Pediatric Respiratory Care Practice Quiz
1. Which of the following is the most common cause of respiratory distress in pediatric patients?
A. Asthma
B. Pneumonia
C. Foreign body aspiration
D. Bronchiolitis
2. What is the primary goal of oxygen therapy in pediatric respiratory care?
A. To prevent hypoxemia
B. To reduce carbon dioxide levels
C. To increase tidal volume
D. To stimulate respiratory drive
3. Which device is most appropriate for delivering high-flow oxygen to a pediatric patient with respiratory distress?
A. Nasal cannula
B. Simple face mask
C. High-flow nasal cannula (HFNC)
D. Non-rebreather mask
4. What is the preferred airway clearance technique for a pediatric patient with cystic fibrosis?
A. Suctioning
B. Chest physiotherapy (CPT)
C. Manual bag-mask ventilation
D. Incentive spirometry
5. Which of the following is a sign of impending respiratory failure in pediatric patients?
A. Nasal flaring
B. Retractions
C. Grunting
D. All of the above
6. What is the most appropriate ventilatory strategy for pediatric patients with acute respiratory distress syndrome (ARDS)?
A. High tidal volumes
B. Low tidal volumes with high PEEP
C. Increased respiratory rate with low PEEP
D. High inspiratory pressures
7. What is the normal respiratory rate for a pediatric patient aged 1–5 years?
A. 10-20 breaths per minute
B. 20-30 breaths per minute
C. 30-40 breaths per minute
D. 40-50 breaths per minute
8. Which medication is commonly used in pediatric respiratory emergencies for upper airway swelling?
A. Albuterol
B. Epinephrine
C. Ipratropium bromide
D. Montelukast
9. What is the best method to confirm proper endotracheal tube (ETT) placement in a pediatric patient?
A. Chest X-ray
B. End-tidal CO₂ monitoring
C. Auscultation alone
D. Oxygen saturation monitoring
10. Which device is best suited for delivering nebulized medication to a pediatric patient?
A. Dry powder inhaler
B. Metered-dose inhaler (MDI)
C. Jet nebulizer with mask
D. Nasal cannula
11. What is the primary reason for using heliox therapy in pediatric respiratory care?
A. To increase FiO₂
B. To decrease airway resistance
C. To treat bacterial pneumonia
D. To improve mucociliary clearance
12. Which condition is best managed with continuous positive airway pressure (CPAP) in pediatric patients?
A. Asthma exacerbation
B. Croup
C. Obstructive sleep apnea
D. Pneumonia
13. What is the most common cause of stridor in children?
A. Asthma
B. Croup
C. Foreign body aspiration
D. Bronchiolitis
14. Which factor increases the risk of ventilator-associated pneumonia (VAP) in pediatric patients?
A. Frequent suctioning
B. Use of humidified oxygen
C. Prolonged intubation
D. Use of non-invasive ventilation
15. Which mode of mechanical ventilation is most commonly used for pediatric patients with normal lung compliance?
A. Volume-controlled ventilation
B. Pressure-controlled ventilation
C. Airway pressure release ventilation
D. High-frequency oscillatory ventilation
16. What is the most appropriate action when a pediatric patient develops severe bradycardia due to hypoxia?
A. Administer epinephrine
B. Increase oxygen therapy
C. Start chest compressions
D. Perform immediate intubation
17. Which of the following conditions is characterized by a “steeple sign” on an X-ray?
A. Epiglottitis
B. Croup
C. Foreign body aspiration
D. Asthma
18. What is the recommended initial dose of albuterol for nebulized treatment in pediatric asthma exacerbation?
A. 0.25 mg
B. 1.25 mg
C. 2.5 mg
D. 5 mg
19. What is the most common cause of pediatric obstructive sleep apnea?
A. Obesity
B. Neuromuscular disease
C. Adenotonsillar hypertrophy
D. Laryngomalacia
20. What is the primary purpose of a cough assist device in pediatric patients with neuromuscular disorders?
A. Increase lung compliance
B. Improve secretion clearance
C. Deliver continuous positive pressure
D. Prevent atelectasis
21. Which of the following is a contraindication for non-invasive ventilation (NIV) in pediatric patients?
A. Mild hypoxemia
B. Hypercapnia
C. Apnea
D. Respiratory distress
22. Which clinical finding is most concerning in a pediatric patient with an asthma exacerbation?
A. Expiratory wheezing
B. Increased respiratory rate
C. Silent chest
D. Pulsus paradoxus
23. What is the recommended position for a pediatric patient in respiratory distress?
A. Supine
B. Prone
C. Tripod
D. Lateral
24. What is the primary indication for high-frequency oscillatory ventilation (HFOV) in pediatric patients?
A. Mild pneumonia
B. Acute respiratory distress syndrome (ARDS)
C. Foreign body aspiration
D. Bronchiolitis
25. Which of the following is an early sign of respiratory distress in pediatric patients?
A. Cyanosis
B. Bradycardia
C. Retractions
D. Apnea
26. What is the gold standard for diagnosing obstructive sleep apnea in pediatric patients?
A. Chest X-ray
B. Spirometry
C. Polysomnography
D. Capnography
27. Which of the following interventions is most effective in preventing post-extubation stridor in pediatric patients?
A. Heliox therapy
B. Dexamethasone administration
C. CPAP
D. Suctioning
28. What is the recommended method for suctioning an intubated pediatric patient?
A. Open suction technique
B. Closed suction system
C. Nasal suctioning
D. Deep tracheal suctioning every hour
29. Which of the following is a major risk factor for developing bronchopulmonary dysplasia (BPD) in pediatric patients?
A. Prematurity
B. Asthma
C. Foreign body aspiration
D. Pneumothorax
30. What is the most common bacterial cause of pneumonia in pediatric patients?
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Mycoplasma pneumoniae
D. Staphylococcus aureus
31. What is the most common viral cause of bronchiolitis in pediatric patients?
A. Influenza virus
B. Respiratory syncytial virus (RSV)
C. Parainfluenza virus
D. Adenovirus
32. Which of the following conditions is characterized by a “thumbprint sign” on a lateral neck X-ray?
A. Croup
B. Epiglottitis
C. Foreign body aspiration
D. Tracheomalacia
33. What is the best method for assessing oxygenation in a pediatric patient receiving mechanical ventilation?
A. Pulse oximetry
B. Capnography
C. Arterial blood gas (ABG) analysis
D. End-tidal CO₂ monitoring
34. Which of the following is a contraindication for high-flow nasal cannula (HFNC) therapy in pediatric patients?
A. Hypoxemia
B. Hypercapnic respiratory failure
C. Severe respiratory distress with apnea
D. Upper airway obstruction
35. Which of the following is a common side effect of albuterol nebulization in pediatric patients?
A. Bradycardia
B. Hypotension
C. Tachycardia
D. Hypoglycemia
36. What is the recommended first-line treatment for moderate to severe croup in pediatric patients?
A. Albuterol
B. Racemic epinephrine
C. Ipratropium bromide
D. Montelukast
37. Which of the following assessments best evaluates the effectiveness of oxygen therapy in pediatric patients?
A. Blood pressure monitoring
B. Capillary refill time
C. Pulse oximetry
D. Respiratory rate
38. What is the primary reason for performing a bronchoscopy in pediatric patients with chronic cough and suspected aspiration?
