Questions for OB unit 2

A nurse is preparing a care plan for a 5-day-old newborn under phototherapy. Which of the following client care outcomes should be included in the nursing care plan? "During the next 24 hour period, the baby will: 1. Have at least 6 wet diapers." 2. Breastfeed 2 to 4 times." 3. Lose less than 12% of the baby's birth weight." 4. Have an apical heart rate of 160 to 170 bpm."

1. Have at least 6 wet diapers."

The nurse assesses a newborn as follows: Heart rate: 70 Respirations: weak and irregular Tone: flaccid Color: pale Baby grimaces when a pediatrician attempts to insert an endotracheal tube What should the nurse calculate the baby's Apgar score too be?

3

A baby with hemolytic jaundice is being treated with fluorescent phototherapy. To provide safe newborn care, which of the following actions should the nurse perform? 1. Cover the baby's eyes with eye pads. 2. Turn the lights off for 10 minutes every hour. 3. Clothe the baby in a shirt and diaper only. 4. Tightly swaddle the baby in a baby blanket.

1. Cover the baby's eyes with eye pads.

A neonate has asymmetrical intrauterine growth restriction (IUGR) secondary to placental insufficiency. Which of the following methods would the nurse expect the mother to use when first making physical contact with her baby? 1. Fingertip touch. 2. Palmar touch. 3. Kangaroo hold. 4. Cradle hold.

1. Fingertip touch.

Which of the following signs and symptoms would the nurse 6. A full-term, 36-hour-old neonate's bilirubin level is 13 mg/dL (222.3 pmol/L). expect to see? Select all that apply. 1. Lethargy. 2. Jaundice. 3. Polyphagia. 4. Diarrhea. 5. Excessive yawning.

1,2

neonate who is admitted to the neonatal The nurse notifies the neonatologist to request an order for which of the following nursery is noted to have a 2-vessel cord. assessments? Select all that apply. 1. Renal function tests. 2. Echocardiogram. 3. Glucose tolerance test. 4. Electroencephalogram.

1,2

A macrosomic baby in the nursery is suspected of having a fractured clavicle from a traumatic delivery. Which of the following signs/symptoms would the nurse expect to see? Select all that apply. 1. Pain with movement. 2. Hard lump at the fracture 3. Malpositioning of the arm. 4. Asymmetrical Moro reflex. 5. Marked localized ecchymosis. well-baby nursery

1,2,3,4

A neonate is being assessed for necrotizing enterocolitis (NEC). Which of the following actions by the nurse is appropriate? Select all that apply. 1. Perform hemoccult test on stools. 2. Monitor for an increase in abdominal girth. 3. Measure gastric contents before each feed. 4. Assess bowel sounds before each feed. 5. Assess for anal fissures daily.

1,2,3,4

A baby at 30 weeks' gestation is admitted mother had been treated with a tocolytic intravenous magnesium sulfate for the to the neonatal intensive care unit. The preceding 10 days. For which of the following laboratory findings should the nurse assess the neonate? 1. Hypocalcemia. 2. Hyperkalemia. 3. Hypochloremia. 4. Hypernatremia.

1. Hypocalcemia

A baby was just born to a mother who had positive vaginal cultures for group B streptococci (GBS). The mother was admitted to the labor room two hours before the birth. For which of the following should the nursery nurse closely observe this baby? 1. Hypothermia. 2. Mottling. 3. Omphalocele. 4. Stomatitis.

1. Hypothermia.

the neonatologist to see Four babies are in the newborn nursery. The nurse pages the baby who exhibits which of the following? 1. Intercostal retractions. 2. Erythema toxicum. 3. Pseudostrabismus. 4. Vernix caseosa.

1. Intercostal retractions.

A nurse is inserting a gavage tube into a preterm baby who is unable to suck and swallow. Which of the following actions must the nurse take during the procedure? 1. Measure the distance from the tip of the ear to the nose and the xiphoid process. 2. Lubricate the tube with an oil-based solution. 3. Insert the tube quickly if the baby becomes cyanotic. 4. Inject a small amount of sterile water to check placement.

1. Measure the distance from the tip of the ear to the nose and the xiphoid process.

A baby is born to a mother with type 1 diabetes mellitus (TIDM) and poor blood sugar control. If a blood sample was drawn, which of the following laboratory values would the nurse expect the neonate to exhibit during the immediate postpartum period? 1. Plasma glucose 30 mg/dL (1.7 mmol/L). 2. Red blood cell count 1 million/mm'. 3. White blood cell count 2,000/mm'. 4. Hemoglobin 8 g/dL.

