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Question 1
Which procedure is indicated to remove a large foreign-body airway obstruction in a child?
Correct Answer:
Rigid bronchoscopy
Explanation:
When a child has a large foreign body blocking the airway, the priority is to securely visualize and remove it while keeping the airway open. Rigid bronchoscopy provides a stiff, wide conduit that maintains airway patency and allows ventilation during the procedure, plus a large channel for grasping tools to retrieve the object intact. This makes it the best option for removing big, central airway foreign bodies. Flexible bronchoscopy can be used for certain distal or smaller objects, but it has a smaller working channel and less secure airway control for removing a large object. Bronchial lavage is for washing secretions, not extracting a solid obstruction, and thoracentesis drains the pleural space, not the airway.
Question 2
A fiberoptic light is place on an infant's right chest. A lighted halo is seen around the point of contact. The light is then placed on the infant's left chest and no light can be seen. This would indicate that
Correct Answer:
The left hemidiaphragm is herniated
Explanation:
Transillumination relies on how light passes through chest tissues. Air-filled lung transmits light differently than solid or fluid-filled structures. Seeing a light halo when the light is on the right chest means the right thorax has air-filled, relatively translucent lungs. The absence of any light when the light is placed on the left chest means the left thorax is not translucent, most consistent with abdominal contents herniating into the chest and displacing or replacing the left lung. This pattern points to a left congenital diaphragmatic hernia, where stomach or bowel sits in the left chest. Left-sided CDH is more common because the liver on the right offers some protection. If it were a pneumothorax on the left, you’d expect increased light transmission on that side, not a lack of light. Imaging would follow to confirm.
Question 3
After establishing unresponsiveness in a pediatric patient, the next step would be to
Correct Answer:
call for help
Explanation:
Activating emergency response is the immediate priority when you encounter an unresponsive pediatric patient. Getting help on the scene brings in advanced care, including equipment for airway management, ventilation support, and possible defibrillation, which are essential to improving outcomes. While opening the airway, checking for breathing, or suctioning are important parts of the overall resuscitation process, they don’t replace the need to summon help and begin basic life support right away. If you’re alone, shout for help and start CPR; if someone else is present, have them call EMS while you begin chest compressions and rescue breaths as appropriate.
Question 4
Which NO dosing range is commonly used in pediatric nitric oxide therapy?
Correct Answer:
20-80 ppm
Explanation:
Inhaled nitric oxide therapy in children is dosed to achieve effective pulmonary vasodilation while watching for safety, so the dosing window you’ll see most often is mid to high range. Starting around 20 ppm is common because lower doses (just a few ppm) may not produce sufficient vasodilation in many neonates with pulmonary hypertension. If the response isn’t adequate, clinicians can increase the dose toward 80 ppm, which provides a stronger effect. However, higher doses raise the risk of toxicity, especially methemoglobinemia and nitrogen dioxide formation, so patients are closely monitored during titration. For these reasons, the range from about 20 to 80 ppm is the typical, commonly used window. Lower ranges are used when the disease is milder or testing tolerance, but they’re not the standard for therapeutic effect, and doses above 80 ppm are avoided due to safety concerns.
Question 5
When utilizing an inspiratory muscle training device, the neonatal/pediatric specialist should initially set the resistor at
Correct Answer:
The lowest available resistance setting
Explanation:
Starting inspiratory muscle training in neonates and children should be done with the smallest possible load. Using the lowest resistance allows the patient to safely generate breaths, learn proper technique, and maintain a comfortable breathing pattern without overworking the muscles. This cautious start helps prevent fatigue, distress, and poor technique, which can undermine training gains. Once the child demonstrates tolerance and appropriate effort over sessions, the resistance can be gradually increased in small steps based on observable performance and comfort. Setting based on a measured maximal inspiratory pressure would impose a heavy load right away and isn’t appropriate for initial training. Relying on a fixed percentage of inspiratory capacity or on the average of attempts for the starting point doesn’t provide a controlled, safe initial load for beginners. Starting with the lowest setting is the safest, most practical approach to begin conditioning the inspiratory muscles in this population.
Question 1
Exam overview

About this Exam

Welcome to your comprehensive guide for preparing to become a Neonatal/Pediatric Specialist (NPS).

This article, designed to support you as you gear up for your Neonatal/Pediatric Specialist (NPS) Practice Exam, will break down everything you need to know about the official NPS credential and how to succeed.

