Deck 8: Health Problems of Newborns

Question 1

The nurse is caring for a newborn with Erb palsy. The nurse understands that which reflex is absent with this condition?

A) Root reflex
B) Suck reflex
C) Grasp reflex
D) Moro reflex

Answer 1

Moro reflex

Question 2

A woman who is Rh-negative is pregnant with her first child, and her husband is Rh positive. During her 12-week prenatal visit, she tells the nurse that she has been told that this is dangerous. What should the nurse tell her?

A) That no treatment is necessary
B) That an exchange transfusion will be necessary at birth
C) That no treatment is available until the infant is born
D) That administration of Rh immunoglobulin is indicated at 26 to 28 weeks of gestation

Answer 2

That administration of Rh immunoglobulin is indicated at 26 to 28 weeks of gestation

Question 3

What is an important nursing intervention for a full-term infant receiving phototherapy?

A) Observing for signs of dehydration
B) Using sunscreen to protect the infant's skin
C) Keeping the infant diapered to collect frequent stools
D) Informing the mother why breastfeeding must be discontinued

Answer 3

Observing for signs of dehydration

Question 4

Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture?

A) Positive scarf sign
B) Asymmetric Moro reflex
C) Swelling of fingers on affected side
D) Paralysis of affected extremity and muscles

Question 5

The nurse is planning care for an infant receiving calcium gluconate for treatment of hypocalcemia. Which route of administration should be used?

A) Oral
B) Intramuscular
C) Intravenous
D) Intraosseous

Question 6

A newborn has been diagnosed with brachial nerve paralysis. The nurse should assist the breastfeeding mother to use which hold or position during feeding?

A) Reclining
B) The cradle hold
C) The football hold
D) The cross-over hold

Question 7

When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant?

A) 2 to 12 hours
B) 12 to 24 hours
C) 2 to 4 days
D) After the fifth day

Question 8

A mother is upset because her newborn has erythema toxicum neonatorum. The nurse should reassure her that this is what?

A) Easily treated
B) Benign and transient
C) Usually not contagious
D) Usually not disfiguring

Question 9

Rh hemolytic disease is suspected in a mother's second baby, a son. Which factor is important in understanding how this could develop?

A) The first child was a girl.
B) The first child was Rh positive.
C) Both parents have type O blood.
D) She was not immunized against hemolysis.

Question 10

Which intervention may decrease the incidence of physiologic jaundice in a healthy full-term infant?

A) Institute early and frequent feedings.
B) Bathe newborn when the axillary temperature is 36.3° C (97.5° F).
C) Place the newborn's crib near a window for exposure to sunlight.
D) Suggest that the mother initiate breastfeeding when the danger of jaundice has passed.

Question 11

When should the nurse expect jaundice to be present in a full-term infant with hemolytic disease?

A) At birth
B) Within 24 hours after birth
C) 25 to 48 hours after birth
D) 49 to 72 hours after birth

Question 12

The parents of a newborn ask the nurse what caused the baby's facial nerve paralysis. The nurse's response is based on remembering that this is caused by what?

A) Birth injury
B) Genetic defect
C) Spinal cord injury
D) Inborn error of metabolism

Question 13

A pregnant client asks the nurse to explain the meaning of "cephalopelvic disproportion." Which explanation should the nurse give to the client?

A) "It means a large for gestational age fetus."
B) "It is the narrow opening between the ischial spines."
C) "There is an uneven size between the fetus' presenting part and the pelvis."
D) "The shape of the pelvis is an android shape and is unfavorable for vaginal delivery."

Question 14

What is an infant with severe jaundice at risk for developing?

A) Encephalopathy
B) Bullous impetigo
C) Respiratory distress
D) Blood incompatibility

Question 15

The nurse is caring for a breastfed full-term infant who was born after an uneventful pregnancy and delivery. The infant's blood glucose level is 36 mg/dL. Which action should the nurse implement?

A) Bring the infant to the mother and initiate breastfeeding.
B) Place a nasogastric tube and administer 5% dextrose water.
C) Start a peripheral intravenous line and administer 10% dextrose.
D) Monitor the infant in the nursery and obtain a blood glucose level in 4 hours.

Question 16

A mother brings her 6-week-old infant in with complaints of poor feeding, lethargy, fever, irritability, and a vesicular rash. What does the nurse suspect?

A) Impetigo
B) Candidiasis
C) Neonatal herpes
D) Congenital syphilis

Question 17

Which is a bright red, rubbery nodule with a rough surface and a well-defined margin that may be present at birth?

A) Port-wine stain
B) Juvenile melanoma
C) Cavernous hemangioma
D) Strawberry hemangioma

Question 18

What should nursing care of an infant with oral candidiasis (thrush) include?

A) Avoid use of a pacifier.
B) Continue medication for the prescribed number of days.
C) Remove the characteristic white patches with a soft cloth.
D) Apply medication to the oral mucosa, being careful that none is ingested.

Question 19

The nurse is caring for an infant who will be discharged on home phototherapy. What instructions should the nurse include in the discharge teaching to the parents?

A) Apply an oil-based lotion to the infant's skin two times per day to prevent the skin from drying out under the phototherapy light.
B) Keep the eye shields on the infant's eyes even when the phototherapy light is turned off.
C) Take the infant's temperature every 2 hours while the newborn is under the phototherapy light.
D) Make a follow-up visit with the health care provider within 2 or 3 days after your infant has been on phototherapy.

