Practice Test Flashcards
Magnesium sulfate administration during labor places the neonate at increased risk for
A. Hypertonic reflexes
B. Motor Depression
C. Seizure activity
Motor depression
When completing the Ballard exam it is important to note that all gestational ages, neonates have
A extensor and flexor tone
B symmetrical tone and movement
C the ability to resume a flexed position
B
Neonatal development is based on the principles that development progresses according to
A an orderly sequence based upon readiness and maturation
B individualistic sequential processes from causal to cephlad
C variation in the sequence of development between individuals
A
A mother who is hepatitis B antigen positive has delivered a term neonate. To prevent transmission the recommended treatment is
Administration of Hepatitis B vaccine and immunoglobulin within 12 hrs
Early, minimal enteral fdgs are used in very low birth weight neonates to
A improve gastrointestinal function
B maintain glucose level
C Reduce renal solute load
A
In the fetus, which connects the pulmonary artery to the proximal descending aorta?
Ductus arteriosus
What are murmurs caused by?
Turbulent blood flow
Cardiac output can be best described by what?
The amount of blood ejected from the heart each minute
The cardiac defect where one artery forms both the pulmonary artery and aorta is known as what?
Trunctus arteriosus
When does a PDA typically close?
Within 24 hrs
What is a normal sensible fluid loss?
Skin
Stool
Aspirate
Blood loss
Stool
On the first day of life, a neonates output is 0.8ml/kg/hr. Which phase is the neonate in?
Pre-diuretic
What electrolyte imbalance can cause widened QRS complexes on the ECG?
Hyperkalemia
Which substance is effective in assisting with the absorption of fat?
MCT
What are high levels of alpha-fetoprotein are associated with what?
Neural tube defects
Anemia caused by an intracranial bleed is classified as what?
Neonatal blood loss
Management if symptomatic polycythemia is what?
Increase fluids
What can cause hypermagnesia?
Maternal treatment with magnesium sulfate
What diet restrictions does PKU require?
Protein
Abnormalities in the synthesis of cortisol and aldosterone are found in what?
Congenital adrenal hyperplasia
What maternal medication can cause bleeding for the first 24hrs?
Salicylates
One cause if hypercalcemia is what?
Increased bone reabsorption
Calcium is most directly regulated by what?
Parathyroid hormone
Is mitochondrial inheritance only passed on my females or males?
Females
What is true regarding glomerular filtration rate? (GFR)
It increases rapidly after birth
What finding would indicate possible renal failure?
Oliguria
What is the primary function of benzodiazepines and neonate?
 Sedation
What is the portion of the administeration that reaches the site of action in the body known as?
Bioavailability
Which agent can be used to reverse the action of heparin and control excessive bleeding?
Protamine sulfate
What is a side effect of vancomycin?
Ototoxicity
What is a common side effect of maternal administration of magnesium?
Respiratory depression, hypotonia
What heat loss can occur with a radiant warmer?
Convective heat loss
What is true regarding bathing of the neonate?
Immersion in water is recommended
What are epidermal White says that disappear soon after birth called?
Milia
What is a vascular abnormality, which is associated with a torch infection?
Purpura
What is an important factor that occurs at birth and assist with establishing respirations?
Fluid remaining in the lungs at birth, is absorbed and replaced by air with the first breath
What is true about surfactant?
Surfactant decreases surface tension
What kind of apnea does vagal stimulation cause?
Central
With-high frequency ventilation, a conventional vent is also used to provide what?
Oxygenation
Does ECMO prevent further barotrauma to the lungs?
Yes
What is an abnormal channel connecting the trachea to the esophagus?
Tracheoesophageal fistula
What condition is characterized by fusion between digits?
Syndactyly
What is the Barlow test used to diagnose?
Hip dysplasia
What is a risk factor for perinatal asphyxia?
Maternal preeclampsia
When do the anterior fontanelles close?
Between 18 to 24 months
What stage of ROP includes the outer most crescent of the eye?
