High-risk Newborn: Acquired And Congenital Conditions

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Questions Bank

Maternity and Women's Health Care Today
The Nurse's Role in Maternity and Women's Health Care
Ethical, Social, and Legal Issues
Reproductive Anatomy and Physiology
Hereditary and Environmental Influences on Childbearing
Conception and Prenatal Development
Physiologic Adaptations to Pregnancy
Psychosocial Adaptations to Pregnancy
Nutrition for Childbearing
Antepartum Fetal Assessment
Perinatal Education
Processes of Birth
Nursing Care During Labor and Birth
Intrapartum Fetal Surveillance
Pain Management During Childbirth
Nursing Care During Obstetric Procedures
Postpartum Physiologic Adaptations
Postpartum Psychosocial Adaptations
Normal Newborn: Processes of Adaptation
Assessment of the Normal Newborn
Care of the Normal Newborn
Infant Feeding
Home Care of the Infant
The Childbearing Family with Special Needs
Complications of Pregnancy
Concurrent Disorders During Pregnancy
Intrapartum Complications
Postpartum Maternal Complications
High-Risk Newborn: Complications Associated with Gestational Age and Development
High-Risk Newborn: Acquired and Congenital Conditions
Family Planning
Infertility
Preventive Care for Women
Women's Health Problems
Infertility
Preventive Care for Women
Women's Health Problems

All Questions

Question 1

Free

Multiple Choice

The infant of a diabetic mother is hypoglycemic. Which type of feeding should be instituted first?

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Glucose water

D5W intravenously

Formula via nasogastric tube

Small amount of glucose water followed by formula or breast milk

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Question 2

Free

Multiple Choice

Which defect is present with tetralogy of Fallot?

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Patent ductus arteriosus

Coarctation of the aorta

Hypertrophy of the right ventricle

Transposition of the great arteries

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Question 3

Free

Multiple Choice

The nurse is responsible for monitoring the feedings of the infant with hyperbilirubinemia every 2 to 3 hours around the clock. The purpose of these formula feedings or breastfeedings is to:

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prevent hyperglycemia.

provide fluids and protein.

decrease gastrointestinal motility.

prevent rapid emptying of the bilirubin from the bowel.

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Question 4

Free

Multiple Choice

An infant with severe meconium aspiration syndrome is not responding to conventional treatment. Which method of treatment may be available at a level III facility for use with this infant?

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Insertion of an endotracheal tube

Respiratory support with a ventilator

Extracorporeal membrane oxygenation

Insertion of a laryngoscope and suctioning of the trachea

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Question 5

Free

Multiple Choice

Four hours after the birth of a healthy neonate of an insulin-dependent (type 1) diabetic mother, the baby appears jittery and irritable and has a high-pitched cry. Which nursing action has top priority?

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Notify the clinician stat.

Test for the blood glucose level.

Start an intravenous line with D5W.

Document the event in the nurses' notes.

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Question 6

Multiple Choice

Which newborn should the nurse recognize as being most at risk for developing respiratory distress syndrome?

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A 35-week-gestation male baby born vaginally to a mother addicted to heroin

A 35-week-gestation female baby born vaginally 72 hours after the rupture of membranes

A 36-week-gestation male baby born by cesarean birth to a mother with insulin-dependent diabetes

A 35-week-gestation female baby born vaginally to a mother who has pregnancy-induced hypertension

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Question 7

Multiple Choice

Transitory tachypnea of the newborn (TTN) is thought to occur as a result of:

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a lack of surfactant.

hypoinflation of the lungs.

delayed absorption of fetal lung fluid.

a slow vaginal birth associated with meconium-stained fluid.

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Question 8

Multiple Choice

The nurse must continually assess the infant who has meconium aspiration syndrome for the complication of:

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persistent pulmonary hypertension.

bronchopulmonary dysplasia.

transitory tachypnea of the newborn.

left-to-right shunting of blood through the foramen ovale.

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Question 9

Multiple Choice

The nurse present at the birth is reporting to the nurse who will be caring for the neonate after birth. Which information should be included for an infant who had thick meconium in the amniotic fluid?

