NUR 413 Exam 2 Practice Questions
A family is asking the nurse whether or not their son should be circumcised. The nurse's response should be based on a statement from the American Academy of Pediatrics that indicates that circumcision is an optional procedure. True False
True
True or false Parents are the most important component of Eat, Sleep, Console care for NAS.
True
True or false You need to report if only one of the following are found - Two vessel cord - Webbed, extra, missing digits - Simian Crease - Skin tags - Pilonidal sinus
True
In a neonate diagnosed with HSV, the classic vesicular rash will always develop. True false
False
True or False There is no support for drug afflicted families.
False
True or false If you find one anomaly you should not look for more.
False
True or false Moms who use drugs don't want to be a good mom.
False
True or false NAS is an old issue in newborn care
False
True or false The BP part of routine normal newborn assessment
False
A newborn with hemolytic jaundice has been prescribed phototherapy. To provide safe care, which of the following actions should the nurse perform? a. Cover the baby's eyes with eye pads. b. Leave the lights on when obtaining serum samples for bili levels. c. Keep the newborn clothed in a shirt and diaper. d. Prevent drying of the skin by applying mineral oil.
a
A nurse is providing discharge teaching to the parents of a newborn. Which of the following should be included when teaching parents how to care for the baby's umbilical cord? a. Call the doctor if green drainage appears b. Remove it with tweezers after 1 week c. Cover it with a sterile dressing until it falls off. d. Cleanse with hydrogen peroxide if it starts to smell.
a
The nurse is assessing a group of newborns. Which newborn does the nurse identify as being the most at risk for Ophthalmia neonatorum? a. The newborn whose mother has gonorrhea and delivered vaginally b. The newborn whose mother has rubella and delivered via CS c. The newborn whose mother smokes 3 packs of cigarettes a day d. The newborn whose mother is infected with Chlamydia and delivered via CS
a
The nurse is assessing an infant. Which assessment finding indicates that the baby is preterm? a. Excessive lanugo b. Wrinkled skin c. Dry skin d. Swelling of breast buds
a
The nurse is caring for a newborn with HSV. What precautions are most appropriate for this infant? a. Contact b. Droplet c. Airborne d. No precautions are necessary
a
The nurse is discussing spot spots with two new parents 5 hours postpartum. The nurse educates the patient that tummy time is important in order to prevent a. Plagiocephaly b. Depressed fontanels c. Bulging fontanels d. Molding
a
The nurse is discussing the importance of erythromycin cream application with the parents of a newborn. Which of the following does the nurse include in her rationale? a. Prevents ophthalmia neonatorum b. Prevents hypothermia c. Prevents vitamin K deficiency bleeding d. Prevents omphacele
a
The nurse is discussing thermoregulation with new parents. Which statement by the parents indicates teaching was effective? a. "Skin-to-skin is an appropriate way to warm our baby." b. "We do not need to be concerned about fans facing our baby." c. "An axillary temperature of 36.5 C is okay." d. "If the baby comes into contact with a cold surface, they will loose heat through radiation."
a
The nurse is educating a pregnant client who has been diagnosed with syphilis. For which of the following is the nurse most concerned about in regard to the neonate and syphilis? a. Stillborn or death following delivery b. Neurological consequences c. Respiratory distress d. Musculoskeletal deformities
a
The nurse understands that an infection that is related to prolonged rupture of membranes is called a. ascending infection b. transplacental infection c. congenital infection d. Vertical infection
a
When preparing to give an infant a gavage feed, the nurse correctly takes which of the following steps? (Select all that apply) a. Warms the milk/formula b. Positions the infant on their right side c. Pours the milk into a syringe without a plunger d. Raises the bag 8-10 inches above the newborn
a, b, c
The nurse is assessing the baby that is diagnosed with RDS. What symptoms does the nurse expect? (Select all that apply) a. Tachypnea b. Grunting, c. Flaring of the nostrils d. Retractions e. Hypertonia
a, b, c, d
The nurse understands that which of the following are permanent consequences of rubella in the neonate? (Select all that apply) a. Patent ductus b. Retinopathy c. Microphthalmia d. Microcephaly e. Deafness
a, b, c, d, e
A nurse is discussing the benefits of circumcision with a newborn's parents. Which of the following pieces of information should the nurse include? (Select all that apply) a. Reduced risk for phimosis b. Reduced risk for epispadias c. Reduced risk for paraphosis d. Reduced risk for balanitis e. Reduced risk for hypospadias
a, c, d
Which of the following put an infant at a moderate risk for hyperbilirubinemia? (Select all that apply) a. GA 37-38 wks b. Jaundice in 1st 24 hrs c. Macrocosmic infant of diabetic mother d. Bili in high/intermediate risk zone e. Asian race
