Question 1

A premature newborn has a pulse pressure of 33 mm Hg.What action by the nurse takes priority?

Accepted Answer

A)  Assess the infant for patent ductus arteriosus. 
B)  Ensure the blood pressure cuff is the right size. 
C)  Increase fluids to 1.5 times the maintenance rate. 
D)  Sedate the baby to prevent fighting the ventilator. 
A)  Assess the infant for patent ductus arteriosus. 
B)  Ensure the blood pressure cuff is the right size. 
C)  Increase fluids to 1.5 times the maintenance rate. 
D)  Sedate the baby to prevent fighting the ventilator.

Question 2

The pediatric nurse explains to the nursing student that respiratory distress syndrome results from a developmental lack of which substance?

Accepted Answer

A)  Calcium 
B)  Lecithin 
C)  Magnesium 
D)  Surfactant 
A)  Calcium 
B)  Lecithin 
C)  Magnesium 
D)  Surfactant

Question 3

The nurse working in labor and delivery knows that which infant is at highest risk of having a long-bone fracture?

Accepted Answer

A)  Intrauterine growth restriction 
B)  Mother with osteoporosis 
C)  Multiples with one breech presentation 
D)  Premature 
A)  Intrauterine growth restriction 
B)  Mother with osteoporosis 
C)  Multiples with one breech presentation 
D)  Premature

Question 4

A premature infant has not had a bowel movement,and the nurse assesses abdominal distention after the last feeding.What action by the nurse takes priority?

Accepted Answer

A)  Document the findings in the chart. 
B)  Facilitate a bowel x-ray. 
C)  Notify the health-care provider. 
D)  Place the infant on NPO status. 
A)  Document the findings in the chart. 
B)  Facilitate a bowel x-ray. 
C)  Notify the health-care provider. 
D)  Place the infant on NPO status.

Question 5

A baby was born 4 days ago at 34 weeks' gestation and is receiving phototherapy for neonatal jaundice.The baby has symptoms of temperature instability,dry skin,poor feeding,lethargy,and irritability.What are the nurse's priority nursing interventions?

Accepted Answer

A)  Assess the baby's temperature to check for hypothermia. 
B)  Check to make sure the infant's face mask stays in place. 
C)  Educate the mother to feed the child every 2 hours. 
D)  Verify laboratory results to check for hypoglycemia. 
E)  Verify laboratory results to check for hypomagnesemia. 
A)  Assess the baby's temperature to check for hypothermia. 
B)  Check to make sure the infant's face mask stays in place. 
C)  Educate the mother to feed the child every 2 hours. 
D)  Verify laboratory results to check for hypoglycemia. 
E)  Verify laboratory results to check for hypomagnesemia.

Question 6

A small-for-gestational-age (SGA)newborn is admitted to the NICU.The nurse notes that the baby's head circumference is in the 68th percentile for gestational age,but the baby's weight is under the 10th percentile.The baby also has a scaphoid abdomen and long fingernails.How does the nurse classify this baby in the handoff report?

Accepted Answer

A)  Asymmetrical intrauterine growth restriction 
B)  Cold-stressed infant 
C)  Intrauterine growth retardation 
D)  Small for gestational age 
A)  Asymmetrical intrauterine growth restriction 
B)  Cold-stressed infant 
C)  Intrauterine growth retardation 
D)  Small for gestational age

Question 7

A postterm newborn is being treated for persistent pulmonary hypertension.Which assessment finding best indicates that a priority outcome has been met?

Accepted Answer

A)  Blood pressure in normal range for age 
B)  Maintains temperature 
C)  Oxygen saturation 95% 
D)  Weight gain 
A)  Blood pressure in normal range for age 
B)  Maintains temperature 
C)  Oxygen saturation 95% 
D)  Weight gain

Question 8

A nurse monitors all newborns in the NICU for hypoglycemia.Which manifestations could indicate hypoglycemia in one of the babies?

Accepted Answer

A)  Apneic episodes 
B)  None (asymptomatic) 
C)  Eye rolling 
D)  Lethargy 
E)  Palmar sweating 
A)  Apneic episodes 
B)  None (asymptomatic) 
C)  Eye rolling 
D)  Lethargy 
E)  Palmar sweating

Question 9

The pediatric nurse prepares a newborn for phototherapy.The nurse explains to the parents that certain organs need to be protected during treatment.Which organs are these?

Accepted Answer

A)  Eyes and ears 
B)  Eyes and hands 
C)  Eyes and genitals 
D)  Genitals and hands 
A)  Eyes and ears 
B)  Eyes and hands 
C)  Eyes and genitals 
D)  Genitals and hands

Question 10

A nurse has given a premature hypoglycemic infant an IV glucose solution.How would the nurse best determine if the goals for this treatment have been met?

