Question 1

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 2

HIV may be perinatally transmitted:

Accepted Answer

A)  only in the third trimester from the maternal circulation. 
B)  from the use of unsterile instruments. 
C)  only through the ingestion of amniotic fluid. 
D)  through the ingestion of breast milk from an infected mother.

Question 3

Near the end of the first week of life,an infant who has not been treated for any infection develops a copper-colored,maculopapular rash on the palms and around the mouth and anus.The newborn is showing signs of:

Accepted Answer

A)  gonorrhea. 
B)  herpes simplex virus infection. 
C)  congenital syphilis. 
D)  human immunodeficiency virus.

Question 4

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 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

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

Accepted Answer

A)  anemia. 
B)  hyponatremia. 
C)  respiratory distress syndrome. 
D)  sepsis.

Question 7

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 8

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 9

The most important nursing action in preventing neonatal infection is:

Accepted Answer

A)  good hand washing. 
B)  isolation of infected infants. 
C)  separate gown technique. 
D)  Standard Precautions.

Question 10

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 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 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 11

Infants born between 34 0/7 and 36 6/7 weeks of gestation are called late-preterm infants because they have many needs similar to those of preterm infants.Because they are more stable than early-preterm infants,they may receive care that is much like that of a full-term baby.The mother-baby or nursery nurse knows that these babies are at increased risk for: (Select all that apply.)

Accepted Answer

A)  problems with thermoregulation. 
B)  cardiac distress. 
C)  hyperbilirubinemia. 
D)  sepsis. 
E)  hyperglycemia.

Question 12

A newborn was admitted to the neonatal intensive care unit after being delivered at 29 weeks of gestation to a 28-year-old multiparous,married,Caucasian woman whose pregnancy was uncomplicated until premature rupture of membranes and preterm birth.The newborn's parents arrive for their first visit after the birth.The parents walk toward the bedside but remain approximately 5 feet away from the bed.The nurse's most appropriate action would be to:

Accepted Answer

A)  wait quietly at the newborn's bedside until the parents come closer. 
B)  go to the parents, introduce himself or herself, and gently encourage the parents to come meet their infant; explain the equipment first, and then focus on the newborn. 
C)  leave the parents at the bedside while they are visiting so they can have some privacy. 
D)  tell the parents only about the newborn's physical condition, and caution them to avoid touching their baby.

Question 13

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 30 minutes. 
D)  Cold, medium bolus feedings over 20 minutes.

Question 14

A careful review of the literature on the various recreational and illicit drugs reveals that:

Accepted Answer

A)  more longer-term studies are needed to assess the lasting effects on infants when mothers have taken or are taking illegal drugs. 
B)  heroin and methadone cross the placenta; marijuana, cocaine, and phencyclidine (PCP) do not. 
C)  mothers should discontinue heroin use (detox) any time they can during pregnancy. 
D)  methadone withdrawal for infants is less severe and shorter than heroin withdrawal.

Question 15

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 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 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 16

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 17

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 18

A macrosomic infant is born after a difficult forceps-assisted delivery.After stabilization the infant is weighed,and the birth weight is 4550 g (9 lbs,6 ounces).The nurse's most appropriate action is to:

Accepted Answer

A)  leave the infant in the room with the mother. 
B)  take the infant immediately to the nursery. 
C)  perform a gestational age assessment to determine whether the infant is large for gestational age. 
D)  monitor blood glucose levels frequently and observe closely for signs of hypoglycemia.

Question 19

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours.A cesarean section is performed for failure to progress.The fetal heart rate (FHR)before birth is 180 beats/min with limited variability.At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic.On the basis of the maternal history,the cause of this newborn's distress is most likely to be:

Accepted Answer

A)  hypoglycemia. 
B)  phrenic nerve injury. 
C)  respiratory distress syndrome. 
D)  sepsis.

Question 20

The abuse of which of the following substances during pregnancy is the leading cause of cognitive impairment in the United States?

Accepted Answer

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

Exam 25: The High-Risk Newborn