OB Test 4 Study Guide
A newborn has been diagnosed with retinopathy of prematurity. The nurse is teaching the parents about this condition. Which statement would the nurse most likely include in the teaching? A) "You'll need to schedule follow-up eye examinations with the pediatric ophthalmologist." B) "Let's talk about the surgery that will be needed." C) "You'll need to give the eye drops each day for the next few weeks." D) "It's difficult now, but rest assured that your baby will grow out of it."
A
A newborn with severe meconium aspiration syndrome (MAS) is not responding to conventional treatment. Which measure would the nurse anticipate as possibly necessary for this newborn? A) extracorporeal membrane oxygenation (ECMO) B) respiratory support with a ventilator C) insertion of a laryngoscope for deep suctioning D) replacement of an endotracheal tube via X-ray
A
A nurse is developing a plan of care for a newborn with omphalocele. Which measure would the nurse most likely include? A) placing the newborn into a sterile drawstring bowel bag B) using clean technique for dressing changes C) preparing the newborn for incision and drainage D) instituting gavage feedings
A
An LGA newborn has a blood glucose level of 30 mg/dL and is exhibiting symptoms of hypoglycemia. Which action would the nurse do next? A) Administer intravenous glucose immediately. B) Feed the newborn 2 ounces of formula. C) Initiate blow-by oxygen therapy. D) Place the newborn under a radiant warmer.
A
The nurse is providing care to a newborn with severe meconium aspiration syndrome (MAS). The nurse is reviewing the newborn's diagnostic test results. Which finding would the nurse expect? A) patchy fluffy infiltrates on chest X-ray B) vocal cords negative for meconium C) elevated blood pH D) increased PaO2
A
The nurse recognizes that the risk of osteoporosis is higher in an individual with which risk factor? A) White or Asian race B) African-American race C) History of participating in active sports D) Obesity
A
A nurse is assessing a newborn who has been classified as small for gestational age. Which characteristics would the nurse expect to find? Select all that apply. A) wasted extremity appearance B) increased amount of breast tissue C) sunken abdomen D) adequate muscle tone over buttocks E) narrow skull sutures
A,C,E
A nurse is developing a plan of care for a preterm newborn to address the nursing diagnosis of risk for delayed development. Which measures would the nurse include? Select all that apply. A) clustering care to promote rest B) positioning newborn in extension C) using kangaroo care D) loosely covering the newborn with blankets E) providing nonnutritive sucking
A,C,E
The nurse is providing patient education for a patient taking an oral contraceptive. Which drugs may cause interactions with oral contraceptives? Select All A) Cephalexin (Keflex) B) Guaifenesin (Robitussin) C) Warfarin (Coumadin) D) Ibuprofen (Motrin) E) Theophylline (Uniphyl)
A,C,E
A newborn has an Apgar score of 6 at 5 minutes. Which action would be the priority? A) initiating IV fluid therapy B) beginning resuscitative measures C) promoting kangaroo care D) obtaining a blood culture
B
A nurse is assisting in the resuscitation of a newborn. The nurse would expect to stop resuscitation efforts when the newborn has no heartbeat and respiratory effort after which time frame? A) 5 minutes B) 10 minutes C) 15 minutes D) 20 minutes
B
A nurse is providing care to a newborn who is receiving phototherapy. Which action would the nurse most likely include in the plan of care? A) keeping the newborn in the supine position B) covering the newborn's eyes while under the bililights C) ensuring that the newborn is covered or clothed D) reducing the amount of fluid intake to 8 ounces daily
B
A nurse is reviewing the maternal history of an LGA newborn. Which factor, if noted in the maternal history, would the nurse identify as possibly contributing to the birth of this newborn? A) drug abuse B) diabetes C) preeclampsia D) infection
B
The nurse is assessing a preterm newborn who is in the neonatal intensive care unit (NICU) for signs and symptoms of overstimulation. Which sign would the nurse be most likely to assess? A) increased respirations B) flaying hands C) eupnea D) increased heart rate
B
The nurse is preparing to administer the contraceptive form of medroxyprogesterone (Depo-Provera). What route is appropriate? A) Subcutaneous B) Intramuscular C) Vaginal D) Transdermal
B
Which measure would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn? A) Avoid using the terms "death" or "dying." B) Provide opportunities for them to hold the newborn. C) Refrain from initiating conversations with the parents. D) Quickly refocus the parents to a more pleasant topic.