a, c, d
Which of the following statements provides an accurate rationale for the increased risk of hypothermia in the neonate? (select all that apply) a. Blood vessels are closer to the surface of the skin b. Newborns have brown fat c. Less adipose tissue and subcutaneous fat d. Newborns have large body surface-to-body weight ratio e. Neonates are not at an increased risk for hypothermia
a, c, d
Which of the following symptoms would indicate infection in the neonate? (Select all that apply) a. Lethargy b. Pink skin c. Hypothermia d. Mottling e. Tachypnea
a, c, d, e
Which of the following are elements of the Finnegan Scoring Tool? (select all that apply) a. Sleeping for 1-3 hours after feeding b. Shivering c. Hypoactive moro reflex d. Fever e. High pitched crying
a, d, e
A condition in which a child, at birth, goes through withdrawal as a consequence of maternal drug use a. Sudden Infant Death Syndrome (SIDs) b. Neonatal abstinence syndrome (NAS) c. Respiratory distress syndrome (RDS) d. Small for gestational age (SGA)
b
A full term newborn was just delivered. Which nursing intervention should be performed first? a. Insert eye prophylaxis b. Remove wet blankets c. Elicit the Moro reflex d. Assess the Apgar score
b
A new mother is expressing concerns to the nurse that she is infected with the rubella virus but does not understand how it passed to her baby. Which rational is most appropriate for the nurse to give to the mother? a. The virus enters the fetus during the birth process b. The virus enters the fetus through the placenta c. The virus enters the fetus through the respiratory tract d. The virus enters the fetus through the breast milk
b
A newborn has bulging fontanels, noticeable scalp veins, increased head circumference, a high-pitched cry, and is very sleepy. After assessing the infant, the nurse decides that the patient likely has a. Hydrocephaly b. Craniostenosis c. Microcephaly d. Macrocephaly
b
A newborn has just delivered. Which of the following physiological changes is of highest priority a. Thermoregulation. b. Spontaneous respirations. c. Extrauterine circulatory shift. d. Successful feeding.
b
A nurse is caring for a neonate who has been diagnosed with HSV. What does the nurse anticipate to administer to the infant? a. IV valanciclovir b. PO Acylovir c. IV Ganciclovir d. PO penicillin
b
A rare birth defect where the urethra does not develop properly and the urine exits the body from an abnormal location a. Ambiguous genitalia b. Epispadias c. Hyposadias d. Imperforate anus
b
If the baby's suture lines are to fuse prematurely, the nurse understands that this means the baby has a. Hydrocephaly b. Craniostenosis c. Microcephaly d. Macrocephaly
b
The neonate has many pinpoint red spots covering the skin after birth. The nurse recognizes that these are called a. Ecchymosis b. Petechiae c. Abrasion d. Caput succedaneum
b
The nurse correctly identifies this as the most common metabolic disorder in the newborn. a. Galactosemia b. Phenylketonuria (PKU) c. SIDs d. Retal hydrops
b
The nurse is assessing a group of clients for their risk for hemolytic disease. Which patient is at the greatest risk? a. The mother who is Rh+ with an Rh+ infant b. The mother who is Rh- with an Rh+ infant c. The mother who is blood type AB+ with a baby who is blood type B- d. The mother who is blood type O+ with a baby who is O-
b
The nurse is assessing a newborn that has patent ductus arteriosus (PDA). When listening to the newborn's heart, what does the nurse expect to hear? a. A low pitched high-grade intermediate murmur heard best at the pulmonic position, with a harsh machinelike quality that often radiates to the left clavicle b. A medium pitched high-grade continuous murmur heard best at the pulmonic position, with a harsh machinelike quality that often radiates to the left clavicle c. A medium pitched low-grade intermediate murmur heard best at the pulmonic position, with a harsh machinelike quality that often radiates to the right clavicle. d. A low pitched high-grade continuous murmur heard best in the pulmonic position, with a harsh machinelike quality that often radiates to the right clavicle
b
The nurse is assessing the neurological status of a newborn. The infant has her eyes open but is not crying to fidgeting. The nurse correctly identifies this behavioral state as a. Active alert b. Quiet alert c. Sleeping d. Crying
b
The nurse is delegating tasks to the CNA. Which task is the most appropriate to delegate to the CNA? a. Providing car seat safety training to the parents before discharge b. Providing the 10 hour old infant with a bath c. Administering a dose of vitamin K to the 3 hour old infant d. Performing a head-to-toe assessment on the 5 hour old infant
b
The nurse is discussing hypoglycemia management in the newborn with a group of students. Which statement by the student requires further education? a. "Glucose gel can be used if the baby is exclusively breastfed." b. "Sugar water will bring the baby's blood sugar up." c. "The blood sugar should be monitored within 30 mins of feeding." d. "A blood sugar of less than 40 in the first 4 hours of life requires intervention."