3
What might an absent red reflux indicate?
Congenital cataracts
What is a large tongue which is associated with trisomies and hypothyroidism, known as?
Macroglossia
What is true regarding cleft palate and lip?
Require surgical repair
What is the etiology of trachealmalacia?
An abnormal collapse of the trachea walls
What can pain contribute to?
Hypoxia
What causes mottled in color in a 32 week neonate with stimulation?
 Physiologic stress response
Who, what, where, when, why and how of nursing practice is known as:
Scope of practice
What is true regarding medical errors?
It is rare that a single issue leads to a Medical error
What is barotrauma?
Damage to the long caused by excessive pressure
What is volutrauma?
Alveolar damage related to high tidal volume ventilation
What is atelectotrauma?
Injury caused by repetitive forced opening and closing up alveoli
What is biotrauma?
Inflammatory response
What would you change with an elevated PCO2?
Increase rate, increase pip
Would you change if you have a low PCO2?
Decreased rate, decreased PIP
What if PO2 is low or have low O2 sats?
Increase oxygen, increase, PIP, increase i-time, increase PEEP
What does the map on the HFOV effect??
Oxygenation
What would you adjust on HFOV for the CO2?
Amplitude
What does increasing pip do?
Will increase tidal volume so the PCO2 may also go down
What are Brushfield spots?
Speckled appearance around the circumference of the eye
What is the normal liver edge in centimeters?
1 to 2 cm below right coastal margin in midclavicular line
What is polydactyly?
Supernumerary digits (extra)
What is brachydactyly?
Shorten digit from shorten finger joint. Associated with achondroplasia and trisomy 21.
What is clinodactyly?
Congenital deviation of digits curvature
What is the Babinski reflex?
Stimulate sole of foot infant will either flex or extend toes
What does Autosomal genetic mean?
One of the 22 chromosomes that do not determine the sex of the end
What sex are affected by autosomal dominant disorder’s?
Male and females affected equally, either parent can pass the Gene on
Who are affected by autosomal recessive disorders?
Both male and females are equally affected. 25% chance with each pregnancy.
What is title volume?
The amount of air that moves into or out of the lungs with each breath (4-6 ml/kg)
What is vital capacity?
The volume of air max and Emily inspired in maximally expired (40 ml/kg)
What is functional residual capacity?
Volume of gas that remains in the lungs after a normal expiration (30ml/kg)
What is total lung capacity?
The amount of air contained in the long after a maximal inspiration (63ml/kg)
What is the genetic disease trisomy 18?
Edwards syndrome 
Which is an example of an autosomal recessive disease?
Cystic fibrosis
What is a defect in chromosome 22?
DiGeorge syndrome
What is tidal volume?
The amount of air that moves into or out of the lungs with each breath (4 to 6ml/kg)
What is FRC?
The volume of gas that remains in the lungs after a normal expiration (30ml/kg)
What is mean air pressure?
Mean, or average pressure transmitted to the airways throughout an entire respiratory cycle is depending on the ventilator circuit, peak, inspiratory, pressure, peep, and inspiratory time. Decrease atelectasis, and a major determinant of oxygenation.
What is the amount of oxygen that can be delivered to the tissues dependent on?
Cardiac output in the oxygen content of the blood
What vent changes should be made if your CO2 is elevated?
Increased rate and pip
What changes should be made if your CO2 is lower?
 Decreased rate and pip
What is half-life?
The time necessary for a measured concentration to fall to half its original value
What is the purpose of surfactant?
It lowers surface tension
What type of cells produce surfactant?
Alveolar type two cells
What is the purpose of umbilical arteries?
They carry deoxygenated blood from the fetus to the placenta
What is the purpose of umbilical veins?
It carries oxygenated blood, and nutrients from the placenta to the fetus
What is lung compliance?
When the alveoli in lungs are readily acceptable of volume and gas exchange
What is PPHN?