B
The nurse is assessing the newborn of a mother who had gestational diabetes. Which findings would the nurse expect? Select all that apply. A) pale skin color B) buffalo hump C) distended upper abdomen D) excessive subcutaneous fat E) long slender neck
B,C,D
A group of pregnant women are discussing high-risk newborn conditions as part of a prenatal class. When describing the complications that can occur in these newborns to the group, which would the nurse include as being at lowest risk? A) small-for-gestational-age (SGA) newborns B) large-for-gestational-age (LGA) newborns C) appropriate-for-gestational-age (AGA) newborns D) low-birth-weight newborns
C
A newborn is suspected of developing persistent pulmonary hypertension. The nurse would expect to prepare the newborn for which procedure to confirm the suspicion? A) chest X-ray B) blood cultures C) echocardiogram D) stool for occult blood
C
A newborn is suspected of having fetal alcohol syndrome. Which finding would the nurse expect to assess? A) bradypnea B) hydrocephaly C) flattened maxilla D) hypoactivity
C
A nurse is assessing a post-term newborn. Which finding would the nurse correlate with this gestational age variation? A) moist, supple, plum skin appearance B) abundant lanugo and vernix C) thin umbilical cord D) absence of sole creases
C
A nurse is conducting a presentation for a group of pregnant women who are considered high-risk. After describing the complications that can occur in newborns, the nurse determines that the teaching was successful when the group identifies which newborn as having the lowest risk for problems? A) small-for-gestational-age B) large-for-gestational-age C) appropriate-for-gestational-age D) low-birthweight
C
A nurse is preparing a presentation for a group of neonatal nurses on congenital clubfoot. The nurse determines that the presentation was successful when the group makes which statement? A) Clubfoot is a common genetic disorder. B) The condition affects girls more often than boys. C) The exact cause of clubfoot is not known. D) The intrinsic form can be manually reduced.
C
A nurse is providing care to newborn. The nurse suspects that the newborn is developing sepsis based on which assessment finding? A) increased urinary output B) interest in feeding C) temperature instability D) wakefulness
C
A patient is receiving oxytocin to induce labor. During administration of this medication, the nurse will also implement which action? A) Giving magnesium sulfate along with the oxytocin B) Administering the medication in an IV bolus C) Administering the medication with an IV infusion pump D) Monitoring fetal heart rate and maternal vital signs every 6 hours
C
Assessment of newborn reveals a large protruding tongue, slow reflexes, distended abdomen, poor feeding, hoarse cry, goiter, and dry skin. Which condition would the nurse suspect? A) phenylketonuria B) galactosemia C) congenital hypothyroidism D) maple syrup urine disease
C
The nurse frequently assesses the respiratory status of a preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syndrome because of which factor? A) inability to clear fluids B) immature respiratory control center C) deficiency of surfactant D) smaller respiratory passages
C
A nurse is assisting the anxious parents of a preterm newborn to cope with the situation. Which statement by the nurse would be least appropriate? A) "I'll be here to help you all along the way." B) "What has helped you to deal with stressful situations in the past?" C) "Let me tell you about what you will see when you visit your baby." D) "Forget about what's happened in the past, and focus on the now."
D
A nurse is developing the plan of care for an SGA newborn. Which action would the nurse determine as a priority? A) preventing hypoglycemia with early feedings B) observing for respiratory distress syndrome C) promoting bonding between the parents and the newborn D) monitoring vital signs every 2 hours
A
A nurse is providing care to a LGA newborn. The nurse checks the newborn's blood glucose level and finds it to be 23 mg/dL. Which action would the nurse do first? A) Administer intravenous glucose immediately. B) Feed the newborn 2 ounces of formula. C) Initiate blow-by oxygen therapy. D) Place the newborn under a radiant warmer.