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The parents spent an hour bonding with the baby after birth.

An IV was started immediately after birth to treat dehydration.

There was no meconium below the vocal cords when they were visualized.

The infant needed vigorous stimulation immediately after birth to initiate crying.

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Question 10

Multiple Choice

Which intervention should make phototherapy most effective in reducing the indirect bilirubin in an affected newborn?

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Turn the infant every 2 hours.

Place eye patches on the newborn.

Wrap the infant in triple blankets to prevent cold stress.

Increase the oral intake of water between and before feedings.

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Question 11

Multiple Choice

A mother with diabetes has done some reading about the effects of her condition on a newborn. Which statement shows a misunderstanding that should be clarified by the nurse?

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"The red appearance of my baby's skin is due to an excessive number of red blood cells."

"My baby will be watched closely for signs of low blood sugar, especially during the early days after birth."

"My baby's pancreas may not produce enough insulin because the cells became smaller than normal during my pregnancy."

"Although my baby is large, some women with diabetes have very small babies because the blood flow through the placenta may not be as good as it should be."

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Question 12

Multiple Choice

Newborns whose mothers are substance abusers frequently have which behaviors?

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Hypothermia, decreased muscle tone, and weak sucking reflex

Excessive sleep, weak cry, and diminished grasp reflex

Circumoral cyanosis, hyperactive Babinski reflex, and constipation

Decreased amounts of sleep, hyperactive Moro reflex, and difficulty feeding

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Question 13

Multiple Choice

When a cardiac defect causes the mixing of arterial and venous blood in the right side of the heart, the nurse might expect to find:

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cyanosis.

diuresis.

signs of pulmonary congestion.

increased oxygenation of the tissues.

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Question 14

Multiple Choice

In an infant with cyanotic cardiac anomaly, the nurse should expect to see:

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feedings taken eagerly.

a consistent and rapid weight gain.

a decrease in the heart rate with activity.

little to no improvement in color with oxygen administration.

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Question 15

Multiple Choice

The difference between pathologic jaundice and physiologic jaundice is that pathologic jaundice:

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usually results in kernicterus.

appears during the first 24 hours of life.

begins on the head and progresses down the body.

results from the breakdown of excessive erythrocytes not needed after birth.

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Question 16

Multiple Choice

While caring for a post-term infant, the nurse recognizes that the elevated hematocrit level most likely results from:

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hypoxia in utero.

underproduction of red blood cells.

increased breakdown of red blood cells.

the normal expected shift from fetal hemoglobin to normal hemoglobin.

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Question 17

Multiple Choice

Shortly after a cesarean birth, a newborn begins to exhibit difficulty breathing. Nasal flaring and slight retractions are noted. The newborn is admitted to the neonatal intensive care unit (NICU) for closer observation, with a diagnosis of transient tachypnea (TTN). The parents are notified and become anxious because they have no idea what this means in terms of medical condition. The best action that the nurse can take at this time is to:

Choose correct answer/s

refer them to the neonatologist for more information.

tell them not to worry because their infant will be monitored closely by trained staff.

explain to them that this often occurs following a birth but it will most likely resolve in the next 24 to 48 hours.

tell them that they will be able to come and see their baby, which will help make them feel better.

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Question 18

Multiple Choice

While in utero, the fetus passes meconium. Based on this assessment, which nursing diagnosis takes priority for the newborn at birth?

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Risk for infection related to release of meconium

Risk for injury related to high-risk birth interventions, such as amino infusion

Risk for aspiration related to retained secretions

Risk for thermoregulation because of high-risk labor status

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Question 19

Multiple Choice

Which diagnostic test is used to help confirmation of hyperbilirubinemia in an infant?

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Direct Coombs test based on maternal blood sample

Indirect Coombs test based on infant cord blood sample

Infant bilirubin level

Maternal blood type

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Question 20

Multiple Choice

Which of the following lab values indicates that an infant may have polycythemia?

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Hb 18 g/dL, Hct 50%

Hb 25/dL, Hct 55%

Hb 20/dL, Hct 65%

Hb 30 g/dL, Hct 70%

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