NUR 420 MATERNITY PREPU
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?
"Can we schedule follow-up vision screenings with the pediatric ophthalmologist now?"
An infant born 10 minutes prior was brought into the nursery for an examination. The nurse notices the infant's lip and palate are malformed. The parent comes up to door and asks if the infant seems okay. What is the appropriate response by the nurse?
"Come on over and I will explain your infant's exam and findings."
A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby?" Which response by the nurse would be most appropriate?
"If you keep your intake to less than 200 mg/day, you should be okay."
A woman's baby is HIV positive at birth. She asks the nurse if this means the baby will develop AIDS. Which statement would be the nurse's best answer?
"The antibodies may be those transferred across the placenta; the baby may not develop AIDS."
A newborn with high serum bilirubin is receiving phototherapy. Which is the most appropriate nursing intervention for this client?
Application of eye dressings to the infant
A nurse is caring for an infant with an elevated bilirubin level who is under phototherapy. What evaluation data would best indicate that the newborn's jaundice is improving?
Bilirubin level went from 15 to 11.
The nurse is preparing to administer a tube feeding to a preterm infant. When checking for residual prior to the feeding, there is a residual of 3 mL. What action should the nurse take?
Call the physician.
A term neonate is admitted to the neonatal intensive care unit. At birth, thick green amniotic fluid was noted. Which action is the priority?
Continue assessment and evaluation for respiratory distress.
A preterm newborn has developed necrotizing enterocolitis (NEC). Which of the following gastrointestinal (GI) characteristics would the nurse explain as predisposing a preterm newborn to NEC?
Diminished gastric enzymes
A male newborn is born with hypospadias. The nurse doing the newborn physical assessment notes that the penis is also curved downward. What information would the nurse provide the parents for this infant?
His ability to void and have an erection in adulthood may be impaired and surgery is needed.
The nurse has administered erythromycin ointment to a newborn. What outcome indicates this nursing intervention has been effective?
The newborn does not contract opthalmia neonatorum.
Which respiratory disorder in a neonate is usually mild and runs a self-limited course?
Transient tachypnea
A newborn is admitted to the nursery. Maternal history reveals the use of opioids. When assessing this newborn for symptoms of opioid withdrawal, which of the following the nurse expect the newborn to exhibit first?
Tremors
A 36-week neonate born weighing 1,800 g has microcephaly and microophthalmia. Based on these findings, which risk factor might be expected in the maternal history?
Use of alcohol
What assessment findings would the nurse expect to find in a newborn born to a cocaine-addicted mother?
anencephaly genitals not well-formed high-pitched cry
The nurse suspects a preterm newborn receiving enteral feedings of having necrotizing enterocolitis (NEC). What assessment finding best correlates with this diagnosis?
bloody stools
In the child diagnosed with hydrocephalus, an obstruction occurs that blocks the normal process of:
cerebrospinal fluid.
A nurse in the newborn nursery has noticed that an infant is frothing and appears to have excessive drooling. Further assessment reveals that the baby has episodes of respiratory distress with choking and cyanosis. What disorder should the nurse suspect based on these findings?
esophageal atresia
The nurse observes a newborn experiencing coughing, choking, and unexplained cyanosis during feeding. These are classic signs of what condition?
esophageal atresia
The newborn nursery nurse suspects a newborn of having neonatal abstinence syndrome. What assessment findings would most correlate with the diagnosis?
frequent yawning and sneezing
Which symptom would most accurately indicate that a newborn has experienced meconium aspiration during the birth process?
meconium stained fluids followed by tachypnea
A nurse is conducting a presentation at a community health center about congenital malformations. The nurse describes that some common congenital malformations can occur and are recognized to be caused by multiple genetic and environmental factors. Which example would the nurse most likely cite?
spina bifida
The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion?
thin upper lip
The nurse is assessing a toddler at a well-child visit and notes the following: small in stature, appears mildly developmentally delayed; short eyelid folds; and the nose is flat. Which advice should the nurse prioritize to the mother in response to her questions about having another baby?
"It's a good idea to stop drinking alcohol 3 months before trying to get pregnant."
Which assessment findings are most prominent in the infant with Tetralogy of Fallot and significant pulmonary stenosis?
Dyspnea on limited exertion, fatigue, cyanosis
Which of the following would lead you to suspect that a newborn has developmental hip dysplasia?
Inability of the right hip to abduct
A neonate undergoing phototherapy treatment must be monitored for which adverse effect?
Increased insensible water loss
A nurse is caring for a preterm newborn born at 29 weeks' gestation. Which nursing diagnosis would have the highest priority?
Ineffective thermoregulation related to decreased amount of subcutaneous fat
A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby?
Instill a prophylactic agent in the eyes of the newborn.
A nurse is providing postoperative care to an infant who had a ventriculoatrial shunt placed. Approximately 8 hours after surgery, the nurse notes on assessment shrill crying and projective vomiting. Which response should the nurse prioritize at this time?
Notify the primary care provider immediately.
