Neonatology Flashcards
In some cases, the spinal cord and associated structures of a newborn may be exposed. This abnormality is called a:
Question 1 options:
A)
meningomyelocele.
B)
Tetralogy of Fallot.
C)
choanal atresia.
D)
omphalocele.
meningomyelocele
Which of the following best describes Pierre Robin syndrome?
Question 2 options:
A)
Repeat febrile seizures within the first 6 months of life
B)
Persistent pneumonia following meconium aspiration
C)
A congenital condition characterized by a small jaw and large tongue in conjunction with a cleft palate
D)
A condition in which the ductus arteriosis fails to close completely
a congenital condition characterized by a small jaw and large tongue in conjunction with a cleft palate
Which of the following is TRUE regarding vaginal delivery?
Question 3 options:
A)
The compression of the infant’s chest during vaginal delivery aids in the removal of fluid from the fetal lungs.
B)
Infants delivered vaginally are at greater risk of post-delivery complications.
C)
Vaginal delivery stimulates the production of insulin in the newborn.
D)
The foramen ovale close more successfully in newborns delivered vaginally.
the compression of the infants chest during vaginal delivery aids in the removal of fluids from the fetal lungs
Factors that stimulate the newborn to take the first breath include all of the following EXCEPT:
Question 4 options:
A)
hypothermia.
B)
hyperglycemia.
C)
hypoxia.
D)
acidosis.
hyperglycemia
You are caring for a newborn who had prolonged respiratory distress and hypoxia following birth. You recognize that continued hypoxia and subsequent severe acidosis can cause:
Question 5 options:
A)
persistent fetal circulation.
B)
the formation of congenital heart defects.
C)
refractory hypotension.
D)
rapid development of fetal alveoli to compensate for hypoxia.
persistent fetal circulation
You have been called to the residence of a five-day-old infant. His parents are concerned because he sleeps about 18 hours a day. They took a rectal temperature and got a reading of 100°F. Which of the following is the best course of action?
Question 6 options:
A)
Contact medical control to order acetaminophen.
B)
Reassure the parents that the infant’s sleep patterns and temperature are normal.
C)
Undress the infant to his diaper and sponge him with tepid water.
D)
Administer a 10 mL/kg fluid bolus.
reassure the parents that the infants sleep patterns and temperature are normal
You have just assisted in the delivery of a full-term infant in the back of the ambulance. Ten minutes after delivery, you obtain vital signs on the newborn and find the following: heart rate 120, respirations 54, and SpO2 of 90%. You recognize:
Question 7 options:
A)
the need for immediate supplemental oxygen.
B)
tachycardia and the possibility of shock.
C)
appropriate vital signs for this infant.
D)
tachypnea and possible respiratory distress.
tachycardia and the possibility of shock
Which of the following is NOT an option for prehospital vascular access in the newborn?
Question 8 options:
A)
Cannulation of a peripheral vein in an extremity
B)
Femoral vein cannulation
C)
Umbilical vein cannulation
D)
Intraosseous needle placed in the proximal tibia
femoral vein cannulation
Which of the following is NOT a recommended method for assessing the heart rate of a newborn?
Question 9 options:
A)
Palpate the umbilical pulse
B)
Palpating the carotid pulse
C)
Palpate a femoral pulse
D)
Auscultate heart sounds
palpating the carotid pulse
Which of the following statements is TRUE regarding the cardiac output of a neonate?
Question 10 options:
A)
Cardiac output doubles within the first few hours of life.
B)
Newborns have a fixed stroke volume; cardiac output depends mostly on heart rate.
C)
Neonates do not readily alter their pulse rate; cardiac output depends mainly on stroke volume.
D)
The cardiac output of a neonate is strongly influenced by body temperature.
newborns have a fixed stroke volume; cardiac output depends mostly on heart rate
A newborn has just been delivered. You notice a greenish-brown substance on the infant, and observe a vigorous cry and active movement. What is the appropriate way to manage this patient?
Question 11 options:
A)
Rub the infant with a dry towel and place on the mother’s chest.
B)
Lay the infant supine and place padding behind the shoulders.
C)
Using a bulb syringe, suction the nose and then the mouth.
D)
Prepare to suction the trachea with an endotracheal tube and meconium aspirator.
rub the infant with a dry towel and place on the mothers chest
At 90 seconds after birth, based on the following findings, which newborn does NOT require resuscitative efforts beyond routine care?
Question 12 options:
A)
HR = 98, RR = 27, peripheral cyanosis, APGAR = 6
B)
HR = 75, RR = 25, central cyanosis, APGAR = 5
C)
HR = 100, RR = 30, peripheral cyanosis, APGAR = 8
D)
HR = 158, RR = 40, central cyanosis, APGAR = 6
HR 100, RR 30 , peripheral cyanosis, APGAR 8
You have just assisted in the delivery of a 34-week-gestation infant in the office of a methadone clinic. After 30 seconds of drying and stimulation, the infant remains limp and cyanotic, with a pulse of 50. Which of the following is the most appropriate action to take at this point?
