Ch 23 and 24 Flashcards
Ch 23
1.
The nurse is teaching a group of students about the differences between a full-term newborn and a preterm newborn. The nurse determines that the teaching is effective when the students state that the preterm newborn has:
A)
Fewer visible blood vessels through the skin
B)
More subcutaneous fat in the neck and abdomen
C)
Well-developed flexor muscles in the extremities
D)
Greater surface area in proportion to weight
Greater surface area in proportion to weight
2. When assessing a postterm newborn, which of the following would the nurse correlate with this gestational age variation? A) Moist, supple, plum skin appearance B) Abundant lanugo and vernix C) Thin umbilical cord D) Absence of sole creases
Thin umbilical cord
3.
The parents of a preterm newborn being cared for in the neonatal intensive care unit (NICU. are coming to visit for the first time. The newborn is receiving mechanical ventilation and intravenous fluids and medications and is being monitored electronically by various devices. Which action by the nurse would be most appropriate?
A)
Suggest that the parents stay for just a few minutes to reduce their anxiety.
B)
Reassure them that their newborn is progressing well.
C)
Encourage the parents to touch their preterm newborn.
D)
Discuss the care they will be giving the newborn upon discharge.
Encourage the parents to touch their preterm newborn.
4.
When performing newborn resuscitation, which action would the nurse do first?
A)
Intubate with an appropriate-sized endotracheal tube.
B)
Give chest compressions at a rate of 80 times per minute.
C)
Administer epinephrine intravenously.
D)
Suction the mouth and then the nose.
Suction the mouth and then the nose.
5. The nurse frequently assesses the respiratory status of a preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syndrome because of which of the following? A) Inability to clear fluids B) Immature respiratory control center C) Deficiency of surfactant D) Smaller respiratory passages
Deficiency of surfactant
6. The nurse prepares to assess a newborn who is considered to be large for gestational age (LGA). Which of the following would the nurse correlate with this gestational age variation? A) Strong, brisk motor skills B) Difficulty in arousing to a quiet alert state C) Birth weight of 7 lb 14 oz D) Wasted appearance of extremities
Difficulty in arousing to a quiet alert state
7.
An LGA newborn has a blood glucose level of 30 mg/dL and is exhibiting symptoms of hypoglycemia. Which of the following would the nurse do next?
A)
Administer intravenous glucose immediately.
B)
Feed the newborn 2 ounces of formula.
C)
Initiate blow-by oxygen therapy.
D)
Place the newborn under a radiant warmer.
Administer intravenous glucose immediately.
8. A group of pregnant women are discussing high-risk newborn conditions as part of a prenatal class. When describing the complications that can occur in these newborns to the group, which would the nurse include as being at lowest risk? A) Small-for-gestational-age (SGA. newborns B) Large-for-gestational-age (LGA. newborns C) Appropriate-for-gestational-age (AGA. newborns D) Low-birth-weight newborns
Appropriate-for-gestational-age (AGA) newborns
9. While caring for a preterm newborn receiving oxygen therapy, the nurse monitors the oxygen therapy duration closely based on the understanding that the newborn is at risk for which of the following? A) Retinopathy of prematurity B) Metabolic acidosis C) Infection D) Cold stress
Retinopathy of prematurity
10.
When planning the care for an SGA newborn, which action would the nurse determine as a priority?
A)
Preventing hypoglycemia with early feedings
B)
Observing for respiratory distress syndrome
C)
Promoting bonding between the parents and the newborn
D)
Monitoring vital signs every 2 hours
Preventing hypoglycemia with early feedings
11.
A woman gives birth to a newborn at 36 weeks’ gestation. She tells the nurse, “I’m so glad that my baby isn’t premature.” Which response by the nurse would be most appropriate?
A)
“You are lucky to have given birth to a term newborn.”
B)
“We still need to monitor him closely for problems.”
C)
“How do you feel about delivering your baby at 36 weeks?”
D)
“Your baby is premature and needs monitoring in the NICU.”
“We still need to monitor him closely for problems.”
12.
Which of the following would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn?
A)
Avoid using the terms “death” or “dying.”
B)
Provide opportunities for them to hold the newborn.
C)
Refrain from initiating conversations with the parents.
D)
Quickly refocus the parents to a more pleasant topic.
Provide opportunities for them to hold the newborn.
13. Which of the following, if noted in the maternal history, would the nurse identify as possibly contributing to the birth of an LGA newborn? A) Drug abuse B) Diabetes C) Preeclampsia D) Infection
Diabetes
14. Which of the following would alert the nurse to suspect that a preterm newborn is in pain? A) Bradycardia B) Oxygen saturation level of 94% C) Decreased muscle tone D) Sudden high-pitched cry
Sudden high-pitched cry
15. When describing newborns with birth-weight variations to a group of nursing students, the instructor identifies which variation if the newborn weighs 5.2 lb at any gestational age? A) Small for gestational age B) Low birth weight C) Very low birth weight D) Extremely low birth weight
Low birth weight
16. A nurse is assessing a newborn who has been classified as small for gestational age. Which of the following would the nurse expect to find? (Select all that apply.) A) Wasted extremity appearance B) Increased amount of breast tissue C) Sunken abdomen D) Adequate muscle tone over buttocks E) Narrow skull sutures
Wasted extremity appearance
Sunken abdomen
17. The nurse is reviewing the medical record of a newborn born 2 hours ago. The nurse notes that the newborn was delivered at 35 weeks' gestation. The nurse would classify this newborn as which of the following? A) Preterm B) Late preterm C) Full term D) Postterm
Late preterm
18. A nursing instructor is describing common problems associated with preterm birth. When describing the preterm newborn's risk for perinatal asphyxia, the instructor includes which of the following as contributing to the newborn's risk? (Select all that apply.) A) Surfactant deficiency B) Placental deprivation C) Immaturity of the respiratory control centers D) Decreased amounts of brown fat E) Depleted glycogen stores
Surfactant deficiency
Immaturity of the respiratory control centers
19. After determining that a newborn is in need of resuscitation, which of the following would the nurse do first? A) Dry the newborn thoroughly B) Suction the airway C) Administer ventilations D) Give volume expanders
Dry the newborn thoroughly
20. A nurse is developing a plan of care for a preterm infant experiencing respiratory distress. Which of the following would the nurse be least likely to include in this plan? A) Stimulate the infant with frequent handling. B) Keep the newborn in a warmed isolette. C) Administer oxygen using a oxygen hood. D) Give gavage or continous tube feedings.
Stimulate the infant with frequent handling
21. A nurse suspects that a preterm newborn is having problems with thermal regulation. Which of the following would support the nurse's suspicion? (Select all that apply.) A) Shallow, slow respirations B) Cyanotic hands and feet C) Irritability D) Hypertonicity E) Feeble cry
Shallow, slow respirations
Cyanotic hands and feet
Feeble cry
22. The nurse is assessing a preterm newborn's fluid and hydration status. Which of the following would alert the nurse to possible overhydration? A) Decreased urine output B) Tachypnea C) Bulging fontanels D) Elevated temperature
Bulging fontanels
