Question 1

What explains why a neutral thermal environment is essential for a high-risk neonate?

Accepted Answer

A)  The neonate produces heat by increasing activity and shivering. 
B)  Metabolism slows dramatically in the neonate experiencing cold stress. 
C)  It permits the neonate to maintain a normal core temperature with minimum oxygen consumption. 
D)  It permits the neonate to maintain a normal core temperature with increased caloric consumption. 
A)  The neonate produces heat by increasing activity and shivering. 
B)  Metabolism slows dramatically in the neonate experiencing cold stress. 
C)  It permits the neonate to maintain a normal core temperature with minimum oxygen consumption. 
D)  It permits the neonate to maintain a normal core temperature with increased caloric consumption.

Question 2

Which is a central factor responsible for respiratory distress syndrome in a newborn?

Accepted Answer

A)  Absence of alveoli 
B)  Immature bronchioles 
C)  Overdeveloped alveoli 
D)  Deficient surfactant production 
A)  Absence of alveoli 
B)  Immature bronchioles 
C)  Overdeveloped alveoli 
D)  Deficient surfactant production

Question 3

The nurse is planning care for a family expecting their newborn infant to die because of an incurable birth defect.What should the nurse's interventions be based on?

Accepted Answer

A)  Tangible remembrances of the infant (e.g., lock of hair, picture) prolong grief. 
B)  Photographs of infants should not be taken after death. 
C)  Funerals are not recommended because the mother is still recovering from childbirth. 
D)  The parents should be given the opportunity to "parent" the infant, including seeing, holding, touching, or talking to the infant in private. 
A)  Tangible remembrances of the infant (e.g., lock of hair, picture) prolong grief. 
B)  Photographs of infants should not be taken after death. 
C)  Funerals are not recommended because the mother is still recovering from childbirth. 
D)  The parents should be given the opportunity to "parent" the infant, including seeing, holding, touching, or talking to the infant in private.

Question 4

The nurse is preparing to administer a gavage feeding to an infant.The nurse should place the infant in which position for the feeding?

Accepted Answer

A)  Supine with the head flat 
B)  Sitting upright in a car seat 
C)  Left side-lying with the head flat 
D)  Prone with the head slightly elevated 
A)  Supine with the head flat 
B)  Sitting upright in a car seat 
C)  Left side-lying with the head flat 
D)  Prone with the head slightly elevated

Question 5

The nurse is teaching parents of a bottle-fed preterm infant techniques to facilitate feeding.Which techniques should the nurse include?

Accepted Answer

A)  Choose a soft nipple. 
B)  Avoid arousing the infant. 
C)  Recognize the infant's limits. 
D)  Prepare a calm, quiet area for the feeding. 
E)  Ensure a restful environment between feedings. 
A)  Choose a soft nipple. 
B)  Avoid arousing the infant. 
C)  Recognize the infant's limits. 
D)  Prepare a calm, quiet area for the feeding. 
E)  Ensure a restful environment between feedings.

Question 6

A preterm infant is being fed by gavage.What is an important consideration for this infant?

Accepted Answer

A)  Warm the feeding to body temperature before feeding. 
B)  Feed the infant in an isolette to minimize handling. 
C)  Provide a pacifier for nonnutritive sucking during bolus feeding. 
D)  Do not allow the infant to have increased stress by becoming hungry. 
A)  Warm the feeding to body temperature before feeding. 
B)  Feed the infant in an isolette to minimize handling. 
C)  Provide a pacifier for nonnutritive sucking during bolus feeding. 
D)  Do not allow the infant to have increased stress by becoming hungry.

Question 7

A preterm infant with respiratory distress syndrome is receiving inhaled nitric oxide (NO).What is the reason for administering the inhaled nitric oxide?

Accepted Answer

A)  To mature the lungs 
B)  To deliver a level of oxygen that is safe 
C)  To increase the removal of pulmonary debris such as meconium 
D)  To reduce pulmonary vasoconstriction and pulmonary hypertension 
A)  To mature the lungs 
B)  To deliver a level of oxygen that is safe 
C)  To increase the removal of pulmonary debris such as meconium 
D)  To reduce pulmonary vasoconstriction and pulmonary hypertension

Question 8

What is a characteristic of most neonatal seizures?

