Deck 27: The Newborn at Risk: Conditions Present at Birth

Question 1

The nurse is caring for a newborn in the special care nursery. The infant is positioned prone and has hydrocephalus. The nurse is especially careful to cleanse all stool after bowel movements. This care is most appropriate for an infant born with:

A)Omphalocele.
B)Gastroschisis.
C)Diaphragmatic hernia.
D)Myelomeningocele.

Answer 1

Myelomeningocele.

Question 2

The nurse is working with a family that just experienced the birth of their first child at 34 weeks. Which statements indicate that additional teaching is needed?

A)"Our baby will be in an isolette to keep him warm."
B)"Breathing might be harder for our baby because he is early."
C)"The growth of our baby will be faster than if he were term."
D)"Tube feedings will be required because his stomach is small."
E)"Because he came early, he will not produce urine for two days."

Answer 2

"The growth of our baby will be faster than if he were term."
"Tube feedings will be required because his stomach is small."
"Because he came early, he will not produce urine for two days."

Question 3

Parents have been told their child has fetal alcohol syndrome. Which statement indicates that additional teaching is required?

A)"Our baby's heart murmur is from this syndrome."
B)"He might be a fussy baby because of this."
C)"His face looks like it does due to this problem."
D)"Cuddling and rocking will help him stay calm."

Answer 3

"Cuddling and rocking will help him stay calm."

Question 4

A 38-week newborn is found to be small for gestational age. Which of the following nursing interventions should be included in the care of this newborn?

A)Monitor for feeding difficulties.
B)Assess for facial paralysis.
C)Monitor for signs of hyperglycemia.
D)Maintain a warm environment.

Question 5

The nurse is assessing a 36-week gestational age newborn. Upon auscultation, she hears a late systolic murmur in the left intrascapular area with no femoral pulse but increased brachial pulses. What treatment should this infant receive?

A)Indomethacin with surgical ligation.
B)Lanoxin with surgical closure with a Dacron patch.
C)Prostaglandin E₁ and surgical resection of the aorta.
D)Palliative surgery to increase blood flow to the lungs followed by corrective surgery.

Question 6

The nurse is caring for a newborn born to a drug-addicted mother. Which of the following assessment findings would be common for this newborn?

A)Hyperirritability
B)Decreased muscle tone
C)Exaggerated reflexes
D)Depressed respiratory effort
E)Transient tachypnea

Question 7

The family of a newborn has just been told their infant has tetralogy of Fallot. The family does not seem to understand the explanation given by the physician. What statement by the nurse is best?

A)"With this defect, not enough of the blood circulates through the lungs, leading to a lack of oxygen in the baby's body."
B)"The baby's aorta has a narrowing in a section near the heart that makes the left side of the heart work harder."
C)"The blood vessels that attach to the ventricles of the heart are positioned on the wrong sides of the heart."
D)"Your baby's heart doesn't circulate blood well because the left ventricle is smaller and thinner than normal."

Question 8

The nurse is caring for a 2-hour-old newborn whose mother is diabetic. The nurse assesses that the newborn is experiencing tremors. What nursing action has the highest priority?

A)Obtain a bilirubin level.
B)Obtain a blood calcium level.
C)Take the newborn's temperature.
D)Place a pulse oximeter on the newborn.

Question 9

Small-for-gestational-age infants often have complications at birth, but they may also experience long-term complications. The long-term effect that is most likely to occur in SGA infants is:

A)Change from thin and underweight as a child to overweight or obese as adolescents
B)Poor fine motor coordination
C)Paralysis below the hips
D)Permanent disfiguration

Question 10

The nurse is caring for an infant with abdominal contents protruding out approximately at the location of the umbilicus. What is the primary mechanism used to differentiate between omphalocele or gastroschisis?

A)With omphalocele, the abdominal contents are covered with a sac; with gastroschisis, the abdominal contents are not covered by a sac.
B)With omphalocele, the abdominal contents are not covered with a sac; with gastroschisis, the abdominal contents are covered by a sac.
C)With omphalocele, the abdominal contents protrude to the right of an intact umbilical cord; with gastroschisis, the abdominal contents protrude into the base of the umbilical cord.
D)With omphalocele, the abdominal contents protrude into the base of the umbilical cord; with gastroschisis, the abdominal contents protrude to the right of an intact umbilical cord.

Question 11

A 7 pound, 14 ounce girl was born to an insulin-dependent type 2 diabetic mother two hours ago. The infant's blood sugar is 45mg/dl. The best nursing action is:

A)Recheck the blood sugar in four hours.
B)Begin an IV of 10% dextrose.
C)Feed the baby one ounce of formula.
D)Document the findings in the chart.

Question 12

An infant was born at 31-weeks' gestation and weighed 1430 g. What is the correct initial feeding regimen for this infant?

A)10 mg/kg/day of premature formula 24 kcal/oz.
B)20 mg/kg/day of premature formula 24 kcal/oz.
C)40 mg/kg/day of postdischarge formula 22 kcal/oz.
D)50 mg/kg/day of term formula 20 kcal/oz.

Question 13

The nurse is caring for pregnant patients. Which of these clients should the nurse anticipate is most likely to have a newborn at risk for mortality or morbidity?

A)37-year-old G8 P2323, works in a chemical factory
B)23-year-old primip, low socioeconomic status, unmarried
C)16-year-old primip, began prenatal care at 30 weeks
D)28-year-old G2 P1001, history of gestational diabetes

Question 14

Which of the following should be considered potentially infectious when providing nursing care for a newborn with an HIV-positive mother?

A)Soiled linens
B)Urine
C)Blood
D)Mask worn while caring for infant
E)Feces