b
The nurse is providing patient education regarding car seat safety to a group of new parents. Which statement indicates the need for further teaching? a. "I should keep my infant in a rear-facing car seat until she is 2 years old" b. "I should place the rear-facing car seat in the front seat whenever possible" c. "When buckling my baby into his car seat, I should place the chest clip at the nipple line" d. "The safest spot in the car for my baby is the center back seat"
b
The nurse recognizes that which infant is at the LEAST risk for developing hyperbilirubinemia? a. The preterm infant who is breastfeeding. b. The term infant who is formula fed. c. The term infant who is breastfed. d. Infants are not at a risk for hyperbilirubinemia
b
The nurse understands that an infection that is transmitted to fetus through the placenta is called a. ascending infection b. transplacental infection c. congenital infection d. Vertical infection
b
The nurse understands that the appropriate time to perform eat, sleep, console (ESC) is when the infant has a. SIDs b. NAS c. RDS d. SGA
b
The nurse is assessing the pregnant clients ADLs to determine necessary lifestyle modifications. When asking about the client's daily activities, for which does the nurse intervene? a. Vacuuming the house once a day b. Cleaning the litter box daily c. Taking the dog for a walk around the neighborhood daily d. Folding and putting away laundry once a week
b (Increased risk of toxoplasmosis)
The nurse is performing a head-to-toe on a newborn. Which of the following findings is indicative of Erb's palsy? (Select all that apply) a. Limited motion on both sides b. Limited motion on one side c. Absence of Moro reflex on one side d. Absence of Babinski reflex on one side
b, c
Which of the following put an infant at a high risk for hyperbilirubinemia? (Select all that apply) a. Jaundice before discharge b. Rh or ABO incompatibility c. Cephalohematoma d. GA 35-36 wks e. Sibling received phototherapy
b, c, d, e
When performing the Orlanti-barlow maneuver, which of the following is the nurse assessing for to confirm congenital hip dysplasia? Select all that apply a. Equal hop abduction b. Differences in height of knees c. Differences in gluteal folds d. Resistance to adduction e. Resistance to abduction
b, c, e
The nurse is caring for a newborn with a cleft lip. The nurse understands that the primary concern for this infant is a. Developmental delays b. Constipation c. Difficulty feeding d. Aspiration
c
A birth defect in which the urethra doesn't fully develop and reach the tip of the penis a. Ambiguous genitalia b. Epispadias c. Hyposadias d. Imperforate anus
c
A mother confides that she has no crib for her baby at home. The mother asks the nurse which of the following places is the best place for the newborn to sleep. Which of the following places should the nurse suggest? a. In the living room on the pull-out sofa. b. In bed with the mother and father. c. In a large empty dresser drawer placed on the floor in the parents room. d. In bed with the 5-year old sibling.
c
A mother is asking the nurse about a "bulge" on the back of her newborn's head. The nurse notes that the bulge covers the right parietal bone but does not cross suture lines. The nurse explains that this bulge is known as: a. Stork bite b. Molding c. Cephalohematoma d. Capet saccedaneum
c
A newborn was just delivered to a mother that was positive for group B streptococci. The mother was admitted to labor and delivery 2 hours prior to the birth. The nurse should carefully monitor this newborn for which of the following? a. Omphacele b. Harlequin sign c. Hypothermia d. Bulging fontanels
c
The healthcare provider has measured the distance around a newborn baby's head and finds it to be smaller than expected. The nurse correctly identifies this as a. Macrocephaly b. Hydrocephaly c. Microcephaly d. Cephalhematoma
c
The nurse correctly identifies a collection of capillary blood vessels close to the skin as a. Nevus flammeus b. Nevus vasculosis c. Telangiectatic nevus d. Mongolian spot
c
The nurse is assessing a newborn whose spine is not completely formed. The newborn's spinal cord is exposed right above the sacrum. The nurse understands that this is known as a. Hirschprung's disease b. Omphalocele c. Myelomeningocele d. Gastroschisis
c
The nurse is assessing the fontanels of a newborn. Which assessment finding indicates that the baby may be dehydrated? a. Bulging fontanels b. Overriding fontanels c. Depressed fontanels d. Flat and open fontanels
c
The nurse is assessing the newborn that has a protrusion of the abdominal contents through the abdominal wall that are contained within a sac. This abnormality is known as a. Gastroschisis b. Myelomeningocele c. Omphalocele d. Hirschprung's disease
c
The nurse is assessing the newborn's cry. Which of the following indicates that the baby has a lusty cry? a. Lethargic, gasping, and slow b. Absent c. Healthy, energetic, and full of strength d. Weak, quiet, and diminished
c
The nurse is assessing the skin of a newborn. Which assessment finding does the nurse identify as a Mongolian spot? a. An pale purple, elevated spot that appears on the face. b. A red mark on the nape of the neck. c. A large, blue-gray spot on the lower back. d. A non-elevated red spot seen on the face that does not blanch.
