North American Registry of Midwives (NARM) Practice Exam

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Who is at high risk for pneumothorax in newborns?

  1. Newborns with a family history of respiratory illness

  2. Newborns who are mechanically ventilated

  3. Newborns with low birth weight

  4. Newborns delivered via cesarean section

The correct answer is: Newborns who are mechanically ventilated

Newborns who are mechanically ventilated are at a higher risk for pneumothorax due to several factors related to the use of mechanical ventilation. When a newborn requires mechanical ventilation, it often indicates underlying respiratory distress or compromise, which may lead to ventilator-induced lung injury. The pressure adjustments and positive pressure from the ventilator can create greater stress on the delicate lung tissues, increasing the risk of air leaks into the pleural space. Additionally, mechanical ventilation can result in barotrauma, which occurs when excess pressure is transmitted to the alveoli, causing them to rupture and allowing air to escape into the pleural cavity. This condition can culminate in a pneumothorax, characterized by the presence of air in the pleural space, leading to respiratory distress and potential life-threatening consequences if not promptly addressed. While the other conditions listed may have varying degrees of association with respiratory issues or complications, they do not present the same direct and elevated risk for pneumothorax as mechanical ventilation does. Family history, low birth weight, and cesarean delivery can contribute to other complications but are not primary contributors to the risk of developing pneumothorax in the same way that mechanical ventilation is. Understanding the dynamics of mechanical ventilation in the context