Question 20

Which term is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery?

A) Hydrocephalus
B) Cephalhematoma
C) Caput succedaneum
D) Subdural hematoma

Question 21

MATCHING
Match the cranial syndrome or sequence with its facial features.

Asymmetric facial deformity, including absent cheekbones

A)Crouzon syndrome
B)Apert syndrome
C)Treacher Collins syndrome
D)Pierre Robin sequence

Question 22

The nursery nurse is aware that which are risk factors for hyperbilirubinemia? (Select all that apply.)

A) An infant born prematurely
B) An infant born to a mother with diabetes
C) An infant born to a white mother
D) An infant fed exclusively with formula
E) An infant born with a metabolic disease

Question 23

Which interventions should the nurse implement for a newborn with a subgaleal hemorrhage? (Select all that apply.)

A) Monitor bilirubin levels.
B) Monitor hematocrit levels.
C) Prepare the newborn for skull radiography.
D) Monitor the newborn's level of consciousness.
E) Place a warm compress on the affected area.

Question 24

MATCHING
Match the cranial syndrome or sequence with its facial features.

Shallow orbits and underdevelopment of the middle third of the face

A)Crouzon syndrome
B)Apert syndrome
C)Treacher Collins syndrome
D)Pierre Robin sequence

Question 25

MATCHING
Match the cranial syndrome or sequence with its facial features.

Displacement of the chin as a result of micrognathia

A)Crouzon syndrome
B)Apert syndrome
C)Treacher Collins syndrome
D)Pierre Robin sequence

Question 26

A mother has just given birth to a newborn with a cleft lip. Sensing that something is wrong, she starts to cry and asks the nurse, "What is wrong with my baby?" What is the most appropriate nursing action?

A) Encourage the mother to express her feelings.
B) Explain in simple language that the baby has a cleft lip.
C) Provide emotional support until the practitioner can talk to the mother.
D) Tell the mother a pediatrician will talk to her as soon as the baby is examined.

Question 27

The nurse is teaching a new nurse about types of physical injuries that can occur at birth. Which soft tissue injuries should the nurse include in the teaching? (Select all that apply.)

A) Petechiae
B) Retinal hemorrhage
C) Facial paralysis
D) Cephalhematoma
E) Subdural hematoma
F) Subconjunctival hemorrhage

Question 28

The nurse is caring for an infant with hemolytic disease. Which medication should the nurse anticipate to be prescribed to decrease the bilirubin level?

A) Phenytoin (Dilantin)
B) Valproic acid (Depakene)
C) Carbamazepine (Tegretol)
D) Phenobarbital (Phenobarbital)

Question 29

The nurse suspects a newborn has a fractured clavicle. What are signs of a fractured clavicle? (Select all that apply.)

A) An asymmetric Moro reflex
B) Limited use of the affected arm
C) Crying when the arm is moved
D) Muscles of the hand are paralyzed
E) The arm hangs limp alongside the body

Question 30

The nurse is caring for a child after a cleft palate repair who is on a clear liquid diet. Which feeding device should the nurse use to deliver the clear liquid diet?

A) Straw
B) Spoon
C) Sippy cup
D) Open cup

Question 31

A 4-month-old infant is discharged home after surgery for the repair of a cleft lip. What should instructions to the parents include?

A) Provide crib toys for distraction.
B) Breast- or bottle-feeding can begin immediately.
C) Give pain medication to the infant to minimize crying.
D) Leave the infant in the crib at all times to prevent suture strain.

Question 32

An infant requires surgery for repair of a cleft lip. An important priority of the preoperative nursing care is which?

A) Initiating discharge teaching
B) Performing baseline physical and behavioral assessment
C) Observing for allergic reactions to preoperative antibiotics
D) Determining whether this defect exists in other family members

Question 33

An infant with an isolated cleft lip is being bottle fed. Which actions should the nurse plan to implement to assist with the feeding? (Select all that apply.)

A) Use an NUK nipple.
B) Use cheek support.
C) Enlarge the nipple opening.
D) Position the infant upright.
E) Thicken the formula with rice cereal.

Question 34

MATCHING
Match the cranial syndrome or sequence with its facial features.

Craniosynostosis resulting in a prominent forehead

A)Crouzon syndrome
B)Apert syndrome
C)Treacher Collins syndrome
D)Pierre Robin sequence

Question 35

The parents of an infant with a cleft palate ask the nurse, "What follow-up care will our infant need after the repair?" Which is an accurate response by the nurse?

A) "Your infant will not need any subsequent follow-up care."
B) "Your infant will only need to be evaluated by an audiologist."
C) "Your infant will only need follow-up with a speech pathologist."
D) "Your infant will need follow-up with audiologists and orthodontists."

Question 36

The nurse is preparing to administer a topical application of 1 ml of nystatin (Mycostatin) to an infant with oral thrush. Which actions should the nurse plan to implement? (Select all that apply.)

A) Administer after a feeding.
B) Use a sponge applicator to swab the oral mucosa and tongue.
C) Administer after warming the medication under running warm water.
D) If white patches are no longer present, hold the medication.
E) Deposit the remainder of the dose in the mouth with a syringe so the infant swallows a small amount.

Question 37

Which birth injuries should the nurse assess for if an infant was born with the use of a vacuum extractor? (Select all that apply.)

A) Torticollis
B) Brachial palsy
C) Fractured clavicle
D) Cephalhematoma
E) Subgaleal hemorrhage