1. Plasma glucose 30 mg/dL (1.7 mmol/L).

Based on maternal history of alcohol abuse, a baby in the neonatal nursery is being monitored for signs of fetal alcohol syndrome (FAS). The nurse should assess this baby for which of the following? 1. Poor suck reflex. 2. Ambiguous genitalia. 3. Webbed neck. 4. Absent Moro reflex.

1. Poor suck reflex.

During neonatal cardiopulmonary resuscitation, which of the following actions should be performed? 1. Provide assisted ventilation at about 30 breaths per minute. 2. Begin chest compressions when heart rate is 0 to 20 beats per minute. 3. Compress the chest using the three-finger technique. 4. Administer compressions and breaths in a 5:1 ratio.

1. Provide assisted ventilation at about 30 breaths per minute.

A baby who is receiving phototherapy for hyperbilirubinemia must have a venipuncture to obtain a blood specimen. Which of the following nursing care actions should the nurse perform at this time? 1. Provide the baby with a sucrose-covered pacifier to suck on. 2. Advise the baby's mother to leave the room while the procedure is being performed. 3. Administer oxygen to the baby via face mask throughout the procedure. 4. Remove the eye patches while the procedure is being performed.

1. Provide the baby with a sucrose-covered pacifier to suck on

Four full-term babies were admitted to the neonatal nursery. The mothers of each of the babies had labors of 4 hours or less. The nursery nurse should carefully monitor which of the babies for tachypnea? 1. The baby whose mother cultured positive for group B streptococci during her edar third trimester. 2. The baby whose mother has cerebral palsy. mother was hospitalized for 3 months with complete placenta 3. The baby whose previa. 4. The baby whose mother previously had a stillbirth.

1. The baby whose mother cultured positive for group B streptococci during her edar third trimester.

Four clients at 38 weeks' gestation have just delivered. Which of the babies should be monitored closely for respiratory distress? 1. The baby whose mother has diabetes mellitus. 2. The baby whose mother has lung cancer. 3. The baby whose mother has mitral valve prolapse. 4. The baby whose mother has asthma.

1. The baby whose mother has diabetes mellitus. The lung maturation of infants of diabetic mothers is often delayed. These babies must be monitored at birth for respiratory distress.

A baby's blood type is B negative. The baby is at risk for hemolytic jaundice if the mother which of the following blood types? 1. Type O negative. 2. Type A negative. 3. Type B positive. 4. Type AB positive.

1. Type O negative.

A baby was born 24 hours ago to a mother who received no prenatal care. The infant has tremors, sneezes excessively, constantly route on its hands suck, and has a shrill, high pitch crack. The baby's serum glucose levels are normal. For which of the following should the nurse request an order from the Pediatrician? 1. Urine drug toxicology test 2. Biophysical profile test. 3. Chest and abdominal ultrasound evaluations. 4. Oxygen saturation and blood gas assessments

1. Urine drug toxicology test

A client who received an intravenous analgesic 4 hours ago has had recurrent latedecelerations in labor. She will deliver her baby shortly. Which of the following is the priority action for the delivery room nurse to take? 1. Preheat the overhead warmer. 2. Page the neonatologist on call. 3. Draw up Narcan (naloxone) for injection. 4. Assemble the oral ophthalmic antibiotic. intensive

2. Page the neonatologist on call.

An 18-hour-old baby with an elevated bilirubin level is placed under the bili lights. Which of the following is an expected nursing action in these circumstances? 1. Give the baby oral rehydration therapy in place of all feedings. 2. Rotate the baby from side to back to side to front every 2 hours. 3. Apply restraints to keep the baby under the light source. 4. Administer intravenous fluids via pump per doctor orders.

2. Rotate the baby from side to back to side to front every 2 hours.

A baby has just been born to a mother with type 1 diabetes mellitus (T1DM) who has retinopathy and nephropathy. Which of the following neonatal findings would the nurse expect to see? 1. Hyperalbuminemia. 2. Polycythemia. 3. Hypercalcemia. 4. Hypoinsulinemia.

2. Polycythemia The mother's diagnoses retinopathy and nephropathy indicate a very serious diabetic condition. As such, the placenta is likely to be functioning less than optimally. It is highly likely that the baby will be polycythemic, having increased its red blood cells to improve the oxygen carrying capacity of the blood in utero.

The birth of a baby who weighed following neonatal complications should the 9 lbs 9 oz (4,500 grams), was complicated by shoulder dystocia. Which of the nursery nurse observe for? 1. Leg deformities. 2. Brachial palsy. 3. Fractured radius. 4. Buccal abrasions.

2. Brachial palsy.

A newborn nursery nurse notes that a 36-hour-old baby's body is slightly jaundiced. Which of the following nursing interventions will be most therapeutic? 1. Maintain a warm ambient environment. 2. Have the mother feed the baby frequently. 3. Have the mother hold the baby skin to skin. 4. Place the baby naked by a closed sunlit window.

