Deck 29: The Newborn at Risk: Acquired and Congenital Problems

Question 1

During a prenatal examination,the woman reports having two cats at home.The nurse informs her that she should not be cleaning the litter box while she is pregnant.When the woman asks why,what is the basis for the nurse's response?

A) Cats could be carrying toxoplasmosis which is a parasite that can infect the mother and unborn child.
B) The mother and fetus can be exposed to the human immunodeficiency virus (HIV)in cats' feces.
C) Inform her that it is not a clean task and the father of the baby should clean the litter box.
D) Cat feces are known to carry Escherichia coli,which can cause severe infections in both mother and baby.

Answer 1

Cats could be carrying toxoplasmosis which is a parasite that can infect the mother and unborn child.

Question 2

Which should nurses be aware of with regard to injuries to the infant's plexus during labour and birth?

A) If the nerves are stretched with no avulsion,they should recover completely in 3 to 6 months.
B) Erb palsy is caused by damage to the lower plexus.
C) Parents of children with brachial palsy are taught to pick up the child from under the axillae.
D) Breastfeeding is not recommended for infants with facial nerve paralysis until the condition resolves.

Answer 2

If the nerves are stretched with no avulsion,they should recover completely in 3 to 6 months.

Question 3

The use of which substance during pregnancy is the leading cause of cognitive impairment?

A) Alcohol
B) Tobacco
C) Marijuana
D) Heroin

Answer 3

Alcohol

Question 4

What should be included in a plan of care for an infant experiencing symptoms of drug withdrawal?

A) Administer chloral hydrate for sedation.
B) Feed every 4 to 6 hours to allow extra rest.
C) Swaddle the infant snugly and hold him or her tightly.
D) Play soft music during feeding.

Question 5

Near the end of the first week of life,an infant who has not been treated for any infection develops a copper-coloured,maculopapular rash on the palms and around the mouth and anus.What is the newborn showing signs of?

A) Gonorrhea
B) Herpes simplex virus
C) Congenital syphilis
D) Human immunodeficiency virus (HIV)

Question 6

Which should the nurse be aware of when caring for a mother who has abused (or is abusing)alcohol and for her infant?

A) The pattern of growth restriction of the fetus begun in prenatal life is halted after birth,and normal growth takes over.
B) Newborns with fetal alcohol syndrome (FAS)are below the twenty-fifth percentile for weight and height.
C) Alcohol-related neurodevelopmental disorders that do not meet FAS criteria are often not detected until the child goes to school.
D) Both the distinctive facial features of the FAS infant and the diminished mental capacities tend toward normal over time.

Question 7

What should the nurse understand about the treatment of infants born to mothers who are substance users?

A) Infants born to addicted mothers are also addicted.
B) Mothers who use one substance likely will use or abuse another,compounding the infant's difficulties.
C) The NICU Network Neurobehavioral Scale (NNNS)is designed to assess the damage the mother has done to herself.
D) No laboratory procedures are available that can identify the intrauterine drug exposure of the infant.

Question 8

Which infant is more likely to have Rh incompatibility?

A) An infant with an Rh-negative mother and Rh-positive father homozygous for the Rh factor
B) An infant who is Rh negative and whose mother is Rh negative
C) An infant with an Rh-negative mother and Rh-positive father heterozygous for the Rh factor
D) An infant who is Rh positive and whose mother is Rh positive

Question 9

How can human immunodeficiency virus (HIV)be transmitted from mother to infant?

A) Only in the third trimester from the maternal circulation.
B) From a needlestick injury at birth from unsterile instruments.
C) Only through the infant's ingestion of amniotic fluid.
D) Through the ingestion of breast milk from an infected mother.

Question 10

While completing a newborn assessment,the nurse should be aware that which is the most common birth injury?

A) Injury to the soft tissues
B) Caused by forceps gripping the head on delivery
C) Fracture of the humerus and femur
D) Fracture of the clavicle

Question 11

Which drug is contraindicated for infants born to narcotic-addicted mothers?

A) Naloxone
B) Gentamycin
C) Vitamin K
D) Erythromycin

Question 12

What should the nurse be aware of with regard to the classification of a neonatal bacterial infection?

A) Congenital infection progresses more slowly than nosocomial infection.
B) Hospital-acquired infection can be prevented by effective hand hygiene;early-onset infections cannot.
C) Infections occur with about the same frequency in boy and girl infants,although female mortality is higher.
D) The clinical sign of a rapid,high fever makes infection easier to diagnose.

Question 13

A primigravida has just delivered a healthy infant girl.The nurse is about to administer erythromycin ointment to the infant's eyes when the mother asks,"What is that medicine for?" What is the basis for the nurse's response?

A) It is an eye ointment to help newborns see clearer.
B) It is to protect newborns from contracting maternal herpes.
C) Erythromycin is given prophylactically to all newborns to prevent a gonorrheal infection.
D) This medicine will protect newborn's eyes from drying out over the next few days.

Question 14

What is the most important nursing action for preventing neonatal infection?

