OB PrepU Chapter 23

Hypoglycemia in a mature infant is defined as a blood glucose level below which amount? a. 40 mg/100 ml whole blood b. 30 mg/100 ml whole blood c. 100 mg/100 ml whole blood d. 80 mg/100 ml whole blood

a. 40 mg/100 ml whole blood

The nurse in a newborn nursery is observing for developmentally appropriate care. Which is an example of self-regulation? a. Infant has hand in mouth. b. Infant is crying. c. Infant is quiet. d. Infant is kicking feet.

a. Infant has hand in mouth.

The nurse observes a neonate born at 28 weeks' gestation. Which finding would the nurse expect to see? a. The pinna of the ear is soft and flat and stays folded. b. Creases appear on the interior two-thirds of the sole. c. The neonate has 7 to 10 mm of breast tissue. d. The skin is pale, and no vessels show through it.

a. The pinna of the ear is soft and flat and stays folded.

Which safety precautions should a nurse take to prevent infection in a newborn? Select all that apply. a. Use sterile gloves for an invasive procedure. b. Initiate universal precautions when caring for the infant. c. Cover jewelry while washing hands. d. Avoid using disposable equipment. e. Avoid coming to work when ill.

a. Use sterile gloves for an invasive procedure. b. Initiate universal precautions when caring for the infant. e. Avoid coming to work when ill.

The nurse notices while holding him upright that a day-old newborn has a significantly indented anterior fontanelle. She immediately brings it to the attention of the primary care provider. What does this finding indicate? a. dehydration b. cyanosis c. vernix caseosa d. increased intracranial pressure

a. dehydration

The obstetrical nurse admits a premature, small-for-gestational age infant to the observational unit for assessment. The maternal record reveals an obese 27-year-old homeless woman with limited prenatal, medical, or dental care. Her blood pressure on admission was 170/90 mm Hg. Which factors in the maternal history would have suggested a high-risk pregnancy? Select all that apply. a. periodontal disease b. lack of prenatal care c. maternal age d. maternal hypertension e. obesity f. homelessness

a. periodontal disease b. lack of prenatal care d. maternal hypertension e. obesity f. homelessness

A nursing student, observing care of a 30-week-gestation infant in the neonatal intensive care unit, asks the nurse, "Are premature infants more susceptible to infection as I have to wash my hands so often in this department?" What is the nurse's best response? a. "Not really, as premature infants are cared for in an isolate, protecting them from infection." b. "That is correct; a 30-week-gestation infant lacks the protective antibody called IgG." c. "Yes, as they lack the antibody called IdD that acts as protection from infections." d. "Feeding premature infants breast milk establishes the best protective mechanisms."

b. "That is correct; a 30-week-gestation infant lacks the protective antibody called IgG."

The nurse is concerned that a newborn is hypoglycemic. Which blood glucose level would support the nurse's intervention? a. 40 mg/dl (2.25 mmol/l) b. 30 mg/dl (1.67 mmol/l) c. 60 mg/dl (3.33 mmol/l) d. 50 mg/dl (2.77 mmol/l)

b. 30 mg/dl (1.67 mmol/l)

A nurse is assessing a preterm newborn's status based on the understanding that the newborn is at greatest risk for which complication? a. intracranial hemorrhage b. atelectasis c. hypoglycemia d. infection

b. atelectasis

When examining a neonate, which characteristic would indicate to the nurse that the infant is preterm? Select all that apply. a. bulging posterior fontanel (fontanelle) b. covered with vernix caseosa c. elevated breast bud d. absence of sole creases e. extended extremities

b. covered with vernix caseosa d. absence of sole creases e. extended extremities

A nurse is conducting an in-service presentation for a group of neonatal nurses. After teaching the group about the effects of prematurity on various body systems, the nurse determines that the class was successful when the group identifies which condition as an effect of prematurity? a. rapid glomerular filtration rate b. fragile cerebral blood vessels c. enhanced ability to digest proteins d. enlarged respiratory passages

b. fragile cerebral blood vessels

A client asks the nurse what surfactant is. Which explanation would the nurse give as the main role of surfactant in the neonate? a. helps maintain a rhythmic breathing pattern b. helps the lungs remain expanded after the initiation of breathing c. promotes clearing of mucus from the respiratory tract d. assists with ciliary body maturation in the upper airways

b. helps the lungs remain expanded after the initiation of breathing

When caring for a neonate of a mother with diabetes, which physiologic finding is most indicative of a hypoglycemic episode? a. serum glucose level of 60 mg/dl b. jitteriness c. hyperalert state d. loud and forceful crying

b. jitteriness

The nurse assesses a post-term newborn. What finding corresponds with this gestational age diagnosis? a. abundant vernix caseosa and lanugo b. meconium-stained skin and fingernails c. few creases on soles d. Wharton's jelly

b. meconium-stained skin and fingernails

The nurse is teaching nursing students about the risks that late preterm infants may experience. The nurse feels confident learning has taken place when the students make which statement? a. "Late preterm infant complications are considered minor compared to the preterm newborn." b. "The late preterm infant is more mature and able to cope as well as a full-term infant." c. "A late preterm newborn may have more clinical problems compared with full-term newborns." d. "Late preterm newborns have fewer clinical problems leading to shorter hospital stays."

c. "A late preterm newborn may have more clinical problems compared with full-term newborns."

