chapter 23 and 24 Flashcards
The nurse is teaching a group of students about the difference between a full term newborn and a preterm new born. The nurse determines that the teaching is effective when the student states 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 muscles in the extremities
D: Greater surface area in proportion to weight
D: Greater surface area in proportion to weight
When assessing a post-term newborn, which of the following would the nurse correlate with the gestational age variation? A: moist, supple, plum skin appearance B: abundant lanugo and vernix C: thin umbilical cord D: absence of sole creases.
C: thin umbilical cord
The parents of a preterm newborn being cared for in the NICU are coming to visit for the first time. The newborn is receiving mechanical ventilation and IV fluids and meds and is being monitored electronically by various devices. What action by the nurse would be most appropriate?
A: suggest that the parents stay for just a few minutes to reduce 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
C: encourage the parents to touch their preterm newborn
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 80x per min
C: administer epinephrine iv
D: suction the mouth and then the nose
D: suction the mouth and then the nose
The nurse frequently assess 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: immaturity respiratory control center C: deficiency of surfactant D: smaller respiratory passages
C: deficiency of sufractant
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 the gestational age?
A: strong brisk motor skills
B: difficulty in arousing to a quiet alert state
C: birth weight of 7lb 14oz
D: waisted appearance in extremities
B: difficulty in arousing to a quiet alert state
A large gestational newborn has a blood glucose level of 30mg/dl and is exhibiting symptoms of hypoglycemia. Which of the following would the nurse do first?
A: administer IV glucose immediately
B: feed the newborn 2oz of formula
C: initiate blood by oxygen therapy
D: place the newborn under the radiant warmer
A: administer IV glucose immediately
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
C: appropriate for gestational age (AGA) newborns
While caring for 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
A: Retinopathy of prematurity
When planning the care for an SGA newborn, which action would the nurse determine as priority?
A: preventing hypoglycemia with early feedings
B: observing for respiratory distress syndrome
C: promoting bonding between the parents and newborn
D: monitor vital signs every 2 hours
A: Preventing hypoglycemia with early feedings
A women gives birth to a newborn at 36 weeks gestation. She tells the nurse, I’, so glad that my baby isn’t preterm. Which response by the nurse would be most appropriate?
A: you are lucky to have given birth to a term newborn
B: you 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
D: you still need to monitor him closely for problems
Which of the following would be most appropriate for the nurse to do when assisting patients who have been experienced the loss of their preterm newborn?
A: avoid using the term death or dying
B: provide opportunities for them to hold their newborn
C: refrain from initiating conversation with the parents
D: focus the parents on a more pleasant topic
B: provide opportunities for them to hold their newborn
Which of the following, if noted in the maternal history, would the nurse identify as possibly contributing to the birth of a LGA newborn? A: drug abuse B: diabetes C: preclampsia D: infection
B: diabetes
Which of the following would alert the nurse to suspect that a preterm newborn is in pain? A: bradycardia B: oxygen sat level 94% C: decreased muscle tone D: sudden high pitched cry
D: sudden high pitched cry
When discussing newborns with birth weight variations to a group of nursing students, the instructor identifies which variation if the newborn weighs 5lb 2oz at any gestational age? A: small for gestational age B: low birth weight C: very low birth weight D: extremely low birth weight
B: low birth weight
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: waisted extremity appearance B: increased amount of breast tissue C: sunken abdomen D: adequate muscle tone over buttocks E: narrow skull sutures.
A: waisted extremity appearance
C: sunken abdomen
E: narrow skull sutures
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: post term
B: late preterm
A nursing instructor is describing common problems associated with preterm birth. When describing the preterm newborn risk for perinatal asphyxia, the instructor includes which of the following as contributing to the newborns risk? (Select all that apply)
A: surfactant deficiency
B: placental deprivation
C: immaturity of the respiratory control center
D: deceased amount of brown fat
E: depleted glycogen stores
A; surfactant deficiency
C: immaturity of the respiratory control center
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 explanders
A: dry the newborn thoroughly
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 isolate
C: administer oxygen using oxygen hood
D: give gavage or continuous tube feeding
A; stimulate the infant with frequent handling
A nurse suspects that a preterm newborn is having problems with thermal regulation. Which of the following would support the nurses suspicion. (Select all that apply) A: Shallow, slow respirations B: cyanotic hands and feet C: irritability D: hypertonicity E: feeble cry
A: shallow, slow respirations
B: Cyanotic hands and feet
E: feeble cry
The nurse is assessing a preterm newborns 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
C: bulging fontanels
The nurse is assessing a preterm newborn who is in the NICU for signs and symptoms of overstimulation. Which of the following would the nurse be least likely to assess? A: increased respirations B: flaying hands C: periods of apnea D: decreased heart rate
A: increased respirations
A group of nursing students are reviewing the literature in preparation for a class presentation of newborn pain prevention and management. Which of the following would the student be most likely to find about this topic?
A: newborn pain is frequently recognized and treated
B: newborns rarely experience pain with procedures
C: pain is frequently mistaken for irritability or agitation
D: newborns may be less sensitive to pain than adults
C: pain is frequently mistaken for irritability or agitation
A nurse is developing a plan of care for a preterm newborn to address the nursing diagnosis of risk for delayed development which of the following would the nurse include? (Select all that apply)
A: clustering care to promote rest
B: Positioning newborn in extension
C: using kangaroo care
D: loosely covering the newborn with blankets
E: Providing non-nutritive sucking
A: clustering care to promote rest
C: Using kangaroo care
E: providing non-nutritive sucking
A nurse is assisting the anxious parents of a preterm newborn to cope with the situation. Which statement by the nurse would be least appropriate?
A: I’ll be here to help you along the way
B: What has helped you to deal with this stressful situation in the past?
C: let me tell you about what you will see when you visit your baby
D: Forget about what happened in the past and focus on now.
D: forget about what happened in the past and focus on now.
