Deck 14: The Newborn With a Perinatal Injury or Congenital Malformation

Question 1

The nurse explains that the Rh-negative mother who should receive RhoGAM is the mother who:

A) Has had one Rh-negative child and is pregnant with an Rh-negative child
B) Had an Rh-positive baby and is pregnant with an Rh-positive baby
C) Has had an O-negative child and is pregnant with a B-negative child
D) Is a primipara with an O-negative child

Answer 1

Had an Rh-positive baby and is pregnant with an Rh-positive baby

Question 2

Following delivery, a mother asks the nurse about newborn screening tests. The nurse explains that the optimal time for testing for phenylketonuria is:

A) In the first 24 hours of life
B) After 2 to 3 days
C) At 4 to 6 weeks of age
D) At 2 months of age

Answer 2

After 2 to 3 days

Question 3

The nurse advising parents about feeding their infant who has phenylketonuria, would include the information to:

A) Provide a life-long high-protein diet.
B) Use a formula that is low in the amino acid leucine.
C) Feed the baby a soy-based formula.
D) Substitute Lofenalac for some protein foods.

Answer 3

Substitute Lofenalac for some protein foods.

Question 4

Obstruction within the ventricles of the brain or inadequate reabsorption of cerebrospinal fluid may be responsible for the occurrence of:

A) Meningitis
B) Meningocele
C) Spina bifida occulta
D) Hydrocephalus

Question 5

The nurse counsels the parents of a child with a cleft palate that they should be alert for signs of:

A) Facial paralysis
B) Ear infections
C) Increasing ICP
D) Drooling

Question 6

After feeding a baby with hydrocephalus, the nurse will take special care to:

A) Sit the baby upright in an infant seat
B) Place the baby over the shoulder to "burp"
C) Leave the baby in a side-lying position
D) Stimulate the baby by rubbing its feet

Question 7

The nurse bathing an infant would recognize a sign of developmental hip dysplasia, which is:

A) Hypotonicity of the leg muscles
B) One leg is shorter than the other
C) Broadening and flattening of the buttocks
D) Two skin folds on the back of each thigh

Question 8

A 3-month-old infant is diagnosed with developmental hip dysplasia. The nurse explains that the usual treatment for this infant would be:

A) A Pavlik harness
B) A body spica cast
C) Traction
D) Triple-diapering

Question 9

The nurse caring for an infant with hydrocephalus would take special precaution to:

A) Align the limbs
B) Support the head
C) Keep the head lower than the hips
D) Check intake and output

Question 10

An 18-month-old child who has had a surgical repair of a cleft palate is now allowed to eat a regular diet. The adjustment the nurse would make in feeding is:

A) Feed solid foods with the spoon at the side of the mouth.
B) Puree foods and offer them through a straw.
C) Place small bites of food in the mouth with a tongue blade.
D) Offer small, frequent meals of finger foods.

Question 11

The nurse observes that the infant's anterior fontanelle is bulging after placement of a ventriculoperitoneal shunt. The nurse positions this infant:

A) Prone, with the head of the bed elevated
B) Supine, with the head flat
C) Side-lying on the operative side
D) In the semi-Fowler's position

Question 12

Parents of a 2-month-old Down syndrome infant should be instructed, because of the generalized hypotonicity of the child, that special attention should be given to:

A) Careful feeding
B) Respiratory care
C) Range of motion
D) Incontinent care

Question 13

A newborn was just admitted to the NICU with a meningomyelocele. The priority for preoperative nursing care of this newborn is to protect the sac by:

A) Keeping the sac dry
B) Diapering snugly
C) Positioning prone in an incubator
D) Moving from side to side every hour

Question 14

Phototherapy is instituted for an infant with jaundice. An appropriate nursing action for the infant with jaundice is to:

A) Cover the infant's head with a hat.
B) Dress the infant lightly in a T-shirt.
C) Keep the infant's eyes covered.
D) Reposition at least every 4 to 8 hours.

Question 15

The nurse instructing parents about positioning their toddler who has just had a body spica cast applied would include to:

A) Prop the child upright with pillows for meals.
B) Use the bar between the legs to turn the child.
C) Put the child on her abdomen to sleep.
D) Change the child's position frequently.

Question 16

The nurse caring for the child who has had a ventriculoperitoneal shunt for hydrocephalus observes an increasing abdominal girth. The most appropriate response would be to:

A) Elevate the child's head
B) Check bowel sounds
C) Record retention of feeding
D) Notify charge nurse of possible malabsorption

Question 17

Postoperative nursing care of the infant following surgical repair of a cleft lip would include:

A) Feeding the infant with a spoon to avoid sucking
B) Positioning the infant on the abdomen to facilitate drainage
C) Applying elbow restraints to protect the surgical area
D) Providing minimal stimulation to prevent injury to the incision

Question 18

The statement that indicates parents understand how to feed their infant who had surgical repair of a cleft lip is:

A) "We are feeding the baby with a dropper for two weeks."
B) "We resumed bottle feeding after discharge."
C) "We started the baby on solid food yesterday."
D) "The baby is drinking well from a straw."

Question 19

Parents of a newborn with a unilateral cleft lip are concerned about having the defect repaired. The nurse explains that a child with a cleft lip usually undergoes surgical repair:

A) Immediately after birth
B) By 3 months of age
C) After 12 months of age
D) Varies in every case

Question 20

When the parents ask what the light does for their jaundiced baby, the nurse responds that the light:

A) Increases the baby's metabolism
B) Stimulates liver function
C) Dilates blood vessels
D) Breaks down bilirubin

Question 21

The nurse uses a diagram to show that when the CSF is obstructed in the subarachnoid space rather than in the ventricles, the resulting hydrocephalus is diagnosed as ____________________ hydrocephalus.

Question 22

The nurse demonstrates how to flush the ventriculoperitoneal shunt by the use of the ____________________ that is in place behind the baby's ear.

Question 23

The nurse is caring for a newborn whose mother has diabetes. The nurse would assess the neonate for:

A) Hypoglycemia
B) Erythroblastosis fetalis
C) Intracranial hemorrhage
D) Pancreatic failure

Question 24

The nurse assesses the hydrocephalic child for increasing ICP, which would be manifested by: Select all that apply.

A) High-pitched cry
B) Inequality of pupils
C) Bulging fontanelles
D) Diarrhea
E) Strabismus

Question 25

The nurse clarifies to the parents of a child with spina bifida that their child has a portion of the spinal cord in the sac, in addition to the meninges, which makes this defect a ____________________.

Question 26

The nurse in the newborn nursery is watchful for neonatal abstinence syndrome in the newborn of a crack-addicted mother, which would be manifested by: Select all that apply.

A) Body tremors
B) Excessive sneezing
C) Hyperirritability
D) Drowsiness
E) Excessive appetite