The Neonatal Experience

A neonate has a large number of secretions. After vigorously suctioning the neonate, the nurse should assess what possible result? A. Bradycardia B. Rapid eye movement C. Seizures D. Tachypnea

A

The nurse is developing a plan of care for a neonate who is to undergo gastroschisis surgery. What should be included? Select all that apply A. Prevention of hypothermia B. Maintenence of fluid and electrolyte balance C. Controlling preoperative pain D. Prevention of infection E. Providing developmental care

A B D

The nurse explains to the mother of a neonate dx with erythroblastosis fetalis that the exchange transfusion is necessary to prevent damage primarily to which organ in the neonate? A. Kidneys B. Brain C. Liver D. Lungs

B

An infant born premature at 34 weeks gestation is receiving gavage feedings. The client holding her infant asks the nurse why she must place a pacifier in the infants mouth during the feedings. What does the nurse state is the purpose of the pacifier is what during feedings? Select all that apply A. Coordinates the swallowing of feedings B. Encourages sucking behaviors C. Improves weight gain D. Instills a calming effect E. Improves digestion

B C D E

The nurse has received a shift report on a group of newborns. The nurse should make rounds on which client first? A. A newborn who is LGA needs repeated blood glucose prior to the next feeding in 15 minutes B. A neonate born at 36 weeks gestation weighing 5 lb who is due to breastfeeding for the first time in 15 minutes C. A neonate who was born 24 hours ago by cesarean birth and had a RR of 62 breaths per minute an hour ago D> A newborn who had a borderline low temperature and was double wrapped with a hat 30 min ago to bring up the temperature

C

A preterm neonate admitted to the NICU at about 30 weeks gestation is placed in an oxygenated isolette. The neonate's mother tells the nurse that she is planning to breastfeed the neonate. Which instructions about breastfeeding would be the most appropriate? A. Breastfeeding is not recommended because the neonate needs increased fat in the diet B. Once the neonate no longer needs O2 and continuous monitoring, breastfeeding can be done C. Breastfeeding is contraindicated because the neonate needs a high calorie formula every 2 hours D. Gavage feedings using breast milk can be given until the neonate can coordinate sucking and swallowing

D

While assessing a male neonate whose mother desires for him to be circumcised, the nurse observes that the neonate's urinary meatus is located on the ventral surface of the penis. The HCP is notified because the nurse suspects which complication? A. Phimosis B. Hydrocele C. Epispadias D. Hypospadias

D

When caring for a neonate weighing 4,564 g born vaginally to a mother with diabetes, the nurse should assess the neonate for fracture of which area? A. Clavicle B. Skull C. Wrist D. Rib cage

A

Which subject should the nurse include when teaching the mother of a neonate dx with retinopathy of prematurity about what possible treatment for complications? A. Laser therapy B. Anti-inflammatory eye drops C. Frequent testing for glaucoma D. Corneal transplants

A

A 6lb, 8oz neonate was born vaginally at 38 weeks' gestation. At 5 minutes of life, the neonate has the following signs: HR 110 BPM, intermittent grunting with a respiratory rate of 70 breaths/min, flaccid tone, no response to stimulus, and overall pale white in color. What is the APGAR score? A. 2 B. 3 C. 4 D. 6

C

After teaching the multiparous client about hemolytic disease of the newborn, the nurse determines that the client understands why she is not sensitized during her other pregnancy when she makes which statement? A. My other baby had a different father B. Like most women, I have immunity to the Rh factor C. Antibodies are not usually formed until after exposure to an antigen D. My blood could not neutralize antibodies formed in my first pregnancy

C

While performing a physical assessment on a term neonate shortly after birth, which finding would cause the nurse to notify the HCP? A. Deep creases of the soles of the feet B. Frequent sneezing during the assessment C. Single crease on each of the palms D. Absence of lanugo of the skin

C

The nurse instructs a primiparous client about bottle-feeding her neonate. Which action demonstrates that the mother has understood the nurse's instructions? A. Placing the neonate on his back after the feeding B. Bubbling the baby after 1 oz. of formula C. Putting three-quarters of the bottle nipple into the baby's mouth D. Pointing the nipple toward the neonate's palate

A

When caring for a multiparous client who is HIV positive and asking to breastfeed her neonate as soon as possible, the nurse should include which instructions about breast milk in the teaching plan? A. It may help prevent the spread of HIV virus B. It contains antibodies that can protect the neonate from HIV C. It can be beneficial for the bonding process D. It has been found to contain the retrovirus of HIV

D

Which finding would the nurse expect as common for a multiparous client giving birth to a viable newborn at 41 week's gestation with the aid of a vacuum extractor? A. Caput succedaneum B. Cephalohematoma C. Maternal lacerations D. Neonate intracranial pressure

