Question 1

A premature infant with respiratory distress syndrome receives artificial surfactant.How would the nurse explain surfactant therapy to the parents?

Accepted Answer

A)  "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide." 
B)  "The drug keeps your baby from requiring too much sedation." 
C)  "Surfactant is used to reduce episodes of periodic apnea." 
D)  "Your baby needs this medication to fight a possible respiratory tract infection." 
A)  "Surfactant improves the ability of your baby's lungs to exchange oxygen and carbon dioxide." 
B)  "The drug keeps your baby from requiring too much sedation." 
C)  "Surfactant is used to reduce episodes of periodic apnea." 
D)  "Your baby needs this medication to fight a possible respiratory tract infection." A

Question 2

The goal of treatment of the infant with phenylketonuria (PKU)is to:

Accepted Answer

A)  cure mental retardation. 
B)  prevent central nervous system (CNS) damage, which leads to mental retardation. 
C)  prevent gastrointestinal symptoms. 
D)  cure the urinary tract infection. 
A)  cure mental retardation. 
B)  prevent central nervous system (CNS) damage, which leads to mental retardation. 
C)  prevent gastrointestinal symptoms. 
D)  cure the urinary tract infection. B

Question 3

With regard to hemolytic diseases of the newborn,nurses should be aware that:

Accepted Answer

A)  Rh incompatibility matters only when an Rh-negative child is born to an Rh-positive mother. 
B)  ABO incompatibility is more likely than Rh incompatibility to precipitate significant anemia. 
C)  exchange transfusions frequently are required in the treatment of hemolytic disorders. 
D)  the indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth. 
A)  Rh incompatibility matters only when an Rh-negative child is born to an Rh-positive mother. 
B)  ABO incompatibility is more likely than Rh incompatibility to precipitate significant anemia. 
C)  exchange transfusions frequently are required in the treatment of hemolytic disorders. 
D)  the indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth. D

Question 4

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates.A nonstress test (NST)in the obstetrician's office revealed a nonreactive tracing.On artificial rupture of membranes,thick,meconium-stained fluid was noted.The nurse caring for the infant after birth should anticipate:

Accepted Answer

A)  meconium aspiration, hypoglycemia, and dry, cracked skin. 
B)  excessive vernix caseosa covering the skin, lethargy, and respiratory distress syndrome. 
C)  golden yellow- to green stained-skin and nails, absence of scalp hair, and an increased amount of subcutaneous fat. 
D)  hyperglycemia, hyperthermia, and an alert, wide-eyed appearance. 
A)  meconium aspiration, hypoglycemia, and dry, cracked skin. 
B)  excessive vernix caseosa covering the skin, lethargy, and respiratory distress syndrome. 
C)  golden yellow- to green stained-skin and nails, absence of scalp hair, and an increased amount of subcutaneous fat. 
D)  hyperglycemia, hyperthermia, and an alert, wide-eyed appearance.

Question 5

In the assessment of a preterm infant,the nurse notices continued respiratory distress even though oxygen and ventilation have been provided.The nurse should suspect:

Accepted Answer

A)  hypovolemia and/or shock. 
B)  a nonneutral thermal environment. 
C)  central nervous system injury. 
D)  pending renal failure. 
A)  hypovolemia and/or shock. 
B)  a nonneutral thermal environment. 
C)  central nervous system injury. 
D)  pending renal failure.

Question 6

An infant with severe meconium aspiration syndrome (MAS)is not responding to conventional treatment.Which highly technical method of treatment may be necessary for an infant who does not respond to conventional treatment?

Accepted Answer

A)  Extracorporeal membrane oxygenation 
B)  Respiratory support with a ventilator 
C)  Insertion of a laryngoscope and suctioning of the trachea 
D)  Insertion of an endotracheal tube 
A)  Extracorporeal membrane oxygenation 
B)  Respiratory support with a ventilator 
C)  Insertion of a laryngoscope and suctioning of the trachea 
D)  Insertion of an endotracheal tube

Question 7

Premature infants who exhibit 5 to 10 seconds of respiratory pauses followed by 10 to 15 seconds of compensatory rapid respiration are:

Accepted Answer

A)  suffering from sleep or wakeful apnea. 
B)  experiencing severe swings in blood pressure. 
C)  trying to maintain a neutral thermal environment. 
D)  breathing in a respiratory pattern common to premature infants. 
A)  suffering from sleep or wakeful apnea. 
B)  experiencing severe swings in blood pressure. 
C)  trying to maintain a neutral thermal environment. 
D)  breathing in a respiratory pattern common to premature infants.