A nurse is caring for a newborn client who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury?
Place the newborn in a prone or lateral position.
Cytomegalovirus infection can result in different congenital anomalies. It can also be transmitted via different routes. When discussing this infection with a pregnant woman, the nurse integrates understanding that permanent fetal disability can occur with which type of transmission of CMV?
in utero transmission
A nurse is providing preoperative care to a female newborn client with the congenital abnormality myelomeningocele. Which intervention is the priority?
preventing infection
A nurse is conducting a review class for a group of perinatal nurses working at the local clinic. The clinic sees a high population of women who are HIV positive. After discussing the recommendations for antiretroviral therapy with the group, the nurse determines that the teaching was successful when the group identifies which rationale as the underlying principle for the therapy?
reduction in viral loads in the blood
Which assessment finding would best validate a problem in a small-for-gestational age newborn secondary to meconium in the amniotic fluid?
respiratory rate of 60 to 70 bpm
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)?
tetralogy of Fallot
When caring for a newborn, the nurse observes that the neonate has developed white patches on the mucus membranes of the mouth. Which condition is the newborn most likely experiencing?
thrush
The nurse should carefully monitor which neonate for hyperbilirubinemia?
Neonate with ABO incompatibility
The client brings her infant daughter to the pediatrician's office for her first visit since hospital discharge. At birth, the newborn was at the 8th percentile with a weight of 2,350 g. She was born at 36 weeks' gestation. Which documentation is most accurate?
The infant was a preterm, low birth weight and small for gestational age neonate.
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?
The infant's mother probably had diabetes.
A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world?
cytomegalovirus
A pregnant single mom living alone tells the nurse she is considering getting a cat for her 2-year-old daughter. Which is the best response by the nurse?
"You should wait until after you give birth to obtain the cat for your daughter."
The parents of an 8-month-old tell the nurse that they have a fear that the infant will develop sudden infant death syndrome (SIDS). What is the best response by the nurse?
"Infants who die from SIDS are usually 2 to 4 months old, but I understand your concern."
The pregnant woman with diabetes asks the nurse why her last baby weighed 11 pounds. What is the best response by the nurse?
"The fetus increases insulin production in response to elevated glucose levels of the mother, which acts as a fetal growth hormone."
A gravida woman in her second trimester has shared that she still enjoys a glass of wine about once a week with dinner. What response by the nurse is most appropriate?
"There is no amount of alcohol consumption in pregnancy that is considered safe for the fetus."
The nurse is caring for a newborn client newly diagnosed with developmental dysplasia of the hip (DDH). Which response by the nurse educates the parents on the correct plan of treatment for this diagnosis?
"Treatment will begin immediately."
The nurse is reviewing the medical record of a woman who has delivered a newborn diagnosed with hypoxic ischemic encephalopathy for possible risk factors associated with this condition. Which of the following would the nurse expect to find? Select all that apply.
Abruptio placenta Pregnancy-induced hypertension Trauma due to cephalopelvic disproportion
A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response?
It is recommended to formula-feed your newborn as it is transmitted through your breast milk."
A newborn is suspected to have fetal alcohol syndrome as a result of maternal use of alcohol during pregnancy. Which of the following would the nurse expect to assess.
Low nasal bridge
A nurse is caring for a newborn with a flat, thin upper lip, small eyes, short palpebral fissures, and a flattened midface with a short nose. Which of the following should the nurse consider as a possible cause for these features?
Maternal alcohol abuse
Newborns receive an antibiotic in their eyes within the first hour after birth to prevent neonatorum ophthalmia. Which type of bacteria is most likely to cause this condition?
Neisseria gonorrhoeae
Assessment of a pregnant client reveals that she has tested positive for a sexually transmitted infection (STI). The nurse understands that the client's newborn is at risk for which of the following?
Neurologic damage
A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the neonate is being born. Which intervention should the nurse implement as a result of this finding?
Provide supplemental oxygen and monitor respiratory status
The nursery nurse notes that one of the newborn infants has white patches on his tongue that look like milk curds. What action would be appropriate for the nurse to take?
Report the finding to the pediatrician.
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?
The exact cause of clubfoot is not known.
The nurse is teaching new parents about their newborn who was born with respiratory distress syndrome (RDS). The nurse determines the teaching session is successful when the parents correctly choose which explanation as being the cause of their newborn's condition?
The lungs are immature and deficient in surfactant.
Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?
cocaine
A nurse is conducting a presentation for a group of pregnant women about measures to prevent toxoplasmosis. The nurse determines that additional teaching is needed when the group identifies which measure as preventive?
cooking all meat to an internal temperature of 125° F (52° C)
The nurse is providing care to a neonate whose mother has heroin use disorder. The nurse suspects that the neonate is experiencing neonatal abstinence syndrome based on which finding?
sneezing
A nursing student is caring for a newborn with a defect in the neural arch where the posterior laminae of the vertebrae have failed to close. The nurse knows that this infant is suffering from which disorder?
spina bifida
A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection?
toxoplasmosis
