621 CHP 23, 24
A
Bronchopulmonary dysplasia (BPD) is the result of lung injury in the preterm newborn. What can be done to reduce the incidence of BPD in the preterm newborn? A) antepartal administration of steroids to the mother B) mechanical ventilation of the newborn with 100% oxygen content C) steroid injection at birth to all infants at risk for BPD D) exogenous surfactant given to the mother before the baby's birth
B
The nurse assesses an infant. Which finding may indicate heart failure? A) capillary refill time B) diminished peripheral pulses C) color of hands and feet D) blood glucose level
A
Following birth, the newborn's independent circulatory system is established. If there is an abnormal opening between the chambers in the heart, which cardiac defect may occur? A) ventricular septal defect B) coarctation of the aorta C) patent ductus arteriosus D) transposition of the great vessels
A
A pregnant woman gives birth to a small for gestational age neonate who is admitted to the neonatal intensive care unit with seizure activity. The neonate appears to have abnormally small eyes and a thin upper lip. The infant is noted to be microcephalic. Based on these findings, which substance would the nurse suspect the women of using during pregnancy? A) alcohol B) cocaine C) heroin D) methamphetamine
A
An infant that is diagnosed with meconium aspiration displays which symptom? A) intercostal and substernal retractions B) pink skin C) respirations of 45 D) no heart murmur
C
What is a consequence of hypothermia in a newborn? A) respirations of 46 B) heart rate of 126 C) holds breath 25 seconds D) skin pink and warm
A
A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. What should the nurse expect when assessing the condition of the newborn? A) meconium aspiration in utero or at birth B) seizures, respiratory distress, cyanosis, and shrill cry C) yellow appearance of the newborn's skin D) tremors, irritability, and high-pitched cry
A
A client who gave birth 2 hours ago expresses concern about her baby developing jaundice. Which response from the nurse would be best? A) "I understand your concern because as many as 50% of babies can develop jaundice." B) "You don't need to worry about your baby developing jaundice because you are both fine." C) "If you are concerned about your baby developing jaundice, don't breastfeed your baby until you get home." D) "We will monitor the baby now, and your baby will not develop jaundice after the first 24 hours of life."
B
A newborn boy is diagnosed with esophageal atresia and tracheoesophageal fistula. After the nurse provides preoperative teaching, which statement indicates that the parents need additional teaching? A) "He'll need antibiotics for a bit after the surgery to prevent infection." B) "We can probably start feeding him with the bottle about a day after the surgery." C) "The head of his bed will be elevated to prevent him from aspirating." D) "We can give him a pacifier to help satisfy his need to suck."
A
A newborn girl who was born at 38 weeks of gestation weighs 2000 g and is below the 10th percentile in weight. The nurse recognizes that this girl will be placed in which classification? A) term, small for gestational age, and low-birth-weight infant B) term, small for gestational age, and very-low-birth-weight infant C) late preterm and appropriate for gestational age D) late preterm, large for gestational age, and low-birth-weight infant
A
A newborn is found to have hemolytic disease. Which combination would be found related to the blood types of this newborn and the parents of the newborn? A) newborn who is type A, mother who is type O B) newborn who is type A, father who is type O C) newborn who is type O mother who is type O D) newborn who is type O, father who is type A
A
A newborn is found to have hemolytic disease. Which combination would be found related to the blood types of this newborn and the parents of the newborn? A) newborn who is type A, mother who is type O B) newborn who is type A, father who is type O C) newborn who is type O, mother who is type O D) newborn who is type O, father who is type A
D
A newborn is identifies as extremely low birth weight placing the newborn's weight at which level? A) More than 4,000 g. B) Approximately 2,500 g. C) At a maximum of 1,500 g. D) Less than 1,000 g.
A
A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the baby is being born. Which intervention should the nurse implement as a result of this finding? A) intubation and suctioning of the trachea B) administration of oxygen via a bag and mask C) gently shaking the infant D) flicking the sole of the infant's foot
A
A nurse is assessing a newborn for jaundice. The nurse would first notice jaundice at which area? A) face B) trunk C) legs D) arms
B
A nurse is assigned to care for a high-risk newborn with a periventricular-intraventricular hemorrhage (PVH-IVH) in the home environment after discharge. For which condition should the nurse monitor the infant? A) formula intolerance B) hydrocephalus C) spina bifida D) urinary tract infection
B
A nurse is assigned to care for a newborn with hyperbilirubinemia. The newborn is relatively large in size and shows signs of listlessness. What most likely occurred? A) The infant's mother must have had a long labor. B) The infant's mother probably had diabetes. C) The infant may have experienced birth trauma. D) The infant's mother probably used alcohol.