A

The nurse assesses a 15-hour-old newborn and finds jaundice? What is the priority action the nurse needs to take? A. Continue with normal newborn care B. Notify the HCP of the finding C. Wait and assess the skin color when the infant is over 24 hours old D. Provide an extra feeding for the infant

B

The nurse is caring for a neonate weighing 10 lb at birth who was born via C-section 1 hour ago to a mother with insulin-dependent diabetes. She asks the nurse, "Why is my baby in the NICU?" The nurse bases a response on the understanding that neonates of mothers with diabetes commonly develop which condition? A. Anemia B. Persistent pulmonary hypertension C. Hemolytic disease D. Hypoglycemia

D

Based on the understanding of periods of reactivity, what should the nurse encourage the mother of a term neonate to do approximately 90 minutes after birth? A. Feed the neonate B. Allow the neonate to sleep C. Get to know the neonate D. Change the neonate's diaper

B

The nurse is caring for a neonate dx with early-onset sepsis and is being treated with IV antibiotics. Which instruction will the nurse include in the patient's teaching plan? A. Wear protective gear near the isolation incubator B. Visit but do not touch the neonate C. Wash hands thoroughly before touching the neonate D. Wear a mask when holding the neonate

C

The nurse recognizes that a parent needs more teaching about the complications of neonatal opioid exposure when the parent states that the baby may exhibit which GI problem? A. Constipation B. Increased sucking C. Poor feeding D. Vomiting

C

After teaching the parents of a neonate with a cleft lip and palate about appropriate feeding techniques. The nurse determines the parent need further education when the mom makes what statement? A. I should clean her mouth after each feeding B. I should feed her in an upright position C. I need to remember to burp her often D. I may need to use special for feeding

A

Assessment of a 2-day-old neonate born at 34 weeks' gestation reveals absent apical pulse left of the midclavicular line., cyanosis, grunting, and diminished breath sounds. After beginning O2 what is the priority intervention? A. Obtain a prescription for a stat chest x-ray B. Reposition the neonate, and then assess if the grunting and cyanosis resolve C. Obtain a prescription for an EKG D. Obtain a CBCto determine infection

A

Assessment of a term neonate at 8 hours after birth reveals tachypnea, diminished femoral pulses and poor lower body perfusion. The nurse notifies the HCP based on the interpretation of these symptoms are associated with which complication? A. Coarctation of the aorta B. Atrioventricular septal defect C. Pulmonary atresia D. Transposition of the great arteries

A

A neonate is born by cesarean section at 36 weeks gestation. The temperature in the birthing room is 70 F. To prevent heat loss from convection, which action should the nurse take? A. Dry the neonate quickly after birth B. Keep the neonate away from air conditioning vents C. Place the neonate away from outside windows D. Prewarm the bed

B

After circumcision with a Plastibell, the nurse should instruct the neonate's mother to cleanse the circumcision site using which agent? A. Antibacterial soap B. Warm water C. Povidone-iodine solution D. Diluted hydrogen peroxide

B

A neonate born at 38 weeks gestation is admitted to the neonatal nursery for observation. The neonate's mother, who is positive for human immunodeficiency virus (HIV) infection, has received no prenatal care. The mother asks the nurse if her neonate is positive for HIV. The nurse can tell the mother which information? A. More than 50% of neonates born to mothers who are positive for HIV will be positive at 18 months B. An enlarged liver at birth generally means the neonate is HIV positive C. A CBC analysis is the primary method for determining whether the neonate is HIV positive D. We will test your baby now, but testing will need to be repeated for an accurate diagnosis

D

During an assessment of a neonate born at 33 weeks gestation, a nurse finds and reports a cardiac murmur. An EKG reveals a patent ductus arteriosus, for which the neonate received indomethacin. What is the expected outcome after the administration of indomethacin to a neonate with patent ductus arteriosus? A. Closure of a patent ductus arteriosus B. Decreased bleeding time C. Increased GI function D. Increased renal output

A

After teaching a new mother about the care of her neonate after circumcision with a Gomco clamp, which statement by the mother indicates to the nurse that additional teaching is needed? A. The petroleum gauze may fall off into the diaper B. A few drops of blood oozing from the site are normal C. I will leave the gauze in place for 24 hours D. I will remove any yellowish crusting gently with water

D

The nurse is preparing to administer a vitamin K injection to a male neonate shortly after birth. What statement by the mother indicates that she understands the purpose of the vitamin K injections? A. My baby does not have the normal bacteria in his intestines to produce this vitamin B. My baby is at high risk for a problem involving the blood's ability to clot C. The red blood cells my baby formed during pregnancy are destroying the Vitamin K D. My baby's liver is not able to produce enough of this vitamin so soon after birth

A

The lab results show that a mother has a blood type of O positive and her infant has the blood type of A negative. As part of the plan of care, the nurse should assess the infant for which condition? A. Breast milk jaundice B. Pathologic hyperbilirubinemia C. Physiologic hyperbilirubinemia D. Rh incompatibility

