nrsg 376 Exam 4
baby Tim is 48 hours old and was just circumcised. the nurses priority care immediately following a circumcsion should include: a. frequent assessments for bleeding b. teaching the parents about circumcision care c. assuring he has a hat on at all times d. performing the Wisconsin state screen
a
the neonatal period refers to: a. the first 28 days of life b. the first year of life c. the time between birth and the infants second birthday d. the first 2 weeks of life
a
what is cephalohematoma
Blood under the periosteum Does not cross the suture line and manifest a few hours after birth
a full-term newborn was just born. which nursing intervention is important for the nurse to perform first? a. remove wet blankets b. assess APGAR score c. insert eye prophylaxis d. elicit the moro reflex
a
following birth, the nurse's first priority is to assess which two newborn body systems that undergo the most rapid, significant changes to support extra uterine life? a. respiratory and cardiovascular b. gastrointestinal and hepatic c. urinary and hematologic d. neurologic and temperature control
a
the nurse is conducting a state-mandated evaluation of the neonate's hearing. infants are assessed for deficits because hearing-impaired babies are high risk for which of the following? a. delayed speech development b. otitis externa c. poor parental bonding d. choanal atresia
a
the nurse tests the newborns Rooting Reflex by doing which of the following? a. touching the corner of the newborns mouth or cheek b. stroking the lateral aspect of the sole from the heel upward and across the ball of the foot c. stroking the spine when the newborn is prone d. placing a finger in the palm of the newborns hand
a
to reduce the risk of hypoglycemia in a full-term neonate weight 2900 grams, what should the nurse do? a. maintain the infant's temperature above 97.7 degrees F b. feed the infant glucose water every 3 hours until breastfeeding well c. assess blood glucose levels every 3 hours for the first 12 hours d. encourage the mother to breastfeed every 4hours
a
which of the following is most accurate in teaching parents the position to place their infant for sleeping? a. on their back b. any position c. on their stomach d. either side and supported with a blanket
a
while assessing a 6 hour old infant, the nurse auscultates bowel sounds and documents recent passing of meconium. these findings include: a. a patent anus with no bowel obstruction and normal peristalsis b. this infant needs to be made NPO immediately c. an intestinal anomaly that needs immediate surgery d. abnormal newborn gastrointestinal transition; change feedings to soy formula
a
a 40 week gestation neonate is in the first period of reactivity. which of the following actions should the nurse take at this time (SATA) a. encourage the parents to bond with their baby b. notify the neonatologist of the finding c. encourage and support parents in feeding their baby d. perform the gestational age assessment e. place the baby under the overhead warmer f. swaddle the infant snuggly and sway, hoping to help settle the infant to sleep g. encourage extended family to visit so they can see the baby while awake
a, c
which of the following are important topics to educate parents on priori to discharge? (SATA) a. feeding, bathing, and elimination b. introduction of infant cereal c. cord and circ (if applicable) care d. safe infant travel in appropriate care seat e. holding and positioning f. sleep patterns g. follow-up care and danger signs
a, c, d, e, f, g
a nurse notes that a 6 year old neonate has cyanotic hands and feet. which of the following actions by the nurse is appropriate? a. place child in an isolette b. administer oxygen c. swaddle baby in a blanket d. apply pulse oximeter
c
which of the following organs is responsible for conjugation of the breakdown of red blood cells (bilirubin)? a. neurologic b. gastrointestinal c. liver d. kidneys
c
what is caput
superficial edema, crosses sutures of fontanels "Caput covers the head"
what is stork bite "aneva simplex"
superficial vascular pink - nape of neck and eyelids
What is vernix caseosa?
thick white substance
what is milia
unopened sebaceous glands - infants nose
A mother questions why the ophthalmic medication is given to the baby. Which of the following responses by the nurse would be appropriate to make at this time? 1. "I am required by law to give the medicine." 2. "The medicine helps to prevent eye infections." 3. "The medicine promotes neonatal health." 4. "All babies receive the medicine at delivery."