A. To remove secretions
B. To diagnose bacterial pneumonia
C. To visualize the airways and identify foreign bodies
D. To assess lung volumes
39. What is the correct technique for administering a metered-dose inhaler (MDI) with a spacer to a pediatric patient?
A. Breathe in quickly and hold for 5 seconds
B. Inhale slowly and deeply, then hold for 10 seconds
C. Exhale completely before inhaling the medication
D. Use a dry powder inhaler instead
40. Which of the following pediatric conditions often presents with a “barking cough”?
A. Asthma
B. Pneumonia
C. Croup
D. Bronchiolitis
41. What is the most common cause of sudden airway obstruction in toddlers?
A. Croup
B. Epiglottitis
C. Foreign body aspiration
D. Bronchitis
42. What is the most common chronic respiratory disease in pediatric patients?
A. Asthma
B. Cystic fibrosis
C. Chronic bronchitis
D. Tracheomalacia
43. Which of the following findings suggests worsening respiratory failure in a pediatric patient?
A. Increased work of breathing
B. Decreased respiratory rate
C. Audible wheezing
D. Improved breath sounds
44. What is the first-line antibiotic for treating bacterial pneumonia in pediatric patients?
A. Azithromycin
B. Amoxicillin
C. Ciprofloxacin
D. Vancomycin
45. Which of the following airway devices provides the highest oxygen concentration?
A. Nasal cannula
B. Venturi mask
C. Non-rebreather mask
D. Simple face mask
46. What is the best way to prevent ventilator-associated pneumonia (VAP) in pediatric patients?
A. Suctioning every hour
B. Keeping the head of the bed elevated
C. Using dry oxygen therapy
D. Avoiding non-invasive ventilation
47. Which pulmonary function test is most useful for diagnosing asthma in pediatric patients?
A. Peak expiratory flow rate (PEFR)
B. Diffusion capacity (DLCO)
C. Arterial blood gas analysis
D. Capnography
48. What is the most common congenital respiratory disorder in pediatric patients?
A. Tracheoesophageal fistula
B. Congenital diaphragmatic hernia
C. Laryngomalacia
D. Bronchopulmonary dysplasia (BPD)
49. Which therapy is most effective in treating acute respiratory distress syndrome (ARDS) in pediatric patients?
A. High-flow nasal cannula
B. Low tidal volume ventilation
C. Non-invasive ventilation
D. Heliox therapy
50. What is the primary purpose of a pediatric peak flow meter?
A. To monitor airway inflammation
B. To assess asthma control
C. To measure lung volume
D. To improve lung expansion
51. Which age group is most at risk for developing bronchiolitis?
A. Newborns
B. 2–6 months
C. 6–12 months
D. 2–5 years
52. Which of the following symptoms is an early indicator of oxygen toxicity in pediatric patients?
A. Coughing
B. Hypotension
C. Hypercapnia
D. Wheezing
53. What is the best position for a pediatric patient experiencing severe respiratory distress?
A. Supine
B. Trendelenburg
C. Semi-Fowler’s
D. Lateral decubitus
54. Which device is preferred for airway suctioning in neonates and infants?
A. Yankauer suction catheter
B. Bulb syringe
C. Closed suction catheter
D. Oral suction wand
55. What is the primary purpose of chest physiotherapy (CPT) in pediatric patients?
A. Reduce airway inflammation
B. Improve oxygenation
C. Remove mucus and secretions
D. Increase lung compliance
56. Which of the following is a late sign of respiratory failure in pediatric patients?
A. Nasal flaring
B. Retractions
C. Cyanosis
D. Tachypnea
57. What is the most effective treatment for a pediatric patient with anaphylaxis-induced respiratory distress?
A. Albuterol
B. Epinephrine
C. Ipratropium
D. Oxygen therapy
58. Which of the following can be a complication of excessive suctioning in pediatric patients?
A. Atelectasis
B. Hyperoxygenation
C. Decreased airway resistance
D. Increased mucus production
59. What is the best way to confirm nasogastric tube placement in a pediatric patient?
A. Aspirating gastric contents
B. Chest X-ray
C. pH testing of gastric fluid
D. Auscultation over the stomach
60. Which of the following factors increases the risk of developing respiratory distress syndrome (RDS) in pediatric patients?
A. Full-term birth
B. Maternal diabetes
C. Male gender
D. C-section delivery
61. What is the primary treatment for pediatric patients with moderate to severe asthma exacerbation?
A. Epinephrine
B. Albuterol and corticosteroids
C. Heliox therapy
D. Chest physiotherapy
62. Which of the following is the most reliable sign of increased work of breathing in a pediatric patient?
A. Retractions
B. Cough
C. Nasal congestion
D. Clear breath sounds
63. What is the primary benefit of using a heated high-flow nasal cannula (HFNC) in pediatric patients?
A. Delivers a higher oxygen concentration
B. Provides continuous positive airway pressure
C. Decreases carbon dioxide retention
D. Improves ventilation-perfusion mismatch
64. Which of the following interventions is most effective in preventing aspiration pneumonia in pediatric patients?
A. Chest physiotherapy
B. Proper positioning during feeding
C. Increasing fluid intake
D. Frequent deep suctioning
65. What is the recommended dose of epinephrine for treating anaphylaxis in pediatric patients?
A. 0.01 mg/kg intramuscularly
B. 0.1 mg/kg intravenously
C. 1 mg/kg subcutaneously
D. 0.5 mg/kg orally
66. Which of the following conditions is commonly associated with recurrent pneumonia in pediatric patients?
A. Asthma
B. Cystic fibrosis
C. Bronchiolitis
D. Epiglottitis
67. What is the most common cause of wheezing in children under 2 years of age?
A. Foreign body aspiration
B. Pneumonia
C. Bronchiolitis
D. Asthma
68. Which of the following is the most common bacterial cause of epiglottitis in children?
A. Haemophilus influenzae type B
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Staphylococcus aureus
69. Which test is most commonly used to diagnose cystic fibrosis in pediatric patients?
A. Chest X-ray
B. Spirometry
C. Sweat chloride test
D. Bronchoscopy
70. What is the primary effect of racemic epinephrine in treating croup?
A. Bronchodilation
B. Reducing airway inflammation and edema
C. Increasing oxygen diffusion
D. Improving mucus clearance
71. Which of the following conditions is best treated with pulmonary surfactant therapy?
A. Cystic fibrosis
B. Bronchiolitis
C. Respiratory distress syndrome (RDS)
D. Asthma
72. What is the preferred method of oxygen delivery for a pediatric patient with mild hypoxemia?
A. High-flow nasal cannula
B. Venturi mask
C. Simple nasal cannula
D. Non-rebreather mask
73. What is the best intervention for a pediatric patient experiencing stridor and moderate respiratory distress due to croup?
A. Nebulized albuterol
B. Racemic epinephrine and corticosteroids
C. Antibiotic therapy
D. Non-invasive ventilation
74. Which of the following respiratory conditions is associated with a “ground-glass” appearance on a chest X-ray?
A. Bronchiolitis
B. Pneumothorax
C. Respiratory distress syndrome (RDS)
D. Cystic fibrosis
75. What is the purpose of using hypertonic saline in pediatric patients with bronchiolitis?
A. Reduce airway inflammation
B. Improve mucociliary clearance
C. Increase alveolar recruitment
D. Promote bronchodilation
76. Which ventilator mode is most appropriate for pediatric patients with neuromuscular disease and poor respiratory effort?
