A 32 week gestation infant with decreased renal function develops systemic candidiasis. The best choice of antifungal therapy for this baby is
a.
... [Show More] amphotericin B lipid complex
b. fluconazole
c. flucytosine - correct answer a. amphotericin B lipid complex
Increased bowel sounds are indicative of
a. Ileus
b. Malrotation
c. Starvation - correct answer b. Malrotation
Infants with Beckwith-Wiedemann syndrome have a high risk for which anomaly?
a. Microglossia
b. Omphalocele
c. Volvulus - correct answer b. Omphalocele
A term neonate is found to have ambiguous genitalia. The anticipated immediate action would include obtaining
a. blood electrolytes
b. intravenous pyelogram
c. pelvic ultrasound - correct answer a. blood electrolytes
4. Plethora can be seen in infants who are
a. overfed
b. overheated
c. stimulated - correct answer b. overheated
5. Neonatal manifestation of systemic lupus erythematosus is attributed to
a. interference with protein synthesis
b. maternal deficiency of autoantibodies and immune complexes
c. placental transfer of antibodies to the fetus - correct answer c. placental transfer of antibodies to the fetus
In a 26 week gestational age neonate, the expected physical findings would include a
a. barely apparent Moro reflex
b. no resistance to heel to ear maneuver
c. weak finger grasp - correct answer b. no resistance to heel to ear maneuver
A female neonate was delivered at 28 weeks gestation. The amniotic fluid was meconium stained. Physical examination shows a erythematores rash with small, pale papules. Tone is poor and the infant has had several episodes of apnea. Infection is suspected. The organism most likely responsible for this neonate's symptoms is
a. Escherichia coli
b. Group B streptococcus
c. Listeria monocytogenes - correct answer c. Listeria monocytogenes
A neonate is receiving a calcium infusion for treatment of hypocalcemia. The nurse should
a. monitor for oxygen saturation changes
b. obtain an EKG before and after the infusion
c. place the infant on a cardiac monitor - correct answer c. place the infant on a cardiac monitor
Patients with respiratory distress syndrome exhibit prominent retractions with respiratory effort. This is due to the work required to
a. generate high intrathoracic pressures
b. overcome the negative intrapleural pressure generated by contraction of the diaphragm and the respiratory muscles
c. trap alveolar air and maintain functional residual capacity - correct answer a. generate high intrathoracic pressures
Assessment of a term neonate is as follows: IUGR, microcephaly, congenital cataracts, hepatosplenomegaly, and jaundice. Based on these findings, the most likely diagnosis is congenital
a. cytomegalovirus
b. rubella
c. toxoplasmosis - correct answer b. rubella
Infants born to mothers with myasthenia gravis
a. are at risk for aspiration
b. will present with symptoms within first 12 hours of life.
c. transient myasthenia gravis will resolve spontaneously around 6 months of age. - correct answer a. are at risk for aspiration
Based on the intrauterine growth chart shown, this neonate would be classified as (38wks, 25th percentile)
a. post-term, SGA
b. term, AGA
c. term, SGA - correct answer b. term, AGA
Continued posturing of a limb is characteristic of
a. clonic seizures
b. myoclonic seizures
c. tonic seizures - correct answer c. tonic seizures
A disadvantage of continuous renal replacement therapy with hemofiltration in the treatment of acute renal failure is that
a. constant heparinization during therapy is required
b. it causes rapid solute and fluid shifts
c. the patient must be hemodynamically stable prior to therapy - correct answer a. constant heparinization during therapy is required
The hallmark finding of pneumatosis intestinalis is
a. air within the wall of the intestine
b. local bowel edema
c. perforation of the bowel wall - correct answer a. air within the wall of the intestine
A neonate is born to a mother with a positive tuberculin test but no signs of active disease. Management of this neonate should include
a. initiate medication therapy on mother and infant
b. no special evaluation or therapy
c. separate mother and neonate until status can be confirmed - correct answer b. no special evaluation or therapy
An unexpected occurrence involving death or serious physical or psychological injury is called
a. a sentinel event
b. an incident
c. malpractice - correct answer a. a sentinel event
Bullous lesions appear on an infant's skin on day 2 of life. The nurse should recognize that this finding is
a. benign
b. due to an irritant
c. indicative of infection - correct answer c. indicative of infection
A neonate is apneic at birth and positive-pressure ventilation with 21% oxygen is initiated. After 30 seconds the neonate's heart rate is 50. What is the next step in resuscitation of this neonate?
