OB Prep
A nurse is caring for a child with complex esophageal atresia who will be undergoing surgery for repair. What comment by the parents indicates further teaching is required?
"After this surgery is done tomorrow, my baby will be able to eat and drink."
A nursing instructor is teaching about newborn congenital disorders and realizes that the student needs further instruction after making which statement?
"All congenital disorders can be diagnosed at birth."
The nurse is teaching the caregivers of an infant diagnosed with hypospadias how to properly care for the infant. The nurse determines the session is successful when the caregivers make which statement?
"Being able to most likely correct this in one stage rather than several is reassuring.
The nurse is teaching the caregivers of an infant diagnosed with hypospadias how to properly care for the infant. The nurse determines the session is successful when the caregivers make which statement?
"Being able to most likely correct this in one stage rather than several is reassuring."
A client who gave birth 2 hours ago expresses concern about her baby developing jaundice. Which response from the nurse would be best?
"I understand your concern because as many as 50% of babies can develop jaundice."
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."
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?
"The bladder will covered in a sterile plastic bag to keep it moist.
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."
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?
"We can probably start feeding him with the bottle about a day after the surgery."
A newborn is prescribed gentamicin for suspected neonatal sepsis. The newborn weighs 1600 grams, and the drug is to be given at 2.5 mg/kg every 12 hours. What is the correct dosage to be administered every 12 hours? Record your answer using a whole number.
4
The nurse is caring for a client who is at her due date. The client asks. "How long is the health care provider going to let me go?" The nurse is correct to state that typical a mother should not pass how many weeks' gestation?
42 Weeks
Following surgery for cleft lip, the infant will have a Logan bar. Which explanation of the Logan bar is most accurate?
A Logan bar is an apparatus that may be used to protect the surgical incision following a cleft lip repair.
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?
ABG
When providing care to a newborn with necrotizing enterocolitis (NEC), the nurse would need to report which finding immediately?
Abd appearing red and shiney
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?
Alcohol
Which health care provider assessment technique does the nurse anticipate being used to determine developmental dysplasia of the hip (DDH) on a newborn?
Barlow sign and Ortolani click
A newborn at 33 weeks' gestation has an Apgar score of 5 at 10 minutes of life. Which nursing action is a priority?
Begin resuscitation measures.
The nurse suspects a preterm newborn receiving enteral feedings of having necrotizing enterocolitis (NEC). What assessment finding best correlates with this diagnosis?
Bloody stools
For which potential neonatal infection does the nurse anticipate using ophthalmic erythromycin?
Chlamydia trachomatis
The nurse is teaching the parents of a newborn who was born with a high type of imperforate anus the care the newborn will need at home after surgery. The parents need to be aware that the newborn will require which measure temporarily?
Colostomy
A dietitian is consulted to assist with the planning of meals for a family that must follow a low phenylalanine diet since their child is now 2 years old and eating more table foods. Which instruction is anticipated? Select all that apply.
Common foods must be eliminated. The child must remain on the diet until early adulthood. Meats and fish must be eliminated. Care must be provided when eating out
Periventricular-intraventricular hemorrhage is suspected in a newborn of 30 weeks' gestation. The nurse would anticipate preparing the newborn for which diagnostic tool to confirm the diagnosis?
Cranial US
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?
Creases covering two-thirds of the anterior foot
The nurse is caring for an infant born to a mother with cocaine use disorder during her pregnancy. The nurse would likely notice that this infant:
Cries when touched
Which finding might be seen in a neonate suspected of having an infection?
Decreased temperature
A 3-day-old neonate needs phototherapy for hyperbilirubinemia. Nursery care of a neonate receiving phototherapy includes which treatment?
Eye patches to prevent retinal damage
After assessing the status of a newborn, the nurse is concerned that this newborn has persistent pulmonary hypertension. When explaining it to the parents, the nurse would integrate knowledge about which event as having most likely occurred?
Foramen ovale has not closed
From which pair of metabolic disorders must the nurse instruct the parents to eliminate breast and cow's milk from the diet?
Galactosemia and phenylketonuria
The nurse is doing an examination on an infant with a diagnosis of developmental dysplasia of the hip (DDH). Which finding would be an indication of this diagnosis?
