Deck 29: The High-Risk Newborn: Problems Related to Gestational Age and Development

Question 1

A nurse is caring for an SGA newborn.What nursing action is most important?

A) Observe for respiratory distress syndrome.
B) Observe for and prevent dehydration.
C) Promote bonding.
D) Prevent hypoglycemia by early and frequent feedings.

Answer 1

Prevent hypoglycemia by early and frequent feedings.

Question 2

A preterm infant is on a respirator with intravenous lines and much equipment around her when her parents come to visit for the first time.What action by the nurse is most important?

A) Suggest that the parents visit for only a short time to reduce their anxieties.
B) Reassure the parents that the baby is progressing well.
C) Encourage the parents to touch her.
D) Discuss the care they will give her when she goes home.

Answer 2

Encourage the parents to touch her.

Question 3

Of all the signs seen in infants with respiratory distress syndrome,which sign is especially indicative of the syndrome?

A) Pulse more than 160 beats/min
B) Circumoral cyanosis
C) Grunting
D) Substernal retractions

Answer 3

Grunting

Question 4

Compared to the term infant,the preterm infant has

A) few blood vessels visible though the skin.
B) more subcutaneous fat.
C) well-developed flexor muscles.
D) greater surface area in proportion to weight.

Question 5

To maintain optimal thermoregulation for the premature infant,what action by the nurse is most appropriate?

A) Bathe the infant once a day.
B) Put an undershirt on the infant in the incubator.
C) Assess the infant's hydration status.
D) Lightly clothe the infant under the radiant warmer.

Question 6

What is most helpful in preventing premature birth?

A) High socioeconomic status
B) Adequate prenatal care
C) Transitional Assistance to Needy Families
D) Women, Infants, and Children nutritional program

Question 7

While caring for the postterm infant,the nurse recognizes that the fetus may have passed meconium prior to birth as a result of

A) hypoxia in utero.
B) NEC.
C) placental insufficiency.
D) rapid use of glycogen stores.

Question 8

Overstimulation may cause increased oxygen use in a preterm infant.Which nursing intervention helps to avoid this problem?

A) Group all care activities together to provide long periods of rest.
B) While giving your report to the next nurse, stand in front of the incubator and talk softly about how the infant responds to stimulation.
C) Teach the parents signs of overstimulation, such as turning the face away or stiffening and extending the extremities and fingers.
D) Keep charts on top of the incubator so the nurses can write on them there.

Question 9

Decreased surfactant production in the preterm lung is a problem because surfactant

A) causes increased permeability of the alveoli.
B) provides transportation for oxygen to enter the blood supply.
C) keeps the alveoli open during expiration.
D) dilates the bronchioles, decreasing airway resistance.

Question 10

A nurse is caring for a late preterm infant.What action by the nurse is inconsistent with best practice to prevent cold stress?

A) Wean the infant directly to an open crib.
B) Check temperature every 3 to 4 hours.
C) Encourage kangaroo care.
D) Place infant on a radiant warmer.

Question 11

A nurse is assessing an SGA infant with asymmetric intrauterine growth restriction.What assessment finding correlates with this condition?

A) One side of the body appears slightly smaller than the other.
B) All body parts appear proportionate.
C) The head seems large compared with the rest of the body.
D) The extremities are disproportionate to the trunk.

Question 12

Which combination of expressing pain could be demonstrated in a neonate?

A) Low-pitched crying, tachycardia, eyelids open wide
B) Cry face, flaccid limbs, closed mouth
C) High-pitched, shrill cry, withdrawal, change in heart rate
D) Cry face, eye squeeze, increase in blood pressure

Question 13

Which statement is true about large for gestational age ( LGA )infants?

A) They weigh more than 3500g.
B) They are above the 80th percentile on gestational growth charts.
C) They are prone to hypoglycemia, polycythemia, and birth injuries.
D) Postmaturity syndrome and fractured clavicles are the most common complications.

Question 14

Which preterm infant should receive gavage feedings instead of a bottle?

A) Sometimes gags when a feeding tube is inserted
B) Is unable to coordinate sucking and swallowing
C) Sucks on a pacifier during gavage feedings
D) Has an axillary temperature of 98.4° F, an apical pulse of 149 beats/min, and respirations of 54 breaths/min

Question 15

Which data should alert the nurse that the neonate is postmature?

A) Cracked, peeling skin
B) Short, chubby arms and legs
C) Presence of vernix caseosa
D) Presence of lanugo

Question 16

A premature infant never seems to sleep longer than an hour at a time.Each time a light is turned on,an incubator closes,or people talk near her crib,she wakes up and cries inconsolably until held.The correct nursing diagnosis is ineffective coping related to

A) severe immaturity.
B) environmental stress.
C) physiologic distress.
D) behavioral responses.

Question 17

Which is true about newborns classified as small for gestational age ( SGA )?

A) They weigh less than 2500g.
B) They are born before 38 weeks of gestation.
C) Placental malfunction is the only recognized cause of this condition.
D) They are below the 10th percentile on gestational growth charts.

Question 18

With regard to eventual discharge of the high-risk newborn or transfer to a different facility,nurses and families should be aware that

A) infants will stay in the NICU until they are ready to go home.
B) once discharged to home, the high-risk infant should be treated like any healthy term newborn.
C) parents of high-risk infants need special support and detailed contact information.
D) if a high-risk infant and mother need transfer to a specialized regional center, it is better to wait until after birth and the infant is stabilized.

Question 19

In caring for the preterm infant,what complication is thought to be a result of high arterial blood oxygen level?

A) Necrotizing enterocolitis (NEC)
B) Retinopathy of prematurity (ROP)
C) Bronchopulmonary dysplasia (BPD)
D) Intraventricular hemorrhage (IVH)

Question 20

Because of the premature infant's decreased immune functioning,what nursing diagnosis should the nurse include in a plan of care for a premature infant?

A) Delayed growth and development
B) Ineffective thermoregulation
C) Ineffective infant feeding pattern
D) Risk for infection

Question 21

A nurse is caring for a preterm infant who has a weak cry and is irritable.What action by the nurse is best?

A) Assess the infant for pain.
B) Take the infant's temperature.
C) Obtain a bedside glucose reading.
D) Reduce stimulation in the environment.

Question 22

An important nursing factor during the care of the infant in the NICU is assessment for signs of adequate parental attachment.The nurse must observe for signs that bonding is not occurring as expected.These include (Select all that apply.)

A) using positive terms to describe the infant.
B) showing interest in other infants equal to that of their own.
C) naming the infant.
D) decreasing the number and length of visits.
E) refusing offers to hold and care for the infant.

Question 23

The nurse tells the nursing student that late preterm infants are at increased risk for which of the following problems? (Select all that apply.)

A) Problems with thermoregulation
B) Cardiac distress
C) Hyperbilirubinemia
D) Sepsis
E) Hyperglycemia

Question 24

A nurse is caring for a preterm baby who weighs 4.8 pounds.What assessment finding indicates the baby is dehydrated?

A) Urine output of 3.3 mL/hour
B) Urine specific gravity of 1.001
C) Low serum sodium
D) Weight gain of 43 g in one day

Question 25

The nurse is observing a parent holding a preterm infant.The infant is sneezing,yawning,and extending the arms and legs.What action by the nurse is best?

A) Cover the infant with a warmed blanket.
B) Encourage the parent to do kangaroo care.
C) Encourage the parent to place the infant back in the warmer
D) Have the parent fold the infant's arms across the chest.