Deck 29: High-Risk Newborn: Complications Associated with Gestational Age and Development

Question 1

Following the vaginal birth of a macrosomic infant, the nurse should assess the infant for:

A) Hyperglycemia.
B) Clavicle fractures.
C) Hyperthermia.
D) An increase in red blood cells.

Answer 1

Clavicle fractures.

Question 2

Which is most helpful in preventing premature birth?

A) High socioeconomic status
B) Adequate prenatal care
C) Aid to Families with Dependent Children
D) Women, Infants, and Children (WIC) nutritional program

Answer 2

Adequate prenatal care

Question 3

Which nursing action is especially important for an SGA newborn?

A) Promote bonding.
B) Observe for and prevent dehydration.
C) Observe for respiratory distress syndrome.
D) Prevent hypoglycemia with early and frequent feedings.

Answer 3

Prevent hypoglycemia with early and frequent feedings.

Question 4

An infant delivered preterm at 28 weeks' gestation weighs 1200 g. Based on this information, the infant is designated as:

A) SGA.
B) VLBW.
C) ELBW.
D) Low birth weight at term.

Question 5

To determine a preterm infant's readiness for nipple feeding, the nurse should assess the:

A) Skin turgor.
B) Bowel sounds.
C) Current weight.
D) Respiratory rate.

Question 6

In comparison with the term infant, the preterm infant has:

A) More subcutaneous fat.
B) Well-developed flexor muscles.
C) Few blood vessels visible through the skin.
D) Greater surface area in proportion to weight.

Question 7

In caring for the post-term infant, thermoregulation can be a concern, especially in an infant who also has a(n):

A) Hematocrit level of 58%.
B) RBC count of 5 million/mL.
C) WBC count of 15,000 cells/mm³.
D) Blood glucose level of 25 mg/dL.

Question 8

Which statement is most true about large-for-gestational age (LGA) infants?

A) They weigh more than 3500g.
B) They are above the 80th percentile on gestational growth charts.
C) They are prone to hypoglycemia, polycythemia, and birth injuries.
D) Postmaturity syndrome and fractured clavicles are the most common complications.

Question 9

A nurse is observing a 38-week gestation newborn in the nursery. Data reveals periods of apnea lasting approximately 10 seconds followed by a period of rapid respirations. The infant's color and heart rate remain unchanged. The nurse suspects that the infant:

A) Is exhibiting signs of RDS.
B) Requires tactile stimulation around the clock to ensure that apneic periods do not progress further.
C) Is experiencing periodic breathing episodes and will require continuous monitoring while in the nursery unit.
D) Requires the use of CPAP to promote airway expansion.

Question 10

Which nursing diagnosis would be considered a priority for a newborn infant who is receiving phototherapy in an isolette?

A) Hypothermia because of phototherapy treatment
B) Impaired skin integrity related to diarrhea as a result of phototherapy
C) Fluid volume deficit related to phototherapy treatment
D) Knowledge deficit (parents) related to initiation of medical therapy

Question 11

An infant presents with lethargy in the newborn nursery on the second day of life. On further examination, vital signs are stable but muscle tone is slightly decreased, with sluggish reflexes noted. Other physical characteristics are noted as being normal. Lab tests reveal a decreased hematocrit and increased blood sugar. The nurse suspects that the infant may be exhibiting signs and symptoms of:

A) RDS.
B) PIVH.
C) BPD.
D) ROP.

Question 12

Which is true about newborns classified as small for gestational age (SGA)?

A) They weigh less than 2500g.
B) They are born before 38 weeks of gestation.
C) They are below the tenth percentile on gestational growth charts.
D) Placental malfunction is the only recognized cause of this condition.

Question 13

Decreased surfactant production in the preterm lung is a problem because:

A) Surfactant keeps the alveoli open during expiration.
B) Surfactant causes increased permeability of the alveoli.
C) Surfactant dilates the bronchioles, decreasing airway resistance.
D) Surfactant provides transportation for oxygen to enter the blood supply.

Question 14

A preterm infant is on a respirator, with intravenous lines and much equipment. When the parents come to visit for the first time, which is an important response by the nurse?

A) Encourage the parents to touch their infant.
B) Reassure the parents that the infant is progressing well.
C) Discuss the care they will give their infant when the infant goes home.
D) Suggest that the parents visit for only a short time to reduce their anxiety.

Question 15

In caring for the preterm infant, which complication is thought to be a result of high arterial blood oxygen level?

A) Necrotizing enterocolitis (NEC)
B) Retinopathy of prematurity (ROP)
C) Intraventricular hemorrhage (IVH)
D) Bronchopulmonary dysplasia (BPD)

Question 16

What will the nurse note when assessing an infant with asymmetric intrauterine growth restriction?

A) All body parts appear proportionate.
B) The extremities are disproportionate to the trunk.
C) The head seems large compared with the rest of the body.
D) One side of the body appears slightly smaller than the other.

Question 17

Which data should alert the nurse caring for an SGA infant that additional calories may be needed?

A) The latest hematocrit was 53%.
B) The infant's weight gain is 40 g/day.
C) The infant is taking 120 mL/kg every 24 hours.
D) Three successive temperature measurements were 97°, 96°, and 97° F.

Question 18

Which preterm infant should receive gavage feedings instead of bottle feedings?

A) Sucks on a pacifier during gavage feedings
B) Sometimes gags when a feeding tube is inserted
C) Has a sustained respiratory rate of 70 breaths/min
D) Has an axillary temperature of 98.4° F, an apical pulse of 149 beats/min, and respirations of 54 breaths/min

Question 19

A characteristic of a post-term infant who weighs 7 lb, 12 oz, and who lost weight in utero, is:

A) Soft and supple skin.
B) A hematocrit level of 55%.
C) Lack of subcutaneous fat.
D) An abundance of vernix caseosa.

Question 20

Overstimulation may cause increased oxygen use in a preterm infant. Which nursing intervention helps to avoid this problem?

A) Group all care activities together to provide long periods of rest.
B) Keep charts on top of the incubator so the nurses can write on them there.
C) While giving a report to the next nurse, stand in front of the incubator and talk softly about how the infant responds to stimulation.
D) Teach the parents signs of overstimulation, such as turning the face away or stiffening and extending the extremities and fingers.

Question 21

Because late preterm infants are more stable than early preterm infants, they may receive care that is much like that of a full-term baby. The mother-baby or nursery nurse knows that these infants are at increased risk for which of the following? (Select all that apply.)

A) Sepsis
B) Hyperglycemia
C) Hyperbilirubinemia
D) Cardiac distress
E) Problems with thermoregulation

Question 22

Following a traumatic birth of a 10-pound infant, the nurse should assess:

A) gestational age status.
B) flexion of both upper extremities.
C) infant's percentile on growth chart.
D) blood sugar to detect hyperglycemia.

Question 23

A newborn assessment finding that would support the nursing diagnosis of postmaturity would be:

A) loose skin.
B) ruddy skin color.
C) presence of vernix.
D) absence of lanugo.