a. Administer epinephrine 0.1-0.3 ml/kg
b. Begin chest compressions
c. Increase oxygen to 50% - correct answer b. Begin chest compressions
When developing a plan for a preterm neonate to transition to oral feedings, the nurse should consider that
a. breast feeding requires more energy than bottle feeding in all infants
b. coordination of suck-swallow reflex and breathing is developed by 34 weeks postconceptual age
c. vigorous non-nutritive sucking is a predictor for oral feeding readiness - correct answer b. coordination of suck-swallow reflex and breathing is developed by 34 weeks postconceptual age
Ideally antiretroviral prophylaxis is initated and administered in the HIV exposed neonate within
a. 12 hours of birth
b. 24 hours of birth
c. 48 hours of birth - correct answer a. 12 hours of birth
A 5 day old infant develops a very watery eye discharge that progressed rapidly to purulent exudate. Chlamydia trachomatis conjunctivitis is diagnosed. The nurse should be aware that
a. gentle pressure over nasolacrimial sac results in mucopurulent drainage
b. this patient is at risk for corneal ulceration, perforation and visual impairment
c. therapy of choice is oral erythromycin x 14 days - correct answer c. therapy of choice is oral erythromycin x 14 days
Concerning administration of immunizations to hospitalized preterm infants, the nurse should be aware that
a. administration of dexamethasone may decrease immune response
b. doses are lower than doses for term infants
c. measles-mumps-rubella vaccine should not be given - correct answer c. measles-mumps-rubella vaccine should not be given
When developing a plan for a preterm neonate to transition to oral feedings, the nurse should consider that
a. breast feeding requires more energy than bottle feeding in all infants
b. coordination of suck-swallow reflex and breathing is developed by 34 weeks postconceptual age
c. vigorous non-nutritive sucking is a predictor for oral feeding readiness - correct answer b. coordination of suck-swallow reflex and breathing is developed by 34 weeks postconceptual age
Because neonates have a limited ability to excrete concentrated urine, there is an increased risk for
a. dehydration
b. fluid overload
c. infection - correct answer a. dehydration
The 3000 gm neonate born at 36 weeks is at increased risk for
a. ABO Incompatability
b. hyperbilirubinemia
c. no major significant problems - correct answer b. hyperbilirubinemia
Twin to twin transfusion occurs in multiple gestations when which factor is involved?
a. Delayed cord clamping
b. Dizygotic twins
c. Unequal placental sharing - correct answer c. Unequal placental sharing
A term, small for gestational age neonate at four hours of age is tachypneic, plethoric, lethargic and has a blood sugar of 53 mg/dL and a central hematocrit of 70%. The most likely diagnosis is
a. hyperviscosity
b. hypocalcemia
c. hypoglycemia - correct answer a. hyperviscosity
The mother of a newborn daughter with spina bifida states that she feels helpless as her four year old son has started wetting the bed and asks what she can do to change his behavior. The best response would be to
a. enroll the son in half-day preschool to promote interaction with other children
b. explain that her son may feel that he is the cause of his sister's condition
c. explain this behavior is normal, and it gets better on its own - correct answer b. explain that her son may feel that he is the cause of his sister's condition
A newborn exhibits respiratory distress in the delivery room that resolves with crying. What is the likely diagnosis?
a. Choanal atresia
b. Robin anomaly
c. Laryngeal web - correct answer a. Choanal atresia
After establishing what appeared to be effective ventilation in a resuscitation the heart rate remains below 60. The next step to consider is
a. administering IV epinephrine
b. beginning chest compressions at 1/4 diameter of chest
c. initiating intubation - correct answer c. initiating intubation
A benefit of habituation is
a. hand to mouth coordination
b. language development
c. protection from overstimulation - correct answer c. protection from overstimulation
A father's reaction to stress
a. is no different than the mother's reaction
b. is just as important as the mother's reaction
c. often manifests as anger - correct answer b. is just as important as the mother's reaction
The determination that the standard of care has been met is based on what similarity of a prudent and reasonable nurse?
