Practice Test Flashcards
(335 cards)
1
Q
Magnesium sulfate administration during labor places the neonate at increased risk for
A. Hypertonic reflexes
B. Motor Depression
C. Seizure activity
A
Motor depression
2
Q
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
A
B
3
Q
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
4
Q
A mother who is hepatitis B antigen positive has delivered a term neonate. To prevent transmission the recommended treatment is
A
Administration of Hepatitis B vaccine and immunoglobulin within 12 hrs
5
Q
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
A
6
Q
In the fetus, which connects the pulmonary artery to the proximal descending aorta?
A
Ductus arteriosus
7
Q
What are murmurs caused by?
A
Turbulent blood flow
8
Q
Cardiac output can be best described by what?
A
The amount of blood ejected from the heart each minute
9
Q
The cardiac defect where one artery forms both the pulmonary artery and aorta is known as what?
A
Trunctus arteriosus
10
Q
When does a PDA typically close?
A
Within 24 hrs
11
Q
What is a normal sensible fluid loss?
Skin
Stool
Aspirate
Blood loss
A
Stool
12
Q
On the first day of life, a neonates output is 0.8ml/kg/hr. Which phase is the neonate in?
A
Pre-diuretic
13
Q
What electrolyte imbalance can cause widened QRS complexes on the ECG?
A
Hyperkalemia
14
Q
Which substance is effective in assisting with the absorption of fat?
A
MCT
15
Q
What are high levels of alpha-fetoprotein are associated with what?
A
Neural tube defects
16
Q
Anemia caused by an intracranial bleed is classified as what?
A
Neonatal blood loss
17
Q
Management if symptomatic polycythemia is what?
A
Increase fluids
18
Q
What can cause hypermagnesia?
A
Maternal treatment with magnesium sulfate
19
Q
What diet restrictions does PKU require?
A
Protein
20
Q
Abnormalities in the synthesis of cortisol and aldosterone are found in what?
A
Congenital adrenal hyperplasia
21
Q
What maternal medication can cause bleeding for the first 24hrs?
A
Salicylates
22
Q
One cause if hypercalcemia is what?
A
Increased bone reabsorption
23
Q
Calcium is most directly regulated by what?
A
Parathyroid hormone
24
Q
Is mitochondrial inheritance only passed on my females or males?
A
Females
25
What is true regarding glomerular filtration rate? (GFR)
It increases rapidly after birth
26
What finding would indicate possible renal failure?
Oliguria
27
What is the primary function of benzodiazepines and neonate?
 Sedation
28
What is the portion of the administeration that reaches the site of action in the body known as?
Bioavailability
29
Which agent can be used to reverse the action of heparin and control excessive bleeding?
Protamine sulfate
30
What is a side effect of vancomycin?
Ototoxicity
31
What is a common side effect of maternal administration of magnesium?
Respiratory depression, hypotonia
32
What heat loss can occur with a radiant warmer?
Convective heat loss
33
What is true regarding bathing of the neonate?
Immersion in water is recommended
34
What are epidermal White says that disappear soon after birth called?
Milia
35
What is a vascular abnormality, which is associated with a torch infection?
Purpura
36
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
37
What is true about surfactant?
Surfactant decreases surface tension
38
What kind of apnea does vagal stimulation cause?
Central
39
With-high frequency ventilation, a conventional vent is also used to provide what?
Oxygenation
40
Does ECMO prevent further barotrauma to the lungs?
Yes
41
What is an abnormal channel connecting the trachea to the esophagus?
Tracheoesophageal fistula
42
What condition is characterized by fusion between digits?
Syndactyly
43
What is the Barlow test used to diagnose?
Hip dysplasia
44
What is a risk factor for perinatal asphyxia?
Maternal preeclampsia
45
When do the anterior fontanelles close?
Between 18 to 24 months
46
What stage of ROP includes the outer most crescent of the eye?
3
47
What might an absent red reflux indicate?