A. Volume-controlled ventilation
B. Pressure support ventilation
C. High-frequency oscillatory ventilation
D. Airway pressure release ventilation
77. Which of the following medications is most commonly used for maintenance therapy in pediatric asthma?
A. Albuterol
B. Montelukast
C. Inhaled corticosteroids
D. Racemic epinephrine
78. What is the primary function of continuous positive airway pressure (CPAP) in pediatric respiratory care?
A. Improve ventilation
B. Increase oxygenation and prevent alveolar collapse
C. Reduce mucus production
D. Prevent apnea episodes
79. Which imaging modality is preferred for diagnosing a foreign body in the airway of a pediatric patient?
A. Chest X-ray
B. CT scan
C. MRI
D. Bronchoscopy
80. Which of the following is a risk factor for pediatric obstructive sleep apnea?
A. Obesity
B. Cystic fibrosis
C. Pneumonia
D. RSV infection
81. What is the most common sign of pneumothorax in pediatric patients?
A. Decreased breath sounds on the affected side
B. Stridor
C. Productive cough
D. Increased breath sounds
82. What is the primary treatment for mild bronchiolitis in infants?
A. Nebulized albuterol
B. Antibiotic therapy
C. Supportive care with hydration and oxygen as needed
D. Steroid therapy
83. What is the recommended first-line treatment for pediatric patients with mild croup?
A. Nebulized epinephrine
B. Dexamethasone
C. Albuterol
D. High-dose oxygen
84. Which of the following is a common complication of prolonged mechanical ventilation in pediatric patients?
A. Pulmonary fibrosis
B. Ventilator-associated pneumonia (VAP)
C. Bronchiolitis
D. Pulmonary embolism
85. What is the preferred method for weaning a pediatric patient from mechanical ventilation?
A. Sudden extubation
B. Gradual decrease in ventilator support
C. Increasing FiO₂ before extubation
D. Placing the patient on CPAP immediately
86. What is the primary indication for the use of heliox therapy in pediatric patients?
A. Severe asthma exacerbation with airway obstruction
B. Respiratory distress syndrome
C. Pulmonary edema
D. Foreign body aspiration
87. Which of the following signs is most concerning in a pediatric patient with an asthma exacerbation?
A. Wheezing
B. Increased respiratory rate
C. Silent chest
D. Use of accessory muscles
88. Which of the following conditions is best managed with bilevel positive airway pressure (BiPAP) in pediatric patients?
A. Mild bronchiolitis
B. Asthma exacerbation with hypercapnia
C. Simple pneumonia
D. Croup
89. What is the most important step in managing a pediatric patient with suspected anaphylaxis?
A. Administer albuterol
B. Give intramuscular epinephrine
C. Provide high-flow oxygen
D. Start IV fluids
90. What is the most common cause of bacterial tracheitis in pediatric patients?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Mycoplasma pneumoniae
91. Which of the following pediatric respiratory conditions is most commonly associated with a steeple sign on an X-ray?
A. Epiglottitis
B. Croup
C. Foreign body aspiration
D. Pneumonia
92. What is the preferred rescue medication for an acute asthma attack in pediatric patients?
A. Salmeterol
B. Montelukast
C. Albuterol
D. Cromolyn sodium
93. Which of the following is a potential complication of high-flow nasal cannula (HFNC) therapy in pediatric patients?
A. Barotrauma
B. Hypercapnia
C. Hypoventilation
D. Increased work of breathing
94. Which of the following conditions is commonly associated with nasal polyps in pediatric patients?
A. Asthma
B. Cystic fibrosis
C. Bronchopulmonary dysplasia
D. Tracheomalacia
95. Which of the following is the most effective way to prevent hospital-acquired pneumonia in ventilated pediatric patients?
A. Suctioning every 2 hours
B. Keeping the head of the bed elevated
C. Using humidified oxygen
D. Providing deep sedation
96. What is the primary benefit of using heliox in pediatric patients with airway obstruction?
A. Decreases airway resistance
B. Increases oxygen diffusion
C. Reduces lung compliance
D. Enhances mucociliary clearance
97. What is the most appropriate intervention for a pediatric patient experiencing respiratory failure due to Guillain-Barré syndrome?
A. Non-invasive ventilation
B. High-flow nasal cannula
C. Endotracheal intubation and mechanical ventilation
D. Oxygen therapy via nasal cannula
98. Which of the following is the most common cause of congenital stridor in infants?
A. Tracheomalacia
B. Cystic fibrosis
C. Epiglottitis
D. Bronchiolitis
99. Which mode of mechanical ventilation is most commonly used in pediatric patients with acute respiratory distress syndrome (ARDS)?
A. Volume control ventilation
B. High-frequency oscillatory ventilation (HFOV)
C. Pressure control ventilation
D. Bilevel positive airway pressure (BiPAP)
100. What is the primary cause of obstructive sleep apnea (OSA) in pediatric patients?
A. Asthma
B. Enlarged tonsils and adenoids
C. Cystic fibrosis
D. Allergic rhinitis
101. Which of the following is a common early sign of hypoxia in pediatric patients?
A. Cyanosis
B. Bradycardia
C. Restlessness
D. Decreased respiratory rate
102. Which of the following medications is commonly used to prevent apnea of prematurity?
A. Albuterol
B. Caffeine citrate
C. Epinephrine
D. Ipratropium bromide
103. What is the primary function of nitric oxide therapy in pediatric patients?
A. Reduce pulmonary hypertension
B. Increase oxygen diffusion
C. Improve secretion clearance
D. Enhance lung compliance
104. Which of the following oxygen delivery methods provides the highest FiO₂?
A. Simple face mask
B. Venturi mask
C. High-flow nasal cannula
D. Non-rebreather mask
105. What is the most common cause of respiratory distress syndrome (RDS) in preterm infants?
A. Bacterial infection
B. Meconium aspiration
C. Surfactant deficiency
D. Congenital heart disease
106. Which of the following is the best indicator of the severity of an asthma exacerbation in a pediatric patient?
A. Presence of wheezing
B. Decreased peak expiratory flow rate (PEFR)
C. Increased respiratory rate
D. Nasal congestion
107. What is the primary goal of chest physiotherapy in pediatric patients with cystic fibrosis?
A. Improve lung compliance
B. Decrease airway inflammation
C. Facilitate mucus clearance
D. Increase tidal volume
108. Which of the following conditions is characterized by persistent productive cough and digital clubbing in pediatric patients?
A. Cystic fibrosis
B. Asthma
C. Bronchiolitis
D. Epiglottitis
109. What is the most effective way to prevent sudden infant death syndrome (SIDS)?
A. Placing infants on their back to sleep
B. Using soft bedding
C. Co-sleeping with parents
D. Keeping the infant in a warm environment
110. Which test is most commonly used to diagnose bacterial pneumonia in pediatric patients?
A. Sputum culture
B. Chest X-ray
C. Pulmonary function test
D. Arterial blood gas analysis
111. What is the recommended treatment for a pediatric patient with a mild pertussis infection?
A. Albuterol
B. Corticosteroids
C. Azithromycin
D. Racemic epinephrine
112. What is the primary advantage of using a spacer with a metered-dose inhaler (MDI) in pediatric patients?
A. Increases medication dose
B. Reduces medication side effects
C. Improves medication delivery to the lungs
D. Prevents bronchospasm
113. Which of the following interventions is most appropriate for a pediatric patient experiencing a mild allergic reaction with respiratory symptoms?
A. Epinephrine
B. Diphenhydramine
C. Albuterol
D. Corticosteroids
114. What is the most common cause of upper airway obstruction in pediatric patients?
A. Foreign body aspiration
B. Asthma
C. Pneumonia
D. Bronchiolitis
115. Which of the following signs indicates severe respiratory distress in a pediatric patient?
A. Nasal flaring
B. Intercostal retractions
C. Grunting
D. Mild tachypnea
116. Which of the following is an early sign of carbon dioxide retention in pediatric patients?
A. Hypotension
B. Bradycardia
C. Confusion and drowsiness
D. Cyanosis
117. What is the preferred position for a pediatric patient experiencing epiglottitis?
A. Supine
B. Tripod position
C. Prone
D. Lateral recumbent
118. What is the primary cause of transient tachypnea of the newborn (TTN)?
A. Delayed clearance of lung fluid
B. Meconium aspiration
C. Pulmonary infection
D. Premature birth
119. Which of the following conditions is a contraindication for using non-invasive ventilation (NIV) in pediatric patients?
