Chapter 24- Nursing Management of the Newborn at Risk PDF

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A) B) C) D)

A) B) C) D)

A) B) C) D)

A) B) C) D)

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

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

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

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

5.Which action would be most appropriate for

A) B) C) D)

A) B) C) D)

A) B) C) D)

A) B) C) D)

the nurse to take when a newborn has an unexpected anomaly at birth? Show the newborn to the parents as soon as possible while explaining the defect. Remove the newborn from the birthing area immediately. Inform the parents that there is nothing wrong at the moment. Tell the parents that the newborn must go to the nursery immediately.

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

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

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

9.A newborn is suspected of having fetal

A) B) C) D)

A) B) C) D)

alcohol syndrome. Which of the following would the nurse expect to assess? Bradypnea Hydrocephaly Flattened maxilla Hypoactivity

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

A) B) C) D)

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

A) B) C) D)

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

A newborn is suspected of developing persistent pulmonary hypertension. The 13.nurse would expect to prepare the newborn for which of the following to confirm the suspicion?

A) B) C) D)

Chest x-ray Blood cultures Echocardiogram Stool for occult blood

A) B) C) D)

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

A) B) C) D)

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

A) B) C) D)

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

A) B)

After teaching the parents of a newborn with retinopathy of prematurity (ROP. about the 17.disorder and treatment, which statement by the parents indicates that the teaching was successful? “Can we schedule follow-up eye examinations with the pediatric ophthalmologist now?” “We can fix the problem with surgery.”

D)

“We'll make sure to administer eye drops each day for the next few weeks.” “I'm sure the baby will grow out of it.”

A) B) C) D) E)

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

A) B) C) D)

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

A) B) C) D) E) F)

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

A)

A nurse is developing a plan of care for a 21.newborn with omphalocele. Which of the following would the nurse include? Placing the newborn into a sterile drawstring

C)

B) C) D)

A) B) C) D) E)

bowel bag Using clean technique for dressing changes Preparing the newborn for incision and drainage Instituting gavage feedings

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

C) D)

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

A) B) C) D)

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

A) B)

25.A group of students are reviewing

A) B) C) D)

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? Alcohol Nicotine Marijuana Cocaine

A) B) C) D)

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

A) B) C) D) E)

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 27. 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.) Weight loss Pale skin Fever Absence of edema Increased respiratory rate

A) B) C) D)

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

emotions

A) B) C) D)

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

A) B) C) D) E)

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

Answer Key 1.A2.C3.B4.D5.A6.B7.B8.B9.C10.B11.B12.A13.C14.D15.B16.B17.A18.B, C, D19.C20.A, C, D, F21.A22.A, C, D23.C24.C25.C26.C27.A, C, E28.B29.B30.B, C, E...