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

Question 1

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:

A) elevate the child's head.
B) check bowel sounds.
C) record retention of feeding.
D) notify charge nurse of possible malabsorption.

Answer 1

notify charge nurse of possible malabsorption.

Question 2

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

A) "We are feeding the baby with a dropper for two weeks. "
B) "We resumed bottle feeding after discharge. "
C) "We started the baby on solid food yesterday. "
D) "The baby is drinking well from a straw. "

Answer 2

"We are feeding the baby with a dropper for two weeks. "

Question 3

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

A) sit the infant upright in an infant seat.
B) place the infant over the shoulder to burp.
C) leave the infant in a side-lying position.
D) stimulate the infant by rubbing its feet.

Answer 3

leave the infant in a side-lying position.

Question 4

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

A) align the limbs.
B) support the head.
C) keep the head lower than the hip.
D) check intake and output.

Question 5

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

A) prop the child upright with pillows for meals.
B) use the bar between the legs to turn the child.
C) put the child on her abdomen to sleep.
D) change the child's position frequently.

Question 6

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

A) facial paralysis.
B) ear infections.
C) increasing intracranial pressure (ICP).
D) drooling.

Question 7

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

A) has had one Rh-negative child and is pregnant with an Rh-negative child.
B) had an Rh-positive infant and is pregnant with an Rh-positive fetus.
C) has had an O-negative child and is pregnant with a B-negative child.
D) is a primipara with an O-negative child.

Question 8

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

A) prone, with the head of the bed elevated.
B) supine, with the head flat.
C) side-lying on the operative side.
D) in a semi-Fowler's position.

Question 9

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

A) meningitis.
B) meningocele.
C) spina bifida occulta.
D) hydrocephalus.

Question 10

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:

A) feed solid foods with the spoon at the side of the mouth.
B) puree foods and offer them through a straw.
C) place small bites of food in the mouth with a tongue blade.
D) offer small, frequent meals of finger foods.

Question 11

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

A) cover the infant's head with a hat.
B) dress the infant lightly in a T-shirt.
C) keep the infant's eyes covered.
D) reposition at least every 4 to 8 hours.

Question 12

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

A) hypotonicity of the leg muscles.
B) one leg is shorter than the other.
C) broadening and flattening of the buttocks.
D) two skin folds on the back of each thigh.

Question 13

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:

A) preventing hyperthermia.
B) respiratory care.
C) prevention of diarrhea.
D) incontinence care.

Question 14

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

A) Lifelong high-protein diet
B) A formula that is low in the amino acid leucine
C) A soy-based formula
D) Substitute Lofenalac for some protein foods

Question 15

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

A) feeding the infant with a spoon to avoid sucking.
B) positioning the infant on the abdomen to facilitate drainage.
C) applying elbow restraints to protect the surgical area.
D) providing minimal stimulation to prevent injury to the incision.

Question 16

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:

A) keeping the sac dry.
B) diapering snugly.
C) positioning prone in an incubator.
D) moving from side to side every hour.

Question 17

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

A) in the first 24 hours of life.
B) after 2 to 3 days.
C) at 4 to 6 weeks of age.
D) at 2 months of age.

Question 18

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

A) a Pavlik harness.
B) a body spica cast.
C) traction.
D) triple-diapering.

Question 19

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

A) increases the infant's metabolism.
B) stimulates liver function.
C) dilates blood vessels.
D) breaks down bilirubin.

Question 20

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:

A) immediately after birth.
B) by 3 months of age.
C) after 12 months of age.
D) varies in every case.

Question 21

The nurse demonstrates how to flush the ventriculoperitoneal shunt by the use of the ____________________ that is in place behind the infant's ear.

Question 22

What would be included in the plan of care for a child just returned to the floor from surgery in which a clubfoot was repaired? Select all that apply.

A) Keep cast uncovered to allow drying.
B) Check toes for capillary refill.
C) Circle with a pen any area of bleeding on the cast.
D) Keep casted leg lowered.
E) Observe for skin irritation.

Question 23

The nurse in the newborn nursery is watchful for neonatal abstinence syndrome in the newborn of a crack-addicted mother.What would be the manifestation(s)of this syndrome? Select all that apply.

A) Body tremors
B) Excessive sneezing
C) Hyperirritability
D) Drowsiness
E) Excessive appetite

Question 24

The nurse clarifies to the parents of a child with spina bifida that their child has a portion of the spinal cord in the sac in addition to the meninges.This type of spina bifida is known as a(n)____________________.

Question 25

The nurse uses a picture to show which characteristic(s)typical of Down syndrome? Select all that apply.

A) Close-set eyes
B) Simian creases
C) Wide-spaced front teeth
D) Protruding tongue
E) Curved, small fingers

Question 26

In caring for an infant with an intracranial hemorrhage,what will the nurse include in the plan of care? Select all that apply.

A) Keep positioned with head elevated.
B) Feed slowly to reduce possibility of vomiting.
C) Stimulate often to maintain level of consciousness.
D) Hold and coddle frequently to stimulate.
E) Observe for increased intracranial pressure.

Question 27

The nurse is caring for a macrosomic newborn whose mother has diabetes.The nurse would assess the neonate for:

A) hypoglycemia.
B) erythroblastosis fetalis.
C) intracranial hemorrhage.
D) pancreatic failure.

Question 28

When the CSF is obstructed in the subarachnoid space rather than in the ventricles,the resulting hydrocephalus is diagnosed as ____________________ hydrocephalus.

Question 29

The nurse is aware that the child with Down syndrome has a high incidence of deformities of the:

A) reproductive system.
B) urinary tract.
C) cardiovascular system.
D) lower gastrointestinal tract.

Question 30

The assessment made that would lead the nurse to suspect hip dysplasia would be:

A) asymmetrical gluteal folds.
B) limited adduction of the affected side.
C) foot turned inward.
D) deep inguinal creases.

Question 31

What manifestation(s)of increasing ICP in the hydrocephalic child should the nurse be aware of? Select all that apply.

A) High-pitched cry
B) Inequality of pupils
C) Bulging fontanelles
D) Diarrhea
E) Hiccups