Question 8

In caring for the preterm infant,what complication is thought to be a result of high arterial blood oxygen level?

Accepted Answer

A)  Necrotizing enterocolitis (NE
C)  
B)  Retinopathy of prematurity (ROP) 
C)  Bronchopulmonary dysplasia (BP
D)  
D)  Intraventricular hemorrhage (IVH) 
A)  Necrotizing enterocolitis (NE
C)  
B)  Retinopathy of prematurity (ROP) 
C)  Bronchopulmonary dysplasia (BP
D)  
D)  Intraventricular hemorrhage (IVH)

Question 9

To care adequately for infants at risk for neonatal bacterial infection,nurses should be aware that:

Accepted Answer

A)  congenital infection progresses more slowly than does nosocomial infection. 
B)  nosocomial infection can be prevented by effective hand washing; early-onset infections cannot. 
C)  infections occur with about the same frequency in boy and girl infants, although female mortality is higher. 
D)  the clinical sign of a rapid, high fever makes infection easier to diagnose. 
A)  congenital infection progresses more slowly than does nosocomial infection. 
B)  nosocomial infection can be prevented by effective hand washing; early-onset infections cannot. 
C)  infections occur with about the same frequency in boy and girl infants, although female mortality is higher. 
D)  the clinical sign of a rapid, high fever makes infection easier to diagnose.

Question 10

The most common cause of pathologic hyperbilirubinemia is:

Accepted Answer

A)  hepatic disease. 
B)  hemolytic disorders in the newborn. 
C)  postmaturity. 
D)  congenital heart defect. 
A)  hepatic disease. 
B)  hemolytic disorders in the newborn. 
C)  postmaturity. 
D)  congenital heart defect.

Question 11

As related to the eventual discharge of the high risk newborn or transfer to a different facility,nurses and families should be aware that:

Accepted Answer

A)  infants will stay in the neonatal intensive care unit (NICU) until they are ready to go home. 
B)  once discharged to home, the high risk infant should be treated like any healthy term newborn. 
C)  parents of high risk infants need special support and detailed contact information. 
D)  if a high risk infant and mother need transfer to a specialized regional center, it is better to wait until after birth and the infant is stabilized. 
A)  infants will stay in the neonatal intensive care unit (NICU) until they are ready to go home. 
B)  once discharged to home, the high risk infant should be treated like any healthy term newborn. 
C)  parents of high risk infants need special support and detailed contact information. 
D)  if a high risk infant and mother need transfer to a specialized regional center, it is better to wait until after birth and the infant is stabilized.

Question 12

A plan of care for an infant experiencing symptoms of drug withdrawal should include:

Accepted Answer

A)  administering chloral hydrate for sedation. 
B)  feeding every 4 to 6 hours to allow extra rest. 
C)  swaddling the infant snugly and holding the baby tightly. 
D)  playing soft music during feeding. 
A)  administering chloral hydrate for sedation. 
B)  feeding every 4 to 6 hours to allow extra rest. 
C)  swaddling the infant snugly and holding the baby tightly. 
D)  playing soft music during feeding.

Question 13

During a prenatal examination,the woman reports having two cats at home.The nurse informs her that she should not be cleaning the litter box while she is pregnant.When the woman asks why,the nurse's best response would be:

Accepted Answer

A)  "Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that can infect you and have severe effects on your unborn child." 
B)  "You and your baby can be exposed to the human immunodeficiency virus (HIV) in your cats' feces." 
C)  "It's just gross. You should make your husband clean the litter boxes." 
D)  "Cat feces are known to carry Escherichia coli, which can cause a severe infection in both you and your baby." 
A)  "Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that can infect you and have severe effects on your unborn child." 
B)  "You and your baby can be exposed to the human immunodeficiency virus (HIV) in your cats' feces." 
C)  "It's just gross. You should make your husband clean the litter boxes." 
D)  "Cat feces are known to carry Escherichia coli, which can cause a severe infection in both you and your baby."

Question 14

MATCHING
Car seat safety is an essential part of discharge planning, and infants younger than 37 weeks of gestation should have a period of observation in an appropriate car seat to monitor for possible apnea, bradycardia, and decreased SaOS1U1B12S1U1B0. The nurse who is about to perform a car seat evaluation on a late-preterm infant will perform the sequence of the test in which order?