The NPS designation is an advanced, specialty certification for Respiratory Therapists who are dedicated to providing expert care to neonates and children requiring respiratory support.

Whether you're already in the field looking to validate your expertise or a registered therapist aspiring to specialize, this credential signifies your deep commitment and knowledge.

Leverage practice exams as a cornerstone of your preparation to confidently approach the official certification journey.

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Additional Information

What the Course Entails and Exam Details

The National Board for Respiratory Care (NBRC) offers the Neonatal/Pediatric Specialist (NPS) credential.

While there isn't a single, prescriptive "course" leading directly to the exam, the NPS examination content is incredibly thorough, ensuring that successful candidates possess a high level of specialized skill.

To obtain your NPS, you will need to demonstrate mastery over several core competencies.

Expect the exam to cover detailed patient assessment techniques specific to newborns and children, including physical examinations and interpretation of diagnostic data.

You must understand the selection, application, and troubleshooting of specialized equipment like neonatal and pediatric ventilators, delivery room resuscitation tools, and monitoring devices.

The vast majority of the exam will test your understanding of pathophysiology and management for diverse conditions, from Respiratory Distress Syndrome (RDS) and Bronchopulmonary Dysplasia (BPD) in neonates to complex pediatric diseases like cystic fibrosis, asthma, and congenital cardiac anomalies.

Furthermore, critical procedures and therapeutic interventions across both populations are a significant focus.

Ethical considerations and patient safety principles related specifically to small patients are also implicitly and explicitly woven throughout the content.



What to Expect in the Final Exam

Ready to understand the structure of the real official NPS exam?

It is designed to be comprehensive and challenging, combining two distinct formats.

Expect to answer approximately 140 multiple-choice questions, covering a wide range of neonatal and pediatric topics with varying difficulty.

In addition to these standard questions, you will encounter multiple clinical simulation problems, testing your ability to make critical decisions in realistic, complex patient scenarios.

The total testing time is generous, usually around four hours, providing sufficient opportunity to carefully read each question and problem.

Passing is determined by a scaled score, with 75 typically being the passing threshold set by the NBRC.

Remember that the exam is strictly computer-administered at an authorized testing center.

Strict rules apply regarding what you can bring, proper identification is mandatory, and electronic devices are strictly prohibited during the examination.


How to Study and Exam Centers

Effective study is crucial for success on both your practice exams and the ultimate certification.

Leverage high-quality Neonatal/Pediatric Specialist (NPS) Practice Exams, which mirror the actual test format and content weighting, as your primary practice tool.

Dive deep into the officially recommended NBRC content outline to understand exactly what will be tested.

Supplement your practice with credible neonatal and pediatric respiratory care textbooks and clinical guidelines.

Create a dedicated study schedule, breaking down topics and incorporating review sessions for difficult subjects.

Make flashcards for complex formulas, normal lab values for different age groups, critical medications, and disease characteristics.

Take advantage of online forums or study groups with fellow candidates to discuss difficult concepts and share insights.

Take complete, timed practice exams to build stamina and simulate test-day pressure.

Analyze your results from these practice assessments to strategically focus your study efforts on areas of weakness.

Once you feel prepared, scheduling your official NPS exam involves several steps.

First, you must apply and pay through the National Board for Respiratory Care (NBRC) website.

After your application is approved, you will receive instructions on how to schedule your testing appointment.

All NBRC examinations, including the NPS, are administered exclusively at authorized Pearson VUE testing centers.

These professional, secure physical centers are located worldwide, allowing you to choose a convenient location and date.


Job Opportunities from the Course

Unlocking the NPS credential opens doors to advanced career opportunities within specialized respiratory care.

Successfully obtaining your Neonatal/Pediatric Specialist certification qualifies you for numerous exciting and impactful roles, including:

Neonatal Intensive Care Unit (NICU) Respiratory Therapist

Pediatric Intensive Care Unit (PICU) Respiratory Therapist

Neonatal/Pediatric Transport Team Respiratory Therapist

Specialized Neonatal/Pediatric Respiratory Care Practitioner

Pediatric Pulmonary Clinic or Asthma Education Specialist

Newborn Hearing Screener/Coordinator (often in smaller hospitals, sometimes filled by specialized RTs)

Clinical Educator/Preceptor for Neonatal and Pediatric Respiratory Therapy


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