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Flashcards in Chapter 42 Neonatal Care Deck (75)
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1. Which of the following is NOT an antepartum risk factor that increases the potential that a newborn may require resuscitation?
A) Preeclampsia
B) Prolapsed cord
C) Polyhydramnios
D) Multiple gestations

Ans: B
Page: 1964
Type: General Knowledge


2. The risk of newborn complications is HIGHEST if the amniotic sac:
A) encases the baby's face at birth.
B) is still intact at the time of birth.
C) contains thin, brown amniotic fluid.
D) ruptured more than 18 hours before birth.

Ans: D
Page: 1964
Type: General Knowledge


3. Which of the following events is a critical part of fetal transition?
A) Diversion of blood flow to the fetus's lungs
B) An acute increase in intrapulmonary pressure
C) Fetal lung expansion within 5 minutes after birth
D) Blood flow diversion across the ductus arteriosis

Ans: A
Page: 1864-1865
Type: General Knowledge


4. Causes of delayed fetal transition include all of the following, EXCEPT:
A) acidosis.
B) hypothermia.
C) birth at 41 weeks.
D) meconium aspiration.

Ans: C
Page: 1964
Type: General Knowledge


5. A newborn born between ___ and ___ weeks of gestation is described as term.
A) 36, 38
B) 38, 42
C) 40, 42
D) 42, 44

Ans: B
Page: 1964
Type: General Knowledge


6. A delay in clamping the umbilical cord and keeping the baby below the level of the placenta can result in fetal:
A) anemia.
B) hypovolemia.
C) exsanguination.
D) polycythemia.

Ans: D
Page: 1967
Type: General Knowledge


7. While preparing equipment for newborn resuscitation, which of the following items is/are NOT considered optional?
A) Pulse oximeter
B) Cardiac monitor
C) Endotracheal tubes
D) Laryngeal mask airway

Ans: C
Page: 1966
Type: General Knowledge


8. Which of the following statements regarding the Apgar score is correct?
A) If resuscitation is necessary, the Apgar score is completed to determine the result of the resuscitation.
B) The Apgar score is determined on the basis of the newborn's condition at 2 and 10 minutes after birth.
C) If resuscitation is needed, it should commence immediately after you obtain the 1-minute Apgar score.
D) A newborn with a heart rate of greater than 80 beats/min would be assigned a score of 2 on the Apgar score.

Ans: A
Page: 1967-1968
Type: General Knowledge


9. According to the Apgar score, a newborn with a heart rate of 80 beats/min and slow, irregular breathing should receive a combined score of:
A) 2.
B) 3.
C) 4.
D) 5.

Ans: A
Page: 1968
Type: General Knowledge


10. An infant born with a pink body and blue extremities, a pulse rate of 90 beats/min, a strong cry, and active movement should be assigned an initial Apgar score of:
A) 5.
B) 6.
C) 7.
D) 8.

Ans: D
Page: 1968
Type: General Knowledge


11. If a newborn does not respond to the initial steps of resuscitation, the need for further intervention is based upon:
A) pulse rate, activity, and appearance.
B) respiratory effort, pulse rate, and color.
C) appearance, skin color, and muscle tone.
D) respirations, appearance, and muscle tone.

Ans: B
Page: 1968-1969
Type: General Knowledge


12. The initial steps of newborn resuscitation include:
A) free-flow oxygen.
B) proper positioning.
C) assessment of pulse rate.
D) positive-pressure ventilation.

Ans: B
Page: 1968-1969
Type: General Knowledge


13. If you feel 13 pulsations in a 6-second time frame, the newborn's heart rate is approximately:
A) 30 beats/min.
B) 60 beats/min.
C) 90 beats/min.
D) 130 beats/min.

Ans: D
Page: 1968
Type: General Knowledge


14. The MOST common etiology for bradycardia in a newborn is:
A) severe hypoxia.
B) untreated acidosis.
C) occult hypovolemia.
D) increased vagal tone.

Ans: A
Page: 1969
Type: General Knowledge


15. A newborn with central cyanosis, adequate respirations, and a heart rate of 120 beats/min should initially be treated with:
A) continued observation only.
B) high-flow oxygen via mask.
C) free-flow oxygen at 5 L/min.
D) positive-pressure ventilation.

Ans: C
Page: 1968, 1970
Type: General Knowledge


16. Choanal atresia is defined as a:
A) small chin that causes a posteriorly positioned tongue.
B) condition in which high-flow oxygen causes blindness.
C) bony or membranous obstruction of the back of the nose.
D) condition in which the occipital skull is abnormally large.