Accepted Answer

A)  Blood glucose is 42 mg/dL. 
B)  Blood glucose is 58 mg/dL. 
C)  The baby has a normal-sounding cry. 
D)  The baby is sucking vigorously. 
A)  Blood glucose is 42 mg/dL. 
B)  Blood glucose is 58 mg/dL. 
C)  The baby has a normal-sounding cry. 
D)  The baby is sucking vigorously.

Question 11

A preterm infant in the NICU is receiving oxygen,and the nurse notes that the oxygen saturation is 98%.Which action by the nurse is most appropriate?

Accepted Answer

A)  Call respiratory therapy to draw an arterial blood gas. 
B)  Document the findings and continue to monitor. 
C)  Lower the infant's oxygen concentration and reassess. 
D)  See if the infant can tolerate more stimulation and activity. 
A)  Call respiratory therapy to draw an arterial blood gas. 
B)  Document the findings and continue to monitor. 
C)  Lower the infant's oxygen concentration and reassess. 
D)  See if the infant can tolerate more stimulation and activity.

Question 12

A premature infant is born and admitted to the NICU.A student nurse questions why the primary nurse is starting to plan discharge teaching so early.Which response by the nurse is best?

Accepted Answer

A)  "All these babies have the same needs, so discharge planning here is pretty routine." 
B)  "By starting early I can ensure that social work and specialty nurses can see the baby." 
C)  "I'm not really planning the baby's discharge; I'm just writing some notes about it." 
D)  "The parents have so much to learn we have to start planning discharge on admission." 
A)  "All these babies have the same needs, so discharge planning here is pretty routine." 
B)  "By starting early I can ensure that social work and specialty nurses can see the baby." 
C)  "I'm not really planning the baby's discharge; I'm just writing some notes about it." 
D)  "The parents have so much to learn we have to start planning discharge on admission."

Question 13

A baby with brachial plexus injury is being discharged home.What information should the nurse include on the teaching plan?

Accepted Answer

A)  Encourage the baby to move the arm by holding out toys to reach for. 
B)  Keep the baby's arm in the sling for 23 out of every 24 hours. 
C)  Perform passive range-of-motion exercises to affected extremity. 
D)  Return to the hospital on day 7 for microsurgical repair. 
A)  Encourage the baby to move the arm by holding out toys to reach for. 
B)  Keep the baby's arm in the sling for 23 out of every 24 hours. 
C)  Perform passive range-of-motion exercises to affected extremity. 
D)  Return to the hospital on day 7 for microsurgical repair.

Question 14

A diabetic woman had a cesarean delivery and her baby is noted to have a respiratory rate of 82 breaths/minute with retractions.The baby's blood gas analyses are as follows: pH,7.20; PCO2,52 mm Hg; PaO3,80 mm Hg; PHCO2-,21 mEq/L.What is an important safety measure the nurse should plan to implement when caring for this infant?

Accepted Answer

A)  Ensure the CPAP pressures do not exceed 6 cm H2O. 
B)  Maintain secure position of the endotracheal tube with tape. 
C)  Place the skin temperature sensor over the liver border. 
D)  Plan to check the baby's blood glucose every 2 hours. 
A)  Ensure the CPAP pressures do not exceed 6 cm H2O. 
B)  Maintain secure position of the endotracheal tube with tape. 
C)  Place the skin temperature sensor over the liver border. 
D)  Plan to check the baby's blood glucose every 2 hours.

Question 15

An infant is born at 35 weeks and 3 days.How would the nurse document this gestational age? ____________________

Accepted Answer

35 3/7
Gestational a

Question 16

An infant is born with an encephalocele.Which action by the nurse takes priority?

Accepted Answer

A)  Admit the baby to the NICU. 
B)  Consult the palliative care team. 
C)  Place warm sterile gauze on the defect. 
D)  Prepare the infant for surgery. 
A)  Admit the baby to the NICU. 
B)  Consult the palliative care team. 
C)  Place warm sterile gauze on the defect. 
D)  Prepare the infant for surgery.

Question 17

A nurse is documenting the types of high-risk newborns on the unit.Which infants would be classified as preterm? (Select all that apply).

Accepted Answer

A)    weeks 
B)    weeks 
C)    weeks 
D)    weeks 
E)    weeks 
A)    weeks 
B)    weeks 
C)    weeks 
D)    weeks 
E)    weeks

Question 18

A nurse is caring for a baby with neonatal abstinence syndrome.Which of the following medications should the nurse be prepared to give?

Accepted Answer

A)  Chlorpromazine (Thorazine) 
B)  Clonidine (Catapres) 
C)  Diazepam (Valium) 
D)  Phenobarbital (Luminal) 
E)  Naloxone (Narcan) 
A)  Chlorpromazine (Thorazine) 
B)  Clonidine (Catapres) 
C)  Diazepam (Valium) 
D)  Phenobarbital (Luminal) 
E)  Naloxone (Narcan)

Question 19

A premature infant in the NICU has a sudden increase in head circumference.Which drug does the nurse anticipate administering?