Systematic arterial hypoxemia, secondary to elevated pulmonary resistance, leading to right to left shunting and alterations, and pulmonary vaso reactivity
D- immediate surgery
B
D
Never visible on first day of life.
D
Never visible on first day of life.
B
C
B- congenital infection, jaundice
What diagnosis is indicates with diffuse intracranial calcifications?
Congenital Toxoplasmosis
What is treatment of Toxoplasmosis?
Pyrimethamine, sulfadiazine, leucovorin
D
What is a HIDA Scan?
Helps visualize biliary ducts, thinking biliary atresia
How does biliary atresia present?
Normal at delivery but within 2-3 woks of life jaundice, dark urine, clay color stool
C- relieve the obstruction first (n-acetcysteine is added to fluid)
Meconium ileus can be indicated with what?
Cystic Fibrosis
Meconium plug
Meconium is normal but the intestine is functionally immature, meconium becomes backed up forming a plug
A- considering continental syphillis
Watery secretions
A-
Baby stable but bilious vomiting is congenital. Double bubble but positive occult blood so volvulus rather than duodenal atresia
C begin taking within 12 hrs of birth for 6 weeks. Testing done after dose given
E-
Cocaine more worried about pregnancy
A- absent Moro, arm held in pronated extended injury
Erbs- Injury to c5, c6
What is erbs palsy?
Lack of shoulder motion
B- crosses suture lines
What test indicates glomerular filtration rate?
Creatinine
First day- 80ml/kg/day
1.5 x80= 120 total/24= 5ml- iv rate should be 5ml/hr
C
A
B
D
D
What is BPD?
A
C
C
D
D
C- avoid the calcaneus or curvature of the heel
A
C
Which vent mode describes the right delivery of a synchronized breath with each spontaneous breath meaning the threshold criteria or the delivery of mechanical breaths at a preset rate if there is no spontaneous respiratory effort?
A
D
A
A
B
What is the best indicator favorable for extubation?
D
B
C
C
D
A Survanta
B curosurf
C infasurf
D Surfaxin
D
D
D
C
C
C
D
C
D
D
D
B
C
D
C
B
C
A
C
B
D
D
A
A
C
B
D
B
D
D
C
A
C
B
D
D
D
A
C
B
B
B
C
D
A
C
C
C
D
A
A
A
B
C
D
D
A
B
D
B
A
A
A
B
D
C
D
B
B
A
B
C
A
D
C
C
D
B- daily antibiotic therapy
A
A
C
B
D
What are chances of have another baby with cystic fibrosis?
Because cystic fibrosis is an autosomal dominant condition there is a 50% chance with each pregnancy of having another affected offspring
B
A
B
A
D
A
Best way to prevent getting cytomegalovirus
Avoiding exposure is virtually impossible
D
B
A
C
C
D
A
C
D
B
A
D
A
D
A
A
B
D
B
Olihydramnios- could indicate
Renal Agenesis
C
C
A is correct not c
When women give birth sitting upright, which of the following indicators show lower values in cord blood?
A ph
B pco2
C po2
B
A newborn infant with respiratory difficulty is diagnosed with a congenital chylothorax. A thoracentesis followed by placement of a tube thoracotomy for continuous drainage is performed. The nurse must monitor this patient closely for.
A air leak
B infection
C subcutaneous emphysema
B
Erb palsy
An infant is born with Leet years, excess new goals, skin and broad chest widely space, nipples, peripheral lymphedema, and absent pulses in the lower extremities. The nurse suspects the infant has cation of the aorta which chromosomal defect can cause this constellation of findings?
Turner syndrome
The nurse should expect an infant to have which of the following heart defects when a chest radiograph reveals a heart that fills the entire chest?
Epstein malformation
Why is spiral lactone Aldactone not useful in emergency situations?
The onset of action is approximately 60 hours
The form of circulating bilirubin that places the infant at the highest risk for kernicterus is
Indirect free, BiliRubin
B
At what age is lung development completed by?