a. Actions taken in the same situation
b. Comparative workplace and conditions
c. Equivalent education - correct answer a. Actions taken in the same situation
Congenital varicella syndrome is characterized by:
a. cataracts
b. early death
c. microcephaly - correct answer b. early death
A term neonate has a brief history of lethargy and poor feeding. Upon examination, the neonate is noted to be pale, mottled and diaphoretic. Palpation reveals strong pulses in the upper extremities and diminished pulses in the lower extremities. The following data are obtained: Axillary temperature: 36.6°C (97.8°F); Heart rate: 176 b/p/m; Respiratory rate: 84 breaths per minute; Capillary refill: 5 seconds; Urine output: 0.2 mL/kg/hour. A diagnostic step that is useful is
a. assessing for the presence of diastolic murmur
b. drawing serial blood gases in room air and 100% oxygen
c. obtaining blood pressures in all four extremities - correct answer c. obtaining blood pressures in all four extremities
An umbilical artery catheter was inserted in the delivery room during resuscitation of a 34 week gestation female neonate. In caring for this infant, the nurse should recognize
a. addition of heparin to the infusate decreases the risk of aortic thrombus
b. heparin use in flush solution will help decrease risk of catheter occlusions
c. low placement of the UAC decreases the risk of vascular accident - correct answer b. heparin use in flush solution will help decrease risk of catheter occlusions
In teaching parents how to interact with their infant, they should be taught that
a. vision is more important for attachment than hearing.
b. talking gently to their infant while providing care is encouraged.
c. repetitive sounds usually result in overstimulation. - correct answer b. talking gently to their infant while providing care is encouraged.
Increased left atrial pressure is responsible for what circulatory change at birth?
a. Constriction of the ductus arteriosus
b. Elimination of right-to-left shunting
c. Increased systemic pressure - correct answer b. Elimination of right-to-left shunting
The en face position takes place in what phase of initial attachment?
a. acquaintance
b. engrossment
c. reciprocity - correct answer a. acquaintance
A characteristic that is common to trisomy 13, trisomy 18 and trisomy 21 is that these neonates commonly have
a. eye abnormalities
b. hand or finger abnormalities
c. renal malformation - correct answer b. hand or finger abnormalities
Despite good oxygenation an infant has weak peripheral pulses, persistent tachycardia and diminished muscle tone. The most appropriate intervention would be
a. epinephrine 0.1 - 0.3 ml/kg
b. normal saline 10 ml/kg
c. sodium bicarbonate 2 mEq/kg - correct answer b. normal saline 10 ml/kg
The likely cause of hypomagnesmia in an asymptomatic twelve-hour old neonate is
a. inmature renal fuction
b. maternal insulin-dependent diabetes
c. placental insufficiency - correct answer c. placental insufficiency
The most useful diagnostic tool to differentiate between respiratory and nonrespiratory disease in the neonate is
a. arterial blood gas
b. chest x-ray
c. shunt study - correct answer c. shunt study
A one week old neonate born at 33 weeks gestation often engages in foot or leg bracing when stimulated. These behaviors are most consistent with
a. a disorganized response
b. pain responses
c. self-regulating behaviors - correct answer c. self-regulating behaviors
A 3 day old full term infant's unconjugated bilirubin level is 20 mg/dl. The best therapy for this infant is
a. phototherapy and administration of phenobarbital
b. phototherapy and exchange transfusion
c. phototherapy only - correct answer c. phototherapy only
The ability to habituate to sound is
a. a negative response to sound
b. accomplished by preterm infants more quickly than term infants
c. indicative of an intact CNS - correct answer c. indicative of an intact CNS
A mother has overheard a discussion that her preterm neonate is to have a Brazelton assessment. She asks what this examination entails. The nurse's best response is that Brazelton assessment assists in
a. assessing neurologic integrity and behavioral factors
b. confirming gestational age based on socialization abilities
c. evaluating the interactive behavior of the newborn - correct answer c. evaluating the interactive behavior of the newborn
Physiologic characteristics of Ebstein's Anomaly include
a. bicuspid aortic valve
b. downward displacement of the tricuspid valve
c. severe pulmonary parenchymal disease - correct answer b. downward displacement of the tricuspid valve
A key principle for resuscitation is that
a. maximal pressure should be used for cardiac compressions
b. medications are not a substitute for adequate ventilation
c. suctioning should be aggressive for optimal outcome
Submit Submit Submit Submit - correct answer b. medications are not a substitute for adequate ventilation
A common complication of percutaneous central lines include
a. cardiac perforation
b. catheter entrapment
c. extravasation - correct answer c. extravasation
Transient tachypnea of the newborn is defined as what type of lung disease?