2
A neonate has an elevated bilirubin and is slightly jaundiced on day 3 of life. What is the probable reason for these changes? 1. Hemolysis of neonatal red blood cells by the maternal antibodies. 2. Physiological destruction of fetal red blood cells during the extrauterine period. 3. Pathological liver function resulting from hypoxemia during the birthing process. 4. Delayed meconium excretion resulting in the production of direct bilirubin.
2
Four newborns were admitted into the neonatal nursery 1 hour ago. They are all sleeping in overhead warmers. Which of the babies should the nurse ask the neonatalogist to evaluate? 1. The neonate with a temperature of 97.9ºF and weight of 3000 grams. 2. The neonate with white spots on the bridge of the nose. 3. The neonate with raised white specks on the gums. 4. The neonate with respirations of 72 and heart rate of 166.
4
Four babies have just been admitted into the neonatal nursery. Which of the babies should the nurse assess first? a. The baby with respirations 52, oxygen saturation 98% b. The baby with Apgar 9/9, weight 2960 grams c. The baby with temperature 98.0°F, length 21 inches d. The baby with glucose 60 mg/dL, heart rate 132
b
second most abundant immunoglobulin. does not cross the placenta. predominantly found in breastmilk, with very high concentrations in colostrum is ...
IgA
the major immunoglobulin, most abundant. Only class able to cross the placenta, conferring passive immunity to fetus is ...
IgG
first to respond to infection. Does not cross the placenta. Found in blood and lymph. Produced by infant starting 10-15 weeks gestation is ...
IgM
what is molding
The ability of the fetal head to change shape to fit thru the maternal pelvis
a 2-day old breastfeeding baby born via normal spontaneous vaginal delivery has just been weighed in the newborn nursery. the nurse determines that the baby has lost 3.5% of the birth weight. which of the following nursing actions is appropriate? a. continue to monitor, as this is normal weight loss b. notify the neonatologist of the significant weight loss c. advise the mother to bottle feed the baby at the next feed d. assess the baby for hypoglycemia with a glucose monitor
a
the nurse is discussing the neonatal blood screening test with a new mother. the nurse knows that the teaching was successful when the mother states that the test screens for the presence of which of the following disease in the newborn? (SATA) a. hypothyroidism b. sickle cell disease c. galactosemia d. cerebral palsy e. cystic fibrosis
a, b, c, e
what are the 4 consequences of Cold Stress (SATA) a. respiratory distress and hypoxemia b. hypoglycemia c. hyperglycemia d. babinski e. hyperbilirubinemia f. erythema toxic neonatorum g. metabolic acidosis
a, b, e, g
a full-term neonate has brown adipose fat tissue (BAT) stores that were deposited during the latter part of the third trimester. what does the nurse understand is the function of BAT stores? a. to promote melanin production in the neonatal period b. to provide heat production when the baby is hypothermic c. to protect the bony structures of the body from injury d. to provide calories for neonatal growth between feedings
b
a new mother is examining her baby who is 10 hours old, and asks why her newborns hands and feet feel cool and they look slightly blue from the rest of her body? the best response by the nurse would be a. this is not normal. I will call the baby's doctor and report it immediately b. this is due to the decreased peripheral circulation to the extremities, which will eventually increase. it is called acrocyanosis c. you can help to warm them by holding them in your hands, but its nothing to worry about d. this is a normal response to the external room temperature; within 2 weeks the baby will be able to compensate, and his/her hands and feet will become pink
b
the nurse has provided anticipatory guidance to a couple that has just delivered a baby. which of the following is an appropriate short-term goal for the care of their new baby? a. the baby will have a bath with soap every morning b. during a supervised play period, the baby will be place on the tummy every day c. the baby will be given a pacifier after each feeding d. for the first month of life, the baby will sleep on its side in a crib next to the parents
b
which time period is most appropriate for the nurse to initiate breastfeeding with the newborn and new mother? a. the second period of reactivity b. the first period of reactivity c. the second period of inactiivty d. the first period of inactivity
b