Congenital cataracts
48
What is a large tongue which is associated with trisomies and hypothyroidism, known as?
Macroglossia
49
What is true regarding cleft palate and lip?
Require surgical repair
50
What is the etiology of trachealmalacia?
An abnormal collapse of the trachea walls
51
What can pain contribute to?
Hypoxia
52
What causes mottled in color in a 32 week neonate with stimulation?
 Physiologic stress response
53
Who, what, where, when, why and how of nursing practice is known as:
Scope of practice
54
What is true regarding medical errors?
It is rare that a single issue leads to a Medical error
55
What is barotrauma?
Damage to the long caused by excessive pressure
56
What is volutrauma?
Alveolar damage related to high tidal volume ventilation
57
What is atelectotrauma?
Injury caused by repetitive forced opening and closing up alveoli
58
What is biotrauma?
Inflammatory response
59
What would you change with an elevated PCO2?
Increase rate, increase pip
60
Would you change if you have a low PCO2?
Decreased rate, decreased PIP
61
What if PO2 is low or have low O2 sats?
Increase oxygen, increase, PIP, increase i-time, increase PEEP
62
What does the map on the HFOV effect??
Oxygenation
63
What would you adjust on HFOV for the CO2?
Amplitude
64
What does increasing pip do?
Will increase tidal volume so the PCO2 may also go down
65
What are Brushfield spots?
Speckled appearance around the circumference of the eye
66
What is the normal liver edge in centimeters?
1 to 2 cm below right coastal margin in midclavicular line
67
What is polydactyly?
Supernumerary digits (extra)
68
What is brachydactyly?
Shorten digit from shorten finger joint. Associated with achondroplasia and trisomy 21.
69
What is clinodactyly?
Congenital deviation of digits curvature
70
What is the Babinski reflex?
Stimulate sole of foot infant will either flex or extend toes
71
What does Autosomal genetic mean?
One of the 22 chromosomes that do not determine the sex of the end
72
What sex are affected by autosomal dominant disorder’s?
Male and females affected equally, either parent can pass the Gene on
73
Who are affected by autosomal recessive disorders?
Both male and females are equally affected. 25% chance with each pregnancy.
74
What is title volume?
The amount of air that moves into or out of the lungs with each breath (4-6 ml/kg)
75
What is vital capacity?
The volume of air max and Emily inspired in maximally expired (40 ml/kg)
76
What is functional residual capacity?
Volume of gas that remains in the lungs after a normal expiration (30ml/kg)
77
What is total lung capacity?
The amount of air contained in the long after a maximal inspiration (63ml/kg)
78
What is the genetic disease trisomy 18?
Edwards syndrome 
79
Which is an example of an autosomal recessive disease?
Cystic fibrosis
80
What is a defect in chromosome 22?
DiGeorge syndrome
81
What is tidal volume?
The amount of air that moves into or out of the lungs with each breath (4 to 6ml/kg)
82
What is FRC?
The volume of gas that remains in the lungs after a normal expiration (30ml/kg)
83
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.
84
What is the amount of oxygen that can be delivered to the tissues dependent on?
Cardiac output in the oxygen content of the blood
85
What vent changes should be made if your CO2 is elevated?
Increased rate and pip
86
What changes should be made if your CO2 is lower?
 Decreased rate and pip
87
What is half-life?
The time necessary for a measured concentration to fall to half its original value
88
What is the purpose of surfactant?
It lowers surface tension
89
What type of cells produce surfactant?
Alveolar type two cells
90
What is the purpose of umbilical arteries?
They carry deoxygenated blood from the fetus to the placenta
91
What is the purpose of umbilical veins?
It carries oxygenated blood, and nutrients from the placenta to the fetus
92
What is lung compliance?
When the alveoli in lungs are readily acceptable of volume and gas exchange
93
What is PPHN?
Systematic arterial hypoxemia, secondary to elevated pulmonary resistance, leading to right to left shunting and alterations, and pulmonary vaso reactivity
94
D- immediate surgery
95
B
96
D
Never visible on first day of life.
