High-risk Newborn: Acquired And Congenital Conditions

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

All Questions

Question 1

Free

Multiple Choice

The nurse is responsible for monitoring the feedings of the infant with hyperbilirubinemia every 2 to 3 hours around the clock. If breastfeeding must be supplemented, formula should be used instead of water. The purpose of this plan 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 2

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 D10W.

Document the event in the nurses' notes.

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Question 3

Free

Multiple Choice

Which newborn should the nurse recognize as being at the greatest 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 4

Free

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.

inadequate absorption of fetal lung fluid.

a delayed vaginal birth associated with meconium-stained fluid.

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Question 5

Free

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 6

Multiple Choice

The nurse present at the birth is reporting to the nurse who will be caring for the neonate after the delivery. Prior to birth there was meconium present in the amniotic fluid. The infant presented with depressed respirations and weak muscle tone. Which information should be included in the report for this infant?

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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.

The infant required warmed humidified oxygen.

The infant was placed skin to skin with the mother.

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Question 7

Multiple Choice

Which intervention will increase the effectiveness 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 8

Multiple Choice

Newborns whose mothers are substance abusers frequently exhibit which of the following 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 9

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 congestive heart failure.

increased oxygenation of the tissues.

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Question 10

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 11

Multiple Choice

The difference between nonphysiologic jaundice (pathologic jaundice) and physiologic jaundice is that nonphysiologic jaundice

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may result 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 12

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 of the neonate (TTN). The parents are notified and become anxious because they have no understanding of what this means for their infant. The best action that the nurse can take at this time is to

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refer them to the neonatologist for more information.

reassure them not to worry. The infant will be monitored closely by trained staff.

explain to them that this often occurs following a birth and 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 calm their anxiety.

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Question 13

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 14

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 15

Multiple Choice

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

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Hct 50%

Hct 55%

Hct 62%

Hct 70%

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Question 16

Multiple Choice

The nurse notes that the infant has been feeding poorly over the last 24 hours. The nurse should immediately assess for other signs of

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hyperglycemia.

neonatal infection.

hemolytic anemia.

increased bilirubin levels.

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Question 17

Multiple Choice

The priority assessment for the Rh-negative infant whose mother's indirect Coombs test was positive at 36 weeks is

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skin color.

temperature.

respiratory rate.

blood glucose level.

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Question 18

Multiple Choice

The nurse should be alert to a blood group incompatibility if

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both mother and infant are O-positive.

mother is A-positive and infant is A-negative.

mother is O-positive and infant is B-negative.

mother is B-positive and infant is O-negative.

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Question 19

Multiple Choice

Infection can be transmitted to the neonate from mother during the pregnancy or birth or from the mother, family members, visitors, or agency staff after birth. Which viral infections are most likely to be transmitted during the birth process? (Select all that apply.)

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Hepatitis B

Rubella

Herpes

Varicella Zoster

Cytomegalovirus

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Question 20

Multiple Choice

The drug-exposed infant often presents with irritability, frantic crying, and is difficult to console. Which nursing measures can be used to prevent this behavior in this high-risk infant? (Select all that apply.)

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Keep the room well lit.

Swaddle the infant.

Rock slowly and gently.

Coo softly and gently.

Avoid pacifier use.

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