy
- Early intubation and controlled hyperventilation
Correct answer: Supportive care with supplemental oxygen, and surfactant or HFOV if severe
Current guidelines recommend supportive care with oxygen, and for severe MAS, surfactant lavage and HFOV may be used to improve oxygenation.
Question 5: What oxygen saturation target is recommended for preterm neonates to reduce the risk of retinopathy of prematurity (ROP)?
- 85–89%
- 91–95% (Correct answer)
- 96–99%
- 100%
Correct answer: 91–95%
Targeting SpO2 of 91–95% in preterm neonates balances the risk of ROP from hyperoxia against mortality and morbidity from hypoxia.
Question 6: Which neonatal respiratory condition is characterized by unilateral absent breath sounds and persistent pulmonary hypertension?
- Respiratory distress syndrome
- Transient tachypnea of the newborn
- Congenital diaphragmatic hernia (CDH) (Correct answer)
- Bronchopulmonary dysplasia
Correct answer: Congenital diaphragmatic hernia (CDH)
CDH involves herniation of abdominal organs through a diaphragmatic defect, causing ipsilateral lung hypoplasia and pulmonary hypertension.
RRT RRT Neonatal and Pediatric Respiratory Care 1
What is the most common cause of respiratory distress syndrome (RDS) in premature neonates?