16 to 18 years of age
What is the biggest side effect of prostaglandin E1 in regards to transposition of the great vessels?
Hyperthermia, because prostaglandin E1 is a potent vasodilator
Why is Ivy administration of medication’s best in the neonatal population?
IV. Medication bypass all absorptive barriers.
Is it normal to have low urine output after corrective, congenital, heart disease surgery requiring cardio pulmonary bypass?
Yes, oliguria for up to 48 hours
A side effect of anticholinergic ophthalmic medication used in neonates is
Increased gastrointestinal transit time
During evaluation of an infants, ears, the nurse notes a small pit anterior to the tragus. What is the best explanation for this finding?
A minor malformation, that may communicate with the internal ear or brain, and lead to infection
What is the best predictor of the occurrence of preterm labor?
Prior preterm delivery
What is a vascular ring?
Lower airway obstruction, the aortic arch and anomalous vessels form a partial or complete ring around either the trachea, esophagus or both resulting in compression of those structures, they occur outside the pulmonary system, making them extra pulmonary causing
Which of the following is associated with neonatal hypocalcemia?
A perinatal asphyxia
B hypophosphatemia
C Subcutaneous fat necrosis
A
What are acini?
Gas exchanging portion of lung tissue
Surface action is produced in the lungs by:
A acini
B type II pneumocytes
C surfactant protein A
A small for gestational age infant is born with several anomalies, including micromania, a cleft lip, overlapping digits, rocker bottom fee and cutest aplasia. The most likely explanation, for this constellation of anomalies is.:
Trisomy 13
The term infant requires intubation for respiratory to stress at birth the pulse ox reads as follows right hand 75% saturation left foot, 92% saturation the nurse should anticipate which of the following conditions?
A sepsis
B transposition of the great arteries
C truncus arteriosus
B
Which of the following abnormalities is associated with an autosomal dominant inheritance pattern
A Turner syndrome
B sickle cell anemia
C Osteogenesis imperfecta.
C
Which of the following interventions mandatory for an infant suspected having congenital syphilis?
Venereal disease, research laboratory test on cerebral spinal fluid
Newborn presents with cyanosis on examination. The nurse peers a murmur at the left upper sternal border but here’s nothing else unusual what cardiac defect is most likely responsible for these findings?
Tetralogy of flow is the most common sciatic heart defect a grade 2 to 4 murmur is heard over the left upper sternal border
During the assessment of a newborn after delivery, the nurse notes the infant has a barrel shaped chest this finding a scene in infants with
transient tachypnea
What is Kleinfelter syndrome disease related to?
Advanced, maternal age, parental non-disruption errors and maternal meiosis errors
During fetal development, the structure that will eventually give rise to the vast deference. In the presence of testosterone is the.
Mesonephros
What is klumpke palsy?
Results and wrist and hand paralysis with an absent grasp reflex
What is Erb Duchene palsy?
Results from excessive traction and stretching of the brachial plexus nerves. These infants present with an internally rotated arm and a pronated flexed wrist in typically have an absent moro reflex.
What word describes the size of the sample in a study?
Saturation
HS radiograph is ordered for an infant with a suspected patent duct arteriosus the nurse should anticipate which of the following findings
Increase pulmonary vascular with cardiomegaly
What is a side effect of ganCyclovir?
Neutropenia
The extent to which the findings of a research study can be applied to populations beyond the study sample is termed the studies
Generalizability
What are the characteristics of Beth with Wiedeman syndrome?
Omphalacele, large tongue and hypoglycemia
Which sensory development comes first?
A auditory/visual
B olfactory /Gustatory
C tactile/vestibular
C
What does fidelity mean?
Promise, keeping, the duty to keep promises to promote the greatest good
What does beneficience mean?
Acting to benefit others
What does nonmaleficence mean?
Doing no harm
The main structures of the nephron from proximal to distal our
Clarius, descending and ascending loop of Henley, and distal convoluted tubule
How would you explain transitional sleep?
