Question 1

An infant is being discharged from the neonatal intensive care unit after 70 days of hospitalization.The infant was born at 30 weeks of gestation with several conditions associated with prematurity,including respiratory distress syndrome,mild bronchopulmonary dysplasia,and retinopathy of prematurity requiring surgical treatment.During discharge teaching the infant's mother asks the nurse whether her baby will meet developmental milestones on time,as did her son who was born at term.The nurse's most appropriate response is:

Accepted Answer

A) "Your baby will develop exactly like your first child did." 
B) "Your baby does not appear to have any problems at the present time." 
C) "Your baby will need to be corrected for prematurity. Your baby is currently 40 weeks of postconceptional age and can be expected to be doing what a 40-week-old infant would be doing." 
D) "Your baby will need to be followed very closely."

Question 2

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 SaO?. 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 3

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 bpm 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 3

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team.Nursing care for this infant requires a multisystem approach.The first step in the provision of this care is:

Accepted Answer

A) Pharmacologic treatment. 
B) Reduction of environmental stimuli. 
C) Neonatal abstinence syndrome scoring. 
D) Adequate nutrition and maintenance of fluid and electrolyte balance.

Question 4

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 SaO?. 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 2

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 bpm 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 5

Because of the premature infant's decreased immune functioning,what nursing diagnosis should the nurse include in a plan of care for a premature infant?

Accepted Answer

A) Delayed growth and development 
B) Ineffective thermoregulation 
C) Ineffective infant feeding pattern 
D) Risk for infection

Question 6

While completing a newborn assessment,the nurse should be aware that the most common birth injury is:

Accepted Answer

A) To the soft tissues. 
B) Caused by forceps gripping the head on delivery. 
C) Fracture of the humerus and femur. 
D) Fracture of the clavicle.

Question 7

What bacterial infection is definitely decreasing because of effective drug treatment?

Accepted Answer

A) Escherichia coli infection 
B) Tuberculosis 
C) Candidiasis 
D) Group B streptococcal infection

Question 8

On day 3 of life,a newborn continues to require 100% oxygen by nasal cannula.The parents ask whether they can hold their infant during his next gavage feeding.Given that this newborn is physiologically stable,what response would the nurse give?

Accepted Answer

A) "Parents are not allowed to hold infants who depend on oxygen." 
B) "You may hold only your baby's hand during the feeding." 
C) "Feedings cause more physiologic stress, so the baby must be closely monitored. Therefore, I don't think you should hold the baby." 
D) "You may hold your baby during the feeding."

Question 9

Many common drugs of abuse cause significant physiologic and behavioral problems in infants who are breastfed by mothers currently using (Select all that apply):

Accepted Answer

A) Amphetamine. 
B) Heroin. 
C) Nicotine. 
D) PCP. 
E) Morphine.

Question 10

In caring for the mother who has abused (or is abusing)alcohol and for her infant,nurses should be aware that:

Accepted Answer

A) The pattern of growth restriction of the fetus begun in prenatal life is halted after birth, and normal growth takes over. 
B) Two thirds of newborns with fetal alcohol syndrome (FAS) are boys. 
C) Alcohol-related neurodevelopmental disorders not sufficient to meet FAS criteria (learning disabilities, speech and language problems) are often not detected until the child goes to school. 
D) Both the distinctive facial features of the FAS infant and the diminished mental capacities tend toward normal over time.

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.

Question 12

An infant was born 2 hours ago at 37 weeks of gestation and weighing 4.1 kg.The infant appears chubby with a flushed complexion and is very tremulous.The tremors are most likely the result of:

Accepted Answer

A) Birth injury. 
B) Hypocalcemia. 
C) Hypoglycemia. 
D) Seizures.

Question 13

When providing an infant with a gavage feeding,which of the following should be documented each time?

Accepted Answer

A) The infant's abdominal circumference after the feeding 
B) The infant's heart rate and respirations 
C) The infant's suck and swallow coordination 
D) The infant's response to the feeding

Question 14

Risk factors associated with necrotizing enterocolitis (NEC)include (Select all that apply):

Accepted Answer

A) Polycythemia. 
B) Anemia. 
C) Congenital heart disease. 
D) Bronchopulmonary dysphasia. 
E) Retinopathy.

Question 15

With regard to injuries to the infant's plexus during labor and birth,nurses should be aware that:

Accepted Answer

A) If the nerves are stretched with no avulsion, they should recover completely in 3 to 6 months. 
B) Erb palsy is damage to the lower plexus. 
C) Parents of children with brachial palsy are taught to pick up the child from under the axillae. 
D) Breastfeeding is not recommended for infants with facial nerve paralysis until the condition resolves.

Question 16

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.

Question 17

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.

Exam 25: The High Risk Newborn