A. Moderate asthma exacerbation
B. Respiratory failure with apnea
C. Cystic fibrosis exacerbation
D. Obstructive sleep apnea
120. Which of the following interventions is most effective in preventing atelectasis in pediatric postoperative patients?
A. Incentive spirometry
B. Chest physiotherapy
C. Humidified oxygen therapy
D. Increased IV fluid intake
121. What is the most common cause of viral pneumonia in pediatric patients?
A. Respiratory syncytial virus (RSV)
B. Influenza virus
C. Adenovirus
D. Parainfluenza virus
122. Which of the following is the most common cause of bacterial pneumonia in school-aged children?
A. Streptococcus pneumoniae
B. Mycoplasma pneumoniae
C. Haemophilus influenzae
D. Staphylococcus aureus
123. What is the primary purpose of a bubble CPAP system in pediatric patients?
A. Reduce airway resistance
B. Provide continuous positive airway pressure
C. Improve secretion clearance
D. Increase alveolar surface tension
124. Which of the following conditions is associated with tracheoesophageal fistula in newborns?
A. Meconium aspiration syndrome
B. Polyhydramnios
C. Bronchopulmonary dysplasia
D. Transient tachypnea of the newborn
125. Which of the following is a major risk factor for developing bronchopulmonary dysplasia (BPD)?
A. Prematurity and prolonged mechanical ventilation
B. Asthma and allergies
C. Congenital heart defects
D. Foreign body aspiration
126. What is the recommended first-line treatment for mild intermittent asthma in pediatric patients?
A. Inhaled corticosteroids
B. Leukotriene receptor antagonists
C. Short-acting beta-agonists (SABA)
D. Long-acting beta-agonists (LABA)
127. Which diagnostic test is most useful for evaluating the severity of bronchiolitis in an infant?
A. Arterial blood gas analysis
B. Chest X-ray
C. Nasopharyngeal swab for RSV
D. Pulmonary function testing
128. Which of the following therapies is most appropriate for a pediatric patient with status asthmaticus?
A. High-dose inhaled corticosteroids
B. Nebulized albuterol and intravenous corticosteroids
C. Hypertonic saline nebulization
D. Chest physiotherapy
129. What is the purpose of the Pediatric Early Warning Score (PEWS) system?
A. Predicting the risk of severe allergic reactions
B. Identifying children at risk for clinical deterioration
C. Diagnosing cystic fibrosis
D. Measuring lung function in children with asthma
130. Which of the following is a contraindication for high-flow nasal cannula (HFNC) therapy in pediatric patients?
A. Mild hypoxemia
B. Severe respiratory acidosis
C. Apnea
D. Nasal congestion
131. What is the hallmark sign of pertussis (whooping cough) in pediatric patients?
A. Stridor
B. Paroxysmal coughing fits with inspiratory whoop
C. Persistent wheezing
D. Barking cough
132. Which of the following is a common complication of a prolonged asthma attack (status asthmaticus)?
A. Atelectasis
B. Respiratory alkalosis
C. Respiratory failure
D. Pneumothorax
133. What is the first-line treatment for pediatric patients with foreign body aspiration?
A. Back blows and chest thrusts
B. Oxygen therapy
C. Bronchodilator therapy
D. Chest physiotherapy
134. Which of the following findings is most concerning in a child with croup?
A. Barking cough
B. Mild stridor
C. Drooling and difficulty swallowing
D. Hoarseness
135. Which of the following is the best method to confirm endotracheal tube placement in a pediatric patient?
A. Chest X-ray
B. Auscultation of breath sounds
C. Colorimetric capnography
D. Visualizing chest rise
136. What is the most common sign of upper airway obstruction in an infant?
A. Grunting
B. Inspiratory stridor
C. Wheezing
D. Productive cough
137. Which of the following conditions is most commonly associated with meconium aspiration syndrome?
A. Prematurity
B. Post-term birth
C. Low birth weight
D. Neonatal pneumonia
138. Which of the following oxygen therapy methods provides the most stable FiO₂ for pediatric patients?
A. Simple nasal cannula
B. Venturi mask
C. High-flow nasal cannula
D. Non-rebreather mask
139. What is the most appropriate treatment for a pediatric patient with severe epiglottitis?
A. Racemic epinephrine
B. Intubation and IV antibiotics
C. Nebulized albuterol
D. Corticosteroid therapy
140. Which of the following signs indicates impending respiratory failure in a pediatric patient?
A. Retractions
B. Nasal flaring
C. Lethargy and bradypnea
D. Wheezing
141. Which lung sound is most commonly heard in pediatric patients with bronchiolitis?
A. Stridor
B. Fine crackles
C. Expiratory wheezing
D. Pleural rub
142. What is the most appropriate intervention for a pediatric patient experiencing hypercapnic respiratory failure?
A. CPAP
B. BiPAP
C. Heliox therapy
D. Oxygen via nasal cannula
143. What is the most common reason for re-hospitalization in pediatric patients with cystic fibrosis?
A. Mucus plugging
B. Recurrent respiratory infections
C. Pneumothorax
D. Pulmonary edema
144. Which of the following is the first-line treatment for an acute allergic reaction with respiratory distress?
A. Nebulized albuterol
B. Intramuscular epinephrine
C. IV corticosteroids
D. Diphenhydramine
145. Which test is used to diagnose vocal cord dysfunction (VCD) in pediatric patients?
A. Pulmonary function test
B. Chest X-ray
C. Laryngoscopy
D. Bronchoscopy
146. What is the primary purpose of exogenous surfactant therapy in premature infants?
A. Prevent airway collapse
B. Reduce airway resistance
C. Decrease lung compliance
D. Increase oxygen diffusion
147. Which of the following is the most common complication of mechanical ventilation in pediatric patients?
A. Ventilator-associated pneumonia (VAP)
B. Bronchiolitis
C. Pulmonary embolism
D. Pleural effusion
148. What is the gold standard test for diagnosing obstructive sleep apnea in pediatric patients?
A. Pulmonary function test
B. Arterial blood gas
C. Polysomnography
D. Chest X-ray
149. Which of the following is a contraindication for using nebulized hypertonic saline in pediatric patients?
A. Cystic fibrosis
B. Bronchiolitis with severe bronchospasm
C. Asthma exacerbation
D. Recurrent pneumonia
150. Which of the following is an early sign of worsening respiratory distress in a pediatric patient?
A. Bradycardia
B. Intercostal retractions
C. Cyanosis
D. Decreased respiratory rate
151. What is the primary method for delivering inhaled medications to young pediatric patients?
A. Dry powder inhaler
B. Nebulizer with mask
C. Spacer with metered-dose inhaler (MDI)
D. Handheld inhaler
152. Which condition is characterized by chronic productive cough, recurrent lung infections, and pancreatic insufficiency?
A. Asthma
B. Cystic fibrosis
C. Bronchiolitis
D. Epiglottitis
153. What is the most common cause of wheezing in infants younger than one year?
A. Asthma
B. Bronchiolitis
C. Foreign body aspiration
D. Pneumonia
154. Which of the following factors increases the risk of sudden infant death syndrome (SIDS)?
A. Breastfeeding
B. Sleeping in a supine position
C. Smoking exposure
D. Using a firm mattress
155. Which of the following interventions is most effective in treating moderate croup?
A. Nebulized epinephrine
B. Oral dexamethasone
C. Humidified oxygen
D. Broad-spectrum antibiotics
156. What is the most common cause of a tracheostomy in pediatric patients?
A. Airway obstruction
B. Pneumonia
C. Asthma exacerbation
D. Foreign body aspiration
157. Which laboratory test is most useful in diagnosing carbon monoxide poisoning in a pediatric patient?
A. Pulse oximetry
B. Arterial blood gas with co-oximetry
C. Chest X-ray
D. Capnography
158. Which of the following is the best indicator of chronic hypoxemia in a pediatric patient?
A. Clubbing of fingers
B. Cyanosis
C. Tachypnea
D. Nasal flaring
159. What is the recommended position for an infant with gastroesophageal reflux to prevent aspiration?
A. Supine
B. Prone
C. Left lateral
D. Semi-upright
160. Which of the following is the most appropriate airway clearance therapy for a pediatric patient with cystic fibrosis?
