Ch 23 and 24 Flashcards Preview

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Flashcards in Ch 23 and 24 Deck (56):
1

Ch 23
1.
The nurse is teaching a group of students about the differences between a full-term newborn and a preterm newborn. The nurse determines that the teaching is effective when the students state that the preterm newborn has:
A)
Fewer visible blood vessels through the skin
B)
More subcutaneous fat in the neck and abdomen
C)
Well-developed flexor muscles in the extremities
D)
Greater surface area in proportion to weight

Greater surface area in proportion to weight

2

2.
When assessing a postterm newborn, which of the following would the nurse correlate with this gestational age variation?
A)
Moist, supple, plum skin appearance
B)
Abundant lanugo and vernix
C)
Thin umbilical cord
D)
Absence of sole creases

Thin umbilical cord

3

3.
The parents of a preterm newborn being cared for in the neonatal intensive care unit (NICU. are coming to visit for the first time. The newborn is receiving mechanical ventilation and intravenous fluids and medications and is being monitored electronically by various devices. Which action by the nurse would be most appropriate?
A)
Suggest that the parents stay for just a few minutes to reduce their anxiety.
B)
Reassure them that their newborn is progressing well.
C)
Encourage the parents to touch their preterm newborn.
D)
Discuss the care they will be giving the newborn upon discharge.

Encourage the parents to touch their preterm newborn.

4

4.
When performing newborn resuscitation, which action would the nurse do first?
A)
Intubate with an appropriate-sized endotracheal tube.
B)
Give chest compressions at a rate of 80 times per minute.
C)
Administer epinephrine intravenously.
D)
Suction the mouth and then the nose.

Suction the mouth and then the nose.

5

5.
The nurse frequently assesses the respiratory status of a preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syndrome because of which of the following?
A)
Inability to clear fluids
B)
Immature respiratory control center
C)
Deficiency of surfactant
D)
Smaller respiratory passages

Deficiency of surfactant

6

6.
The nurse prepares to assess a newborn who is considered to be large for gestational age (LGA). Which of the following would the nurse correlate with this gestational age variation?
A)
Strong, brisk motor skills
B)
Difficulty in arousing to a quiet alert state
C)
Birth weight of 7 lb 14 oz
D)
Wasted appearance of extremities

Difficulty in arousing to a quiet alert state

7

7.
An LGA newborn has a blood glucose level of 30 mg/dL and is exhibiting symptoms of hypoglycemia. Which of the following would the nurse do next?
A)
Administer intravenous glucose immediately.
B)
Feed the newborn 2 ounces of formula.
C)
Initiate blow-by oxygen therapy.
D)
Place the newborn under a radiant warmer.

Administer intravenous glucose immediately.

8

8.
A group of pregnant women are discussing high-risk newborn conditions as part of a prenatal class. When describing the complications that can occur in these newborns to the group, which would the nurse include as being at lowest risk?
A)
Small-for-gestational-age (SGA. newborns
B)
Large-for-gestational-age (LGA. newborns
C)
Appropriate-for-gestational-age (AGA. newborns
D)
Low-birth-weight newborns

Appropriate-for-gestational-age (AGA) newborns

9

9.
While caring for a preterm newborn receiving oxygen therapy, the nurse monitors the oxygen therapy duration closely based on the understanding that the newborn is at risk for which of the following?
A)
Retinopathy of prematurity
B)
Metabolic acidosis
C)
Infection
D)
Cold stress

Retinopathy of prematurity

10

10.
When planning the care for an SGA newborn, which action would the nurse determine as a priority?
A)
Preventing hypoglycemia with early feedings
B)
Observing for respiratory distress syndrome
C)
Promoting bonding between the parents and the newborn
D)
Monitoring vital signs every 2 hours

Preventing hypoglycemia with early feedings

11

11.
A woman gives birth to a newborn at 36 weeks' gestation. She tells the nurse, “I'm so glad that my baby isn't premature.” Which response by the nurse would be most appropriate?
A)
“You are lucky to have given birth to a term newborn.”
B)
“We still need to monitor him closely for problems.”
C)
“How do you feel about delivering your baby at 36 weeks?”
D)
“Your baby is premature and needs monitoring in the NICU.”