A
A patient wants to try an oral soy product to relieve premenopausal symptoms. The nurse will assess the patient's medication history for which potential drug interaction? A) Thyroid replacement therapy B) Oral anticoagulant therapy C) Nonsteroidal anti-inflammatory drugs D) Beta blockers
A
A preterm newborn has received oxygen therapy during his 3-month stay in the NICU. As the newborn is prepared to be discharged home, the nurse anticipates a referral for which specialist? A) ophthalmologist B) nephrologist C) cardiologist D) neurologist
A
After determining that a newborn is in need of resuscitation, the nurse would perform which action first? A) Dry the newborn thoroughly. B) Suction the airway. C) Administer ventilations. D) Give volume expanders.
A
After teaching the parents of a newborn with retinopathy of prematurity (ROP) about the disorder and treatment, which statement by the parents indicates that the teaching was successful? A) "Can we schedule follow-up vision screenings with the pediatric ophthalmologist now?" B) "We can fix the problem with surgery." C) "We'll make sure to administer eye drops each day for the next few weeks." D) "I'm sure the baby will grow out of it."
A
The nurse is teaching a patient about the adverse effects of fertility drugs such as clomiphene (Clomid). Which is a potential adverse effect of this drug? A) Headache B) Drowsiness C) Dysmenorrhea D) Hypertension
A
Which action would be most appropriate for the nurse to take when a newborn has an unexpected anomaly at birth? A) Show the newborn to the parents as soon as possible while explaining the defect. B) Remove the newborn from the birthing area immediately. C) Inform the parents that there is nothing wrong at the moment. D) Tell the parents that the newborn must go to the nursery immediately.
A
While caring for a preterm newborn receiving oxygen therapy, the nurse monitors the oxygen therapy duration closely based on the understanding that the newborn is at risk for which condition? A) retinopathy of prematurity B) metabolic acidosis C) infection D) cold stress
A
While reviewing a newborn's medical record, the nurse notes that the chest X-ray shows a ground glass pattern. The nurse interprets this as indicative of: A) respiratory distress syndrome. B) transient tachypnea of the newborn. C) asphyxia. D) persistent pulmonary hypertension.
A
A nurse is preparing a presentation for a group of perinatal nurses about common problems associated with preterm birth. When describing the preterm newborn's risk for perinatal asphyxia, the nurse includes which factor as contributing to the newborn's risk? Select all that apply. A) surfactant deficiency B) placental deprivation C) immaturity of the respiratory control centers D) decreased amounts of brown fat E) depleted glycogen stores
A, C
A nurse suspects that a preterm newborn is having problems with thermal regulation. Which findings would support the nurse's suspicion? Select all that apply. A) shallow, slow respirations B) cyanotic hands and feet C) irritability D) hypertonicity E) feeble cry
A,B,E
A nurse is explaining to the parents of a child with bladder exstrophy about the care their infant requires. Which measures would the nurse include in the explanation? Select all that apply. A) covering the area with a sterile, clear, nonadherent dressing B) irrigating the surface with sterile saline twice a day C) monitoring drainage through the suprapubic catheter D) administering prescribed antibiotic therapy E) preparing for surgical intervention in about 2 weeks
A,C,D
The nurse is assessing a newborn and suspects that the newborn was exposed to drugs in utero because the newborn is exhibiting signs of neonatal abstinence syndrome. Which findings would the nurse expect to assess? Select all that apply. A) tremors B) diminished sucking C) regurgitation D) shrill, high-pitched cry E) hypothermia F) frequent sneezing
A,C,D,F
A newborn was diagnosed with a congenital heart defect and will undergo surgery at a later time. The nurse is teaching the parents about signs and symptoms that need to be reported. The nurse determines that the parents have understood the instructions when they state that they will report which signs? Select all that apply. A) weight loss B) pale skin C) fever D) absence of edema E) increased respiratory rate
A,C,E
A nurse is conducting a class for expectant parents about newborns. As part of the class the nurse describes newborns with birth-weight variations. The nurse identifies which variation if the newborn weighs 5.2 lb (2,358 g) at any gestational age? A) small for gestational age B) low birth weight C) very low birth weight D) extremely low birth weight
B