A. Incentive spirometry
B. Chest physiotherapy with percussion
C. Non-invasive ventilation
D. Oxygen therapy
161. Which ventilator setting should be adjusted first for a pediatric patient with persistent hypercapnia on mechanical ventilation?
A. Tidal volume
B. FiO₂
C. Inspiratory time
D. Respiratory rate
162. What is the most common etiology of viral-induced wheezing in children under two years old?
A. Influenza
B. RSV (Respiratory Syncytial Virus)
C. Parainfluenza
D. Rhinovirus
163. Which of the following best describes the primary cause of persistent pulmonary hypertension of the newborn (PPHN)?
A. Delayed closure of the ductus arteriosus
B. Increased left ventricular function
C. Pulmonary vascular resistance remains elevated
D. Decreased surfactant production
164. Which of the following oxygen delivery methods is preferred for pediatric patients requiring high oxygen concentrations without positive pressure?
A. Nasal cannula
B. Simple face mask
C. Non-rebreather mask
D. Venturi mask
165. Which diagnostic test is best for confirming the presence of a pneumothorax in a pediatric patient?
A. Chest X-ray
B. Arterial blood gas
C. Pulmonary function test
D. Capnography
166. What is the preferred initial treatment for a pediatric patient with anaphylaxis and respiratory distress?
A. Albuterol nebulizer
B. Intramuscular epinephrine
C. IV corticosteroids
D. Antihistamines
167. Which of the following conditions is associated with pulsus paradoxus in a pediatric patient?
A. Croup
B. Status asthmaticus
C. Bronchiolitis
D. Foreign body aspiration
168. Which of the following respiratory conditions is most commonly associated with chronic aspiration in pediatric patients?
A. Gastroesophageal reflux disease (GERD)
B. Cystic fibrosis
C. Bronchopulmonary dysplasia
D. Epiglottitis
169. Which of the following is the most appropriate intervention for a pediatric patient with mild laryngomalacia?
A. Tracheostomy
B. Non-invasive ventilation
C. Observation and reassurance
D. Nebulized corticosteroids
170. Which of the following findings is most concerning in a pediatric patient with pneumonia?
A. Fever of 101°F
B. Intercostal retractions
C. Crackles on auscultation
D. Mild tachypnea
171. What is the most appropriate diagnostic test for confirming obstructive sleep apnea (OSA) in a pediatric patient?
A. Chest X-ray
B. Polysomnography
C. Pulmonary function testing
D. Bronchoscopy
172. Which of the following medications is used as a long-term controller therapy for pediatric asthma?
A. Albuterol
B. Inhaled corticosteroids
C. Epinephrine
D. Ipratropium bromide
173. What is the most effective method for preventing ventilator-associated pneumonia (VAP) in pediatric patients?
A. Frequent endotracheal suctioning
B. Routine use of antibiotics
C. Elevating the head of the bed
D. Placing the patient in a prone position
174. What is the preferred treatment for a pediatric patient experiencing moderate bronchiolitis?
A. Nebulized albuterol
B. Nebulized hypertonic saline
C. Antibiotic therapy
D. Chest physiotherapy
175. Which of the following conditions is most commonly associated with persistent tachypnea in a pediatric patient?
A. Asthma
B. Congenital heart disease
C. Foreign body aspiration
D. Allergic rhinitis
176. Which of the following interventions is most appropriate for an infant with a suspected diaphragmatic hernia?
A. Bag-mask ventilation
B. Immediate intubation
C. Non-invasive ventilation
D. Oxygen therapy via nasal cannula
177. What is the most common complication associated with prolonged oxygen therapy in pediatric patients?
A. Oxygen toxicity
B. Hypercapnia
C. Barotrauma
D. Increased mucus production
178. What is the first-line treatment for mild obstructive sleep apnea in pediatric patients?
A. CPAP therapy
B. Tonsillectomy and adenoidectomy
C. Oxygen therapy
D. Tracheostomy
179. Which of the following findings would be expected in a pediatric patient with acute respiratory distress syndrome (ARDS)?
A. Decreased lung compliance
B. Normal chest X-ray
C. Increased lung compliance
D. Decreased work of breathing
180. Which intervention is most appropriate for a child with severe RSV bronchiolitis and respiratory distress?
A. High-flow nasal cannula (HFNC)
B. Non-invasive ventilation
C. Endotracheal intubation
D. Chest physiotherapy
181. Which of the following conditions is characterized by a steeple sign on a lateral neck X-ray?
A. Croup
B. Epiglottitis
C. Bronchiolitis
D. Foreign body aspiration
182. What is the most appropriate intervention for a pediatric patient experiencing acute laryngospasm?
A. Suctioning the airway
B. Nebulized epinephrine
C. Positive pressure ventilation
D. Intravenous corticosteroids
183. Which of the following is a contraindication for using non-invasive ventilation (NIV) in a pediatric patient?
A. Mild respiratory distress
B. Pneumonia
C. Apnea
D. Status asthmaticus
184. What is the most common cause of bacterial tracheitis in children?
A. Haemophilus influenzae
B. Streptococcus pneumoniae
C. Staphylococcus aureus
D. Mycoplasma pneumoniae
185. Which of the following oxygen therapy devices provides the most precise FiO₂?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
186. What is the primary mode of transmission for respiratory syncytial virus (RSV)?
A. Airborne droplets
B. Direct contact
C. Bloodborne transmission
D. Fecal-oral route
187. Which of the following is the most effective way to prevent pneumonia in children?
A. Routine chest X-rays
B. Annual influenza vaccination
C. Routine bronchodilator therapy
D. High-dose vitamin supplementation
188. Which of the following is the most appropriate intervention for an infant with transient tachypnea of the newborn (TTN)?
A. Mechanical ventilation
B. CPAP therapy
C. Surfactant replacement
D. Immediate intubation
189. What is the primary indication for heliox therapy in pediatric respiratory care?
A. Acute bronchiolitis
B. Airway obstruction with increased work of breathing
C. Pulmonary hypertension
D. Pneumonia
190. Which of the following findings is most consistent with an acute asthma exacerbation in a pediatric patient?
A. Decreased peak expiratory flow rate (PEFR)
B. Increased lung compliance
C. Normal arterial blood gas
D. Decreased respiratory rate
191. Which of the following conditions is associated with an abnormal sweat chloride test?
A. Asthma
B. Cystic fibrosis
C. Bronchopulmonary dysplasia
D. Laryngomalacia
192. Which of the following is the preferred intervention for a pediatric patient with a severe acute asthma exacerbation who is not responding to nebulized albuterol?