Accepted Answer

A)  Clonic 
B)  Generalized 
C)  Well organized 
D)  Subtle and barely discernible 
A)  Clonic 
B)  Generalized 
C)  Well organized 
D)  Subtle and barely discernible

Question 9

The home care nurse is visiting a 6-month-old infant with bronchopulmonary dysplasia (BPD).The nurse assesses the child for which signs of overhydration?

Accepted Answer

A)  Edema 
B)  Serum sodium of 140 mEq/L 
C)  Urine specific gravity of 1.008 
D)  Weight gain of 1 lb in 1 week 
A)  Edema 
B)  Serum sodium of 140 mEq/L 
C)  Urine specific gravity of 1.008 
D)  Weight gain of 1 lb in 1 week

Question 10

The nurse knows that during deep sleep the neonate should not be disturbed if possible.Characteristics of deep sleep include what?

Accepted Answer

A)  Regular breathing 
B)  Occasional smiling 
C)  Rapid eye movements 
D)  Apneic pauses of less than 20 seconds 
A)  Regular breathing 
B)  Occasional smiling 
C)  Rapid eye movements 
D)  Apneic pauses of less than 20 seconds

Question 11

The nurse is caring for a newborn who was born at 35 weeks of gestation and is considered a late preterm infant.What intervention should be included in the infant's care plan?

Accepted Answer

A)  Feed the infant dextrose water as the first feeding after 12 hours. 
B)  Promote skin-to-skin care in the immediate postpartum period. 
C)  Avoid administration of the hepatitis B vaccine until after discharge. 
D)  Delay the newborn screening and hearing test until the infant is at 40 weeks' corrected age. 
A)  Feed the infant dextrose water as the first feeding after 12 hours. 
B)  Promote skin-to-skin care in the immediate postpartum period. 
C)  Avoid administration of the hepatitis B vaccine until after discharge. 
D)  Delay the newborn screening and hearing test until the infant is at 40 weeks' corrected age.

Question 12

The nurse is caring for a high-risk neonate who has an umbilical catheter and is in a radiant warmer.The nurse notes blanching of the feet.Which is the most appropriate nursing action?

Accepted Answer

A)  Place socks on the infant's feet. 
B)  Elevate the infant's feet 15 degrees. 
C)  Wrap the infant's feet loosely in a prewarmed blanket. 
D)  Report the findings immediately to the practitioner. 
A)  Place socks on the infant's feet. 
B)  Elevate the infant's feet 15 degrees. 
C)  Wrap the infant's feet loosely in a prewarmed blanket. 
D)  Report the findings immediately to the practitioner.

Question 13

The nurse is caring for a neonate with an intraventricular hemorrhage.What interventions should the nurse avoid to prevent any increase in intracranial pressure?

Accepted Answer

A)  Keeping the head of the bed flat 
B)  Keeping the environment quiet 
C)  Handling the neonate minimally 
D)  Suctioning the endotracheal tube frequently 
E)  Maintaining the neonate's head in a midline position 
A)  Keeping the head of the bed flat 
B)  Keeping the environment quiet 
C)  Handling the neonate minimally 
D)  Suctioning the endotracheal tube frequently 
E)  Maintaining the neonate's head in a midline position

Question 14

Parents of an infant born at 36 weeks' gestation ask the nurse,"Will our infant need a car seat trial before being discharged?" What is the nurse's best response?

Accepted Answer

A)  "Yes, to see if the car seat is the appropriate size." 
B)  "Yes, to determine if blanket rolls will be needed." 
C)  "No, your infant was old enough at birth to not need a trial." 
D)  "Yes, to monitor for possible apnea and bradycardia while in the seat." 
A)  "Yes, to see if the car seat is the appropriate size." 
B)  "Yes, to determine if blanket rolls will be needed." 
C)  "No, your infant was old enough at birth to not need a trial." 
D)  "Yes, to monitor for possible apnea and bradycardia while in the seat."

