Deck 28: Infants with Gestational Age Related Problems

Question 1

Necrotizing enterocolitis (NEC)is an inflammatory disease of the gastrointestinal mucosa.What are some of the generalized signs associated with NEC?

A) Hypertonia,tachycardia,and metabolic alkalosis
B) Abdominal distension,temperature instability,and grossly bloody stools
C) Hypertension,absence of apnea,and ruddy skin colour
D) Scaphoid abdomen,no residual with feedings,and increased urinary output

Answer 1

Abdominal distension,temperature instability,and grossly bloody stools

Question 2

An infant was born 2 hours ago at 37 weeks of gestation.Which blood glucose level would indicate to the nurse that the infant is experiencing hyperglycemia?

A) 2.3 mmol/L
B) 3.2 mmol/L
C) 6.8 mmol/L
D) 8.6 mmol/L

Answer 2

8.6 mmol/L

Question 3

What should nurses be aware of with regard to small-for-gestational-age (SGA)infants and intrauterine growth restrictions (IUGR)?

A) In the first trimester,diseases or abnormalities result in asymmetrical IUGR.
B) Infants with asymmetrical IUGR have the potential for normal growth and development.
C) In asymmetrical IUGR weight will be slightly more than SGA,whereas length and head circumference will be somewhat less than SGA.
D) Symmetrical IUGR occurs in the later stages of pregnancy.

Answer 3

Infants with asymmetrical IUGR have the potential for normal growth and development.

Question 4

A newborn was admitted to the neonatal intensive care unit after being delivered at 29 weeks of gestation to a 28-year-old multiparous,married,white female whose pregnancy was uncomplicated until premature rupture of membranes and preterm birth occurred.The newborn's parents arrive for their first visit after the birth.The parents walk toward the bedside but remain approximately 3 metres away from the bed.What is the nurse's most appropriate action?

A) Wait quietly at the newborn's bedside until the parents come closer.
B) Go to the parents,introduce himself or herself,and gently encourage them to come meet their infant;explain the equipment first,and then focus on the newborn.
C) Leave the parents at the bedside while they are visiting so they can have some privacy.
D) Tell the parents only about the newborn's physical condition and caution them to avoid touching their baby.

Question 5

In the continuing assessment of a preterm infant,the nurse notices continued respiratory distress even though oxygen and ventilation have been provided.What should the nurse suspect?

A) Hypovolemia and/or shock
B) A non-neutral thermal environment
C) Central nervous system injury
D) Pending renal failure

Question 6

A premature infant with respiratory distress syndrome (RDS)receives artificial surfactant.Which is true with regard to surfactant therapy?

A) Surfactant improves the ability of the baby's lungs to exchange oxygen and carbon dioxide.
B) The drug keeps the baby from requiring too much sedation.
C) Surfactant is used to reduce episodes of periodic apnea.
D) The baby needs this medication to fight a possible respiratory tract infection.

Question 7

What should the nurse know with regard to appraising the growth and development potential of a preterm infant?

A) Tell the parents that their child won't catch up until about age 10 (girls)to 12 (boys).
B) Correct for milestones such as motor competencies and vocalizations until the child is approximately 3 years of age.
C) Know that the greatest catch-up period is between 9 and 15 months postconceptual age.
D) Know that the length and breadth of the trunk is the first part of the infant to experience catch-up growth.

Question 8

What is the weight designation of an extremely low birth weight (ELBW)infant?

A) Less than 1500 g
B) Less than 1000 g
C) Less than 2000 g
D) Dependent on the gestational age

Question 9

The nurse knows that infants of mothers with diabetes (IDMs)are at higher risk for developing which problem?

A) Anemia
B) Hyponatremia
C) Respiratory distress syndrome
D) Sepsis

Question 10

An infant is being discharged from the neonatal intensive care unit after 70 days of hospitalization.The infant was born at 30 weeks of gestation with several conditions associated with prematurity,including respiratory distress syndrome,mild bronchopulmonary dysplasia,and retinopathy of prematurity requiring surgical treatment.During discharge teaching the infant's mother asks the nurse if her baby will meet developmental milestones on time,as did her son who was born at term.Which is the basis for the nurse's most appropriate response?

A) Preterm babies develop at the same rate as term babies.
B) Preterm babies are not discharged if there are suspicions that there will be developmental delays.
C) Preterm babies need age-corrected ages for developmental assessments.
D) Preterm babies need to be followed very closely.

Question 11

On day 3 of life,a newborn continues to require 100% oxygen by nasal cannula.The parents ask if they can hold their infant during his next gavage feeding.Given that this newborn is physiologically stable,what is the basis for the nurse's response?

A) Parents are not allowed to hold infants who depend on oxygen.
B) Parents may only hold their baby's hand during the feeding.
C) Feedings cause more physiological stress,so the baby must be closely monitored and should not be held by parents.
D) Parents are encouraged to hold their baby during the feeding.

