OB PrepU Chapter 24

Which assessment finding within the first 24 hours of birth requires immediate health care provider notification? a. Milia is noted on the nose. b. The skin is jaundiced. c. The neonate ate 1 to 2 oz of formula. d. The neonate slept for 18 hours.

b. The skin is jaundiced.

An infant with an umbilical hernia is being discharged. The nurse teaches the parents to notify the provider if which sign occurs? a. fever b. vomiting c. constipation d. diarrhea

b. vomiting

a. chest X-rays b. angiography c. echocardiogram d. arterial blood gases

d. arterial blood gases

The nurse is caring for a newborn who is large-for-gestational-age (LGA). Which characteristics are documented as a contributing factor? Select all that apply. a. Both parents are of a larger stature and size. b. The mother has had previous large-for-gestational-age neonates. c. The mother has poorly controlled diabetes. d. The father is obese but mother is of normal weight. e. The neonate is a female.

a. Both parents are of a larger stature and size. b. The mother has had previous large-for-gestational-age neonates. c. The mother has poorly controlled diabetes.

The nurse is assessing the plantar creases on the newborns for documentation on the Ballard Scale. Which documentation is interpreted as evidence of a full-term infant? a. Creases covering two-thirds of the anterior foot b. Creases extending across the brow c. No deep creases on the newborn's body d. Middle crease across the palm of the hand

a. Creases covering two-thirds of the anterior foot

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. Promote early discharge of all newborns. d. Place newborns in an isolette.

a. Maintain medical asepsis while providing care.

The nurse should carefully monitor which neonate for hyperbilirubinemia? a. Neonate with ABO incompatibility b. Black neonate c. Neonate of an Rh-positive mother d. Neonate with Apgar scores 9 and 10 at 1 and 5 minutes

a. Neonate with ABO incompatibility

Which intervention is helpful for the neonate experiencing drug withdrawal? a. Place the Isolette in a quiet area of the nursery. b. Withhold all medication to help the liver metabolize drugs. c. Place the Isolette near the nurses' station for frequent contact with health care workers. d. Dress the neonate in loose clothing so he won't feel restricted.

a. Place the Isolette in a quiet area of the nursery.

The nurse assesses preterm infants as they come for routine well-baby checkups. The nurse will carefully assess the infant's vision to assess for which potential complication related to their birth? a. Retinopathy b. Amblyopia c. Nystagmus d. Cataracts

a. Retinopathy

The nurse is working in the special care nursery caring for a newborn withdrawing from alcohol. Which nursing intervention promotes client comfort? a. Swaddle and decrease stimulation b. Promote parental bonding c. Provide 1 ounce of formula d. Administer benzodiazepines

a. Swaddle and decrease stimulation

In the infant diagnosed with spina bifida with myelomeningocele, the infant will likely have: a. a partial to complete paralysis in the lower extremities. b. an extremely large and rapidly growing head. c. a membrane between the rectum and the anus. d. a protruding sac that contains abdominal contents.

a. a partial to complete paralysis in the lower extremities.

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. preserving newborn GI function c. promoting newborn nutrition d. maximizing newborn motor function

a. preventing infection

What finding would cause the nurse to suspect a diaphragmatic hernia in an infant at birth? Select all that apply. a. scaphoid abdomen b. cyanosis c. intercostal or subcostal retractions d. unilateral absence of breath sounds e. anteriorly displaced sternum

a. scaphoid abdomen b. cyanosis c. intercostal or subcostal retractions d. unilateral absence of breath sounds

Which newborn would the nurse suspect to be most at risk for intellectual disability due to the mother's actions during pregnancy? a. the child of a client who admits to drinking a liter of alcohol daily during the pregnancy b. the newborn of a client addicted to heroin and in the methadone maintenance program c. the newborn of a client who used cocaine occasionally during her pregnancy d. the child of a teenage client who used marijuana through her pregnancy to cope with stress

a. the child of a client who admits to drinking a liter of alcohol daily during the pregnancy

A nurse is explaining to the parents the preoperative care for their infant born with bladder exstrophy. The parents ask, "What will happen to the bladder while waiting for the surgery?" What is the nurse's best response? a. "Your baby will be cared for in the prone position with a cover over the bladder." b. "The bladder will covered in a sterile plastic bag to keep it moist." c. "We will care for the bladder with frequent sterile tub baths to keep it moist." d. "Disturbances to the bladder with diaper changes will be kept to a minimum."

b. "The bladder will covered in a sterile plastic bag to keep it moist."

The nurse is assessing a newborn and suspects developmental dysplasia of the hip (DDH). For which sign is the nurse prioritizing in this potential diagnosis? a. Bilateral adduction of the legs b. Limited abduction of the affected hip c. Lengthening of the femur d. Symmetry of the gluteal skin folds

b. Limited abduction of the affected hip

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. Turner syndrome b. Phenylketonuria c. Congenital hypothyroidism d. Galactosemia

b. Phenylketonuria

Which environmental consideration is most helpful to promoting comfort when the neonate is withdrawing from alcohol and drugs? a. Incorporate a massage b. Provide a dark, quiet environment c. Offer tactile stimulation d. Play soothing music

b. Provide a dark, quiet environment

When examining a newborn for developmental dysplasia of the hip (DDH), which motion would the newborn's hip be unable to accomplish? a. extension b. abduction c. adduction d. rotation

b. abduction

A newborn with high serum bilirubin is receiving phototherapy. Which nursing intervention is the most appropriate for this client? a. gentle shaking of the baby b. application of eye dressings to the infant c. placing light 6 inches above the newborn's bassinet d. delay of feeding until bilirubin levels are normal