97
D
Never visible on first day of life.
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B
99
C
100
B- congenital infection, jaundice
101
What diagnosis is indicates with diffuse intracranial calcifications?
Congenital Toxoplasmosis
102
What is treatment of Toxoplasmosis?
Pyrimethamine, sulfadiazine, leucovorin
103
D
104
What is a HIDA Scan?
Helps visualize biliary ducts, thinking biliary atresia
105
How does biliary atresia present?
Normal at delivery but within 2-3 woks of life jaundice, dark urine, clay color stool
106
C- relieve the obstruction first (n-acetcysteine is added to fluid)
107
Meconium ileus can be indicated with what?
Cystic Fibrosis
108
Meconium plug
Meconium is normal but the intestine is functionally immature, meconium becomes backed up forming a plug
109
A- considering continental syphillis
Watery secretions
110
A-
Baby stable but bilious vomiting is congenital. Double bubble but positive occult blood so volvulus rather than duodenal atresia
111
C begin taking within 12 hrs of birth for 6 weeks. Testing done after dose given
112
E-
Cocaine more worried about pregnancy
113
A- absent Moro, arm held in pronated extended injury
Erbs- Injury to c5, c6
114
What is erbs palsy?
Lack of shoulder motion
115
B- crosses suture lines
116
What test indicates glomerular filtration rate?
Creatinine
117
First day- 80ml/kg/day
1.5 x80= 120 total/24= 5ml- iv rate should be 5ml/hr
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C
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A
120
B
121
D
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D
123
What is BPD?
A
124
C
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C
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D
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D
128
C- avoid the calcaneus or curvature of the heel
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A
130
C
131
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
132
D
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A
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A
135
B
136
What is the best indicator favorable for extubation?
D
137
B
138
C
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C
140
D
141
A Survanta
B curosurf
C infasurf
D Surfaxin
D
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D
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D
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C
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C
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C
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D
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C
149
D
150
D
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D
152
B
153
C
154
D
155
C
156
B
157
C
158
A
159
C
160
B
161
D
162
D
163
A
164
A
165
C
166
B
167
D
168
B
169
D
170
D
171
C
172
A
173
C
174
B
175
D
176
D
177
D
178
A
179
C
180
B
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B
182
B
183
C
184
D
185
A
186
C
187
C
188
C
189
D
190
A
191
A
192
A
193
B
194
C
195
D
196
D
197
A
198
B
199
D
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B
201
A
202
A
203
A
204
B
205
D
206
C
207
D
208
B
209
B
210
A
211
B
212
C
213
A
214
D
215
C
216
C
217
D
218
B- daily antibiotic therapy
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A
220
A
221
C
222
B
223
D
224
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
225
B
226
A
227
B
228
A
229
D
230
A
231
Best way to prevent getting cytomegalovirus
Avoiding exposure is virtually impossible
232
D
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B
234
A
235
C
236
C
237
D
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A
239
C
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D
241
B
242
A
243
D
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A
245
D
246
A
247
A
248
B
249
D
250
B
251
Olihydramnios- could indicate
Renal Agenesis
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C
253
C
254
255
256
257
258
259
260
261
262
A is correct not c
263
When women give birth sitting upright, which of the following indicators show lower values in cord blood?
A ph
B pco2
C po2
B
264
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
265
Erb palsy
266
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
267
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
268
Why is spiral lactone Aldactone not useful in emergency situations?
The onset of action is approximately 60 hours
269
The form of circulating bilirubin that places the infant at the highest risk for kernicterus is
Indirect free, BiliRubin
270
B
271
At what age is lung development completed by?
16 to 18 years of age
272
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
273
Why is Ivy administration of medication’s best in the neonatal population?
IV. Medication bypass all absorptive barriers.
274
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
275
A side effect of anticholinergic ophthalmic medication used in neonates is
Increased gastrointestinal transit time
276
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
277
What is the best predictor of the occurrence of preterm labor?