A
A nurse is caring for a neonate of 25 weeks' gestation who is at risk for intraventricular hemorrhage (IVH). Which assessment finding should be reported immediately? A) a sudden drop in hemoglobin B) soft, flat anterior fontanels C) pink skin with noted blue extremities D) intake and output for 8 hours
D
A nurse is caring for a newborn with a repaired cleft lip. What intervention can the nurse provide to facilitate drainage of mucus and secretions to prevent aspiration? A) Place a wedge under the child's crib. B) Place the child on the abdomen. C) Place the child on the back. D) Position the child on the side.
A
A nurse is caring for an infant born with polycythemia. Which intervention is most appropriate when caring for this infant? A) Focus on decreasing blood viscosity by increasing fluid volume. B) Check blood glucose within 2 hours of birth by reagent test strip. C) Repeat screening every 2 to 3 hours or before feeds. D) Focus on monitoring and maintaining blood glucose levels.
B, C, F
A nurse is providing care to a preterm neonate. Which interventions would be most effective in minimizing the newborn's pain? Select all that apply. A) covering the newborn loosely with a blanket B) encouraging kangaroo care during procedures C) removing tape gently from the skin D) increasing the volume on device alarms E) using cool blankets to soothe the newborn F) using a colorful mobile for distraction
A
A nurse is providing preoperative care to a female newborn client with the congenital abnormality myelomeningocele. Which intervention is the priority? A) preventing infection B) promoting newborn nutrition C) preserving newborn GI function D) maximizing newborn motor function
A
A nurse is reading a journal article about birth defects and finds that some birth defects are preventable. Which risk factor would the nurse expect to find as being cited as the current leading preventable cause of birth defects? A) alcohol B) smoking C) recreational drugs D) obesity
D
A nurse is working in the newborn observational unit and is assigned four newborns. In which newborn will the nurse suspect difficulties with thermal regulation? A) term infant with the diagnosis of Rh incompatibility B) two-day-old infant postdates at birth C) one-day-old infant of a diabetic mother D) newly born preterm infant
A
A nursing instructor is teaching about newborn congenital disorders and realizes that the student needs further instruction after making which statement? A) "All congenital disorders can be diagnosed at birth." B) "Hydrocephalus may be recognized at birth." C) "Hydrocephalus may not be diagnosed until after a few weeks or months of life." D) "Congenital defects may be caused by genetic or environmental factors."
C
A nursing student has read that cleft lip is diagnosed at birth based on inspection of physical appearance and that cleft palate is diagnosed in which way? A) X-ray B) blood work C) feeling the palate with a gloved finger or using a tongue blade D) ultrasound
A, B, C
A premature, 38-week-gestation neonate is admitted to the observational nursery and placed under bili-lights with evidence of hyperbilirubinemia. Which assessment findings would the neonate demonstrate? Select all that apply. A) increased serum bilirubin levels B) clay-colored stools C) tea-colored urine D) cyanosis F) Mongolian spots
B
A preterm infant will be hospitalized for an extended time. Assuming the infant's condition is improving, which environment would the nurse feel is most suitable for the child? A) Keep the environment free of color to reduce eye straining. B) Provide a mobile the child can see no matter how the child is turned. C) Place the infant's Isolette near the window so the child can see outside. D) Bring the child's open bassinet near the desk area so the infant sees people.
A, B, C, F
A small-for-gestational age infant is admitted to the observational care unit with the nursing diagnosis of ineffective thermoregulation related to lack of fat stores as evidenced by persistent low temperatures. Which are appropriate nursing interventions? Select all that apply. A) Assess the axillary temperature every hour. B) Review maternal history. C) Assess environment for sources of heat loss. D) Bathe the neonate with warmer water. E) Minimize kangaroo care. F) Encourage skin-to-skin contact.
C
A ventilated 33 weeks' gestation newborn in the neonatal intensive care unit (NICU) receives surfactant therapy. Which would the nurse expect to assess as a positive response to this therapy? A) Glucose is 60 mg/dl (3.3 mmol/L). B) Heart rate is 60 bpm. C) Oxygen saturation levels are at 98%. D) PaCO2 is 35 to 45 mm Hg.