A) Good hand hygiene
B) Isolation of infected infants
C) Separate gown technique
D) Standard precautions

Question 15

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours.A Caesarean birth is performed for failure to progress.The fetal heart rate (FHR)before birth is 180 beats/min with limited variability.At birth,the newborn has Apgar scores of 6 at 1 minute and 7 at 5 minutes and is noted to be pale and tachypneic.On the basis of the maternal history,which is the most likely cause of this newborn's distress?

A) Hypoglycemia
B) Phrenic nerve injury
C) Respiratory distress syndrome
D) Sepsis

Question 16

Providing care for a neonate born to a mother who uses substances can present a challenge for the health care team.Nursing care for this infant requires a multisystem approach.What is the first step to take when providing care for this infant?

A) Pharmacological treatment
B) Reduction of environmental stimuli
C) Neonatal abstinence syndrome scoring
D) Adequate nutrition and maintenance of fluid and electrolyte balance

Question 17

Which bacterial infection is definitely decreasing because of effective drug treatment?

A) Escherichia coli infection
B) Tuberculosis
C) Candidiasis
D) Group B streptococcal infection

Question 18

What does a careful review of the literature on mothers addicted to various recreational and illicit drugs reveal?

A) More long-term studies are needed to assess the lasting effects on infants when mothers have taken or are taking illegal drugs.
B) Heroin and methadone cross the placental barrier;marijuana and cocaine do not.
C) Mothers should get off heroin (detox)any time they can during pregnancy.
D) Methadone withdrawal is less severe for infants and has a shorter duration than heroin withdrawal.

Question 19

A pregnant woman presents in labour at term,having had no prenatal care.After birth,her infant is noted to be small for gestational age,with small eyes and a thin upper lip.The infant also is microcephalic.On the basis of her infant's physical findings,this woman should be questioned about her use of which substance during pregnancy?

A) Alcohol
B) Cocaine
C) Heroin
D) Marijuana

Question 20

What should nurses be aware of with regard to skeletal injuries sustained by a newborn during labour or birth?

A) A newborn's skull is still forming and fractures fairly easily.
B) Unless a blood vessel is involved,linear skull fractures heal without special treatment.
C) Clavicle fractures often need to be set with an inserted pin for stability.
D) Other than the skull,the most common skeletal injuries are to leg bones.

Question 21

For infants of mothers who used heroin during their pregnancy,which statement is true?

A) They are usually small for gestational age.
B) They have a higher-than-average birth weight.
C) They have more risk of congenital anomalies.
D) They have a decreased risk of sudden infant death syndrome (SIDS).

Question 22

Which infant is at highest risk of neurological birth injuries?

A) Preterm infant born at 35 weeks of gestation
B) Appropriate-for-gestational age (AGA)infant born at 42 weeks of gestation
C) Very-low-birth-weight (VLBW)infant born at 36 weeks of gestation.
D) Intrauterine growth restriction (IUGR)infant born at 39 weeks of gestation.

Question 23

What should the nurse be aware of concerning hemolytic diseases of the newborn?

A) Rh incompatibility matters only when Rh-negative offspring are born to an Rh-positive mother.
B) ABO incompatibility is more likely than Rh incompatibility to precipitate significant anemia.
C) Exchange transfusions are frequently required in the treatment of hemolytic disorders.
D) The indirect Coombs' test is performed on the mother before birth;the direct Coombs' test is performed on the cord blood after birth.

Question 24

Which will the nurse observe when assessing a 2-week-old newborn with congenital hypothyroidism? Select all that apply.Express answer in small letters followed by a comma and a space-e.g. ,a,b,c

A) Diarrhea
B) Tachycardia
C) Large anterior fontanel
D) Large posterior fontanel
E) Dry mottled skin
F) Hoarse cry
G) Cyanosis

Question 25

Which would an infant diagnosed with erythroblastosis fetalis characteristically exhibit?

A) Edema
B) Immature red blood cells
C) Enlargement of the heart
D) Ascites

Question 26

Multiple genetic and,to a lesser extent,environmental factors may lead to the development of a cleft lip or palate.Which is a risk factor for cleft lip and palate?

A) Maternal methamphetamine use
B) Female gender
C) Use of antispasmodic medication
D) Antibiotic use in pregnancy

Question 27

Which will be present when assessing an infant with untreated phenylketonuria (PKU)?

A) Hypoactivity
B) Rapid weight gain
C) Frequent vomiting
D) Flat affect

Question 28

Which are potential maternal-fetal ABO incompatibilities? Select all that apply.Express answer in small letters followed by a comma and a space-e.g. ,a,b,c

A) Maternal blood group O;fetal blood group A
B) Maternal blood group O;fetal blood group B
C) Maternal blood group B;fetal blood group O
D) Maternal blood group B;fetal blood group AB
E) Maternal blood group A; fetal blood group O
F) Maternal blood group A; fetal blood group B

Question 29

When caring for a newborn that is experiencing withdrawal syndrome,which will the nurse assess for in the infant? Select all that apply.Express answer in small letters followed by a comma and a space-e.g. ,a,b,c

A) Jitteriness
B) Shrill cry
C) Exaggerated Moro reflex
D) Slow,shallow respirations
E) Hypothermia
F) Hyperthermia