A. IV magnesium sulfate
B. Hypertonic saline nebulization
C. Chest physiotherapy
D. Antibiotic therapy
193. What is the preferred treatment for a pediatric patient experiencing acute hypoxic respiratory failure?
A. Non-invasive ventilation
B. Endotracheal intubation
C. Oxygen therapy with high-flow nasal cannula (HFNC)
D. CPAP therapy
194. Which of the following findings is most concerning in a pediatric patient with respiratory distress?
A. Tachycardia
B. Grunting
C. Mild intercostal retractions
D. Nasal congestion
195. Which of the following medications is used to reduce inflammation in pediatric patients with persistent asthma?
A. Albuterol
B. Ipratropium bromide
C. Inhaled corticosteroids
D. Montelukast
196. Which of the following conditions is most commonly associated with upper airway obstruction in children?
A. Bronchiolitis
B. Laryngomalacia
C. Pneumonia
D. Pulmonary edema
197. What is the first step in managing a pediatric patient with anaphylaxis?
A. Administer IV fluids
B. Give IM epinephrine
C. Provide supplemental oxygen
D. Administer antihistamines
198. Which of the following is a sign of worsening respiratory distress in a pediatric patient?
A. Mild tachypnea
B. Increased wheezing
C. Paradoxical breathing
D. Nasal congestion
199. Which diagnostic test is most useful for evaluating pediatric obstructive sleep apnea?
A. Chest X-ray
B. Arterial blood gas
C. Polysomnography
D. Pulmonary function testing
200. What is the purpose of chest physiotherapy in pediatric patients with cystic fibrosis?
A. Reduce lung compliance
B. Improve airway clearance
C. Increase FiO₂ delivery
D. Decrease bronchospasm
201. Which of the following clinical findings suggests moderate-to-severe bronchiolitis?
A. Mild nasal congestion
B. Expiratory wheezing with retractions
C. Barking cough
D. Inspiratory stridor
202. What is the most common presenting symptom of a pediatric patient with foreign body aspiration?
A. Persistent cough
B. Fever
C. Cyanosis
D. Clubbing
203. Which of the following ventilator settings is most appropriate for an infant with ARDS?
A. High tidal volume, low respiratory rate
B. Low tidal volume, high PEEP
C. High FiO₂, low PEEP
D. Increased inspiratory time
204. Which medication is commonly used as an alternative to inhaled corticosteroids for pediatric patients with mild persistent asthma?
A. Montelukast
B. Theophylline
C. Cromolyn sodium
D. Epinephrine
205. Which of the following findings is most consistent with upper airway obstruction?
A. Stridor
B. Crackles
C. Diminished breath sounds
D. Expiratory wheezing
206. What is the primary reason for using CPAP therapy in pediatric patients with obstructive sleep apnea?
A. Improve oxygenation
B. Reduce the need for intubation
C. Maintain airway patency
D. Decrease respiratory rate
207. Which of the following diagnostic tests is most useful for evaluating the severity of cystic fibrosis lung disease?
A. Chest X-ray
B. Pulmonary function testing
C. Arterial blood gas
D. Bronchoscopy
208. Which therapy is most appropriate for a pediatric patient with severe bronchiolitis and persistent hypoxia?
A. CPAP
B. Non-invasive ventilation
C. High-flow nasal cannula (HFNC)
D. Chest physiotherapy
209. What is the most common complication of mechanical ventilation in pediatric patients?
A. Barotrauma
B. Tracheomalacia
C. Pleural effusion
D. Hypocapnia
210. Which of the following conditions is a contraindication for high-flow nasal cannula therapy in pediatric patients?
A. Mild respiratory distress
B. Severe apnea
C. Hypoxemia
D. Upper respiratory infection
211. Which of the following lung volumes is typically reduced in pediatric patients with restrictive lung disease?
A. Residual volume (RV)
B. Tidal volume (VT)
C. Total lung capacity (TLC)
D. Functional residual capacity (FRC)
212. What is the most appropriate intervention for a pediatric patient with complete upper airway obstruction due to a foreign body?
A. Back blows and chest thrusts (for infants)
B. Finger sweep
C. Bronchodilator therapy
D. Bag-mask ventilation
213. Which of the following findings is most consistent with bacterial pneumonia in a pediatric patient?
A. Sudden onset of high fever and productive cough
B. Gradual onset of wheezing and nasal congestion
C. Barking cough and inspiratory stridor
D. Persistent dry cough with mild fever
214. Which of the following medications is most effective in preventing exercise-induced bronchospasm in children with asthma?
A. Albuterol
B. Cromolyn sodium
C. Montelukast
D. Epinephrine
215. Which of the following airway adjuncts is most appropriate for maintaining a patent airway in an unconscious pediatric patient?
A. Nasopharyngeal airway
B. Laryngeal mask airway (LMA)
C. Oropharyngeal airway
D. Endotracheal tube
216. Which condition is characterized by a “thumb sign” on lateral neck X-ray?
A. Croup
B. Epiglottitis
C. Bronchiolitis
D. Asthma
217. Which of the following is the most appropriate treatment for a pediatric patient with mild croup?
A. Nebulized epinephrine
B. Oral dexamethasone
C. Intravenous antibiotics
D. Chest physiotherapy
218. What is the primary cause of bronchiolitis in infants?
A. Haemophilus influenzae
B. Mycoplasma pneumoniae
C. Respiratory syncytial virus (RSV)
D. Streptococcus pneumoniae
219. What is the primary goal of oxygen therapy in pediatric patients with hypoxemia?
A. Prevent hypercapnia
B. Improve tissue oxygenation
C. Reduce respiratory rate
D. Prevent barotrauma
220. Which of the following ventilator strategies is recommended for pediatric patients with acute respiratory distress syndrome (ARDS)?
A. High tidal volume, low PEEP
B. Low tidal volume, high PEEP
C. Low FiO₂, low PEEP
D. Increased respiratory rate with normal tidal volume
221. Which of the following findings is most concerning in a pediatric patient with status asthmaticus?
A. Decreased wheezing and silent chest
B. Tachypnea with accessory muscle use
C. Persistent expiratory wheezing
D. Mild hypoxemia on pulse oximetry
222. Which type of humidification system is preferred for pediatric patients on mechanical ventilation?
A. Heated humidifier
B. Heat and moisture exchanger (HME)
C. Bubble humidifier
D. Passive humidifier
223. Which of the following interventions is most appropriate for a pediatric patient with severe apnea of prematurity?
A. High-flow nasal cannula
B. Caffeine therapy
C. Oxygen therapy
D. Non-invasive ventilation
224. Which of the following findings is most suggestive of a pneumothorax in a pediatric patient?
A. Diminished breath sounds on one side
B. Diffuse wheezing
C. Stridor
D. Coarse crackles
225. What is the preferred method for assessing oxygenation in a critically ill pediatric patient?
A. Pulse oximetry
B. Arterial blood gas (ABG)
C. Capnography
D. Transcutaneous oxygen monitoring
226. Which of the following lung conditions is characterized by a prolonged expiratory phase?
A. Pneumonia
B. Asthma
C. Pleural effusion
D. Pulmonary edema
227. Which of the following factors increases the risk of developing bronchopulmonary dysplasia (BPD) in premature infants?
A. High oxygen exposure and mechanical ventilation
B. Maternal smoking
C. Vaginal delivery
D. Low birth weight but term delivery
228. Which of the following is the most effective strategy for preventing ventilator-associated pneumonia (VAP) in pediatric patients?
A. Routine use of broad-spectrum antibiotics
B. Elevating the head of the bed
C. Frequent endotracheal suctioning
D. Continuous nebulization therapy
229. Which of the following interventions is most appropriate for treating a pediatric patient with refractory status asthmaticus?