b. application of eye dressings to the infant

When providing postpartum teaching to a couple, the nurse correctly identifies what time as when pathologic jaundice may be found in the newborn? a. between 2 and 4 days of life b. during the first 24 hours of life c. often with formula-fed babies d. after 5 days postpartum

b. during the first 24 hours of life

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. urinary tract infection b. hydrocephalus c. formula intolerance d. spina bifida

b. hydrocephalus

For which condition would the nurse commonly assess in an infant following surgery for a myelomeningocele? a. cerebrovascular accident b. hydrocephalus c. urinary tract infection d. dehydration

b. hydrocephalus

A newborn is diagnosed with congenital hypothyroidism prior to discharge from the hospital. What medication does the nurse anticipate administering to the newborn? a. tapazole b. levothyroxine c. inderal d. radioactive iodine

b. levothyroxine

Which health care provider assessment technique does the nurse anticipate being used to determine developmental dysplasia of the hip (DDH) on a newborn? a. Visual inspection of the hip b. Assessing leg kicks for extension c. Barlow sign and Ortolani click d. Full range of motion of the hip

c. Barlow sign and Ortolani click

The nurse is caring for a 22-hour-old neonate male and notes on assessment at the beginning of the shift: Apgar score of 9, nursing without difficulty, and appeared healthy. As the nurse's shift goes on, subsequent assessment reveals his sclera and skin have begun to take on a yellow hue. The nurse would report this as a possible indication of what condition? a. Heroin withdrawal b. Hypoxia c. Hemolytic disease d. Hypoglycemia

c. Hemolytic disease

In completing the newborn assessment checklist, the nurse documents a meconium stool. This documentation rules out which condition? a. Epispadias b. Hiatal hernia c. Imperforate anus d. Spina bifida occulta

c. Imperforate anus

The use of breast milk for premature neonates helps prevent which condition? a. Hyaline membrane disease b. Down syndrome c. Necrotizing enterocolitis d. Turner's syndrome

c. Necrotizing enterocolitis

Which nursing action is required when caring for the post-term infant? a. temperature checks every 2 hours b. IV initiation c. Serial blood glucose levels d. Echocardiogram at the end of pregnancy

c. Serial blood glucose levels

A newborn is suspected of having gastroschisis at birth. How would the nurse differentiate this problem from other congenital defects? a. The skin over the abdomen is wrinkled and looks like a prune. b. The abdominal contents are contained within a thin, transparent sac. c. The intestines appear reddened and swollen and have no sac around them. d. The umbilical cord comes out of middle of the defect.

c. The intestines appear reddened and swollen and have no sac around them.

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. bowel sounds in all four quadrants c. abdomen appearing red and shiny d. stools negative for blood

c. abdomen appearing red and shiny

A nursing student has read that cleft lip is diagnosed at birth based on inspection of physical appearance and that cleft palate is diagnosed by which method? a. X-ray b. blood work c. feeling the palate with a gloved finger or using a tongue blade d. ultrasound

c. feeling the palate with a gloved finger or using a tongue blade

When providing care to the newborn withdrawing from a drug such as cocaine or heroin, which drug is given to ease the symptoms and prevent complications? a. Acetaminophen b. Aspirin c. Ibuprofen d. Morphine

d. Morphine

A new mother is nervous about sudden infant death syndrome (SIDS) and asks the nurse how to prevent it when the newborn is ready to sleep. Which suggestions should the nurse include in the answer? Select all that apply. a. Keep the infant dressed warmly at night. b. Avoid using a pacifier when putting the infant to sleep. c. Let the newborn sleep in the same bed as the parents. d. Place the infant on his or her back. e. Do not allow anyone to smoke around the infant.

d. Place the infant on his or her back. e. Do not allow anyone to smoke around the infant.

A nurse is caring for a newborn client who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury? a. Place a urine collection bag on newborn for the continuous leakage. b. Place petroleum jelly gauze on the spinal sac to keep it moist. c. Delay the parents from holding the newborn. d. Place the newborn in a prone or lateral position.

d. Place the newborn in a prone or lateral position.

When attempting to interact with a neonate experiencing drug withdrawal, which behavior would indicate that the neonate is willing to interact? a. Hiccups b. Gaze aversion c. Yawning d. Quiet, alert state

d. Quiet, alert state

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 may have been exposed to alcohol during pregnancy. b. The infant may have experienced birth trauma. c. The infant's mother must have had a long labor. d. The infant's mother probably had diabetes.

d. The infant's mother probably had diabetes.

A preterm newborn is noted to be cyanotic. Which laboratory test will the nurse prepare the infant for to determine if the cyanosis is due to respiratory or circulatory problems? a. echocardiogram b. chest X-rays c. angiography d. arterial blood gases

d. arterial blood gases

The nurse suspects a preterm newborn receiving enteral feedings of having necrotizing enterocolitis (NEC). What assessment finding best correlates with this diagnosis? a. meconium stools b. poor suck reflex c. high-pitched cry d. bloody stools

d. bloody stools

The nurse assesses an infant. Which finding may indicate heart failure? a. capillary refill time b. color of hands and feet c. blood glucose level d. diminished peripheral pulses

d. diminished peripheral pulses

A nurse is caring for a child born with a tracheoesophageal fistula. Which finding during pregnancy would have caused the nurse to suspect this might be present? a. oligohydramnios b. a difficult second stage of labor c. bleeding at 32 weeks' gestation d. hydramnios

d. hydramnios

The nursing instructor is teaching a session on techniques that the nursing students can use to properly address concerns of parents with children who are born with a congenital disorder. The instructor determines the session is successful when the students correctly choose which nursing intervention as being the most effective in these situations? a. help the child to understand his or her limitations. b. model good medical practices for the child's family. c. keep the family informed about new and effective treatments. d. use reflective listening and offer nonjudgmental support.

d. use reflective listening and offer nonjudgmental support.