Gluteal fold higher on one side than the other
The nurse is admitting to the nursery a newborn of a mother who continued to drink alcohol during her pregnancy. Which finding does the nurse predict to encounter on the newborn's assessment?
Hyperactive and irritable
In completing the newborn assessment checklist, the nurse documents a meconium stool. This documentation rules out which condition?
Imperforate anus
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
The nurse caring for a newborn notes a distended abdomen approximately 24 hours after birth. Which action should the nurse take after review of the medical record reveals an apparent healthy newborn at birth but no documentation of a bowel movement?
Inform pcp immediately
The parent reports that the health care provider said that the infant had a hernia but she can't remember which type. When recalling what the health care provider said, the parent said that a surgeon will repair it soon and there is no problem with the testes. Which hernia type is anticipated?
Inguinal hernia
When interacting with parents caring for their newborn in opioid withdrawal, which nursing action is most essential?
Instruct the parents with a nonjudgmental, caring attitude
A client with group AB blood whose husband has group O blood has just given birth. Which complication or test result is a major sign of ABO blood incompatibility that the nurse should look for when assessing this neonate?
Jaundice within the first 24 hours of life
A nurse caring for a client in premature labor knows that the best indicator of fetal lung maturity is which data?
Lecithin to sphingomyelin ratio of more than 2:1 Lecithin and sphingomyelin are phospholipids that help compose surfactant in the lungs; lecithin peaks at 36 weeks, and sphingomyelin concentrations remain stable. Meconium is released due to fetal stress before delivery, but it's chronic fetal stress that matures lungs. Glucocorticoids must be given at least 48 hours before delivery. The presence of phosphatidylglycerol indicates lung maturity.
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?
Limited abduction of the affected hip
The nurse is preparing to assess an infant who is diagnosed with a ventricular septal defect. Which assessment finding should the nurse be prepared to document?
Loud, harsh murmur
Which nursing measure is most effective in reducing newborn infections?
Maintain medical asepsis while providing care.
Which facial change is characteristic in a neonate with fetal alcohol spectrum disorder?
Microcephaly
At birth, a neonate is diagnosed with brachial plexus palsy. The parent asks how the nurse knows the baby's positioning of the arm is a result of the palsy and not just a preferred position. The nurse would show the parent that the neonate has asymmetry of which neonatal reflex?
Moro reflex
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?
Morphine
A premature infant in the neonatal intensive care unit exhibits worsening respiratory distress and is noted to have abdominal distention, absent bowel sounds, and frequent diarrhea stools that are positive for hemoccult. What diagnosis would be most likely to correlate with the symptoms?
Necrotizing enterocolitis
The use of breast milk for premature neonates helps prevent which condition?
Necrotizing enterocolitis
The nurse is reviewing a chart for a male client with Klinefelter syndrome. Which physical characteristics does the nurse anticipate?
No development of secondary sex characteristics
A nurse is providing postoperative care to an infant who had a ventriculoarterial 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.
When planning preoperative care for a newborn with a cleft lip and palate, the nurse would plan interventions for which major need?
Nutrition
The nursing instructor is conducting a session with a group of nursing students exploring potential difficulties of newborns involving respiratory concerns. The instructor determines the session is successful after the students correctly choose which contributing factor for transient tachypnea of the newborn?
Often seen with cesarean births
The nurse is assessing for developmental dysplasia of the hip in the newborn. The dislocated hip elicits a characteristic clunk as the femoral head slides over the posterior rim of the acetabulum and the dislocation feels reduced. Which maneuver did the nurse perform?
Ortolani
All infants should be screened for developmental dysplasia of the hip (DDH) from birth up until 3 months of age. What procedure does the nurse use to assess for DDH? Select all that apply.
Ortolani maneuver Barlow evaluation
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.
"Being able to most likely correct this in one stage rather than several is reassuring."
Place the tape measure under the infant's head, wrap around the occiput, and measure just above the eyes.
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?
Position the child on the side
A nurse is assigned to care for a newborn with esophageal atresia. What preoperative nursing care is the priority for this newborn?
Prevent aspiration by elevating the head of the bed, and insert an NG tube to low suction.