Prior preterm delivery
278
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
279
Which of the following is associated with neonatal hypocalcemia?
A perinatal asphyxia
B hypophosphatemia
C Subcutaneous fat necrosis
A
280
What are acini?
Gas exchanging portion of lung tissue
281
Surface action is produced in the lungs by:
A acini
B type II pneumocytes
C surfactant protein A
282
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
283
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
284
Which of the following abnormalities is associated with an autosomal dominant inheritance pattern
A Turner syndrome
B sickle cell anemia
C Osteogenesis imperfecta.
C
285
Which of the following interventions mandatory for an infant suspected having congenital syphilis?
Venereal disease, research laboratory test on cerebral spinal fluid
286
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
287
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
288
What is Kleinfelter syndrome disease related to?
Advanced, maternal age, parental non-disruption errors and maternal meiosis errors
289
During fetal development, the structure that will eventually give rise to the vast deference. In the presence of testosterone is the.
Mesonephros
290
What is klumpke palsy?
Results and wrist and hand paralysis with an absent grasp reflex
291
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.
292
What word describes the size of the sample in a study?
Saturation
293
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
294
What is a side effect of ganCyclovir?
Neutropenia
295
The extent to which the findings of a research study can be applied to populations beyond the study sample is termed the studies
Generalizability
296
What are the characteristics of Beth with Wiedeman syndrome?
Omphalacele, large tongue and hypoglycemia
297
Which sensory development comes first?
A auditory/visual
B olfactory /Gustatory
C tactile/vestibular
C
298
What does fidelity mean?
Promise, keeping, the duty to keep promises to promote the greatest good
299
What does beneficience mean?
Acting to benefit others
300
What does nonmaleficence mean?
Doing no harm
301
The main structures of the nephron from proximal to distal our
Clarius, descending and ascending loop of Henley, and distal convoluted tubule
302
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.
303
What factor predisposes infants with bronco pulmonary dysplasia to pulmonary edema?
Impaired lymphatic drainage
304
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.
305
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
306
Which of the following is the major extracellular cation and mostly closely involved in water balance?
Sodium 
307
What is the optimum ratio of calcium to phosphorus?
2:1
308
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
309
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
310
How do you describe fetal circulation?
The ventricles function in parallel in utero
311
My researcher comments a type 1 error when:
The Noll hypothesis is rejected when it is true
312
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
313
In which phase of lung development, would the nurse expect distal, pulmonary vasculature and capillary networks to develop?
Canalicular
314
What is the purpose of receiving dopamine?
Vasodilation of renal vascular bed
315
Why would a large VSD not be immediately evident at birth?
Elevated pulmonary vascular resistance
316
What is the organism most commonly responsible for nosocomial bloodstream infection in nicu patients?
Coagulatese negative staphylococci
317
What is the initial stage of grief characterized by?
Emotional Numbness
318
What position should the infant be placed in for a tet spell?
Supine, legs extended
319
What setting would you change on the vent to decrease CO2?
Increase the peak, inspiratory pressure
320
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
321
What is the most likely cause of hypothermia in the late preterm infant?
Large temperature gradient between the environment and the neonate
322
What would you expect when assessing an infant who has Potter sequence?
Arthrogryposis
323
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
324
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
325
What is true regarding ventilation perfusion matching?
Ventilation, perfusion, mismatching is the most common reason for hypoxia
326
Neurological and visual development
327
At what gestation does the electrical conducting system of the heart become functional?
10 weeks
328
What is an early cause of hypocalcemia in the neonate?
Maternal diabetes
329
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
330
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
331
Pulmonary interstitial, emphysema results from extraneous air in the
Connective tissue of the peribronchial vascular sheets
332
What rate should trophic feedings be initiated at?
10 to 20 ML’s per kilo per day
333
What would you suspect with a small for gestational age and microcephalic. Cataracts, and a blueberry muffin rash
Rubella
334
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
335
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