which of the following behaviors should nurses known are characteristics of infant abductors? (SATA) a. act on the spur of the moment b. create a diversion on the unit c. ask questions about the routine of the unit d. choose rooms near stairwells e. wear over-sized clothing
b, c, d, e
what is Mongolian spot
blue or purple areas found on buttocks or lower extremities
a nurse is assessing the bonding of the father with his newborn baby. which of the following actions by the father would be of concern to the nurse? a. he holds the baby in the en face position b. he calls the baby by a full name rather than a nickname c. he tells the mother to pick up the crying baby d. he falls asleep in the chair with the baby on his chest
c
a prophylactic antibiotic is instilled in both eyes of all newborns to prevent which of the following conditions? a. enterobacter b. herpes c. thrush d. gonorrhea
d
as a new OB RN you recognize that APGAR scores are routinely assessed at 1 and 5 minutes. "APGAR" is an acronym for a. appearance(muscle tone, color), perfect 10(fingers, ten toes), good (response to light in delivery room), active (movement in eyes), regular (hear rate/rhythm) b. admission(time of delivery), pink(color), good(tone), auditory response(crying), regular (vital signs) c. appearance (color), pulse (heart rate), grimace (reflex irritability), activity (muscle tone), respiratory (respiratory efforts) d. wat a minute; APGAR isn't an acronym
c
four newborns are in the nursery, non of whom are crying or in distress. which of the babies should the nurse report to the neonatologist? a. 16 hour old baby who has yet to pass meconium b. 16 hour old baby whose blood glucose is 50 mg/dl c. 2 day old baby who is irregularly at 70 breaths per minute d. 2 day old who is excreting a milky discharge from both nipples
c
onset of respirations by the infant after birth causes a. increase in PCO2 and increase in pulmonary resistance b. decrease in pulmonary blood flow c. increase in PO2 and decrease in pulmonary resistance d. decrease in PO2 and increase in pulmonary resistance
c
which behavior observed by the nurse indicates good bottle-feeding technique? a. continuing to feed the baby while formally actively leaks out of the baby's mouth b. propping the bottle on a rolled towel c. keeping the nipple full of formula throughout the feeding d. not letting bubbles rise in the formula in the bottle
c
a 2 day old infant received a Vitamin K injection at birth. which of the following s/sx in the baby would indicate that the treatment was effective? a. skin color is pink b. vital signs are normal c. glucose levels are stable d. blood clots after heel sticks
d
a new mother's baby has a cephalohematoma following a traumatic birth. Which is the best statement to help explain this to her? a cephalohematoma is a: a. bluish black spots of pigmentation found on the dorsal areas and the buttocks b. temporary reshaping of the skull resulting from the pressure of birth c. swelling or edema occurring under the fetal scalp from compression on blood vessels during labor d. collection of blood between the cranial bone and the periosteal membrane that results from ruptured blood vessels during birth
d
a nurse is administering Vitamin K (aquaMephyton) to a newborn shortly after birth. Which route and site are most appropriate for this medication? a. SubQ abdomen b. intradermal, forearm c. oral, cheek pouch d. IM, vastus lateralis
d
a physician writes in a breastfeeding mothers chart, "ampicillin 500 mg q 6 hour po. Baby should be bottle fed until medication is discontinued." What should be the nurse's next action? a. follow the order as written b. call the doctor and question the order c. implement the antibiotic order but ignore the order to bottle feed the baby d. refer to a reliable resource to see whether the antibiotic is safe while breastfeeding
d
in order to help clear the airway of an infant with a large amount of frothy mucous in her mouth, the nurse knows to: a. monitor vital signs b. call the physician c. administer oxygen per ventilator d. hold the newborn with her head angled down, aspirate mouth and nasal pharynx with bulb syringe
d
the nurse works to prevent heat loss in the infant through evaporation by: a. turning on the overhead radiant warmer b. closing the doors to the room c. warming the crib pad d. drying the infant with a warm blanker
d
what is the name of the screening test that includes phenylketonuria, and when is it done? a. PKU, one week of age b. CF, one month of age c. Eyes and Thighs, after 24 hours d. Wisconsin State Screen, after 24 hours
d
what is erythema toxicum
general transiet rash - look like flea bites