c
The nurse is educating a student on assessing the reflexes of a newborn. Which statement made by the student requires further education? a. "When assessing the step reflect, the baby will appear to take a step when help upright on a solid surface." b. "When assessing the Babinski reflex, the newborn should fan out the toes when the sole of the foot is touched." c. "When assessing the moro reflex, the baby should turn the head to one side and extend the arm and led on that side while flexing the limbs on the opposite side." d. "When assessing the grasp reflex, the baby should close their hand into a fist when the palm is touched."
c
The nurse is taking report for the day. Which client should the nurse see first? a. The newborn whose blood pressure is 72/44 b. The newborn who is experiencing periods of apnea. c. The newborn whose temperature is 36.1 C d. The newborn who is exibiting acrocyanosis
c
The nurse understands that an infection that is passed from mother to newborn prior to birth in utero is called a. ascending infection b. transplacental infection c. congenital infection d. Vertical infection
c
The student nurse is preparing to administer a Hepatitis B vaccine to an infant. The student nurse should a. Selects a 22 gauge 3/8 needle b. Select a 25 gauge 3/8 needle c. Select a 25 gauge 5/8 needle d. Select a 22 gauge 5/8 needle
c
When performing a gavage feeding, the nurse identifies which of the following as the correct way to assess that the tube is in place? a. Take an x-ray b. Shine the penlight down the back of the baby's throat and look for the tube c. Aspirate gastric contents and return d. Burp the baby to assess for emesis
c
Which of the following medications does the nurse expect to administer for a patient diagnosed with cytomegalovirus? a. IM valanciclovir b. IM acyclovir c. IV Ganciclovir d. IV penicillin
c
A congenital defect in which the opening to the anus is missing or blocked a. Ambiguous genitalia b. Epispadias c. Hyposadias d. Imperforate anus
d
A male infant is born with a birth defect in which the urethra does not fully develop and reach the tip of the penis. Due to this defect, the urethral opening is located on the bottom of the penis. What is the correct term for this condition? a. Ambiguous genitalia b. Epispadias c. Imperforate anus d. Hypospadias
d
A mother and her newborn are preparing for discharge at 48 hours since delivery. Which of the following would require cancellation of the discharge order for the newborn? a. The parents only have a rear-facing car seat b. The newborn has a large bluish spot on their back since delivery c. The newborn's blood glucose is 65 mg/dL d. The newborn's bilirubin is 19 mg/dL
d
A mother asks the nurse what caused the petechiae to form on her newborn. Which of the following is the best response by the nurse? a. "Don't worry. They will go away on their own." b. "Are you worried something might be wrong with the baby?" c. "I will go get the doctor for you to discuss these concerns." d. "These form due to pressure from the vaginal canal and are a form of birth trauma."
d
A newborn is born with an elongated or cone-shaped skull. The nurse understands that this is called a. Fracture b. Mottling c. Bulging d. Molding
d
A nurse is providing education about patent ductus arteriosus. Which statement made by the patient indicates understanding. a. "This is a hole that is located in the left atrium." b. "This is a passageway between the right atrium and right ventricle that does not have a valve." c. "This is a hole that is located in the right ventricle." d. "This is a passageway between the aorta and the pulmonary artery that remains open after birth"
d
Synaptic connections in certain brain regions are more plastic and malleable. Connections are formed or strengthened given the appropriate experience a. Infant tracking b. Ortolani-barlow c. Neurological development d. Critical nature
d
The RN is collecting blood sugars from newborns. Which blood sugar requires intervention? a. 4 hour infant with a bs of 45 b. 5 hour infant with a bs of 55 c. 6 hour infant with a bs of 60 d. 4 hour infant with a bs of 35
d
The nurse is caring for 5 pregnant women. Which patient does the nurse identify as having a neonate at the greatest risk for NAS? a. The mother who has one glass of wine a day b. The mother who smokes 1 pack pf cigarettes daily c. The mother who takes methadone d. The mother who abuses oxycodone
d
The parents of a newborn have confided in the nurse that they are very concerned about the white, cheesy substance that has remained on the newborn. Which of the following is the most appropriate response by the nurse? a. "This is called erythemia toxicum and it will go away on its own so we do not treat it." b. "I will call the doctor right away." c. "This is called milia and will go away on its own." d. "This is called vernix. It is normal and is normally rubbed into the skin. I can remove it with mineral oil if it concerns you."
d
Which of the following is considered to be a long term consequence of hypoglycemia in the neonate? a. Decreased muscle tone b. Unstable temperature c. Lethargy d. Damage to the CNS
d
Which of the following is the nurse likely to find in a newborn diagnosed with post-maturity? a. Abundant lanugo b. Flat breast tissue c. Prominent clitoris d. Wrinkled skin
d