2. Have the mother feed the baby frequently.

Thirty seconds after the birth, a baby who appears preterm has exhibited no effort to breathe. The heart rate is assessed at 70 bpm. Which of the following actions should the nurse perform first? 1. Perform a gestational age assessment. 2. Inflate the lungs with positive pressure. 3. Provide external chest compressions. 4. Assess the oxygen saturation level.

2. Inflate the lungs with positive pressure. compressions.

An infant admitted to the newborn nursery has a blood glucose level of 35 mg/dL (1.9 mmol/L). The nurse should monitor this baby carefully for which of the following? 1. Jaundice. 2. Jitters. 3. Erythema toxicum. 4. Subconjunctival hemorrhages.

2. Jitters

3. A baby is born to a mother with a history of depression. The mother was prescribed fluoxetine to control her symptoms. For which of the following signs and symptoms should the nurse monitor the neonate in the neonatal nursery? 1. Elevated blood pressures in the upper extremities. 2. Marked systemic cyanosis. 3. Pronounced mucus production immediately after birth. 4. Flaccid tone of all musculature. rec

2. Marked systemic cyanosis.

A 30-week-gestation neonate, 2 hours old, has received exogenous surfactant. Which of the following would indicate a positive response to the medication? 1. Axillary temperature 98° F (36.7° C). 2. Oxygen saturation 96%. 3. Apical heart rate 154 bpm. 4. Serum potassium 4 mEq/

2. Oxygen saturation 96%.

A 1-day-old neonate at 32 weeks' nurse assesses the morning axillary temperature as 96.9° F (36.1° C). Which of the gestation is being cared for in an isolette. The following could explain this finding? 1. This is a normal temperature for a preterm neonate. 2. Axillary temperatures are not valid for preterm babies. 3. The supply of brown adipose tissue is incomplete. 4. Conduction heat loss is pronounced in the baby.

3. The supply of brown adipose tissue is incomplete.

A neonate with jaundice must have a heel stick to assess bilirubin levels. Which of the following actions should the nurse make during the procedure? 1. Cover the foot an iced wrap for 1 minute prior to the procedure. 2. Avoid puncturing the lateral heel to prevent damaging sensitive structures 3. Allow the site to dry after rubbing it with an alcohol swab. 4. Firmly grasp the calf of the baby during the procedure to prevent injury.

3. Allow the site to dry after rubbing it with an alcohol swab.

A mother of a preterm baby is performing kangaroo care in the neonatal nursery. Which of the following responses would the nurse evaluate as a positive neonatal outcome? 1. Respiratory rate of 70. 2. Temperature of 97° F (36.1° C). 3. Licking of mother's nipples. 4. Flaring of the baby's nares.

3. Licking of mother's nipples.

A woman who has recently received fentanyl, 50 mcg IV, for labor pain is about to deliver. Which the follow medications is highest priority for the nurse to prepare in case it must be administered to the baby to following the delivery? 1. Oxytocin. 2. Xylocaine. 3. Naloxone. 4. Butorphanol.

3. Naloxone

Which of the following neonates is at highest risk for cold stress syndrome? 1. Infant of diabetic mother. 2. Infant with Rh incompatibility. 3. Neonate that is postdates. 4. Infant with Down's syndrome.

3. Neonate that is postdates.

A neonate whose mother is HIV positive is admitted to the NICU. The nurse is planning care for the neonate. Which of the following interventions should the nurse include as a result of the baby's perinatal exposure to HIV/AIDS? 1. Monitor daily viral load laboratory reports. 2. Check the baby's viral antibody status. 3. Obtain an order for antiviral medication. 4. Place the baby on contact precautions.

3. Obtain an order for antiviral medication.

A baby has been admitted to the neonatal nursery whose mother is hepatitis B surface antigen positive. Which following actions by the nurse should be taken at this time? 1. Monitor the baby for signs of hepatitis B. 2. Place the baby on contact isolation. 3. Obtain an order for the hepatitis B vaccine and the immune globulin. 4. Advise the mother that breastfeeding is absolutely contraindicated.

3. Obtain an order for the hepatitis B vaccine and the immune globulin

Which of the following would lead the nurse to suspect cold stress in a newborn with a temperature of 96.5° F (35.8° C)? 1. Blood glucose of 50 mg/dL (2.8 mmol/L). 2. Acrocyanosis. 3. Tachypnea. 4. Oxygen saturation of 96%.

3. Tachypnea

A nurse is caring for a baby born by vacuum extraction. The nurse should assess this baby for which of the following? 1. Pedal abrasions. 2. Hypobilirubinemia. 3. Hyperglycemia. 4. Cephalohematoma.