A. IV magnesium sulfate
B. High-dose inhaled corticosteroids
C. Non-invasive ventilation
D. Antibiotic therapy
230. What is the primary goal of high-frequency oscillatory ventilation (HFOV) in pediatric respiratory care?
A. Improve oxygenation while minimizing lung injury
B. Increase tidal volume
C. Reduce carbon dioxide elimination
D. Prevent mucus plugging
231. What is the most appropriate intervention for a pediatric patient with carbon monoxide poisoning?
A. High-flow oxygen therapy
B. Non-invasive ventilation
C. Bronchodilator therapy
D. Chest physiotherapy
232. Which of the following conditions is associated with hypercapnia and respiratory acidosis?
A. Pulmonary embolism
B. Asthma exacerbation
C. Pneumothorax
D. Metabolic alkalosis
233. Which of the following medications is used as a mucolytic in pediatric patients with cystic fibrosis?
A. Dornase alfa
B. Albuterol
C. Ipratropium bromide
D. Epinephrine
234. Which of the following interventions is most appropriate for a pediatric patient with moderate respiratory distress due to bronchiolitis?
A. Chest physiotherapy
B. High-flow nasal cannula (HFNC)
C. Nebulized corticosteroids
D. Intravenous antibiotics
235. What is the primary mechanism by which CPAP benefits pediatric patients with obstructive sleep apnea?
A. Reduces airway inflammation
B. Increases functional residual capacity
C. Maintains airway patency
D. Increases tidal volume
236. Which of the following findings is most concerning in a pediatric patient receiving high-flow nasal cannula therapy?
A. Mild tachypnea
B. Nasal flaring
C. Increased work of breathing
D. Minimal secretion clearance
237. Which of the following conditions is characterized by chronic hypoxemia and digital clubbing?
A. Asthma
B. Cystic fibrosis
C. Acute bronchiolitis
D. Foreign body aspiration
238. Which of the following best describes the pathophysiology of acute respiratory distress syndrome (ARDS)?
A. Increased pulmonary compliance
B. Increased alveolar-capillary membrane permeability
C. Decreased lung water content
D. Increased surfactant production
239. Which of the following is the most effective treatment for a pediatric patient with severe epiglottitis?
A. Immediate intubation
B. Nebulized corticosteroids
C. CPAP therapy
D. Heliox therapy
240. Which diagnostic test is most useful in evaluating diaphragmatic paralysis in a pediatric patient?
A. Chest ultrasound
B. Fluoroscopy (“sniff test”)
C. Pulmonary function testing
D. Arterial blood gas
241. Which of the following factors is the most common cause of sudden deterioration in a mechanically ventilated pediatric patient?
A. Pneumothorax
B. Pulmonary edema
C. Sepsis
D. Hyperkalemia
242. Which of the following ventilator settings is most appropriate for a pediatric patient with obstructive lung disease?
A. Low tidal volume, high respiratory rate
B. High tidal volume, low PEEP
C. Low respiratory rate, prolonged expiratory time
D. Increased inspiratory time
243. Which of the following is the most appropriate initial management for a child with suspected foreign body aspiration?
A. Chest X-ray
B. Bronchoscopy
C. Nebulized albuterol
D. Pulmonary function testing
244. Which of the following findings is most consistent with a tension pneumothorax in a pediatric patient?
A. Bilateral wheezing
B. Hypotension and tracheal deviation
C. Fine inspiratory crackles
D. Hyperresonance on percussion bilaterally
245. Which of the following interventions is most appropriate for a pediatric patient with increased work of breathing due to viral croup?
A. Heliox therapy
B. High-dose steroids
C. IV magnesium sulfate
D. Chest physiotherapy
246. Which of the following medications is considered first-line treatment for pediatric patients with acute bronchospasm?
A. Levalbuterol
B. Ipratropium bromide
C. Albuterol
D. Montelukast
247. Which of the following is a major risk factor for pediatric obstructive sleep apnea?
A. Large tonsils and adenoids
B. Low birth weight
C. Passive smoke exposure
D. Chronic sinusitis
248. Which of the following is the most effective intervention for a pediatric patient with severe bronchiolitis and worsening hypoxia?
A. CPAP therapy
B. High-flow nasal cannula (HFNC)
C. Heliox therapy
D. IV corticosteroids
249. Which of the following findings is most concerning in a pediatric patient with respiratory distress?
A. Retractions and tachypnea
B. Grunting and nasal flaring
C. Mild intercostal retractions
D. Frequent dry cough
250. Which of the following is the most common cause of community-acquired pneumonia in children over five years of age?
A. Haemophilus influenzae
B. Mycoplasma pneumoniae
C. Respiratory syncytial virus (RSV)
D. Streptococcus pneumoniae
251. Which of the following is the most appropriate intervention for a pediatric patient with carbon monoxide poisoning?
A. High-flow oxygen therapy
B. Nebulized bronchodilator
C. Intravenous corticosteroids
D. Endotracheal intubation
252. Which of the following conditions is characterized by a “boot-shaped” heart on a chest X-ray?
A. Tetralogy of Fallot
B. Cystic fibrosis
C. Congenital diaphragmatic hernia
D. Pneumonia
253. Which of the following therapies is most appropriate for a pediatric patient with acute pulmonary edema?
A. High-flow nasal cannula (HFNC)
B. Diuretics and CPAP
C. Chest physiotherapy
D. Inhaled corticosteroids
254. Which of the following findings is most consistent with severe respiratory distress in an infant?
A. Mild tachypnea and nasal congestion
B. Cyanosis and bradycardia
C. Nasal flaring and mild wheezing
D. Low-grade fever and persistent cough
255. Which of the following is the best diagnostic test to confirm cystic fibrosis in an infant?
A. Pulmonary function testing
B. Arterial blood gas
C. Sweat chloride test
D. Chest X-ray
256. Which of the following oxygen delivery devices is most appropriate for a pediatric patient with acute respiratory distress syndrome (ARDS) who requires high levels of oxygen?
A. Nasal cannula
B. Non-rebreather mask
C. Simple face mask
D. Venturi mask
257. Which of the following is the most common complication of positive pressure ventilation in pediatric patients?
A. Pulmonary embolism
B. Pneumothorax
C. Pulmonary hypertension
D. Hypokalemia
258. What is the recommended approach for suctioning a pediatric patient with a tracheostomy?
A. Suction continuously while inserting and withdrawing the catheter
B. Use sterile technique and limit suctioning time to <10 seconds
C. Instill normal saline prior to suctioning
D. Apply suction at maximum pressure
259. Which of the following findings is most concerning in a pediatric patient receiving heliox therapy?
A. Improved oxygenation
B. Decreased work of breathing
C. Worsening hypoxemia
D. Decreased respiratory rate
260. Which of the following conditions is characterized by increased pulmonary compliance?
A. Acute respiratory distress syndrome (ARDS)
B. Pneumonia
C. Emphysema
D. Pulmonary fibrosis
261. Which of the following findings on a pediatric chest X-ray suggests a foreign body aspiration?
A. Hyperinflation of one lung
B. Bilateral infiltrates
C. Diffuse ground-glass opacities
D. Flattened diaphragm
262. Which of the following strategies is most appropriate for weaning a pediatric patient from mechanical ventilation?
A. Rapidly decreasing FiO₂ while maintaining PEEP
B. Using a spontaneous breathing trial (SBT)
C. Increasing tidal volume before decreasing rate
D. Switching directly from mechanical ventilation to room air
263. Which of the following medications is most effective for treating persistent wheezing in a pediatric patient with viral bronchiolitis?