The nurse is preparing a nursing care plan for an infant who was born with spina bifida with myelomeningocele. Which nursing goal should the nurse prioritize for this child?
Preventing infection
An infant is suspected of having persistent pulmonary hypertension of the newborn (PPHN). What intervention implemented by the nurse would be appropriate for treating this client?
Provide oxygen by oxygen hood or ventilator.
When attempting to interact with a neonate experiencing drug withdrawal, which behavior would indicate that the neonate is willing to interact?
Quiet, alert state
During the newborn examination, the nurse notes that an infant who is appropriate for gestational age by birth weight has a head circumference below the 10th percentile and the fontanels (fontanelles) are not palpable. What action would the nurse take?
Report the findings to the pediatric health care provider
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?
Retinopathy
During the first feeding, the nurse observes the infant becoming cyanotic, coughing, and having difficulty breathing. Which nursing diagnosis would the nurse identify as a priority for this infant?
Risk of injury related to increased potential for aspiration
An infant has just been born with a cleft lip and palate. The birthing room suddenly becomes very quiet, and the birth team seems somber. The health care provider is busy examining the newborn, but the mother is obviously aware that something is not right. What should the nurse do?
Say to the parents, "Your son has been born with a cleft lip and palate. This condition is highly treatable by surgery, however, and he is otherwise in excellent health."
Which nursing action is required when caring for the post-term infant?
Serial blood glucose levels
The nurse is caring for a preterm infant and notes frothing and excessive drooling. Which additional assessment finding should the nurse prioritize and report immediately?
Severe cyanosis
A nurse is performing a newborn assessment and notices a small dimple on the sacral area. The infant has a normal neurological assessment and moves all extremities well. What does the nurse suspect that the dimple indicates?
Spina Bifida Occulta
The nurse is assessing the neonate shown. From the assessment, the nurse notes that there is paralysis of the lower extremities. For which condition does the nurse anticipate performing care?
Spina bifida with myelomeningocele
A client at 6 weeks' gestation asks the nurse what foods she should eat to help prevent neural tube disorders in her growing baby. The nurse would recommend which foods?
Spinach, oranges, and beans
A nurse is caring for a newborn with necrotizing enterocolitis (NEC) who is scheduled to undergo surgery for a bowel resection. The infant's parents wish to know the implications of the surgery. What information should the nurse provide to the parents regarding this surgery?
Surgery requires placement of a proximal enterostomy.
The nurse is working in the special care nursery caring for a newborn withdrawing from alcohol. Which nursing intervention promotes client comfort?
Swaddle and decrease stimulation
Which sign appears early in a neonate with respiratory distress syndrome?
Tachypnea more than 60 breaths/minute
The nurse is caring for a neonate with an exstrophy of the bladder. When the nurse is planning care, which client goal is the priority?
The client will be free from infection
The nurse is caring for a neonate with an exstrophy of the bladder. When the nurse is planning care, which client goal is the priority?
The client will be free from infection.
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.
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.
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.
The mother has poorly controlled diabetes. The mother has had previous large-for-gestational-age neonates. Both parents are of a larger stature and size.
The nurse is completing gavage feedings for the preterm neonate every 2 hours. Which rationale is most correct?
The neonate requires food in the gut to avoid atrophy of the mucosa.
Which assessment finding within the first 24 hours of birth requires immediate health care provider notification?
The skin is jaundiced.
A nursing instructor is preparing a discussion which will illustrate the different forms of spina bifida. The instructor determines the session is successful after the students correctly choose which form as being spina bifida with myelomeningocele?
The spinal cord, meninges, and nerve roots protrude out the lower back.
The community health nurse is preparing a presentation which will illustrate the various forms of spina bifida for a health fair. Which explanation should the nurse use to explain spina bifida with meningocele?
The spinal meninges protrude through the bony defect and form a cystic sac.
The nurse is reinforcing discharge teaching with the mother of an infant who is being discharged prior to having a required blood test done. The nurse explains to this mother that she needs to bring the newborn back to check the infant's phenylalanine level. Which statement is most accurately related to this blood test?
The test is done after the newborn has ingested protein.
Which respiratory disorder in a neonate is usually mild and runs a self-limited course?