Question 13 options:
A)
Intubate the trachea, ventilate, reassess, and prepare to transport to a NICU.
B)
Begin bag-valve-mask ventilations and establish intravenous access.
C)
Begin CPR at a rate of 3 compressions to 1 ventilation.
D)
Continue to warm and dry the infant for an additional 30 seconds, while preparing to intubate.
begin CPR at a rate of 3 compressions to 1 ventilation
Immediately after delivery, a neonate is crying and moving his arms and legs, but is centrally cyanotic. You recognize:
Question 14 options:
A)
the need to prevent further heat loss.
B)
signs of a congenital heart abnormality.
C)
signs of a normal, healthy infant.
D)
the need for supplemental oxygen.
signs of a normal healthy infant
All of the following are accurate methods for obtaining the heart rate of a newborn EXCEPT:
Question 15 options:
A)
a pulse oximeter.
B)
3-lead ECG.
C)
auscultating heart tones.
D)
palpating a brachial pulse.
palpating a brachial pulse
You are resuscitating a 15-day-old infant who was found pulseless and apneic in her crib. Which of the following questions would be most helpful when obtaining a history from the parents?
Question 16 options:
A)
“Have any of your other children died from SIDS?”
B)
“Is there a family history of heart disease?”
C)
“Was your baby sleeping face up?”
D)
“Does your daughter have any congenital heart abnormalities?”
does your daughter have any congenital heart abnormalities
You are called to the home of a 72-hour-old infant whose mother is concerned because the infant has been “vomiting after she eats.” Based on this information, which of the following should you include in your history and physical assessment?
Question 17 options:
A)
Assessing the fontanels
B)
End-tidal CO2 monitoring
C)
Asking if the baby could have ingested any toxins
D)
Auscultation of gastric sounds
assessing the fontanels
You have just assisted in the delivery of an approximately 4 kg newborn whose mother is a rather petite primapara. On assessment, you note that there is no spontaneous movement of the infant’s right arm at the shoulder, but he moves the elbow and wrist. He otherwise exhibits vigorous movement and has a 1-minute APGAR score of 9. Which of the following should you suspect?
Question 18 options:
A)
Spinal cord damage
B)
Fractured clavicle
C)
Caput succedaneum
D)
Neonatal abstinence syndrome
fractured clavicle
You are assessing a 1-minute APGAR score on a patient who has peripheral cyanosis and a heart rate of 98, who cried spontaneously after delivery, is actively moving his extremities, and has a strong cry. What is the APGAR score of this patient?
Question 19 options:
A)
9
B)
8
C)
10
D)
7
8
A newborn was found pulseless and apneic in his crib. After lengthy attempts at resuscitation, medical control has advised you to stop resuscitation. When you inform the parents, they become hysterical and the mother cries, “Give me my baby! I don’t want you touching him!” You should:
Question 20 options:
A)
request that a law enforcement officer remain with the mother.
B)
gently tell the mother that, unfortunately, she cannot hold the baby until the coroner arrives.
C)
move the infant to the ambulance and transport.
D)
hand the child to the mother and allow the parents time alone with the child.
hand the child to the mother and allow the parents time alone with the child
You are called to a residence to care for a 3-hour-old infant in respiratory distress. Your physical exam reveals retractions, grunting, and tachypnea, along with rhonchi and crackles in the lungs. The midwife reports that the amniotic fluid had “thin meconium.” Which of the following is the most likely cause of this infant’s signs and symptoms?
Question 21 options:
A)
Persistent fetal circulation
B)
Cardiac compromise
C)
Tetralogy of Fallot
D)
Meconium aspiration
meconium aspiration
You respond to an apartment for a “sick child.” You arrive to find a 2-week-old infant in her mother’s arms, wrapped in a thick blanket. The mother reports that the baby has been coughing, and suddenly “went stiff” 10 minutes ago. The infant is listless and not rousable. You should FIRST:
Question 22 options:
A)
unwrap the child and assess skin temperature.
B)
package the infant in a car seat and transport emergently.
C)
obtain a blood pressure and medical history.
D)
apply oxygen and assess blood glucose.
unwrap the child and assess skin temperature
Which of the following is NOT a consequence of respiratory insufficiency in the newborn?
Question 23 options:
A)
Hyperglycemia
B)
Acidosis
C)
Bradycardia
D)
Hypoxia
hyperglycemia
A first-time mother has called 911 because her 5-day-old son is “acting sick.” Your assessment reveals a lethargic infant with a patent airway, adequate respirations, and a pulse rate of 100 beats per minute. His skin is cold to the touch and mottled. The mother reports she was giving the child a bath just prior to calling EMS. You suspect:
Question 24 options:
A)
hyperglycemia.
B)
hypoxia.
C)
hypercarbia.
D)
hypothermia.
hypothermia