Question 15

A woman in premature labor delivers an extremely low-birth-weight (ELBW)infant.Transport to a neonatal intensive care unit is indicated.The nurse explains that which level of service is needed?

Accepted Answer

A)  Level I 
B)  Level IA 
C)  Level II 
D)  Level IIIB 
A)  Level I 
B)  Level IA 
C)  Level II 
D)  Level IIIB

Question 16

The nurse is monitoring an infant's temperature to avoid cold stress.The nurse understands that cold stress in the infant can cause which complications?

Accepted Answer

A)  Hypoxia 
B)  Hypoglycemia 
C)  Metabolic acidosis 
D)  Respiratory alkalosis 
E)  Increased shivering response 
A)  Hypoxia 
B)  Hypoglycemia 
C)  Metabolic acidosis 
D)  Respiratory alkalosis 
E)  Increased shivering response

Exam 9: The High-Risk Newborn and Family

What explains why a neutral thermal environment is essential for a high-risk neonate?

Which is a central factor responsible for respiratory distress syndrome in a newborn?

The nurse is planning care for a family expecting their newborn infant to die because of an incurable birth defect.What should the nurse's interventions be based on?

The nurse is preparing to administer a gavage feeding to an infant.The nurse should place the infant in which position for the feeding?

The nurse is teaching parents of a bottle-fed preterm infant techniques to facilitate feeding.Which techniques should the nurse include?

A preterm infant is being fed by gavage.What is an important consideration for this infant?

A preterm infant with respiratory distress syndrome is receiving inhaled nitric oxide (NO).What is the reason for administering the inhaled nitric oxide?

What is a characteristic of most neonatal seizures?

The home care nurse is visiting a 6-month-old infant with bronchopulmonary dysplasia (BPD).The nurse assesses the child for which signs of overhydration?

The nurse knows that during deep sleep the neonate should not be disturbed if possible.Characteristics of deep sleep include what?

The nurse is caring for a newborn who was born at 35 weeks of gestation and is considered a late preterm infant.What intervention should be included in the infant's care plan?

The nurse is caring for a high-risk neonate who has an umbilical catheter and is in a radiant warmer.The nurse notes blanching of the feet.Which is the most appropriate nursing action?

The nurse is caring for a neonate with an intraventricular hemorrhage.What interventions should the nurse avoid to prevent any increase in intracranial pressure?

Parents of an infant born at 36 weeks' gestation ask the nurse,"Will our infant need a car seat trial before being discharged?" What is the nurse's best response?

A woman in premature labor delivers an extremely low-birth-weight (ELBW)infant.Transport to a neonatal intensive care unit is indicated.The nurse explains that which level of service is needed?

The nurse is monitoring an infant's temperature to avoid cold stress.The nurse understands that cold stress in the infant can cause which complications?

Perspectives of Pediatric Nursing

Social,cultural,religious,and Family Influences on Child Health Promotion

Hereditary Influences on Health Promotion of the Child and Family

Communication, physical, and Developmental Assessment

Pain Assessment and Management in Children

Childhood Communicable and Infectious Diseases

Health Promotion of the Newborn and Family

Health Problems of Newborns

Health Promotion of the Infant and Family

Health Problems of the Infant

Health Promotion of the Toddler and Family

Health Promotion of the Preschooler and Family

Health Problems of Early Childhood

Health Promotion of the School-Age Child and Family

Health Problems of the School-Age Child

Health Promotion of the Adolescent and Family

Health Problems of the Adolescent

Family-Centered Care of the Child With Chronic Illness or Disability

Family-Centered Palliative Care

The Child With Cognitive, sensory, or Communication Impairment

Family-Centered Care of the Child During Illness and Hospitalization

Pediatric Nursing Interventions and Skills

The Child With Fluid and Electrolyte Imbalance

The Child With Renal Dysfunction

The Child With Gastrointestinal Dysfunction

Overview of Oxygen and Carbon Dioxide Exchange

The Child With Respiratory Dysfunction

The Child With Cardiovascular Dysfunction

The Child With Hematologic or Immunologic Dysfunction

The Child With Cancer

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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