C
It would be best to place an infant with a myelomeningocele in which position prior to surgery? A) semi-Fowler's in an infant chair B) on the left side with the head dependent C) on the stomach (prone) D) supine with the head elevated
D
The nurse is admitting a newborn male for observation with the diagnosis of preterm. What assessment finding corresponds with this gestational age diagnosis? A) abundant sole creases B) minimal vernix caseosa C) breasts clearly delineated D) undescended testes
B
The nurse is assessing a newborn and suspects developmental dysplasia of the hip. Which sign is the nurse prioritizing for in this potential diagnosis? A) Symmetry of the gluteal skin folds B) Limited abduction of the affected hip C) Lengthening of the femur D) Bilateral adduction of the legs
A
The nurse is assessing a small-for-gestational age (SGA) newborn, 12 hours of age, and notes the newborn is lethargic with cyanosis of the extremities, jittery with handling, and a jaundiced, ruddy skin color. The nurse expects which diagnosis as a result of the findings? A) polycythemia B) hyperglycemia C) hypercalcemia D) hyponatremia
A
The nurse is caring for an infant born to a mother who abused cocaine during her pregnancy. The nurse would likely notice that this infant: A) cries when touched. B) sleeps for long periods of time. C) weighed above average when born. D) has facial deformities.
C
The nurse is developing a plan of care for a neonate experiencing symptoms of drug withdrawal. What should be included in this plan? A) Administer glucose between feedings. B) Schedule feedings every 4 to 6 hours. C) Swaddle the infant between feedings. D) Rock horizontally.
C
The nurse is monitoring a new mother changing her newborn's diaper and notices a musty smell to the infant's urine. Which condition should the nurse prioritize in further assessments to rule out? A) Galactosemia B) Congenital hypothyroidism C) Phenylketonuria D) Turner syndrome
A
The nurse notices while holding him upright that a day-old newborn has a significantly indented anterior fontanelle. She immediately brings it to the attention of the primary care provider. What does this finding indicate? A) dehydration B) increased intracranial pressure C) vernix caseosa D) cyanosis
D
The nursing instructor is leading a discussion with a group of nursing students who are analyzing the preterm infant's physiologic immaturity and the associated difficulties the newborn and familty must deal with. The instructor determines the session is successful when the students correctly choose which body system that presents with the most critical concerns related to this immaturity? A) The genitourinary system B) The musculoskeletal system C) The endocrine system D) The respiratory system
B, C, E
What are the causes of retinopathy of the preterm newborn? Select all that apply. A) insufficient oxygenation in an Isolette B) assistive ventilation with high oxygen content C) fragility of blood vessels in the eyes in response to changes on oxygenation. D) alkalosis E) shock
C
When planning preoperative care for a newborn with a cleft lip and palate, the nurse would plan interventions for which major need? A) prevention of pneumonia B) prevention of oral infection C) nutrition D) visual stimulation
D
When providing care to a newborn with necrotizing enterocolitis (NEC), the nurse would need to report which finding immediately? A) decrease in abdominal girth B) stools negative for blood C) bowel sounds in all four quadrants D) abdomen appearing red and shiny
B
Which assessment finding would best validate a problem in a small-for-gestational age newborn secondary to meconium in the amniotic fluid? A) total bilirubin level of 15 B) respiratory rate of 60 to 70 bpm C) heart rate of 162 bpm D) hematocrit of 44%
C
Which intervention should a nurse implement to promote thermal regulation in a preterm newborn? A) Assess the newborn's temperature every 8 hours until stable. B) Set the temperature of the radiant warmer at a fixed level. C) Observe for clinical signs of cold stress such as weak cry. D) Check the blood pressure of the infant every 2 hours.
A, B, D
Which maternal factors should the nurse consider contributory to a newborn being large for gestational age? Select all that apply. A) diabetes mellitus B) postdates gestation C) alcohol use D) prepregnancy obesity E) renal infection
A
Which nursing measure is most effective in reducing newborn infections? A) Maintain medical asepsis while providing care. B) Limit the number of newborns in newborn nurseries. C) Place newborns in an isolette. D) Promote early discharge of all newborns.