A nurse is presenting a review class for a group of neonatal nurses about congenital heart disease. The nurse determines that the teaching was effective when the class identifies which condition as associated with decreased pulmonary blood flow? A) atrial septal defect B) tetralogy of Fallot C) ventricular septal defect D) patent ductus arteriosus
B
A nurse is presenting a review class for a group of neonatal nurses on the different types of congenital heart disease in infants. The group demonstrates a need for additional teaching when they identify which condition as an example of increased pulmonary blood flow (left-to-right shunting)? A) atrial septal defect B) tetralogy of Fallot C) ventricular septal defect D) patent ductus arteriosus
B
A nurse is reviewing the medical record of a newborn who has been diagnosed with bronchopulmonary dysplasia. Which factor would the nurse most likely identify as being associated with this condition? A) birth before 36 weeks B) male gender C) African American race D) atrial septal defect
B
A nurse is teaching the mother of a newborn experiencing cocaine withdrawal about caring for the neonate at home. The mother stopped using cocaine near the end of her pregnancy. The nurse determines that additional teaching is needed when the mother identifies which action as appropriate for her newborn? A) wrapping the newborn snugly in a blanket B) waking the newborn every hour C) checking the newborn's fontanels D) offering a pacifier
B
A woman gives birth to a newborn at 36 weeks' gestation. She tells the nurse, "I'm so glad that my baby isn't premature." Which response by the nurse would be most appropriate? A) "You are lucky to have given birth to a term newborn." B) "We still need to monitor him closely for problems." C) "How do you feel about delivering your baby at 36 weeks?" D) "Your baby is premature and needs monitoring in the NICU."
B
After teaching the parents of a newborn with periventricular hemorrhage about the disorder and treatment, which statement by the parents indicates that the teaching was successful? A) "We'll make sure to cover both of his eyes to protect them." B) "Our newborn could develop a learning disability later on." C) "Once the bleeding ceases, there won't be any more worries." D) "We need to get family members to donate blood for transfusion."
B
During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased: A) Incidence of nausea B) Risk for thrombosis C) Levels of triglycerides D) Tendency to bleed during menstruation
B
The nurse is administering oxytocin. Which situation is an indication for the use of oxytocin? A) Decreased fetal heart rate and movements B) Stimulation of contractions during labor C) Cervical ripening near term in pregnant patients D) To reverse premature onset of labor
B
The nurse is providing care to a newborn who was born at 36 weeks' gestation. Based on the nurse's understanding of gestational age, the nurse identifies this newborn as: A) preterm. B) late preterm. C) term. D) post-term.
B
The nurse is reviewing the medical record of a newborn born 2 hours ago. The nurse notes that the newborn was delivered at 35 weeks' gestation. How would the nurse classify this newborn? A) preterm B) late preterm C) full term D) post-term
B
The nurse is reviewing the use of uterine tocolytics, such as indomethacin. Which statement best describes the indication for these drugs? A) Prevention of preterm labor in the 15th week of pregnancy B) Prevention of preterm labor in the 22nd week of pregnancy C) Stimulation of contractions in prolonged labor D) Stimulation of ovulation as part of infertility treatments
B
The nurse prepares to administer a gavage feeding for a newborn with transient tachypnea based on the understanding that this type of feeding is necessary because: A) lactase enzymatic activity is not adequate. B) oxygen demands need to be reduced. C) renal solute lead must be considered. D) hyperbilirubinemia is likely to develop.
B
The nurse prepares to assess a newborn who is considered to be large for gestational age (LGA). Which characteristic would the nurse correlate with this gestational age variation? A) strong, brisk motor skills B) difficulty in arousing to a quiet alert state C) birthweight of 7 lb 14 oz (3,572 g) D) wasted appearance of extremities
B
When developing the plan of care for a newborn with congenital condition, the nurse would include which measure to promote participation by the parents? A) Use verbal instructions primarily for explanations. B) Assist with decision-making process. C) Provide personal views about their decisions. D) Encourage them to refrain from showing emotions.
B
Which information would the nurse include when teaching a new mother about the difference between pathologic and physiologic jaundice? A) Physiologic jaundice results in kernicterus. B) Pathologic jaundice appears within 24 hours after birth. C) Both are treated with exchange transfusions of maternal O- blood. D) Physiologic jaundice requires transfer to the NICU.
