Deck 35: Acquired Problems of the Newborn

Question 1

An infant was born 2 hours ago at 37 weeks of gestation and weighs 4.1 kg.The infant appears chubby with a flushed complexion and is very tremulous.The tremors are most likely the result of what condition?

A) Birth injury
B) Hypocalcemia
C) Hypoglycemia
D) Seizures

Answer 1

Hypoglycemia

Question 2

Human immunodeficiency virus (HIV)may be transmitted perinatally or during the postpartum period.Which statement regarding the method of transmission is most accurate?

A) Only in the third trimester from the maternal circulation
B) From the use of unsterile instruments
C) Only through the ingestion of amniotic fluid
D) Through the ingestion of breast milk from an infected mother

Answer 2

Through the ingestion of breast milk from an infected mother

Question 3

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team.Nursing care for this infant requires a multisystem approach.What is the first step in the provision of care for the infant?

A) Pharmacologic treatment
B) Reduction of environmental stimuli
C) Neonatal abstinence syndrome (NAS) scoring
D) Adequate nutrition and maintenance of fluid and electrolyte balance

Answer 3

Neonatal abstinence syndrome (NAS) scoring

Question 4

Which information regarding to injuries to the infant's plexus during labor and birth is most accurate?

A) If the nerves are stretched with no avulsion, then they should completely recover in 3 to 6 months.
B) Erb palsy is damage to the lower plexus.
C) Parents of children with brachial palsy are taught to pick up the child from under the axillae.
D) Breastfeeding is not recommended for infants with facial nerve paralysis until the condition resolves.

Question 5

For an infant experiencing symptoms of drug withdrawal,which intervention should be included in the plan of care?

A) Administering chloral hydrate for sedation
B) Feeding every 4 to 6 hours to allow extra rest between feedings
C) Snugly swaddling the infant and tightly holding the baby
D) Playing soft music during feeding

Question 6

A primigravida has just delivered a healthy infant girl.The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks,"What is that medicine for?" How should the nurse respond?

A) "It is an eye ointment to help your baby see you better."
B) "It is to protect your baby from contracting herpes from your vaginal tract."
C) "Erythromycin is prophylactically given to prevent a gonorrheal infection."
D) "This medicine will protect your baby's eyes from drying out over the next few days."

Question 7

A macrosomic infant is born after a difficult forceps-assisted delivery.After stabilization,the infant is weighed,and the birth weight is 4550 g (9 lb,6 oz).What is the nurse's first priority?

A) Leave the infant in the room with the mother.
B) Immediately take the infant to the nursery.
C) Perform a gestational age assessment to determine whether the infant is large for gestational age.
D) Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia.

Question 8

The nurse should be cognizant of which condition related to skeletal injuries sustained by a neonate during labor or childbirth?

A) Newborn's skull is still forming and fractures fairly easily.
B) Unless a blood vessel is involved, linear skull fractures heal without special treatment.
C) Clavicle fractures often need to be set with an inserted pin for stability.
D) Other than the skull, the most common skeletal injuries are to leg bones.

Question 9

Which conditions are infants of diabetic mothers (IDMs)at a higher risk for developing?

A) Iron deficiency anemia
B) Hyponatremia
C) Respiratory distress syndrome
D) Sepsis

Question 10

What information regarding a fractured clavicle is most important for the nurse to take into consideration when planning the infant's care?

A) Prone positioning facilitates bone alignment.
B) No special treatment is necessary.
C) Parents should be taught range-of-motion exercises.
D) The shoulder should be immobilized with a splint.

Question 11

The nurse is evaluating a neonate who was delivered 3 hours ago by vacuum-assisted delivery.The infant has developed a cephalhematoma.Which statement is most applicable to the care of this neonate?

A) Intracranial hemorrhage (ICH) as a result of birth trauma is more likely to occur in the preterm, low-birth-weight infant.
B) Subarachnoid hemorrhage (the most common form of ICH) occurs in term infants as a result of hypoxia.
C) In many infants, signs of hemorrhage in a full-term infant are absent and diagnosed only through laboratory tests.
D) Spinal cord injuries almost always result from vacuum-assisted deliveries.

Question 12

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours.A cesarean section is performed for failure to progress.The fetal heart rate (FHR)before birth is 180 beats per minute with limited variability.At birth the newborn has Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic.Based on the maternal history,what is the most likely cause of this newborn's distress?

A) Hypoglycemia
B) Phrenic nerve injury
C) Respiratory distress syndrome
D) Sepsis

Question 13

What is the most important nursing action in preventing neonatal infection?

A) Good handwashing
B) Isolation of infected infants
C) Separate gown technique
D) Standard Precautions

Question 14

Near the end of the first week of life,an infant who has not been treated for any infection develops a copper-colored maculopapular rash on the palms and around the mouth and anus.The newborn is displaying signs and symptoms of which condition?

A) Gonorrhea
B) Herpes simplex virus (HSV) infection
C) Congenital syphilis
D) HIV

Question 15

A pregnant woman arrives at the birth unit in labor at term,having had no prenatal care.After birth,her infant is noted to be small for gestational age with small eyes and a thin upper lip.The infant also is microcephalic.Based on her infant's physical findings,this woman should be questioned about her use of which substance during pregnancy?

A) Alcohol
B) Cocaine
C) Heroin
D) Marijuana

Question 16

What bacterial infection is definitely decreasing because of effective drug treatment?

A) Escherichia coli infection
B) Tuberculosis
C) Candidiasis
D) Group B streptococci (GBS) infection

Question 17

During a prenatal examination,a woman reports having two cats at home.The nurse informs her that she should not be cleaning the litter box while she is pregnant.The client questions the nurse as to why.What is the nurse's most appropriate response?

A) "Your cats could be carrying toxoplasmosis. This is a zoonotic parasite that can infect you and have severe effects on your unborn child."
B) "You and your baby can be exposed to the HIV in your cats' feces."
C) "It's just gross. You should make your husband clean the litter boxes."
D) "Cat feces are known to carry Escherichia coli, which can cause a severe infection in you and your baby."

Question 18

A 3.8-kg infant was vaginally delivered at 39 weeks after a 30-minute second stage.A nuchal cord was found at delivery.After birth,the infant is noted to have petechiae over the face and upper back.Which information regarding petechiae is most accurate and should be provided to the parents?

A) Are benign if they disappear within 48 hours of birth
B) Result from increased blood volume
C) Should always be further investigated
D) Usually occur with a forceps-assisted delivery

Question 19

A number of common drugs of abuse may cross into the breast milk of a mother who is currently using these substances,which may result in behavioral effects in the newborn.Which substances are contraindicated if the mother elects to breastfeed her infant?

A) Cocaine
B) Marijuana
C) Nicotine
D) Methadone
E) Morphine

Question 20

Which substance,when abused during pregnancy,is the most significant cause of cognitive impairment and dysfunction in the infant?

A) Alcohol
B) Tobacco
C) Marijuana
D) Heroin