Question 12

An infant at 26 weeks of gestation arrives from the delivery room intubated.The nurse weighs the infant,places him under the radiant warmer,and attaches him to the ventilator at the prescribed settings.A pulse oximeter and cardiorespiratory monitor are placed.The pulse oximeter is recording oxygen saturations of 80%.The prescribed saturations are 92%.What is the nurse's most appropriate action?

A) Listen to breath sounds and ensure the patency of the endotracheal tube,increase oxygen,and notify a physician.
B) Continue to observe and make no changes until the saturations are 75%.
C) Continue with the admission process to ensure that a thorough assessment is completed.
D) Notify the parents that their infant is not doing well.

Question 13

An infant is born to a diabetic mother after a difficult forceps-assisted delivery.After stabilization the infant is weighed,and the birth weight is 45 0g.What is the nurse's most appropriate action?

A) Leave the infant in the room with the mother.
B) Take the infant immediately to the nursery.
C) Perform a gestational-age assessment to determine whether the infant is large for gestational age.
D) Monitor blood glucose levels frequently and observe closely for signs of hypoglycemia.

Question 14

An infant is to receive gastrostomy feedings.What intervention should the nurse institute to prevent bloating,gastrointestinal reflux into the esophagus,vomiting,and respiratory compromise?

A) Rapid bolusing of the entire amount in 15 minutes
B) Warm cloths to the abdomen for the first 10 minutes
C) Slow,small,bolus feedings over 30 minutes
D) Cold,medium bolus feedings over 20 minutes

Question 15

How are preterm and postterm infants defined?

A) Preterm before 34 weeks if appropriate for gestational age (AGA);before 37 weeks if small for gestational age (SGA)
B) Postterm after 40 weeks if large for gestational age (LGA);beyond 42 weeks if AGA
C) Preterm before 37 weeks,postterm beyond 42 weeks,no matter the size for gestational age at birth
D) Preterm,SGA before 38 to 40 weeks;postterm,LGA beyond 40 to 42 weeks

Question 16

The nurse practising in the perinatal setting should promote kangaroo care,regardless of an infant's gestational age.What should the nurse know about this intervention?

A) It is adopted from classical British nursing traditions.
B) It helps infants with motor and central nervous system impairment.
C) It enhances their temperature regulation.
D) It gets infants ready for breastfeeding.

Question 17

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

A) Infants will stay in the neonatal intensive care unit (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 centre,it is better to wait until after birth and the infant is stabilized.

Question 18

A pregnant woman was admitted for induction of labour at 43 weeks of gestation with sure dates.A nonstress test (NST)in the obstetrician's office revealed a nonreactive tracing.On artificial rupture of membranes,thick,meconium-stained fluid was noted.What should the nurse caring for the infant after birth anticipate?

A) Meconium aspiration,hypoglycemia,and dry,peeling skin
B) Excessive vernix caseosa covering the skin,lethargy,and respiratory distress syndrome
C) Golden yellow- to green-stained skin and nails,absence of scalp hair,and an increased amount of subcutaneous fat
D) Hyperglycemia,hyperthermia,and an alert,wide-eyed appearance

Question 19

Which is reflected when premature infants exhibit 5 to 10 seconds of respiratory pauses,followed by 10 to 15 seconds of compensatory rapid respirations?

A) They are suffering from sleep or wakeful apnea.
B) They are experiencing severe swings in blood pressure.
C) They are trying to maintain a neutral thermal environment.
D) They are breathing in a respiratory pattern common to premature infants.

Question 20

When providing an infant with a gavage feeding,which should be documented each time?

A) The infant's abdominal circumference after the feeding
B) The infant's heart rate and respirations
C) The infant's suck and swallow coordination
D) The infant's response to the feeding

Question 21

The nurse knows that which is the most common time frame for the development of necrotizing enterocolitis (NEC)in the term infant?

A) 1 to 3 days of age
B) 4 to 10 days of age
C) 14 to 21 days of age
D) 1 to 2 months of age

Question 22

While evaluating the plan that has been implemented for a preterm infant,which indicates that the infant is experiencing cold stress?

A) Decreased respiratory rate
B) Bradycardia followed by an increased heart rate
C) Apnea and hypoglycemia
D) Increased physical activity

Question 23

Which are signs of stress or fatigue in a newborn? Select all that apply.Express answer in small letters followed by a comma and a space-e.g. ,a,b,c

A) Hypoflexion
B) Tachypnea
C) Tremors
D) Regular respirations
E) Gape face
F) Hypertonicity

Question 24

To develop an optimal plan of care for this infant,the nurse must understand that which intervention has the greatest effect on lowering the risk of necrotizing enterocolitis (NEC)?

A) Early enteral feedings
B) Breastfeeding
C) Exchange transfusion
D) Prophylactic probiotics