Deck 23: Nursing Care of the Newborn With Special Needs

Question 1

When assessing a postterm newborn, which of the following would the nurse correlate with this gestational age variation?

A) Moist, supple, plum skin appearance
B) Abundant lanugo and vernix
C) Thin umbilical cord
D) Absence of sole creases

Answer 1

Thin umbilical cord

Question 2

The parents of a preterm newborn being cared for in the neonatal intensive care unit (NICU. are coming to visit for the first time. The newborn is receiving mechanical ventilation and intravenous fluids and medications and is being monitored electronically by various devices. Which action by the nurse would be most appropriate?

A) Suggest that the parents stay for just a few minutes to reduce their anxiety.
B) Reassure them that their newborn is progressing well.
C) Encourage the parents to touch their preterm newborn.
D) Discuss the care they will be giving the newborn upon discharge.

Answer 2

Encourage the parents to touch their preterm newborn.

Question 3

When performing newborn resuscitation, which action would the nurse do first?

A) Intubate with an appropriate-sized endotracheal tube.
B) Give chest compressions at a rate of 80 times per minute.
C) Administer epinephrine intravenously.
D) Suction the mouth and then the nose.

Answer 3

Suction the mouth and then the nose.

Question 4

The nurse frequently assesses the respiratory status of a preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syndrome because of which of the following?

A) Inability to clear fluids
B) Immature respiratory control center
C) Deficiency of surfactant
D) Smaller respiratory passages

Question 5

The nurse prepares to assess a newborn who is considered to be large for gestational age (LGA). Which of the following would the nurse correlate with this gestational age variation?

A) Strong, brisk motor skills
B) Difficulty in arousing to a quiet alert state
C) Birth weight of 7 lb 14 oz
D) Wasted appearance of extremities

Question 6

An LGA newborn has a blood glucose level of 30 mg/dL and is exhibiting symptoms of hypoglycemia. Which of the following would the nurse do next?

A) Administer intravenous glucose immediately.
B) Feed the newborn 2 ounces of formula.
C) Initiate blow-by oxygen therapy.
D) Place the newborn under a radiant warmer.

Question 7

A group of pregnant women are discussing high-risk newborn conditions as part of a prenatal class. When describing the complications that can occur in these newborns to the group, which would the nurse include as being at lowest risk?

A) Small-for-gestational-age (SGA. newborns
B) Large-for-gestational-age (LGA. newborns
C) Appropriate-for-gestational-age (AGA. newborns
D) Low-birth-weight newborns

Question 8

While caring for a preterm newborn receiving oxygen therapy, the nurse monitors the oxygen therapy duration closely based on the understanding that the newborn is at risk for which of the following?

A) Retinopathy of prematurity
B) Metabolic acidosis
C) Infection
D) Cold stress

Question 9

When planning the care for an SGA newborn, which action would the nurse determine as a priority?

A) Preventing hypoglycemia with early feedings
B) Observing for respiratory distress syndrome
C) Promoting bonding between the parents and the newborn
D) Monitoring vital signs every 2 hours

Question 10

A woman gives birth to a newborn at 36 weeks' gestation. She tells the nurse, "I'm so glad that my baby isn't premature." Which response by the nurse would be most appropriate?

A) "You are lucky to have given birth to a term newborn."
B) "We still need to monitor him closely for problems."
C) "How do you feel about delivering your baby at 36 weeks?"
D) "Your baby is premature and needs monitoring in the NICU."

Question 11

Which of the following would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn?

A) Avoid using the terms "death" or "dying."
B) Provide opportunities for them to hold the newborn.
C) Refrain from initiating conversations with the parents.
D) Quickly refocus the parents to a more pleasant topic.

Question 12

Which of the following, if noted in the maternal history, would the nurse identify as possibly contributing to the birth of an LGA newborn?

A) Drug abuse
B) Diabetes
C) Preeclampsia
D) Infection

Question 13

Which of the following would alert the nurse to suspect that a preterm newborn is in pain?

A) Bradycardia
B) Oxygen saturation level of 94%
C) Decreased muscle tone
D) Sudden high-pitched cry

Question 14

When describing newborns with birth-weight variations to a group of nursing students, the instructor identifies which variation if the newborn weighs 5.2 lb at any gestational age?

A) Small for gestational age
B) Low birth weight
C) Very low birth weight
D) Extremely low birth weight

Question 15

A nurse is assessing a newborn who has been classified as small for gestational age. Which of the following would the nurse expect to find? (Select all that apply.)

A) Wasted extremity appearance
B) Increased amount of breast tissue
C) Sunken abdomen
D) Adequate muscle tone over buttocks
E) Narrow skull sutures

Question 16

The nurse is reviewing the medical record of a newborn born 2 hours ago. The nurse notes that the newborn was delivered at 35 weeks' gestation. The nurse would classify this newborn as which of the following?

A) Preterm
B) Late preterm
C) Full term
D) Postterm

Question 17

A nursing instructor is describing common problems associated with preterm birth. When describing the preterm newborn's risk for perinatal asphyxia, the instructor includes which of the following as contributing to the newborn's risk? (Select all that apply.)

A) Surfactant deficiency
B) Placental deprivation
C) Immaturity of the respiratory control centers
D) Decreased amounts of brown fat
E) Depleted glycogen stores

Question 18

After determining that a newborn is in need of resuscitation, which of the following would the nurse do first?

A) Dry the newborn thoroughly
B) Suction the airway
C) Administer ventilations
D) Give volume expanders

Question 19

A nurse is developing a plan of care for a preterm infant experiencing respiratory distress. Which of the following would the nurse be least likely to include in this plan?

A) Stimulate the infant with frequent handling.
B) Keep the newborn in a warmed isolette.
C) Administer oxygen using a oxygen hood.
D) Give gavage or continous tube feedings.

Question 20

A nurse suspects that a preterm newborn is having problems with thermal regulation. Which of the following would support the nurse's suspicion? (Select all that apply.)

A) Shallow, slow respirations
B) Cyanotic hands and feet
C) Irritability
D) Hypertonicity
E) Feeble cry

Question 21

The nurse is assessing a preterm newborn's fluid and hydration status. Which of the following would alert the nurse to possible overhydration?

A) Decreased urine output
B) Tachypnea
C) Bulging fontanels
D) Elevated temperature

Question 22

The nurse is assessing a preterm newborn who is in the neonatal intensive care unit (NICU. for signs and symptoms of overstimulation. Which of the following would the nurse be least likely to assess?

A) Increased respirations
B) Flaying hands
C) Periods of apnea
D) Decreased heart rate

Question 23

A group of nursing students are reviewing the literature in preparation for a class presentation on newborn pain prevention and management. Which of the following would the students be most likely to find about this topic?

A) Newborn pain is frequently recognized and treated
B) Newborns rarely experience pain with procedures
C) Pain is frequently mistaken for irritability or agitation
D) Newborns may be less sensitive to pain than adult.

Question 24

A nurse is developing a plan of care for a preterm newborn to address the nursing diagnosis of risk for delayed development. Which of the following would the nurse include? (Select all that apply.)

A) Clustering care to promote rest
B) Positioning newborn in extension
C) Using kangaroo care
D) Loosely covering the newborn with blankets
E) Providing nonnutritive sucking

Question 25

A nurse is assisting the anxious parents of a preterm newborn to cope with the situation. Which statement by the nurse would be least appropriate?

A) "I'll be here to help you all along the way."
B) "What has helped you to deal with stressful situations in the past?"
C) "Let me tell you about what you will see when you visit your baby."
D) "Forget about what's happened in the past and focus on the now."