The predominant sleep state for infants under 36 weeks. Preterm infants do not have significant quiet, seep cycles until approximately 36 weeks. Hence, a third sleep state called transitional sleep is identified in preterm infants.
What factor predisposes infants with bronco pulmonary dysplasia to pulmonary edema?
Impaired lymphatic drainage
What are the expected effects of digoxin?
Increased, cardiac output. Did Jackson is an inotrope and increases cardiac output, and is used to lower the heart rate and infants with tachycardia.
A nurse is caring for an infant who has undergone surgical repair of a VSD. The nursing plan of care should include recognition of which of the following complications?
Cardiac arrhythmias
Which of the following is the major extracellular cation and mostly closely involved in water balance?
Sodium 
What is the optimum ratio of calcium to phosphorus?
2:1
With transposition of the great arteries, and scheduled for a balloon atrial sept ostomy, the nurse should expect which of the following outcomes?
Adequate mixing of the deoxygenated and oxygenated blood
What is klumpke paralysis?
Exhibit swelling in the shoulder and sub clavicular fossa, which could be accompanied by clavicle fracture no grasp of the affected hand
How do you describe fetal circulation?
The ventricles function in parallel in utero
My researcher comments a type 1 error when:
The Noll hypothesis is rejected when it is true
A soft decal age infant is born with hypoplasia of the arm with cicatrical scarring and migcrohthalmia. What is the most likely cause of this congenital infection?
Varicella
In which phase of lung development, would the nurse expect distal, pulmonary vasculature and capillary networks to develop?
Canalicular
What is the purpose of receiving dopamine?
Vasodilation of renal vascular bed
Why would a large VSD not be immediately evident at birth?
Elevated pulmonary vascular resistance
What is the organism most commonly responsible for nosocomial bloodstream infection in nicu patients?
Coagulatese negative staphylococci
What is the initial stage of grief characterized by?
Emotional Numbness
What position should the infant be placed in for a tet spell?
Supine, legs extended
What setting would you change on the vent to decrease CO2?
Increase the peak, inspiratory pressure
Rh incompatibility most often occurs
In mothers, who had an amniocentesis
Because an amniocentesis can cause minute amounts of fetal red blood cells to enter the maternal circulation
What is the most likely cause of hypothermia in the late preterm infant?
Large temperature gradient between the environment and the neonate
What would you expect when assessing an infant who has Potter sequence?
Arthrogryposis
A balloon septostomy is done for an infant with transposition of the great vessels to his achieve what?
Increase pulmonary and systemic mixing at the atrial level
What is true about medication errors in the NICU?
Compared with other areas of the hospital than Nikki has an increased frequency of medication errors, and these errors result in more harm to the patient
What is true regarding ventilation perfusion matching?
Ventilation, perfusion, mismatching is the most common reason for hypoxia
Neurological and visual development
At what gestation does the electrical conducting system of the heart become functional?
10 weeks
What is an early cause of hypocalcemia in the neonate?
Maternal diabetes
What is true of an autosomal dominant disorder?
A 50% chance with each pregnancy of having an affected offspring
B only female offspring are affected
C only male offspring are affected
A
The formation of respiratory bronchioles during the stage of fetal lung development is significant because of Harold’s
Primitive development of the gas exchange section of the lungs
Pulmonary interstitial, emphysema results from extraneous air in the
Connective tissue of the peribronchial vascular sheets
What rate should trophic feedings be initiated at?
10 to 20 ML’s per kilo per day
What would you suspect with a small for gestational age and microcephalic. Cataracts, and a blueberry muffin rash
Rubella
What tocolytic is a calcium channel blocker, has been marketed to treat, hypertension, angina, and arrhythmia, and does not commonly have adverse effect on the fetus or neonate
Nifedipine or Procardia
What is responsible for the movement of blood between the right and left atrium and what direction does the blood primarily flow during fetal life?
Foreman ovale with right to left shunt
