Question 1

A nurse is caring for a baby with neonatal abstinence syndrome.Which of the following medications should the nurse be prepared to give?

Accepted Answer

Several medications are used to treat the infants of drug-abusing mothers,including paregoric (camphorated tincture of opium),phenobarbital (Luminal),clonidine (Catapres),chlorpromazine (Thorazine),and diazepam (Valium).Naloxone (Narcan)is not used because it can increase the severity of drug withdrawal in the infant.

Question 2

A nurse is assessing a newborn and hears bowel sounds in the infant's chest area.What other finding should the nurse specifically assess for?

Accepted Answer

Bowel sounds in the thoracic cavity could indicate a congenital diaphragmatic hernia.The nurse should assess for other signs,including cyanosis,bradycardia,barrel chest,and scaphoid abdomen.The other findings are not related to this condition.

Question 3

An infant is born weighing 6 lb,1 oz and has gastroschisis.The nurse anticipates running this infant's IV fluids at a rate of ____________________ mL/hour.

Accepted Answer

The answer of An infant is born weighing 6 lb,1...

Question 4

A preterm infant has been started on IV fluids.When assessing the patient,which findings would indicate to the nurse that goals for this therapy are being met?

Accepted Answer

In the first few days of life,the goal for hydration is to maintain a urine output of 1-3 mL/kg/hour and a urine specific gravity of < 1.012.The other assessments are not related.

Question 5

A nurse monitors all newborns in the NICU for hypoglycemia.Which manifestations could indicate hypoglycemia in one of the babies?

Accepted Answer

Apneic episodes,eye rolling,and lethargy are among the manifestations of hypoglycemia.Hypoglycemic infants can also be asymptomatic.Palmar sweating is indicative of pain.

Question 6

A baby was born 4 days ago at 34 weeks' gestation and is receiving phototherapy for neonatal jaundice.The baby has symptoms of temperature instability,dry skin,poor feeding,lethargy,and irritability.What are the nurse's priority nursing interventions?

Accepted Answer

Priority nursing actions for the baby undergoing phototherapy include keeping the baby warm,as hypothermia can occur due to exposure,and ensuring the baby receives adequate nutrition.Bilirubin is excreted in the stool.Proper nutrition will also help maintain fluid status.Keeping the baby's mask in place is an important safety action to prevent eye damage,but is not related to this baby's signs.Hypoglycemia can occur with poor nutrition.Magnesium levels are not affected by jaundice.

Question 7

A woman in labor takes high-dose steroids for a connective tissue disorder.She takes no other medications.The nurse educates her that her baby could be at risk for which of the following conditions?

Accepted Answer

High-dose corticosteroids can lead to hyperglycemia.A woman with uncontrolled hyperglycemia is at risk of having a large-for-gestational-age newborn or a newborn with hypothermia.Maternal hyperglycemia does not lead to cold stress,intrauterine growth restriction,or polycythemia.

Question 8

A nurse preceptor of a student nurse explains that although a high-risk newborn can have complications in any body system,the systems most often impacted include which of the following?

Accepted Answer

The three systems most commonly affected in the high-risk newborn are the circulatory,respiratory,and neurological systems.

Question 9

A nurse is caring for a premature newborn.What interventions does the nurse include on the baby's care plan?

Accepted Answer

Cradling the baby with extremities flexed helps with ventilation and neuroevolutive development,and helps prevent flattening of the occiput.While the baby is being warmed,the nurse monitors the baby's temperature continuously with a skin probe.Repositioning every 4 hours helps prevent skin breakdown.The skin of the preterm infant is fragile so bathing is not done daily and is done without soap products.Premature infants need to be weighed daily.

Question 10

An infant is born at 35 weeks and 3 days.How would the nurse document this gestational age? ____________________

Accepted Answer

The answer of An infant is born at 35 weeks...

Question 11

A premature infant was delivered after a prolonged labor with rupture of the maternal membranes >18 hours.The infant's weight is 6 lb,1 oz (2.75 kg).What assessment finding would require the nurse to intervene immediately?

Accepted Answer

This infant is at risk for neonatal sepsis.Signs of this condition include hyperthermia or hypothermia,lethargy,hypoglycemia,and poor feeding.This child's skin temperature reading is below normal,requiring the nurse to intervene.The blood pressure reading is normal for a child of this weight.The two laboratory values are also normal.

Question 12

A premature newborn has a pulse pressure of 33 mm Hg.What action by the nurse takes priority?

Accepted Answer

A normal pulse pressure in a premature infant is 15-25 mm Hg.This widened pulse pressure could be indicative of a patent ductus,so the nurse should assess for this condition.However,the first action would be to ensure that the blood pressure cuff is the appropriate size and is calibrated correctly.Increasing IV fluids and sedating the baby are not indicated.

Question 13

An infant weighing 3 lb,7 oz has apnea of prematurity.The nurse needs to administer the loading dose of caffeine citrate (Cafcit).The dose for this is____________________ mg.

Accepted Answer

The answer of An infant weighing 3 lb,7 oz has...

Question 14

A premature infant is born and admitted to the NICU.A student nurse questions why the primary nurse is starting to plan discharge teaching so early.Which response by the nurse is best?

Accepted Answer

Discharge planning starts on admission to the NICU.Instructions are extensive and parents need time to absorb education and begin planning.Of course,changes in the baby's condition warrant changes in plans,but by starting early,the nurse can ensure the best possible outcome for the family.

Question 15

An experienced NICU nurse is explaining to a new nurse why premature infants have such great nutritional needs.What information should the experienced nurse include?

Accepted Answer

Several factors exist to cause increased nutritional demands in the premature infant.They haven't have time in the uterus to build up nutritional stores like normal term babies do,their many complications increase their metabolic rate,and they lose 10% of their body weight after birth,which they can ill afford,Certainly some premature infants have intestinal and pancreatic problems,but this is not a true statement for all.

Question 16

A nurse is explaining to a student that sudden infant death syndrome (SIDS)has been reduced due mostly to what trend?

Accepted Answer

The "Back to Sleep" campaign of the American Academy of Pediatrics aims for all infants to sleep on their backs,every time.Since initiation of this campaign,there a has been a 50% reduction in SIDS deaths.The other factors are not as firmly related to SIDS as is sleeping supine.

Question 17

An infant has been admitted to the neonatal intensive care unit because of meconium-aspiration syndrome and related complications.The pediatric nurse assesses the patient frequently for which complication?

Accepted Answer

Meconium-aspiration syndrome is often complicated by pneumothorax and/or pneumomediastinum.Hemothorax,pneumonia,and respiratory distress syndrome are not typical complications.

Question 18

A baby is admitted with a long-bone fracture.What nursing actions are appropriate in the care of this baby?

Accepted Answer

Nursing care appropriate for the newborn with a long-bone fracture includes immobilization (usually in a soft splint),frequent neurovascular checks,elevation of the extremity above the heart,cold therapy (not heat),and pain medication.

Question 19

A nurse is documenting the types of high-risk newborns on the unit.Which infants would be classified as preterm? (Select all that apply).

Accepted Answer

Infants born between 38 and 41 weeks' gestation are considered term infants.Infants born before the completion of the 37th week are considered premature.Infants born on or after 42 weeks are considered postterm.

Quiz 19: Caring for the Newborn at Risk