a. Inflammatory
b. Obstructive
c. Restrictive - correct answer b. Obstructive
Neonates with depressed skull fractures commonly
a. are at increased risk for intracranial hemorrhage
b. require follow up but complete recovery is typical
c. require surgical intervention - correct answer a. are at increased risk for intracranial hemorrhage
The principal action of volume expanders during resuscitation is to
a. address myocardial decompensation
b. facilitate peripheral vasoconstriction
c. maintain cardiac output and blood pressure - correct answer c. maintain cardiac output and blood pressure
A 2500 gm neonate is fed 20 cc of formula every 3 hours. Over the past 12 hours gastric residuals have ranged from 3-5 cc's. The most appropriate action is to
a. continue with the feedings
b. decrease the volume
c. slow the rate of feedings - correct answer a. continue with the feedings
A neonate is to start oral feedings. The mother had planned to breastfeed, but she now has a recurrence of herpes and has a lesion on her lower abdomen. The nurse should advise that
a. breastfeeding is contraindicated until the lesion heals
b. she should cover the lesion with a dressing while breastfeeding
c. feeding may be initiated using the mother's pumped breast milk - correct answer b. she should cover the lesion with a dressing while breastfeeding
On examination of the newborn head, the nurse palpates the margin of parietal and occipital regions along the lamboidal suture. The area will collapse and recoil under gentle pressure This finding is indicative of
a. craniosynostosis
b. craniotabes
c. molding - correct answer b. craniotabes
Compared to morphine, fentanyl citrate may produce
a. bronchospasm
b. chest wall rigidity
c. tachycardia - correct answer b. chest wall rigidity
Soy-based formulas are recommended for infants who have
a. Galactosemia
b. Lactose intolerance
c. Renal insufficiency - correct answer a. Galactosemia
During the time a very low birthweight neonate is in the delivery room, methods that can be used to prevent heat loss include
a. dry and wrap in polyethylene sheet
b. place wool cap on head
c. leave the radiant warmer on for 24 hours - correct answer b. place wool cap on head
A neonate can be assumed to be at an advanced gestational age if neuromuscular development demonstrates increased
a. hip flexion and adduction
b. popliteal angle
c. square window angle measurement - correct answer a. hip flexion and adduction
A 5 day old neonate becomes irritable, cyanotic and tachypneic. The nurse notices that when the infant cries, the cyanosis becomes more pronounced. The most likely origin of these symptoms is
a. cardiac
b. metabolic
c. pulmonary - correct answer a. cardiac
The diagnostic tool most helpful in differentiating pneumonia from other neonatal respiratory problems is
a. sepsis work-up
b. serial chest x-rays
c. tracheal aspirate - correct answer b. serial chest x-rays
A neonate has had several episodes of vomiting. The arterial blood gas results are: pH: 7.53; PCO₂: 42 mm Hg; PO₂: 56 mm Hg; Base Excess: 33 mEq/L. This blood gas represents
a. borderline normal finding
b. compensated metabolic acidosis
c. metabolic alkalosis - correct answer c. metabolic alkalosis
The normal 5 to 10 percent weight loss that occurs in the term newborn is primarily due to
a. fluid shifts
b. immature renal function [Show Less]