-Step 5

Accepted Answer

A) Secure the infant in the car seat per guidelines using blanket rolls on the side. 
B) Leave the infant undisturbed for 90 to 120 minutes. 
C) Set the heart rate alarm at 80 beats/min and the apnea alarm at 20 seconds. 
D) Document the infant's tolerance to the test. 
E) Perform the evaluation 1 to 7 days before discharge.
F)Use the parent's car seat.
G)Set the pulse oximeter low alarm at 88%. 
A) Secure the infant in the car seat per guidelines using blanket rolls on the side. 
B) Leave the infant undisturbed for 90 to 120 minutes. 
C) Set the heart rate alarm at 80 beats/min and the apnea alarm at 20 seconds. 
D) Document the infant's tolerance to the test. 
E) Perform the evaluation 1 to 7 days before discharge.
F)Use the parent's car seat.
G)Set the pulse oximeter low alarm at 88%.

Question 15

The nurse practicing in the perinatal setting should promote kangaroo care regardless of an infant's gestational age.This intervention:

Accepted Answer

A)  is adopted from classical British nursing traditions. 
B)  helps infants with motor and central nervous system impairment. 
C)  helps infants to interact directly with their parents and enhances their temperature regulation. 
D)  gets infants ready for breastfeeding. 
A)  is adopted from classical British nursing traditions. 
B)  helps infants with motor and central nervous system impairment. 
C)  helps infants to interact directly with their parents and enhances their temperature regulation. 
D)  gets infants ready for breastfeeding.

Question 16

For clinical purposes,preterm and postterm infants are defined as:

Accepted Answer

A)  preterm before 34 weeks if appropriate for gestational age (AG
A)  and before 37 weeks if small for gestational age (SG
A) . 
B)  Postterm after 40 weeks if large for gestational age (LG
A)  and beyond 42 weeks if AGA. 
C)  Preterm before 37 weeks, and postterm beyond 42 weeks, no matter the size for gestational age at birth. 
D)  Preterm, SGA before 38 to 40 weeks, and postterm, LGA beyond 40 to 42 weeks. 
A)  preterm before 34 weeks if appropriate for gestational age (AG
A)  and before 37 weeks if small for gestational age (SG
A) . 
B)  Postterm after 40 weeks if large for gestational age (LG
A)  and beyond 42 weeks if AGA. 
C)  Preterm before 37 weeks, and postterm beyond 42 weeks, no matter the size for gestational age at birth. 
D)  Preterm, SGA before 38 to 40 weeks, and postterm, LGA beyond 40 to 42 weeks.

Question 17

A primigravida has just delivered a healthy infant girl.The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks,"What is that medicine for?" The nurse responds:

Accepted Answer

A)  "It is an eye ointment to help your baby see you better." 
B)  "It is to protect your baby from contracting herpes from your vaginal tract." 
C)  "Erythromycin is given prophylactically to prevent a gonorrheal infection." 
D)  "This medicine will protect your baby's eyes from drying out over the next few days." 
A)  "It is an eye ointment to help your baby see you better." 
B)  "It is to protect your baby from contracting herpes from your vaginal tract." 
C)  "Erythromycin is given prophylactically to prevent a gonorrheal infection." 
D)  "This medicine will protect your baby's eyes from drying out over the next few days."

Question 18

Necrotizing enterocolitis (NEC)is an acute inflammatory disease of the gastrointestinal mucosa that can progress to perforation of the bowel.Approximately 2% to 5% of premature infants succumb to this fatal disease.Care is supportive; however,known interventions may decrease the risk of NEC.To develop an optimal plan of care for this infant,the nurse must understand which intervention has the greatest effect on lowering the risk of NEC:

Accepted Answer

A)  early enteral feedings. 
B)  breastfeeding. 
C)  exchange transfusion. 
D)  prophylactic probiotics. 
A)  early enteral feedings. 
B)  breastfeeding. 
C)  exchange transfusion. 
D)  prophylactic probiotics.

Question 19

Human immunodeficiency virus (HIV)may be perinatally transmitted:

Accepted Answer

A)  only in the third trimester from the maternal circulation. 
B)  by a needlestick injury at birth from unsterile instruments. 
C)  only through the ingestion of amniotic fluid. 
D)  through the ingestion of breast milk from an infected mother. 
A)  only in the third trimester from the maternal circulation. 
B)  by a needlestick injury at birth from unsterile instruments. 
C)  only through the ingestion of amniotic fluid. 
D)  through the ingestion of breast milk from an infected mother.