“We still need to monitor him closely for problems.”

12

12.
Which of the following would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn?
A)
Avoid using the terms “death” or “dying.”
B)
Provide opportunities for them to hold the newborn.
C)
Refrain from initiating conversations with the parents.
D)
Quickly refocus the parents to a more pleasant topic.

Provide opportunities for them to hold the newborn.

13

13.
Which of the following, if noted in the maternal history, would the nurse identify as possibly contributing to the birth of an LGA newborn?
A)
Drug abuse
B)
Diabetes
C)
Preeclampsia
D)
Infection

Diabetes

14

14.
Which of the following would alert the nurse to suspect that a preterm newborn is in pain?
A)
Bradycardia
B)
Oxygen saturation level of 94%
C)
Decreased muscle tone
D)
Sudden high-pitched cry

Sudden high-pitched cry

15

15.
When describing newborns with birth-weight variations to a group of nursing students, the instructor identifies which variation if the newborn weighs 5.2 lb at any gestational age?
A)
Small for gestational age
B)
Low birth weight
C)
Very low birth weight
D)
Extremely low birth weight

Low birth weight

16

16.
A nurse is assessing a newborn who has been classified as small for gestational age. Which of the following would the nurse expect to find? (Select all that apply.)
A)
Wasted extremity appearance
B)
Increased amount of breast tissue
C)
Sunken abdomen
D)
Adequate muscle tone over buttocks
E)
Narrow skull sutures

Wasted extremity appearance
Sunken abdomen

17

17.
The nurse is reviewing the medical record of a newborn born 2 hours ago. The nurse notes that the newborn was delivered at 35 weeks' gestation. The nurse would classify this newborn as which of the following?
A)
Preterm
B)
Late preterm
C)
Full term
D)
Postterm

Late preterm

18

18.
A nursing instructor is describing common problems associated with preterm birth. When describing the preterm newborn's risk for perinatal asphyxia, the instructor includes which of the following as contributing to the newborn's risk? (Select all that apply.)
A)
Surfactant deficiency
B)
Placental deprivation
C)
Immaturity of the respiratory control centers
D)
Decreased amounts of brown fat
E)
Depleted glycogen stores

Surfactant deficiency
Immaturity of the respiratory control centers

19

19.
After determining that a newborn is in need of resuscitation, which of the following would the nurse do first?
A)
Dry the newborn thoroughly
B)
Suction the airway
C)
Administer ventilations
D)
Give volume expanders

Dry the newborn thoroughly

20

20.
A nurse is developing a plan of care for a preterm infant experiencing respiratory distress. Which of the following would the nurse be least likely to include in this plan?
A)
Stimulate the infant with frequent handling.
B)
Keep the newborn in a warmed isolette.
C)
Administer oxygen using a oxygen hood.
D)
Give gavage or continous tube feedings.

Stimulate the infant with frequent handling

21

21.
A nurse suspects that a preterm newborn is having problems with thermal regulation. Which of the following would support the nurse's suspicion? (Select all that apply.)
A)
Shallow, slow respirations
B)
Cyanotic hands and feet
C)
Irritability
D)
Hypertonicity
E)
Feeble cry

Shallow, slow respirations
Cyanotic hands and feet
Feeble cry

22

22.
The nurse is assessing a preterm newborn's fluid and hydration status. Which of the following would alert the nurse to possible overhydration?
A)
Decreased urine output
B)
Tachypnea
C)
Bulging fontanels
D)
Elevated temperature

Bulging fontanels

23

23.
The nurse is assessing a preterm newborn who is in the neonatal intensive care unit (NICU. for signs and symptoms of overstimulation. Which of the following would the nurse be least likely to assess?
A)
Increased respirations
B)
Flaying hands
C)
Periods of apnea
D)
Decreased heart rate

Increased respirations

24

24.
A group of nursing students are reviewing the literature in preparation for a class presentation on newborn pain prevention and management. Which of the following would the students be most likely to find about this topic?
A)
Newborn pain is frequently recognized and treated
B)
Newborns rarely experience pain with procedures
C)
Pain is frequently mistaken for irritability or agitation
D)
Newborns may be less sensitive to pain than adult.

