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

Question 1

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

Answer 1

Cracked, peeling skin

Question 2

What will the nurse note when assessing an SGA infant with asymmetric intrauterine growth restriction?

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.

Answer 2

The head seems large compared with the rest of the body.

Question 3

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

Answer 3

Cry face, eye squeeze, increase in blood pressure

Question 4

What nursing action is especially important for the SGA newborn?

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

Question 5

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

Question 6

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 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

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 9

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 10

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 11

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 12

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 13

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 14

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 15

The preterm infant who should receive gavage feedings instead of a bottle is the one who

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 16

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

A) They weigh less than 2500 g.
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 17

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 18

Late preterm infants need closer monitoring during her hospital stay than term infants.In order to prevent unrecognized cold-stress the nurse should perform all except

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

Question 19

To maintain optimal thermoregulation for the premature infant,the nurse should

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 20

An infant girl is preterm and on a respirator with intravenous lines and much equipment around her when her parents come to visit for the first time.It is important for the nurse to

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.

Question 21

Approximately 30% of preterm infants weighing less than 1500 g develop bleeding around and into the ventricles of the brain.This condition is known as _______________.

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

Breast milk is best source of food almost all infants and especially for preterm infants.Breast-feeding has numerous benefits for the preterm infant.One of the most important of these benefits is reducing the incidence of necrotizing enterocolitis (NEC).Is this statement true or false?

Question 24

The NICU nurse begins her shift by assessing one of the preterm infants assigned to her care.The infant's color is pale,his O? saturation has decreased,and he is grimacing.This infant is displaying common signs of ________.

Question 25

Infants born between 34 0/7 and 36 6/7 weeks of gestation are called late preterm infants because they have many needs similar to those of preterm infants.Because they are more stable than early preterm infants,they may receive care that is much like that of a full-term baby.The mother-baby or nursery nurse knows that these babies are at increased risk for (select all that apply)

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