4. Cephalohematoma.

A neonate is under phototherapy for elevated bilirubin levels. The baby's stools are now loose and green. Which of the following actions should the nurse take at this time? 1. Discontinue the phototherapy. 2. Notify the healthcare practitioner 3. Take the baby's temperature. 4. Assess the baby's skin integrity.

4. Assess the baby's skin integrity.

A baby is grunting in the neonatal nursery. Which of the following actions by the nurse is appropriate? 1. Place pacifier in the baby's mouth. 2. Check the baby's diaper. 3. Have the mother feed the baby. 4. Assess the respiratory rate.

4. Assess the respiratory rate.

A newborn admitted to the nursery has a positive direct Coombs test. Which of the following is an appropriate action by the nurse? 1. Monitor the baby for jitters. 2. Assess the blood glucose level. 3. Assess the rectal temperature. 4. Monitor the baby for jaundice.

4. Monitor the baby for jaundice.

A baby at 42 weeks' gestation has been admitted to the neonatal intensive care unit. At delivery, thick green amniotic fluid was noted. Which of the following neonatal care actions by the nurse is critical at this time? 1. Bath to remove meconium-contaminated fluid from the skin. 2. Ophthalmic assessment to check for conjunctival irritation. 3. Rectal temperature to assess for septic hyperthermia. 4. Respiratory evaluation to monitor for respiratory distress.

4. Respiratory evaluation to monitor for respiratory distress.

The staff on the maternity unit is developing a protocol for nurses to follow after a baby is delivered and fails breathe spontaneously. Which of the following should be included in the protocol as the first action for the nurse to take? 1. Prepare epinephrine for administration. 2. Provide positive pressure oxygen. 3. Administer chest compressions. 4. Rub the back and feet of the baby.

4. Rub the back and feet of the baby.

A baby has been admitted to the neonatal intensive care unit with a diagnosis of postmaturity. The nurse expects to find which of the following during the initial newborn assessment? 1. Abundant lanugo. 2. Flat breast tissue. 3. Prominent clitoris. 4. Wrinkled skin.

4. Wrinkled skin.

On admission to the nursery, a baby's head and chest circumferences are 39 cm and 32 cm, respectively. Which of the following actions should the nurse take next? 1. Assess the anterior fontanel. 2. Measure the abdominal girth. 3. Check the apical pulse rate. 4. Monitor the respiratory effort.

1. Assess the anterior fontanel. Because the head circumference is significantly larger than the chest circumference, the nurse should assess for another sign of hydrocephalus. A markedly a large bulging fontanel is one of those signs

An infant in the neonatal intensive unit has had a peripherally inserted central catheter (PICC) inserted. The nurse caring for the baby carefully monitors the neonate for which of the following complications related to the procedure? Select all that apply. 1. Infection. 2. Tip migration. 3. Myocardial perforation. 4. Paralysis of the diaphragm. 5. Neurological complications related to scalp vein insertions.

1,2,3,4

A client is delivering her baby at 42 weeks' gestation. A nurse and pediatrician are present at the birth. The amniotic fluid is green and thick. The baby fails to breathe spontaneously. Which of the following actions should the nurse take next? Select all that apply. 1. Stimulate the baby to breathe. 2. Assess neonatal heart rate. 3. Prepare to assist with intubation. 4. Place the baby in the prone position. 5. Place the baby under the overhead warmer.

1,2,3,5

A neonate at 37 weeks' gestation who had Apgars of 1 and 3, is admitted to the neonatal intensive care nursery. The neonatologist orders induced hypothermia to prevent which of the following complications of hypoxic-ischemic encephalopathy (HIE)? Select all that apply. 1. Cerebral palsy. 2. Blindness. 3. Deafness. 4. Bipolar disease. 5. Reduced intellectual disability.

1,2,3,5

A baby born dependent on cocaine is being given oral morphine therapeutically. The nurse knows that which of the following are the main reasons for its use in newborns? Select all that apply. 1. Oral morphine contains no alcohol. 2. Oral morphine is nonsedating. 3. Oral morphine improves respiratory effort. 4. Oral morphine helps to control seizures.

1,4

A neonate is being given intravenous fluids through the dorsal vein of the wrist. Which of the following actions by the nurse is essential? 1. Tape the arm to an arm board. 2. Change the tubing every 24 hours. 3. Monitor the site every 5 minutes. 4. Infuse the fluid intermittently.

1. Tape the arm to an arm board.

A nurse in the newborn nursery suspects gestation, was exposed to meconium in utero. What would lead the nurse to suspect that a new admission, a baby at 42 weeks' this? 1. The baby is bradycardic 2. The baby's umbilical cord is stained green. 3. The baby's anterior fontanel is sunken. 4. The baby is desquamating.

2. The baby's umbilical cord is stained green.