Pain is frequently mistaken for irritability or agitation

25

25.
A nurse is developing a plan of care for a preterm newborn to address the nursing diagnosis of risk for delayed development. Which of the following would the nurse include? (Select all that apply.)
A)
Clustering care to promote rest
B)
Positioning newborn in extension
C)
Using kangaroo care
D)
Loosely covering the newborn with blankets
E)
Providing nonnutritive sucking

Clustering care to promote rest
Using kangaroo care
Providing nonnutritive sucking

26

26.
A nurse is assisting the anxious parents of a preterm newborn to cope with the situation. Which statement by the nurse would be least appropriate?
A)
“I'll be here to help you all along the way.”
B)
“What has helped you to deal with stressful situations in the past?”
C)
“Let me tell you about what you will see when you visit your baby.”
D)
“Forget about what's happened in the past and focus on the now.”

“Forget about what's happened in the past and focus on the now.”

27

Ch 24
1.
A newborn with severe meconium aspiration syndrome (MAS. is not responding to conventional treatment. Which of the following would the nurse anticipate as possibly necessary for this newborn?
A)
Extracorporeal membrane oxygenation (ECMO)
B)
Respiratory support with a ventilator
C)
Insertion of a laryngoscope for deep suctioning
D)
Replacement of an endotracheal tube via x-ray

Extracorporeal membrane oxygenation (ECMO)

28

2.
Which of the following would the nurse expect to assess in a newborn who develops sepsis?
A)
Increased urinary output
B)
Interest in feeding
C)
Hypothermia
D)
Wakefulness

Hypothermia

29

3.
Which of the following would the nurse include in the plan of care for a newborn receiving phototherapy?
A)
Keeping the newborn in the supine position
B)
Covering the newborn's eyes while under the bililights
C)
Ensuring that the newborn is covered or clothed
D)
Reducing the amount of fluid intake to 8 ounces daily

Covering the newborn's eyes while under the bililights

30

4.
A newborn has been diagnosed with a Group B streptococcal infection shortly after birth. The nurse understands that the newborn most likely acquired this infection from which of the following?
A)
Improper handwashing
B)
Contaminated formula
C)
Nonsterile catheter insertion
D)
Mother's birth canal

Mother's birth canal

31

5.
Which action would be most appropriate for the nurse to take when a newborn has an unexpected anomaly at birth?
A)
Show the newborn to the parents as soon as possible while explaining the defect.
B)
Remove the newborn from the birthing area immediately.
C)
Inform the parents that there is nothing wrong at the moment.
D)
Tell the parents that the newborn must go to the nursery immediately.

Show the newborn to the parents as soon as possible while explaining the defect.

32

6.
The nurse prepares to administer a gavage feeding for a newborn with transient tachypnea based on the understanding that this type of feeding is necessary for which reason?
A)
Lactase enzymatic activity is not adequate.
B)
Oxygen demands need to be reduced.
C)
Renal solute lead must be considered.
D)
Hyperbilirubinemia is likely to develop.

Oxygen demands need to be reduced.

33

7.
Which of the following would the nurse include when teaching a new mother about the difference between pathologic and physiologic jaundice?
A)
Physiologic jaundice results in kernicterus.
B)
Pathologic jaundice appears within 24 hours after birth.
C)
Both are treated with exchange transfusions of maternal O- blood.
D)
Physiologic jaundice requires transfer to the NICU.

Pathologic jaundice appears within 24 hours after birth.