A nurse is caring for an infant. A serum blood sugar of 40 was noted at birth. What care should the nurse provide to this newborn? a. Give dextrose intravenously before oral feedings. b. Place infant on radiant warmer immediately. c. Begin early feedings either by the breast or bottle. d. Focus on decreasing blood viscosity by introducing feedings.

c. Begin early feedings either by the breast or bottle.

An infant is suffering from neonatal abstinence syndrome. The nurse provides appropriate care and support for the infant during the infant's time on the unit. Besides nursing and medical care, what other step would the nurse take to support the infant? a. Contact the chaplain. b. Make sure a volunteer feeds the baby. c. Link the family with community sources for aid. d. Make sure the infant was in a bright, loud room.

c. Link the family with community sources for aid.

What action by the nurse provides the neonate with sensory stimulation of a human face? a. encouraging the mother to view the baby through the isolette dome b. teaching parents to maintain a distance of 18 inches (7 cm) from the baby's face c. assisting the mother to position the infant in an en face position d. having mothers look at the infant through the isolette's porthole

c. assisting the mother to position the infant in an en face position

What is a consequence of hypothermia in a newborn? a. respirations of 46 b. heart rate of 126 c. holds breath 25 seconds d. skin pink and warm

c. holds breath 25 seconds

A nurse is assessing a preterm newborn. The nurse determines that the newborn is comfortable and without pain based on which finding? a. sudden high-pitched cry b. increased muscle tone c. lack of body posturing d. fussiness

c. lack of body posturing

A client has just given birth at 42 weeks' gestation. What would the nurse expect to find during her assessment of the neonate? a. a sleepy, lethargic neonate b. vernix caseosa covering the neonate's body c. peeling and wrinkling of the neonate's epidermis d. lanugo covering the neonate's body

c. peeling and wrinkling of the neonate's epidermis

The newborn nursery nurse is admitting a small-for-gestational-age (SGA) infant and is reviewing the maternal history. What factor in the maternal history would the nurse correlate as a risk factor for a SGA infant? a. age of 30 years b. blood group incompatibility c. placental factors d. grand multiparity

c. placental factors

A preterm infant will be hospitalized for an extended time. Assuming the infant's condition is improving, which environment would the nurse feel is most suitable for the child? a. Place the infant's Isolette near the window so the child can see outside. b. Bring the child's open bassinet near the desk area so the infant sees people. c. Keep the environment free of color to reduce eye straining. d. Provide a mobile the child can see no matter how he or she is turned.

d. Provide a mobile the child can see no matter how he or she is turned.

A woman who has given birth to a postterm newborn asks the nurse why her baby looks so thin with so little muscle. The nurse integrates understanding about which concept when responding to the mother? a. A postterm newborn has begun to break down red blood cells more quickly. b. The newborn was exposed to an infection while in utero. c. The newborn aspirated meconium, causing the wasted appearance. d. With postterm birth, the fetus uses stored nutrients to stay alive, and wasting occurs.

d. With postterm birth, the fetus uses stored nutrients to stay alive, and wasting occurs.

At birth, the infant has dry, cracked skin, absence of vernix, lack of subcutaneous fat, fingernail extending beyond the fingertips, and poor skin turgor. Based on these findings, how would the nurse would classify this neonate? a. SGA b. LGA c. postterm d. preterm

c. postterm

The nurse determines a newborn is small-for-gestational age based on which characteristics? a. reduced subcutaneous fat stores to buttocks, thicker umbilical cord, and smaller head compared to body b. wasted appearance of extremities, thin umbilical cord, and reduced subcutaneous fat stores c. normal subcutaneous fat stores, cord-like umbilical cord, and increased development to extremities d. wasted appearance of extremities, gelatinous umbilical cord, and abundant subcutaneous fat stores

b. wasted appearance of extremities, thin umbilical cord, and reduced subcutaneous fat stores

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

b. Application of eye dressings to the infant

A nurse is caring for an infant born with polycythemia. Which intervention is most appropriate when caring for this infant? a. Focus on monitoring and maintaining blood glucose levels. b. Focus on decreasing blood viscosity by increasing fluid volume. c. Check blood glucose within 2 hours of birth by reagent test strip. d. Repeat screening every 2 to 3 hours or before feeds.

b. Focus on decreasing blood viscosity by increasing fluid volume.

