Question 1

The nurse counsels the parents of a child with a cleft palate that they should be alert for signs of:

Accepted Answer

Children with cleft palate are at risk of ear infections and dental disorders.

Question 2

The nurse bathing an infant would recognize a sign of developmental hip dysplasia, which is:

Accepted Answer

When developmental hip dysplasia is present, the leg on the affected side will appear shorter than the leg on the unaffected side.

Question 3

A 3-month-old infant is diagnosed with developmental hip dysplasia. The nurse explains that the usual treatment for this infant would be:

Accepted Answer

In infants more than 2 months of age, longer-term immobilization with a Pavlik harness is required.

Question 4

The nurse caring for the child who has had a ventriculoperitoneal shunt (VP) for hydrocephalus observes an increasing abdominal girth. The most appropriate response would be to:

Accepted Answer

An increasing abdominal girth in a child with a VP shunt may be indicative of malabsorption of the cerebrospinal fluid (CSF) that is being shunted to the peritoneum.

Question 5

Phototherapy is instituted for an infant. An appropriate nursing action for the infant having phototherapy is to:

Accepted Answer

The infant's eyes are protected with patches to prevent damage from the high-intensity lights.

Question 6

Following delivery, a mother asks the nurse about newborn screening tests. The nurse explains that the optimal time for testing for phenylketonuria is:

Accepted Answer

Blood tests for phenylketonuria should be obtained 48 to 72 hours after birth. The newborn will have had enough time to ingest protein through feedings and the chance of false-negative results will be reduced.

Question 7

When the parents ask what the light does for their jaundiced infant, the nurse responds that the light:

Accepted Answer

Severe jaundice can cause kernicterus, an accumulation of bilirubin in the brain tissue, which can lead to serious brain damage. The light breaks down excess bilirubin so that it can be excreted.

Question 8

The nurse advising parents about feeding their infant who has phenylketonuria should suggest which type of formula and/or diet?

Accepted Answer

A synthetic food providing enough protein for growth and tissue repair, but little phenylalanine, is substituted for natural protein foods.

Question 9

Obstruction within the ventricles of the brain or inadequate reabsorption of cerebrospinal fluid may be responsible for the occurrence of:

Accepted Answer

Hydrocephalus is characterized by an increase in cerebrospinal fluid in the ventricles of the brain.

Question 10

After feeding an infant with hydrocephalus, the nurse will take special care to:

Accepted Answer

Because children with hydrocephalus are prone to vomiting, the child is fed and then positioned in the side-lying position in a quiet atmosphere to reduce the incidence of vomiting.

Question 11

Parents of a newborn with a unilateral cleft lip are concerned about having the defect repaired. The nurse explains that a child with a cleft lip usually undergoes surgical repair:

Accepted Answer

A cleft lip is repaired by 3 months of age when weight gain is established and the infant is free of infection.

Question 12

The nurse explains that the Rh-negative mother who should receive RhoGAM is the mother who:

Accepted Answer

The only woman with antibodies against the Rh-positive infant is the Rh-negative woman who has had one Rh-positive child and is now pregnant with another.

Question 13

A newborn was just admitted to the neonatal intensive care unit with a meningomyelocele. The priority for preoperative nursing care of this newborn is to protect the sac by:

Accepted Answer

The infant is placed prone in a humidified incubator, and the sac is covered with dressings of sterile saline. The infant's hips are kept lower than the lesion, and the infant is usually not in diapers.

Question 14

An 18-month-old child who has had a surgical repair of a cleft palate is now allowed to eat a regular diet. The adjustment the nurse would make in feeding is to:

Accepted Answer

The primary concern with feeding is to protect the operative site. The child can be fed with a spoon, but only the side of the spoon is placed into the mouth at the side of the mouth. The spoon must not touch the roof of the mouth.

Question 15

The nurse caring for an infant with hydrocephalus would take special precaution to:

Accepted Answer

The child with hydrocephalus has a heavy head on a small body with poor muscle tone; the head must be supported when feeding and moving the child to prevent injury to the neck.

Question 16

The nurse observes that the infant's anterior fontanelle is bulging after placement of a ventriculoperitoneal shunt. The nurse positions this infant:

Accepted Answer

If the fontanelles are bulging, the child would be positioned in a semi-Fowler's position to promote drainage from the ventricles through the shunt.

Question 17

Parents of a 2-month-old infant with Down syndrome should be instructed, because of the generalized hypotonicity of the child, that special attention should be given to:

Accepted Answer

The child with Down syndrome has generalized hypotonicity, which caused mucus accumulation and respiratory problems.

Question 18

The nurse instructing parents about positioning their toddler who has just had a body spica cast applied would include to:

Accepted Answer

The child's position must be changed frequently to relieve pressure and promote circulation.

Question 19

The statement that indicates parents understand how to feed their infant who had surgical repair of a cleft lip is:

Accepted Answer

The infant is fed with a dropper until the incision is completely healed, about 1 to 2 weeks after surgery.

Question 20

Postoperative nursing care of the infant following surgical repair of a cleft lip would include:

Accepted Answer

Elbow restraints are used postoperatively to prevent the infant from damaging the operative area.

Quiz 14: The Newborn with a Perinatal Injury or Congenital Malformation