Deck 28: The Newborn at Risk: Acquired and Congenital Problems

Question 1

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

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

Answer 1

Group B streptococcal infection

Question 2

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

Answer 2

Alcohol

Question 3

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 nurse's best response?

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

Answer 3

"Erythromycin is given prophylactically to all newborns to prevent a gonorrheal infection."

Question 4

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 5

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 6

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

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

Question 7

While completing a newborn assessment,the nurse should be aware that which one of the following 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 8

With regard to injuries to the infant's plexus during labour and birth,nurses should be aware of which of the following?

A) If the nerves are stretched with no avulsion, they should recover completely in three to six 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.

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

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 11

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

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

Question 12

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 should the nurse's response be?

A) "Your cats could be carrying toxoplasmosis. This is a parasite that can infect you and have severe effects on your unborn child."
B) "You and your baby can be exposed to the human immunodeficiency virus (HIV) in your cats' feces."
C) "It's just gross. You should make your husband clean the litter box."
D) "Cat feces are known to carry Escherichia coli, which can cause severe infections in both you and your baby."

Question 13

With regard to central nervous system injuries to the infant during labour and birth,nurses should be aware of which of the following?

A) Intracranial hemorrhage (ICH) as a result of birth trauma is more likely to occur in preterm, low-birth weight infants.
B) Subarachnoid hemorrhage (the most common form of ICH) occurs in term infants as a result of hypoxia.
C) Signs of hemorrhage in many full-term infants are absent and can be diagnosed only through laboratory tests.
D) Spinal cord injuries almost always result from forceps-assisted deliveries.

Question 14

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, cocaine, and phencyclidine (PCP) 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 15

In caring for a mother who has abused (or is abusing)alcohol and her infant,what should nurses be aware of?

A) The pattern of growth restriction of the fetus begun in prenatal life is halted after birth, and normal growth takes over.
B) Two-thirds of newborns with fetal alcohol syndrome (FAS) are boys.
C) Alcohol-related neurodevelopmental disorders that do not meet FAS criteria (such as learning disabilities, speech and language problems) 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 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

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours.A Caesarean section 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 one minute and 7 at five minutes,and is noted to be pale and tachypneic.On the basis of maternal history,the cause of this newborn's distress is most likely to be which of the following?

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

Question 18

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

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

Question 19

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) Nosocomial infection can be prevented by effective hand washing; 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 20

What should nurses be aware of with regard to skeletal injuries sustained by a neonate 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

Cleft lip or palate is a common congenital midline fissure or opening in the lip or palate resulting from the primary palate's failure to fuse.Multiple genetic,and to a lesser extent,environmental factors may lead to the development of a cleft lip or palate.Which of the following is one factor?

A) Alcohol consumption
B) Female gender
C) Use of antispasmodic medication
D) Antibiotic use in pregnancy

Question 22

What is priority nursing diagnosis for a newborn diagnosed with a diaphragmatic hernia?

A) Risk for impaired parent-infant attachment
B) Imbalanced nutrition: less than body requirements
C) Risk for infection
D) Impaired gas exchange

Question 23

What should the nurse be aware of concerning congenital anomalies of the cardiovascular and respiratory systems?

A) Cardiac disease may manifest as respiratory symptoms.
B) Screening for congenital anomalies of the respiratory system need only be done for infants in respiratory distress.
C) Choanal atresia can be corrected by a suction catheter.
D) Congenital diaphragmatic hernias are diagnosed and treated after birth.

Question 24

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 25

Which one of the following 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

What is a major nursing intervention for an infant born with myelomeningocele?

A) Protect the sac from injury.
B) Prepare the parents for the infant's paralysis from the waist down.
C) Prepare the parents for closure of the sac at around 2 years of age.
D) Assess for cyanosis.

Question 27

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

A) They have an increased incidence of IUGR.
B) They have a higher-than-average birth weight.
C) They have more risk of congenital anomalies.
D) They have a decreased risk of SIDS.

Question 28

When attempting to diagnose and treat developmental dysplasia of the hip (DDH),what should the nurse do?

A) Know how to perform Ortolani and Barlow tests.
B) Teach double or triple diapering for added support.
C) Explain to the parents the need for serial casting.
D) Carefully monitor infants for DDH at follow-up visits.

Question 29

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.