Transient tachypnea
When providing postpartum teaching to a couple, the nurse correctly identifies what time as when pathologic jaundice may be found in the newborn?
Within 24h of life
The neonatal intensive care nurse is assessing a new admission and suspects the newborn to have meconium aspiration syndrome. Which assessment finding would correlate with the nurse's suspicion?
a barrel-shaped chest with an increased anterior-posterior chest diameter
In the infant diagnosed with spina bifida with myelomeningocele, the infant will likely have:
a partial to complete paralysis in the lower extremities.
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 sudden drop in hematocrit
When examining a newborn for developmental dysplasia of the hip (DDH), which motion would the newborn's hip be unable to accomplish?
abduction
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?
absent Moro reflex
Which measure would the nurse expect to be included in the plan of care for an infant of a diabetic mother who has a serum calcium level of 6.2 mg/dl (1.55 mmol/L)?
administration of calcium gluconate
A nurse is conducting a review program for a group of neonatal nurses about pulmonary complications associated with preterm birth, explaining that the most common severe adverse pulmonary outcome of preterm birth is bronchopulmonary dysplasia. Which information would the nurse address as a preventive measure?
antepartum administration of steroids to the mother
A newborn with high serum bilirubin is receiving phototherapy. Which nursing intervention is the most appropriate for this client?
application of eye dressings to the infant
The parents are upset their newborn has a cleft lip. When describing the treatment, the nurse should mention that surgical repair can be done:
between the age of 6 to 12 weeks.
What is the term for a small collection of blood that forms underneath the skull as a result of birth trauma?
cephalohematoma
In the child diagnosed with hydrocephalus, an obstruction occurs that blocks the normal process of:
cerebrospinal fluid.
A woman with hydramnios has just given birth. The nurse recognizes that the infant must be assessed for which condition?
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 nurse is assessing a newborn suspected of having meconium aspiration syndrome. What sign or symptom would be most suggestive of this condition?
expiratory grunting
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?
feeling the palate with a gloved finger or using a tongue blade
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
Congenital myelomeningocele is commonly associated with which condition?
hydeocephalus
Congenital myelomeningocele is commonly associated with which condition?
hydrocephalus
For which condition would the nurse commonly assess in an infant following surgery for a myelomeningocele?
hydrocephalus
A preterm newborn is noted to have hypotonia, apnea, bradycardia, a bulging fontanel (fontanelle), cyanosis, and increased head circumference. These signs indicate the newborn has which complication?
intraventricular hemorrhage (IVH)
What would the nurse expect to prioritize in the assessment of a newborn who has a positive Coombs test?
jaundice development
A newborn is diagnosed with congenital hypothyroidism prior to discharge from the hospital. What medication does the nurse anticipate administering to the newborn?
levothyroxine
While caring for a neonate of a diabetic mother, the nurse should monitor the neonate for which complication?
macrosomia (larger than average infant)
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?
newborn who is type A, mother who is type O
It would be best to place an infant with a myelomeningocele in which position prior to surgery? You Selected:
on the stomach (prone)
A nurse is providing preoperative care to a female newborn client with the congenital abnormality myelomeningocele. Which intervention is the priority?
preventing infection
The nurse is caring for a baby born to a mother with a history of alcohol use disorder. For what characteristics should the nurse observe to determine if the newborn has a fetal alcohol spectrum disorder? Select all that apply.
reduced ocular growth short palpebral fissures flattened nasal bridge
When assessing a newborn, the nurse determines that the newborn is most likely experiencing respiratory distress syndrome (RDS) based on which finding?
see-saw resp.
The nurse is providing education to the parents of an infant who was just diagnosed with transposition of the great arteries. The parents ask, "Which vessels were involved?" The nurse is correct to educate about:
the aorta and pulmonary artery
Which newborn would the nurse suspect to be most at risk for intellectual disability due to the mother's actions during pregnancy?
the child of a client who admits to drinking a liter of alcohol daily during the pregnancy
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?
use reflective listening and offer nonjudgmental support.
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?
ventricular septal defect
An infant with a tracheoesophageal fistula is carefully examined to identify other teratogenic effects at the same week in gestation. Which systems need to be examined? Select all that apply.
vertebral cardiac anal