34

8.
When planning the care of a newborn addicted to cocaine who is experiencing withdrawal, which of the following would be least appropriate to include?
A)
Wrapping the newborn snugly in a blanket
B)
Waking the newborn every hour
C)
Checking the newborn's fontanels
D)
Offering a pacifier

Waking the newborn every hour

35

9.
A newborn is suspected of having fetal alcohol syndrome. Which of the following would the nurse expect to assess?
A)
Bradypnea
B)
Hydrocephaly
C)
Flattened maxilla
D)
Hypoactivity

Flattened maxilla

36

10.
After teaching the parents of a newborn with periventricular hemorrhage about the disorder and treatment, which statement by the parents indicates that the teaching was successful?
A)
ìWe'll make sure to cover both of his eyes to protect them.î
B)
ìOur newborn could develop a learning disability later on.î
C)
ìOnce the bleeding ceases, there won't be any more worries.î
D)
ìWe need to get family members to donate blood for transfusion.î

“Our newborn could develop a learning disability later on.”

37

11.
A newborn has an Apgar score of 6 at 5 minutes. Which of the following is the priority?
A)
Initiating IV fluid therapy
B)
Beginning resuscitative measures
C)
Promoting kangaroo care
D)
Obtaining a blood culture

Beginning resuscitative measures

38

12.
While reviewing a newborn's medical record, the nurse notes that the chest x-ray shows a ground glass pattern. The nurse interprets this as indicative of:
A)
Respiratory distress syndrome
B)
Transient tachypnea of the newborn
C)
Asphyxia
D)
Persistent pulmonary hypertension

Respiratory distress syndrome

39

13.
A newborn is suspected of developing persistent pulmonary hypertension. The nurse would expect to prepare the newborn for which of the following to confirm the suspicion?
A)
Chest x-ray
B)
Blood cultures
C)
Echocardiogram
D)
Stool for occult blood

Echocardiogram

40

14.
Which of the following would alert the nurse to suspect that a newborn has developed NEC?
A)
Irritability
B)
Sunken abdomen
C)
Clay-colored stools
D)
Bilious vomiting

Bilious vomiting

41

15.
Which of the following would not be considered a risk factor for bronchopulmonary dysplasia (chronic lung disease)?
A)
Preterm birth (less than 32 weeks)
B)
Female gender
C)
White race
D)
Sepsis

Female gender

42

16.
A group of nursing students are reviewing the different types of congenital heart disease in infants. The students demonstrate a need for additional review when they identify which of the following as an example of increased pulmonary blood flow (left-to-right shunting)?
A)
Atrial septal defect
B)
Tetralogy of Fallot
C)
Ventricular septal defect
D)
Patent ductus arteriosus

Tetralogy of Fallot

43

17.
After teaching the parents of a newborn with retinopathy of prematurity (ROP. about the disorder and treatment, which statement by the parents indicates that the teaching was successful?
A)
ìCan we schedule follow-up eye examinations with the pediatric ophthalmologist now?î
B)
ìWe can fix the problem with surgery.î
C)
ìWe'll make sure to administer eye drops each day for the next few weeks.î
D)
ìI'm sure the baby will grow out of it.î

“Can we schedule follow-up eye examinations with the pediatric ophthalmologist now?”

44

18.
The nurse is assessing the newborn of a mother who had gestational diabetes. Which of the following would the nurse expect to find? (Select all that apply.)
A)
Pale skin color
B)
Buffalo hump
C)
Distended upper abdomen
D)
Excessive subcutaneous fat
E)
Long slender neck

Buffalo hump
Distended upper abdomen
Excessive subcutaneous fat

45

19.
The nurse is assessing a newborn who is large for gestational age. The newborn was born breech. The nurse suspects that the newborn may have experienced trauma to the upper brachial plexus based on which assessment findings?
A)
Absent grasp reflex
B)
Hand weakness
C)
Absent Moro reflex
D)
Facial asymmetry

