Question 1

The nurse in the newborn nursery is watchful for neonatal abstinence syndrome in the newborn of a mother who took opioids during pregnancy.What would be the manifestations of this syndrome? (Select all that apply. )

Accepted Answer

The neonate with abstinence syndrome will have tremors,be hyperirritable and wakeful,have excessive sneezing or yawning,and have no appetite.

Question 2

The parents of a child diagnosed with cystic fibrosis ask the nurse what caused this disorder.What is the most appropriate response?

Accepted Answer

Inborn errors of metabolism include a number of inherited diseases that affect body chemistry.There may be an absence or a deficiency of a substance necessary for cell metabolism.The deficient substance is usually an enzyme.Almost any organ of the body may be damaged.Examples of inborn errors of metabolism include cystic fibrosis and phenylketonuria (PKU).In disorders of the blood,there is a reduced or missing blood component or an inability of a component to function adequately.Sickle cell disease,thalassemia,and hemophilia fall into this category.Chromosomal abnormalities number in the thousands.Most involve some type of mental retardation,and others are incompatible with life.The newborn with Turner's syndrome or Klinefelter's syndrome may have impaired physical growth and sexual development.Malformations at birth include several types of structural defects.

Question 3

What manifestations of increasing ICP in the hydrocephalic child should the nurse be aware of? (Select all that apply. )

Accepted Answer

Increased ICP is manifested by high-pitched cry,inequality of pupils,and bulging fontanelles.

Question 4

The nurse is providing care to a child with Down syndrome.What body system has the highest risk of congenital anomaly in a child with Down syndrome?

Accepted Answer

Down syndrome children are prone to deformities of the cardiovascular system.

Question 5

The nurse is caring for a macrosomic newborn of a woman diagnosed with gestational diabetes immediately after birth.What assessment findings can the nurse anticipate? (Select all that apply. )

Accepted Answer

Many newborn infants of diabetic mothers have serious complications.When the mother is hyperglycemic,large amounts of glucose are transferred to the fetus.After delivery the infant often has low blood glucose levels because of the abrupt loss of maternal glucose and hypertrophy of the pancreatic islet cells,which results in a temporary overproduction of insulin.Hyperinsulinism,along with excess production of protein and fatty acids,often results in a newborn infant who weighs more than 4082 g (9 lb).These infants suffer from hypoglycemia,hypocalcemia,and hyperbilirubinemia.

Question 6

The nurse is obtaining intake information on a new patient being seen for preconception care and notes a family history of neural tube defects.What interventions can the nurse suggest to this woman to help prevent neural tube anomalies in a developing fetus? (Select all that apply. )

Accepted Answer

The use of drugs during early pregnancy and poor nutrition may contribute to the development of a neural tube defect.The American Academy of Pediatrics (AAP)recommends that all women of childbearing age take a daily multivitamin that contains 0.4 mg of folic acid and continue the intake of folic acid until the 12th week of pregnancy,when basic neural tube development is completed.Studies have shown that the intake of folic acid before conception dramatically decreases the occurrence of neural tube defects such as spina bifida.Daily exercise and bed rest do not decrease the risk of neural tube anomalies.

Question 7

What would be included in the plan of care for a child just returned to the floor from surgery in which a clubfoot was repaired? (Select all that apply. )

Accepted Answer

The casted leg should be kept elevated.All the other options are necessary nursing interventions for a child who is freshly casted.

Question 8

What will the nurse include in the plan of care when caring for an infant with an intracranial hemorrhage? (Select all that apply. )

Accepted Answer

These children should be kept positioned with the head elevated,fed slowly,and monitored for increased intracranial pressure.Children with intracranial hemorrhages are not stimulated and are kept in a quiet environment.

Question 9

What assessment made by the nurse would lead the nurse to suspect hip dysplasia?

Accepted Answer

The gluteal folds are asymmetrical because the head of the femur has slipped out of the acetabulum.There is also limited abduction of the affected side,and when the legs are flexed the affected leg seems to be shorter.

Question 10

What characteristics are typical in a child diagnosed with Down syndrome? (Select all that apply. )

Accepted Answer

Children with Down syndrome have close-set upturned eyes,simian creases in palms of hands,protruding tongue,and curved,small fingers.They also have a wide space between their first and second toe and a high incidence of heart defects.

Question 11

The home health nurse is educating parents on home phototherapy.What will the nurse include when providing information to these parents?

Accepted Answer

Parents should be instructed to use a three-prong plug for safety,keep a diaper in place,and expose as much skin as possible.The light source should be placed on a nonabsorbent surface,not on carpet or in a crib.It is not necessary to cover the infant's eyes when under the light.

Question 12

The nurse is caring for a macrosomic newborn whose mother has diabetes.What should the nurse assess for with this neonate?

Accepted Answer

The newborn of a mother with diabetes is prone to hypoglycemia.

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