Deck 13: Preterm and Postterm Newborns

Question 1

The nurse is caring for an infant born at 35 weeks of gestation. A physical characteristic that the nurse might expect this infant to exhibit is:

A) Thin, long extremities
B) Large genitals for its size
C) Lanugo on the forehead, shoulders, and arms
D) Loose, transparent skin

Answer 1

Loose, transparent skin

Question 2

Parents of a preterm infant come to the NICU every day to see their baby, who is being gavage-fed. The nurse would include in the teaching about stimulating their infant to:

A) Bring in colorful pictures and toys to place in the incubator.
B) Stimulate the baby during feedings to increase intake.
C) Give the baby a pacifier during gavage feedings.
D) Do not disturb the infant between feedings.

Answer 2

Give the baby a pacifier during gavage feedings.

Question 3

The nurse explains that a 4-day-old infant born at 33 weeks of gestation may need to be fed by gavage during the first few days of life because the infant:

A) Often has a very weak or absent sucking or swallowing reflex
B) Is unable to digest food properly
C) Refuses to take formula by mouth
D) Needs a larger quantity of formula at each feeding

Answer 3

Often has a very weak or absent sucking or swallowing reflex

Question 4

When a preterm infant is receiving an intravenous infusion containing calcium gluconate, the nurse would assess this infant for:

A) Seizures
B) Bradycardia
C) Dysrhythmias
D) Tetany

Question 5

The apnea monitor indicates that a preterm infant is having an apneic episode. The appropriate nursing action in this situation is to:

A) Administer oxygen via nasal cannula
B) Gently rub the infant's feet or back
C) Ventilate with an Ambu bag
D) Perform nasopharyngeal suctioning

Question 6

The nurse explains that when a preterm delivery is anticipated, fetal lung maturity can be accelerated before delivery by the administration of:

A) Prostaglandins
B) Oxytocin
C) Magnesium sulfate
D) Corticosteroids

Question 7

The parent of a 4-month-old infant, born prematurely, asks the nurse if her daughter will always be small for her age. An appropriate nursing response would be:

A) "Preterm infants usually remain smaller than term infants throughout childhood."
B) "Your daughter will be the same size as other children by the time she goes to kindergarten."
C) "Prematurity is associated with short stature, but does not affect weight gain."
D) "It takes about two years for the preterm infant to catch up to a full-term infant."

Question 8

A preterm infant has a yellow skin color and a rising bilirubin level. The nurse is aware that this infant is at risk for:

A) Skin breakdown
B) Renal failure
C) Brain damage
D) Congestive heart failure

Question 9

To prevent possible retinopathy in a preterm infant requiring oxygen therapy, the nurse will:

A) Monitor arterial oxygen levels with a pulse oximeter
B) Position with the head slightly lower than the body
C) Administer low concentrations of oxygen
D) Keep the infant's eyes covered at all times

Question 10

When assessing a preterm infant, the nurse observes nasal flaring, sternal retractions, and expiratory grunting. These findings are indicative of:

A) Respiratory distress syndrome
B) Postmaturity syndrome
C) Apneic episode
D) Cold stress

Question 11

The nurse caring for an infant born at 43 weeks of gestation assesses tremors and a weak cry. The nurse is aware that these are symptoms of:

A) Respiratory distress syndrome
B) Hypoglycemia
C) Necrotizing enterocolitis
D) Renal failure

Question 12

When a preterm infant who is being gavage-fed has a bloody stool, the nurse should:

A) Assess for abdominal distention
B) Decrease the amount of the next feeding
C) Institute enteric precautions
D) Get a culture of the next stool

Question 13

The mother of a postterm infant asks the nurse why the baby is being watched so closely. The nurse answers that postterm infants are at risk because:

A) The placenta does not function adequately as it ages.
B) Infants born postmaturely are generally large.
C) Delivery of the postterm infant is more difficult.
D) There is less amniotic fluid.

Question 14

The nurse assessing a preterm infant understands that the infant's level of maturation refers to:

A) Actual time the fetus remained in the uterus
B) Age on the Dubowitz scoring system
C) Infant's weight as compared to the gestational age
D) Ability of the organs to function outside of the uterus

Question 15

The nurse carefully assesses the preterm infant for respiratory distress syndrome because of a deficiency of:

A) Protein
B) Estrogen
C) Hyaline
D) Surfactant

Question 16

The nurse caring for a preterm infant will record the intake and output. The nurse is aware that an optimum output would be:

A) 8 to 11.5 ml/hr
B) 12 to 13.5 ml/hr
C) 14 to 16 ml/hr
D) 17 to 19 ml/hr

Question 17

The nurse in a pediatrician's office is preparing to do a developmental assessment on a 3-month-old infant who was born at 36 weeks. To adjust for the preterm birth, the nurse will evaluate the infant at the level of a _____ achievement.

A) 1-month
B) 2-month
C) 3-month
D) 4-month

Question 18

The nurse recognizes symptoms of cold stress in a preterm infant as:

A) Tremors and weak cry
B) Plasma glucose level <40 mg/dl
C) Warm skin with low core temperature
D) Increased respiratory rate and periods of apnea

Question 19

The nurse's safest action to ensure tube placement when preparing to initiate a gavage feeding is to:

A) Check tube placement by injecting air into the stomach
B) Weigh the infant before the feeding
C) Aspirate stomach contents
D) Check serum glucose level

Question 20

The nurse clarifies that a preterm infant born at 34 weeks of gestation is placed in an incubator because:

A) The infant has a small body-surface to weight ratio.
B) Heat increases the flow of oxygen to the extremities.
C) The infant's temperature control mechanism is immature.
D) Heat within the incubator facilitates drainage of mucus.

Question 21

The nurse clarifies that a fetus has enough surfactant to breathe on its own at the age of ____________________ weeks.

Question 22

The nurse providing stimulation to a preterm infant should schedule stimulation so as not to conflict with ____________________.

Question 23

The nurse reviews the potential problems a postmature infant may experience, such as: Select all that apply.

A) Seizures
B) Asphyxia
C) Paralysis
D) Visual defects
E) Polycythemia

Question 24

The nurse is caring for an infant born at 43 weeks. A physical assessment would reveal:

A) Dry, peeling skin
B) Minimal hair on the head
C) Short, rough nails
D) Abundant lanugo on the body

Question 25

Assessment of altered skin integrity in the preterm infant is made difficult because of the immature immune system that cannot produce an ____________________ reaction.

Question 26

The nurse encourages the anxious mother of a preterm infant to consider the warming technique of holding the baby between her breasts with skin-to-skin contact under a blanket. This technique is the ____________________ care method.