Accepted Answer

A)  Betamethasone (Celestone) 
B)  Caffeine citrate (Cafcit) 
C)  Morphine sulfate (Astromorph) 
D)  Phenobarbital (Luminal Sodium) 
A)  Betamethasone (Celestone) 
B)  Caffeine citrate (Cafcit) 
C)  Morphine sulfate (Astromorph) 
D)  Phenobarbital (Luminal Sodium)

Question 20

A nurse is caring for a premature infant on oxygen.What action is critical for the infant's safety?

Accepted Answer

A)  Educate the parents to care for an infant on oxygen. 
B)  Keep the infant in an incubator while on oxygen. 
C)  Obtain daily chest x-rays to monitor lung maturity. 
D)  Use the lowest amount of oxygen possible. 
A)  Educate the parents to care for an infant on oxygen. 
B)  Keep the infant in an incubator while on oxygen. 
C)  Obtain daily chest x-rays to monitor lung maturity. 
D)  Use the lowest amount of oxygen possible.

Exam 19: Caring for the Newborn at Risk

A premature newborn has a pulse pressure of 33 mm Hg.What action by the nurse takes priority?

The pediatric nurse explains to the nursing student that respiratory distress syndrome results from a developmental lack of which substance?

The nurse working in labor and delivery knows that which infant is at highest risk of having a long-bone fracture?

A premature infant has not had a bowel movement,and the nurse assesses abdominal distention after the last feeding.What action by the nurse takes priority?

A baby was born 4 days ago at 34 weeks' gestation and is receiving phototherapy for neonatal jaundice.The baby has symptoms of temperature instability,dry skin,poor feeding,lethargy,and irritability.What are the nurse's priority nursing interventions?

A postterm newborn is being treated for persistent pulmonary hypertension.Which assessment finding best indicates that a priority outcome has been met?

A nurse monitors all newborns in the NICU for hypoglycemia.Which manifestations could indicate hypoglycemia in one of the babies?

The pediatric nurse prepares a newborn for phototherapy.The nurse explains to the parents that certain organs need to be protected during treatment.Which organs are these?

A nurse has given a premature hypoglycemic infant an IV glucose solution.How would the nurse best determine if the goals for this treatment have been met?

A preterm infant in the NICU is receiving oxygen,and the nurse notes that the oxygen saturation is 98%.Which action by the nurse is most appropriate?

A premature infant is born and admitted to the NICU.A student nurse questions why the primary nurse is starting to plan discharge teaching so early.Which response by the nurse is best?

A baby with brachial plexus injury is being discharged home.What information should the nurse include on the teaching plan?

An infant is born at 35 weeks and 3 days.How would the nurse document this gestational age? ____________________

An infant is born with an encephalocele.Which action by the nurse takes priority?

A nurse is documenting the types of high-risk newborns on the unit.Which infants would be classified as preterm? (Select all that apply).

A nurse is caring for a baby with neonatal abstinence syndrome.Which of the following medications should the nurse be prepared to give?

A premature infant in the NICU has a sudden increase in head circumference.Which drug does the nurse anticipate administering?

A nurse is caring for a premature infant on oxygen.What action is critical for the infant's safety?

Traditional and Community Nursing Care for Women, Families, and Children

Contemporary Issues in Women’s, Families’, and Children’s Health Care

The Evolving Family

Caring for Women, Families, and Children Across the Life Span

Reproductive Anatomy and Physiology

Human Sexuality and Fertility

Conception and Development of the Embryo and Fetus

Physiological and Psychosocial Changes During Pregnancy

The Prenatal Assessment

Promoting a Healthy Pregnancy

Caring for the Woman Experiencing Complications During Pregnancy

The Process of Labor and Birth

Promoting Patient Comfort During Labor and Birth

Caring for the Woman Experiencing Complications During Labor and Birth

Caring for the Postpartal Woman and Her Family

Caring for the Woman Experiencing Complications During the Postpartal Period

Physiological Transition of the Newborn

Caring for the Normal Newborn

Caring for the Developing Child

Caring for the Child in the Hospital,the Community,and Across Care Settings

Caring for the Child With a Psychosocial or Condition

Caring for the Child With a Respiratory Condition

Caring for the Child With a Gastrointestinal Condition

Caring for the Child With an Immunological or Infectious Condition

Caring for the Child With a Cardiovascular Condition

Caring for the Child With an Endocrinological or Metabolic Condition

Caring for the Child With a Neurological or Sensory Condition

Caring for the Child With a Musculoskeletal Condition

Caring for the Child With a Integumentary Condition

Caring for the Child With a Genitourinary Condition

Caring for the Child With a Hematological Condition

Caring for the Child With Cancer

Caring for the Child With a Chronic Condition or the Dying Child

Caring for the Critically Ill Child

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