B

While making a home visit to a primiparous client and her 4-day-old daughter, the nurse observes the mother changing the infant's diaper. Before putting the new diaper on, the mother begins to apply baby powder to the infant's buttocks. Which statement about baby powder would the nurse make? A. It may cause pneumonia to develop B. It can prevent diaper rash C. It keeps the diaper from adhering to the skin D. It can result from allergies later in life

A

When developing a nursing care plan for an infant receiving phototherapy, the nurse should include what information in the plan of care? Select all that apply A. Adequate skin exposure to phototherapy B. Allowing the mother to hold infant as much as she wishes C. Eye protection D. Supplemental water between feedings E. Thermoregulation

A C E

A 6-hour-old neonate born at 38 weeks gestation by cesarean birth after prolonged rupture of membranes and a maternal oral temperature of 102 F is being observed for S/S of infection. Which sign would alert the nurse to notify the HCP? A. WBC count of 15,000 cells/mm3 B. Apical HR of 132 C. Behavioral changes D. Warm, moist skin

C

While performing an assessment, the nurse notes the infant's jaundice has moved from the nipple line to the umbilicus in the past 24 hours. How does the nurse interpret this finding? A. A decrease in bilirubin level is probable B. An increase in bilirubin C. No further assessment is necessary D. Where jaundice is located on the baby is not indicative of bilirubin level

B

After teaching a multiparous client the effects of hemodialysis due to Rh sensitization on the neonate at birth, the nurse determines that the mother needs further teaching when the mother reports that the neonate may have what complication? A. Cardiac decompensation B. Polycythemia C. Anemia D. Splenic enlargement

B

Two hours ago, a neonate at 38 weeks gestation and weighing 3,175 g was born to a primiparous client who tested positive for beta-hemolytic Streptococcus. Which finding would alert the nurse to notify the HCP? A. Alkalosis B. Increased muscle tone C. Temperature instability D. Positive Babinski's Reflex

C

Which observation is expected when the nurse is assessing the gestational age of a neonate born at term? A. Ear lying flat against the head B. Absence of rugae of the scrotum C. Sole creases covering the entire foot D. Square window sign angle of 90 degrees

C

While assessing a neonate weighing 7lb at birth at 39 weeks gestation to a primiparous client who admits to opiate use during pregnancy, which finding would alert the nurse to possible opioid withdrawal? A. Bradycardia B. High pitched cry C. Sluggishness D. Hypocalcemia

A

While caring for a neonate of a woman with diabetes soon after birth, the nurse has fed the newborn formula to prevent hyperglycemia. The nurse checks the neonate's blood glucose level, and it is 60 mg/dL, but the neonate continues to exhibit jitteriness and tremors. What should the nurse do first? A. Request a prescription for a blood calcium level B. Administer IV glucose C. Assess the neonate's temperature D. Refeed the infant

A

While caring for the neonate of an HIV-positive mother, the nurse prepares to administer a prescribed vitamin K dose IM 1 hour after birth. Which actions should the nurse do first? A. Bathe the neonate B. Place the neonate in a radiant warmer C. Wash the injection site with povidone-iodine solution D. Wait until the first dose of antiretroviral medication is given

A

After the birth of a neonate, a quick assessment is completed. The neonate is found to be apneic. After quickly drying and positioning the neonate, what should the nurse do next? A. Assign the first APGAR score B. Start the pressure ventilation C. Administer oxygen D. Start cardiac compressions

B

At a home visit the nurse assesses a neonate born vaginally at 41 weeks gestation 5 days ago. Which of these findings warrants further assessment? A. Frequent hiccups B. Loose, watery stool in diaper C. Pink, papular vesicles on the face D. Dry, peeling skin

B

A female neonate born vaginally at term with a cleft lip and palate is admitted to the regular nursery. Which action should the nurse take the first time that the parents visit the neonate? A. Explain the surgical interventions that will be performed B. Stress that this deficit is not life-threatening C. Emphasize the neonate's normal characteristics D. Reassure the parents about the success rate of the surgery

C

The nurse is caring for a term neonate who is dx with patent ductus arteriosus. While performing a physical assessment of the neonate, the nurse anticipates that the neonate will exhibit which signs? A. Decreased cardiac output B. Profound cyanosis over most of the body C. Loud cardiac murmur through systole and diastole D. Harsh systolic murmur with palpable thrill

C

The newborn nurse has just received shift report about a group of newborns and is to receive another admission in 30 minutes. In order to provide the safest care and plan for the new admission, the nurse should do which tasks in order of first to last. A. Move quickly from room to room, and assess all clients B. Check the room to which the new client will be admitted to ensure all supplies and equipment to be available C. Log on to the clinical information system and determine if there are any new prescriptions D. Review notes from shift report, and prioritize all clients; make rounds on the most critical first

D A C B