B
A newborn is diagnosed with meconium aspiration syndrome. When assessing this newborn, the nurse would expect which findings? Select all that apply. A) pigeon chest B) prolonged tachypnea C) intercostal retractions D) high blood pH level E) coarse crackles on auscultation
B,C,E
A nurse is developing a plan of care for a preterm infant experiencing respiratory distress. Which measure would the nurse be least likely to include in this plan? A) Stimulate the infant with frequent handling. B) Keep the newborn in an open bassinet. C) Administer oxygen using a oxygen hood. D) Give intermittent tube feedings.
C
A nurse is reviewing a journal article about newborn pain prevention and management. Which information would the nurse most likely find discussed in the article? A) Newborn pain is frequently recognized and treated. B) Newborns rarely experience pain with procedures. C) Pain is frequently mistaken for irritability or agitation. D) Newborns may be less sensitive to pain than adult.
C
A nurse is teaching a group of pregnant women about the adverse effects of substances on the fetus. The nurse determines that additional teaching is needed when the group identifies which substance as being teratogenic? A) alcohol B) nicotine C) marijuana D) cocaine
C
A nurse is teaching the mother of a newborn diagnosed with galactosemia about dietary restrictions. The nurse determines that the mother has understood the teaching when she identifies which of the following as needing to be restricted? A) phenylalanine B) protein C) lactose D) iodine
C
The nurse is assessing a newborn who is large for gestational age. The newborn was born breech. The nurse suspects that the newborn may have experienced trauma to the upper brachial plexus based on which assessment finding? A) absent grasp reflex B) hand weakness C) absent Moro reflex D) facial asymmetry
C
The nurse is assessing a preterm newborn's fluid and hydration status. Which finding would alert the nurse to possible overhydration? A) decreased urine output B) tachypnea C) bulging fontanels D) elevated temperature
C
The nurse is providing teaching for a patient who is to receive estrogen replacement therapy. Which statement is correct to include in the teaching? A) "If you miss a dose, double-up on the next dose" B) "There's no need to be concerned about breast lumps or bumps that occur" C) "Be sure to report any weight gain of 5 pounds or more per week" D) "Take this medication on an empty stomach to enhance absorption"
C
The parents of a preterm newborn being cared for in the neonatal intensive care unit (NICU) are coming to visit for the first time. The newborn is receiving mechanical ventilation and intravenous fluids and medications and is being monitored electronically by various devices. Which action by the nurse would be most appropriate? A) Suggest that the parents stay for just a few minutes to reduce their anxiety. B) Reassure them that their newborn is progressing well. C) Encourage the parents to touch their preterm newborn. D) Discuss the care they will be giving the newborn upon discharge.
C
When considering various types of contraceptive drugs, the nurse is aware that which type most closely duplicates the normal hormonal levels of the female menstrual cycle? A) Monophasic B) Biphasic C) Triphasic D) Short acting
C
A newborn has been diagnosed with a Group B streptococcal infection shortly after birth. The nurse understands that the newborn most likely acquired this infection from which cause? A) improper handwashing B) contaminated formula C) nonsterile catheter insertion D) mother's birth canal
D
A nurse is assessing a preterm newborn. Which finding would alert the nurse to suspect that a preterm newborn is in pain? A) bradycardia B) oxygen saturation level of 94% C) decreased muscle tone D) sudden high-pitched cry
D
A patient is being treated for secondary amenorrhea. The nurse expects which drug to be used to treat this problem? A) Methylergonovine (Methergine) B) Estradiol transdermal (Estraderm) C) Raloxifene (Evista) D) Medroxyprogesterone (Provera)
D
The nurse is teaching a group of parents who have preterm newborns about the differences between a full-term newborn and a preterm newborn. Which characteristic would the nurse describe as associated with a preterm newborn but not a term newborn? A) fewer visible blood vessels through the skin B) more subcutaneous fat in the neck and abdomen C) well-developed flexor muscles in the extremities D) greater surface area in proportion to weight
D
The nurse recognizes the use of estrogen drugs is contraindicated in which patient? A) A patient who has atrophic vaginitis B) A patient who has inoperable prostate cancer C) A woman who has just given birth and wants to prevent postpartum lactation D) A woman with a history of thrombophlebitis
D
When performing newborn resuscitation, which action would the nurse do first? A) Intubate with an appropriate-sized endotracheal tube. B) Give chest compressions at a rate of 80 times per minute. C) Administer epinephrine intravenously. D) Suction the mouth and then the nose.
D