Question 20

Which infant would be more likely to have Rh incompatibility?

Accepted Answer

A)  Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor. 
B)  Infant who is Rh negative and whose mother is Rh negative. 
C)  Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor. 
D)  Infant who is Rh positive and whose mother is Rh positive. 
A)  Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor. 
B)  Infant who is Rh negative and whose mother is Rh negative. 
C)  Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor. 
D)  Infant who is Rh positive and whose mother is Rh positive.

Exam 25: The High-Risk Newborn

A premature infant with respiratory distress syndrome receives artificial surfactant.How would the nurse explain surfactant therapy to the parents?

The goal of treatment of the infant with phenylketonuria (PKU)is to:

With regard to hemolytic diseases of the newborn,nurses should be aware that:

In the assessment of a preterm infant,the nurse notices continued respiratory distress even though oxygen and ventilation have been provided.The nurse should suspect:

An infant with severe meconium aspiration syndrome (MAS)is not responding to conventional treatment.Which highly technical method of treatment may be necessary for an infant who does not respond to conventional treatment?

Premature infants who exhibit 5 to 10 seconds of respiratory pauses followed by 10 to 15 seconds of compensatory rapid respiration are:

In caring for the preterm infant,what complication is thought to be a result of high arterial blood oxygen level?

To care adequately for infants at risk for neonatal bacterial infection,nurses should be aware that:

The most common cause of pathologic hyperbilirubinemia is:

As related to the eventual discharge of the high risk newborn or transfer to a different facility,nurses and families should be aware that:

A plan of care for an infant experiencing symptoms of drug withdrawal should include:

During a prenatal examination,the woman reports having two cats at home.The nurse informs her that she should not be cleaning the litter box while she is pregnant.When the woman asks why,the nurse's best response would be:

The nurse practicing in the perinatal setting should promote kangaroo care regardless of an infant's gestational age.This intervention:

For clinical purposes,preterm and postterm infants are defined as:

A primigravida has just delivered a healthy infant girl.The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks,"What is that medicine for?" The nurse responds:

Human immunodeficiency virus (HIV)may be perinatally transmitted:

Which infant would be more likely to have Rh incompatibility?

21st Century Maternity Nursing

The Family, culture, spirituality, and Home Care

Assessment and Health Promotion

Reproductive System Concerns

Infertility, contraception, and Abortion

Genetics, conception, and Fetal Development

Anatomy and Physiology of Pregnancy

Nursing Care of the Family During Pregnancy

Maternal and Fetal Nutrition

Assessment of High-Risk Pregnancy

High-Risk Perinatal Care: Preexisting Conditions

High-Risk Perinatal Care: Gestational Conditions

Labor and Birth Processes

Maximizing Comfort for the Laboring Woman

Fetal Assessment During Labor

Nursing Care of the Family During Labor and Birth

Labor and Birth Complications

Postpartum Physiologic Changes

Nursing Care of the Family During the Postpartum Period

Transition to Parenthood

Postpartum Complications

Physiologic and Behavioral Adaptations of the Newborn

Nursing Care of the Newborn and Family

Newborn Nutrition and Feeding

21st Century Pediatric Nursing

Family, social, cultural, and Religious Influences on Child Health Promotion

Developmental and Genetic Influences on Child Health Promotion

Communication and Physical Assessment of the Child and Family

Pain Assessment and Management in Children

The Infant and Family

The Toddler and Family

The Preschooler and Family

The School-Age Child and Family

The Adolescent and Family

Impact of Chronic Illness, disability, or End-Of-Life Care for the Child and Family

Impact of Cognitive or Sensory Impairment on the Child and Family

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Variations of Nursing Interventions

The Child With Respiratory Dysfunction

The Child With Gastrointestinal Dysfunction

The Child With Cardiovascular Dysfunction

The Child With Hematologic or Immunologic Dysfunction

The Child With Cancer

The Child With Genitourinary Dysfunction

The Child With Cerebral Dysfunction

The Child With Endocrine Dysfunction

The Child With Musculoskeletal or Articular Dysfunction

The Child With Neuromuscular or Muscular Dysfunction

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