A. Albuterol
B. Nebulized hypertonic saline
C. Inhaled corticosteroids
D. IV magnesium sulfate
264. Which of the following interventions is most appropriate for a pediatric patient with severe epiglottitis?
A. Immediate endotracheal intubation
B. Nebulized racemic epinephrine
C. High-flow nasal cannula
D. Chest physiotherapy
265. Which of the following is the best method for assessing ventilation in a pediatric patient on a ventilator?
A. Pulse oximetry
B. End-tidal CO₂ monitoring
C. Chest X-ray
D. Pulmonary function testing
266. What is the primary benefit of using high-frequency oscillatory ventilation (HFOV) in pediatric ARDS patients?
A. Increased oxygenation with reduced barotrauma
B. Improved CO₂ clearance
C. Lower tidal volumes and higher pressures
D. Prevention of mucus plugging
267. Which of the following conditions is associated with the presence of nasal polyps in pediatric patients?
A. Asthma
B. Cystic fibrosis
C. Pneumonia
D. Bronchiolitis
268. What is the most appropriate treatment for a pediatric patient with bacterial tracheitis?
A. IV antibiotics and airway management
B. High-flow nasal cannula
C. Nebulized epinephrine
D. Inhaled corticosteroids
269. Which of the following findings suggests an upper airway obstruction?
A. Inspiratory stridor
B. Expiratory wheezing
C. Crackles
D. Diminished breath sounds
270. Which of the following conditions is a contraindication for high-flow nasal cannula therapy?
A. Severe apnea
B. Mild hypoxia
C. Respiratory distress
D. Bronchiolitis
271. What is the most common causative organism for bacterial pneumonia in children under five years old?
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Respiratory syncytial virus (RSV)
272. Which of the following clinical signs suggests an infant is in impending respiratory failure?
A. Tachypnea and mild intercostal retractions
B. Nasal congestion and mild cough
C. Grunting, bradycardia, and cyanosis
D. Inspiratory stridor and low-grade fever
273. Which pulmonary function test finding is most consistent with obstructive lung disease in a pediatric patient?
A. Decreased forced expiratory volume in 1 second (FEV₁)
B. Decreased total lung capacity (TLC)
C. Increased diffusing capacity of the lungs (DLCO)
D. Increased FEV₁/FVC ratio
274. Which of the following interventions is most appropriate for a child experiencing an acute asthma exacerbation with persistent hypoxia despite nebulized albuterol?
A. IV magnesium sulfate
B. Oral montelukast
C. Chest physiotherapy
D. IV antibiotics
275. Which oxygen delivery device provides the most precise FiO₂ in a pediatric patient with chronic lung disease?
A. Simple face mask
B. Non-rebreather mask
C. High-flow nasal cannula
D. Venturi mask
276. What is the first-line pharmacologic treatment for mild persistent asthma in children?
A. Short-acting beta-agonist (SABA) as needed
B. Inhaled corticosteroids (ICS)
C. Leukotriene receptor antagonist
D. Systemic corticosteroids
277. Which of the following findings is most consistent with diaphragmatic hernia in a newborn?
A. Hyperresonance on percussion
B. Bowel sounds in the chest
C. Decreased breath sounds bilaterally
D. Expiratory wheezing
278. Which ventilator mode is most appropriate for a pediatric patient with ARDS to minimize barotrauma?
A. Volume-controlled ventilation
B. Pressure-controlled ventilation with low tidal volume
C. High tidal volume, low respiratory rate
D. Assist-control ventilation
279. Which of the following conditions is associated with nasal flaring, grunting, and retractions in a newborn?
A. Meconium aspiration syndrome
B. Transient tachypnea of the newborn
C. Respiratory distress syndrome
D. All of the above
280. What is the primary benefit of using heliox in pediatric patients with airway obstruction?
A. Increases mucociliary clearance
B. Reduces airway resistance and improves laminar flow
C. Increases oxygen diffusion
D. Prevents mucus plugging
281. Which of the following best describes the pathophysiology of cystic fibrosis?
A. Decreased surfactant production
B. Mutation in the CFTR gene leading to thickened secretions
C. Autoimmune destruction of alveoli
D. Bronchial hyperresponsiveness to allergens
282. Which of the following is the most common trigger for asthma exacerbations in school-aged children?
A. Viral respiratory infections
B. Exposure to cold air
C. Physical exercise
D. Air pollution
283. What is the most appropriate initial treatment for a child with moderate croup?
A. Oral dexamethasone
B. Nebulized hypertonic saline
C. IV corticosteroids
D. CPAP therapy
284. Which of the following factors increases the risk of ventilator-associated pneumonia (VAP) in pediatric patients?
A. Frequent suctioning
B. Use of heat and moisture exchangers (HMEs)
C. Supine positioning
D. Early extubation
285. What is the best initial imaging modality for evaluating a suspected foreign body aspiration in a child?
A. Chest X-ray
B. CT scan
C. Bronchoscopy
D. MRI
286. Which of the following conditions is most likely to present with pulsus paradoxus in a pediatric patient?
A. Asthma exacerbation
B. Pneumonia
C. Bronchiolitis
D. Tracheomalacia
287. Which therapy is most effective for managing chronic respiratory failure in children with neuromuscular disorders?
A. Non-invasive ventilation (NIV)
B. High-flow nasal cannula
C. Oxygen therapy alone
D. CPAP
288. Which of the following medications is commonly used to prevent respiratory syncytial virus (RSV) infections in high-risk infants?
A. Palivizumab
B. Albuterol
C. Ribavirin
D. Montelukast
289. Which of the following is the best indicator of oxygenation in a pediatric patient on mechanical ventilation?
A. PaO₂ on arterial blood gas
B. SpO₂ on pulse oximetry
C. End-tidal CO₂
D. Respiratory rate
290. What is the most common cause of wheezing in infants under six months old?
A. Asthma
B. Bronchiolitis
C. Pneumonia
D. Foreign body aspiration
291. Which of the following therapies is most appropriate for treating atelectasis in a post-operative pediatric patient?
A. Incentive spirometry
B. IV corticosteroids
C. Nebulized albuterol
D. CPAP therapy
292. Which of the following laboratory findings is most consistent with acute respiratory failure?
A. pH 7.35, PaCO₂ 40 mmHg, PaO₂ 80 mmHg
B. pH 7.28, PaCO₂ 55 mmHg, PaO₂ 50 mmHg
C. pH 7.45, PaCO₂ 30 mmHg, PaO₂ 95 mmHg
D. pH 7.40, PaCO₂ 38 mmHg, PaO₂ 90 mmHg
293. What is the most appropriate management of a child with mild intermittent asthma?
A. Daily inhaled corticosteroids
B. As-needed short-acting beta-agonists
C. Leukotriene receptor antagonists
D. Continuous nebulized bronchodilators
294. Which of the following is the most common indication for tracheostomy in pediatric patients?
A. Airway obstruction
B. Chronic lung disease
C. Severe pneumonia
D. Acute respiratory distress syndrome (ARDS)
295. What is the most important intervention to prevent sudden infant death syndrome (SIDS)?
A. Placing infants in a prone sleeping position
B. Avoiding pacifier use during sleep
C. Avoiding smoke exposure and placing infants on their backs to sleep
D. Co-sleeping with parents
296. Which of the following is the best diagnostic test to confirm pertussis in an infant?
A. Chest X-ray
B. Polymerase chain reaction (PCR) testing
C. Pulmonary function test
D. Arterial blood gas
297. What is the first-line treatment for a pediatric patient with anaphylaxis and airway compromise?
A. IV antihistamines
B. Nebulized albuterol
C. IM epinephrine
D. IV corticosteroids
298. Which of the following ventilator settings is most appropriate for a pediatric patient with severe asthma exacerbation?
A. Low tidal volume, prolonged expiratory time
B. High respiratory rate, low tidal volume
C. High PEEP, low tidal volume
D. Increased inspiratory time
299. Which of the following signs is most specific for respiratory distress in a neonate?
A. Tachycardia
B. Grunting
C. Vomiting
D. Fever
300. What is the most appropriate next step in managing a pediatric patient with severe epiglottitis?
A. Immediate endotracheal intubation
B. Chest physiotherapy
C. IV fluids and observation
D. Nebulized corticosteroids