Absent Moro reflex

46

20.
The nurse is assessing a newborn and suspects that the newborn was exposed to drugs in utero because the newborn is exhibiting signs of neonatal abstinence syndrome. Which of the following would the nurse expect to assess? (Select all that apply.)
A)
Tremors
B)
Diminished sucking
C)
Regurgitation
D)
Shrill, high-pitched cry
E)
Hypothermia
F)
Frequent sneezing

Tremors
Regurgitation
Shrill, high-pitched cry
Frequent sneezing

47

21.
A nurse is developing a plan of care for a newborn with omphalocele. Which of the following would the nurse include?
A)
Placing the newborn into a sterile drawstring bowel bag
B)
Using clean technique for dressing changes
C)
Preparing the newborn for incision and drainage
D)
Instituting gavage feedings

Placing the newborn into a sterile drawstring bowel bag

48

22.
A nurse is explaining to the parents of a child with bladder exstrophy about the care their infant requires. Which of the following would the nurse include in the explanation? (Select all that apply.)
A)
Covering the area with a sterile, clear, nonadherent dressing
B)
Irrigating the surface with sterile saline twice a day
C)
Monitoring drainage through the suprapubic catheter
D)
Administering prescribed antibiotic therapy
E)
Preparing for surgical intervention in about 2 weeks

Covering the area with a sterile, clear, non adherent dressing
Monitoring drainage through the suprapubic catheter
Administering prescribed antibiotic therapy

49

23.
A nursing student is preparing a presentation for the class on clubfoot. The student determines that the presentation was successful when the class states which of the following?
A)
Clubfoot is a common genetic disorder.
B)
The condition affects girls more often than boys.
C)
The exact cause of clubfoot is not known.
D)
The intrinsic form can be manually reduced.

The exact cause of clubfoot is not known.

50

24.
Assessment of newborn reveals a large protruding tongue, slow reflexes, distended abdomen, poor feeding, hoarse cry, goiter and dry skin. Which of the following would the nurse suspect?
A)
Phenylketonuria
B)
Galactosemia
C)
Congenital hypothyroidism
D)
Maple syrup urine disease

Congenital hypothyroidism

51

25.
A group of students are reviewing information about the effects of substances on the newborn. The students demonstrate understanding of the information when they identify which drug as not being associated with teratogenic effects on the fetus?
A)
Alcohol
B)
Nicotine
C)
Marijuana
D)
Cocaine

Marijuana

52

26.
A nurse is teaching the mother of a newborn diagnosed with galactosemia about dietary restrictions. The nurse determines that the mother has understood the teaching when she identifies which of the following as needing to be restricted?
A)
Phenylalanine
B)
Protein
C)
Lactose
D)
Iodine

Lactose

53

27.
A newborn was diagnosed with a congenital heart defect and will undergo surgery at a later time. The nurse is teaching the parents about signs and symptoms that need to be reported. The nurse determines that the parents have understood the instructions when they state that they will report which of the following? (Select all that apply.)
A)
Weight loss
B)
Pale skin
C)
Fever
D)
Absence of edema
E)
Increased respiratory rate

Weight loss
Fever
Increased respiratory rate

54

28.
When developing the plan of care for a newborn with an acquired condition, which of the following would the nurse include to promote participation by the parents?
A)
Use verbal instructions primarily for explanations
B)
Assist with decision making process
C)
Provide personal views about their decisions
D)
Encourage them to refrain from showing emotions

Assist with decision making process

55

29.
A nurse is assisting in the resuscitation of a newborn. The nurse would expect to stop resuscitation efforts when the newborn has no heartbeat and respiratory effort after which time frame?
A)
5 minutes
B)
10 minutes
C)
15 minutes
D)
20 minutes

10 minutes

56

30.
A newborn is diagnosed with meconium aspiration syndrome. When assessing this newborn, which of the following would the nurse expect to find? (Select all that apply.)
A)
Pigeon chest
B)
Prolonged tachypnea
C)
Intercostal retractions
D)
High blood pH level
E)
Coarse crackles on auscultation

Prolonged tachypnea
Intercostal retractions
Coarse crackles on auscultation