Which maternal factors should the nurse consider contributory to a newborn being large for gestational age? Select all that apply. a. renal infection b. diabetes mellitus c. prepregnancy obesity d. postdates gestation e. alcohol use

b. diabetes mellitus c. prepregnancy obesity d. postdates gestation

An obese woman with diabetes has just given birth to a term, large-for-gestational-age (LGA) newborn. Which condition should the nurse most expect to find in this infant? a. hypoglycemia b. hyperglycemia c. hypotension d. hypertension

a. hypoglycemia

A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. What should the nurse expect when assessing the condition of the newborn? a. meconium aspiration in utero or at birth b. tremors, irritability, and high-pitched cry c. seizures, respiratory distress, cyanosis, and shrill cry d. yellow appearance of the newborn's skin

a. meconium aspiration in utero or at birth

A premature infant develops respiratory distress syndrome. With this condition, circulatory impairment is likely to occur because, with increased lung tension,: a. the pulmonary artery closes. b. the ductus arteriosus remains open. c. there are aortic valve strictures. d. the foramen ovale closes prematurely.

b. the ductus arteriosus remains open.

The nurse realizes the educational session conducted on due dates was successful when a participant is overheard making which statement? a. "The ability of my body to provide adequate oxygen and nutrients to my baby after 42 weeks' gestation is thought to be increased." b. "The ability of my umbilical cord to provide adequate oxygen and nutrients to my baby after 42 weeks' gestation is thought to be compromised." c. "The ability of my placenta to provide adequate oxygen and nutrients to my baby after 42 weeks' gestation is thought to be compromised." d. "The ability of my amniotic fluid to provide adequate oxygen and nutrients to my baby after 42 weeks' gestation is thought to be compromised."

c. "The ability of my placenta to provide adequate oxygen and nutrients to my baby after 42 weeks' gestation is thought to be compromised."

At birth, the newborn was at the 8th percentile with a weight of 2350 g and born at 36 weeks' gestation. Which documentation is most accurate? a. The infant was a preterm, very-low-birthweight and small-for-gestational-age b. The infant was born at term but at a very low birth weight and small-for-gestational-age c. The infant was born at term but at a low birth weight and small-for-gestational age d. The infant was a preterm, low-birth-weight and small-for-gestational-age

d. The infant was a preterm, low-birth-weight and small-for-gestational-age

A 20-year-old client gave birth to a baby boy at 43 weeks' gestation. What might the nurse observe in the newborn during routine assessment? a. The testes in the child may be undescended. b. The infant may have excess of lanugo and vernix caseosa. c. The newborn may have short nails and hair. d. The newborn may look wrinkled and old at birth.

d. The newborn may look wrinkled and old at birth.

A preterm newborn has just received synthetic surfactant through an endotracheal tube by a syringe. Which intervention should the nurse implement at this point? a. Place the infant supine in a radiant heat warmer. b. Immediately suction the infant's airway. c. Take a blood sample. d. Tip the infant into an upright position.

d. Tip the infant into an upright position.

A late preterm newborn is being prepared for discharge to home after being in the neonatal intensive care unit for 4 days. The nurse instructs the parents about the care of their newborn and emphasizes warning signs that should be reported to the pediatrician immediately. The nurse determines that additional teaching is needed based on which parental statement? a. "If our newborn's skin turns yellow, it is from the treatments and our newborn is okay." b. "If our newborn does not have a wet diaper in 12 hours, we will call our pediatrician." c. "We will let the pediatrician know if our newborn's temperature goes above 100.4°F (38°C)." d. "We will call 911 if we start to see that our newborn's lips or skin are looking bluish."

a. "If our newborn's skin turns yellow, it is from the treatments and our newborn is okay."

A common symptom that would alert the nurse that a preterm infant is developing respiratory distress syndrome is: a. inspiratory "crowing." b. expiratory grunting. c. expiratory wheezing. d. inspiratory stridor.

b. expiratory grunting.

A newborn girl who was born at 38 weeks' gestation weighs 2000 g and is below the 10th percentile in weight. The nurse recognizes that this girl will be placed in which classification? a. term, small-for-gestational-age, and very-low-birth-weight infant b. term, small-for-gestational-age, and low-birth-weight infant c. late preterm, large-for-gestational-age, and low-birth-weight infant d. late preterm and appropriate for gestational age

b. term, small-for-gestational-age, and low-birth-weight infant

At birth, a term infant has irregular respirations and a weak cry. What is the sequence of events initiated by the nurse when caring for this infant? a. Open the airway, initiate respirations, and dry the infant. b. Dry the infant, administer blow-by oxygen, and keep the infant warm. c. Open the airway, suction the trachea, and administer oxygen. d. Dry the infant, stimulate the infant, and keep the infant warm.

d. Dry the infant, stimulate the infant, and keep the infant warm.

The nurse begins frequent oral feedings for a small-for-gestational-age newborn to prevent which occurrence? a. asphyxia b. meconium aspiration c. polycythemia d. hypoglycemia

d. hypoglycemia