Ans: C
Page: 1970
Type: General Knowledge


17. An oropharyngeal airway would MOST likely be indicated for a newborn with:
A) gasping respirations.
B) Pierre Robin sequence.
C) a diaphragmatic hernia.
D) prolonged periods of apnea.

Ans: B
Page: 1970-1971
Type: General Knowledge


18. A newborn with a pulse rate of 80 beats/min:
A) requires ventilations and chest compressions.
B) should be treated with 0.02 mg/kg of atropine.
C) is likely under the influence of maternal opiates.
D) requires immediate positive-pressure ventilation.

Ans: D
Page: 1968-1969, 1971
Type: General Knowledge


19. The MOST common device used to provide positive-pressure ventilation to a newborn in the prehospital setting is a:
A) T-piece resuscitator.
B) self-inflating bag-mask device.
C) flow-inflating bag-mask device.
D) manually triggered ventilator.

Ans: B
Page: 1971
Type: General Knowledge


20. Common causes of respiratory distress in the newborn include:
A) mucous obstruction of the nose.
B) unrecognized metabolic alkalosis.
C) persistent pulmonary hypotension.
D) maternal use of a narcotic analgesic.

Ans: A
Page: 1971
Type: General Knowledge


21. Compared to subsequent breaths, the first few positive-pressure breaths delivered to a distressed newborn:
A) should provide a volume equal to 40 to 45 mm Hg.
B) should make the chest rise significantly.
C) may necessitate manual disabling of the pop-off valve.
D) generally require a significantly lower volume of air.

Ans: C
Page: 1971
Type: General Knowledge


22. The correct positive-pressure ventilation rate for an apneic newborn is:
A) 12 to 20 breaths/min.
B) 20 to 30 breaths/min.
C) 30 to 40 breaths/min.
D) 40 to 60 breaths/min.

Ans: D
Page: 1971-1972
Type: General Knowledge


23. The MOST common reasons for ineffective bag-mask ventilations in the newborn are:
A) equipment malfunction and a ventilation rate that is too rapid.
B) inadequate mask-to-face seal and incorrect head position.
C) hyperflexion of the newborn's head and thick mucous plugs.
D) pneumothorax and a face mask that is too large for the infant.

Ans: B
Page: 1972
Type: General Knowledge


24. Endotracheal intubation is clearly indicated in the newborn if:
A) its heart rate is improving, but only because of adequate ventilations and chest compressions.
B) meconium is present in the amniotic fluid and the newborn is limp and has a heart rate of 70 beats/min.
C) central cyanosis is persistent despite the administration of free-flow oxygen for 30 to 45 seconds.
D) a small, 27-gauge IV line is present and epinephrine is required to treat refractory bradycardia.

Ans: B
Page: 1972, 1975
Type: General Knowledge


25. What size and type of laryngoscope blade is recommended for use in a full-term newborn?
A) No. 1, straight
B) No. 2, straight
C) No. 1, curved
D) No. 2, curved

Ans: A
Page: 1974
Type: General Knowledge


26. When suctioning the newborn's oropharynx to clear secretions prior to intubation, it is MOST important to:
A) limit suctioning to 15 seconds.
B) use a flexible suction catheter.
C) monitor the newborn's heart rate.
D) assess pulse oximetry and capnography.

Ans: C
Page: 1974-1975
Type: General Knowledge


27. Signs of a diaphragmatic hernia include all of the following, EXCEPT:
A) a scaphoid or concave abdomen.
B) bilaterally absent breath sounds.
C) noted increased work of breathing.
D) audible bowel sounds in the chest.

Ans: B
Page: 1975
Type: General Knowledge


28. After inserting an orogastric tube in a newborn, you should:
A) leave the 20-mL syringe attached.
B) perform intubation within 2 minutes.
C) connect the tube to continuous suction.
D) leave the tube open to allow air to vent.

Ans: D
Page: 1975-1976
Type: General Knowledge


29. Chest compressions are indicated in the newborn if its heart rate remains less than ____ beats/min despite effective positive-pressure ventilations for ____ seconds.
A) 80, 30
B) 60, 30
C) 60, 60
D) 80, 60

Ans: B
Page: 1975
Type: General Knowledge


30. When performing chest compressions on a newborn, you should:
A) compress the chest one third the anteroposterior depth of the chest.
B) use the two-finger compression technique if two rescuers are present.
C) reassess the newborn's heart rate after every 60 seconds of compressions.
D) deliver 120 compressions and 40 ventilations during any 60-second period.

Ans: A
Page: 1975-1976
Type: General Knowledge