Question 1

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

Question 2

An infant is to receive gastrostomy feedings. What intervention should the nurse institute to prevent bloating, gastrointestinal reflux into the esophagus, vomiting, and respiratory compromise?

Accepted Answer

A)   Rapid bolusing of the entire amount in 15 minutes
B)   Warm cloths to the abdomen for the first 10 minutes
C)   Slow, small, warm bolus feedings over 20 to 30 minutes
D)   Cold, medium bolus feedings over 20 minutes C

Question 3

Infants of mothers with diabetes are at higher risk for developing:

Accepted Answer

A)   Anemia.
B)   Hyponatremia.
C)   Respiratory distress syndrome.
D)   Sepsis. C

Question 4

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 if her baby will meet developmental milestones on time, as did her son who was born at term. The nurse's most appropriate response would be:

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 5

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 6

After giving birth to a stillborn infant, the woman turns to the nurse and says, "I just finished painting the baby's room. Do you think that caused my baby to die?" The nurse's best response to this woman is:

Accepted Answer

A)   "That's an old wives' tale; lots of women are around paint during pregnancy, and this doesn't happen to them."
B)   "That's not likely. Paint is associated with elevated pediatric lead levels."
C)   Silence.
D)   "I can understand your need to find an answer to what caused this. What else are you thinking about?"

Question 7

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 8

When helping the mother, father, and other family members actualize the loss of the infant, nurses should:

Accepted Answer

A)   Use the words lost or gone rather than dead or died.
B)   Make sure that the family understands that it is important to name the baby.
C)   If the parents choose to visit with the baby, apply powder and lotion to the baby and wrap the infant in a pretty blanket.
D)   Set a firm time for ending the visit with the baby so the parents know when to let go.

Question 9

The nurse caring for a family during a loss might notice that survival guilt sometimes is felt at the death of an infant by the child's:

Accepted Answer

A)   Siblings.
B)   Mother.
C)   Father.
D)   Grandparents.

Question 10

With regard to small for gestational age (SGA) infants and intrauterine growth restriction (IUGR), nurses should be aware that:

Accepted Answer

A)   In the first trimester diseases or abnormalities result in asymmetric IUGR.
B)   Infants with asymmetric IUGR have the potential for normal growth and development.
C)   In asymmetric IUGR, weight will be slightly more than SGA, whereas length and head circumference will be somewhat less than SGA.
D)   Symmetric IUGR occurs in the later stages of pregnancy.

Question 11

Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. Some generalized signs include:

Accepted Answer

A)   Hypertonia, tachycardia, and metabolic alkalosis.
B)   Abdominal distention, temperature instability, and grossly bloody stools.
C)   Hypertension, absence of apnea, and ruddy skin color.
D)   Scaphoid abdomen, no residual with feedings, and increased urinary output.

Question 12

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."

Question 13

____________________ is a condition in which the ventricles of the brain are enlarged as a result of an imbalance between the production and absorption of the cerebrospinal fluid (CSF). An infant with this condition initially has a bulging anterior fontanel and a head circumference that increases at an abnormal rate, resulting from the increase in CSF pressure.

Accepted Answer

The answer of ____________________ is a condition in which the...

Question 14

A pregnant woman presents in labor at term, having had no prenatal care. After birth her infant is noted to be small for gestational age with small eyes and a thin upper lip. The infant also is microcephalic. On the basis of her infant's physical findings, this woman should be questioned about her use of which substance during pregnancy?

Accepted Answer

A)   Alcohol
B)   Cocaine
C)   Heroin
D)   Marijuana

Question 15

_____________________, a synthetic opiate, has been the therapy of choice for heroin addiction. It crosses the placenta, leading to significant neonatal abstinence syndrome after birth.

Accepted Answer

The answer of _____________________, a synthetic opiate, has been the...

Question 16

An infant at 36 weeks of gestation has increasing respirations (80 to 100 breaths/min with marked substernal retractions). The infant is given oxygen by continuous nasal positive airway pressure. Which arterial oxygen level would indicate hypoxia?

Accepted Answer

A)   PaO2 of 67
B)   PaO2 of 89
C)   PaO2 of 45
D)   PaO2 of 73

Question 17

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

Accepted Answer

A)   Rh incompatibility matters only when an Rh-negative offspring 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.

Question 18

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 19

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 20

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.

Exam 24: The Newborn at Risk