Neonatology: tension pneumothorax: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neonatology: tension pneumothorax

Sample item

A preterm baby on CPAP suddenly deteriorates. The right chest is hyperresonant with reduced breath sounds, the apex beat is shifted to the left, and a fibreoptic light glows brightly across the right hemithorax. What is the immediate step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Needle aspiration of the pleural air

A tension pneumothorax in a collapsing baby is diagnosed clinically, and transillumination supports it. Immediate needle aspiration relieves the tension, followed by an intercostal drain, without waiting for a radiograph.

Option by option

  • A. Wait for a chest radiograph

    Waiting for imaging delays decompression in an unstable baby.

  • B. Increase the CPAP pressure

    More pressure would worsen the air leak and the tension.

  • C. Give a further dose of surfactant

    Surfactant does not treat an air leak and could worsen the situation.

  • D. Needle aspiration of the pleural air (correct)

    Correct. Immediate decompression is life-saving, and a drain follows.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Needle aspiration of the pleural air. A tension pneumothorax in a collapsing baby is diagnosed clinically, and transillumination supports it.

Why is "Wait for a chest radiograph" not the answer?

Waiting for imaging delays decompression in an unstable baby.

Why is "Increase the CPAP pressure" not the answer?

More pressure would worsen the air leak and the tension.

Why is "Give a further dose of surfactant" not the answer?

Surfactant does not treat an air leak and could worsen the situation.

What concept does this question test?

It tests Neonatology: tension pneumothorax in Pediatrics. Immediate needle aspiration relieves the tension, followed by an intercostal drain, without waiting for a radiograph.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neonatology: tension pneumothorax?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.