Deck 35: Acquired Problems of the Newborn

Question 1

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

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 prevent a gonorrheal infection."
D)"This medicine will protect your baby's eyes from drying out over the next few days."

Answer 1

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

Question 2

Many common drugs of abuse cause significant physiologic and behavioral problems in infants who are breastfed by mothers currently using (choose all that apply):

A)Amphetamine
B)Heroin
C)Nicotine
D)PCP
E)Morphine

Answer 2

Amphetamine
Heroin
Nicotine
PCP

Question 3

Infants of mothers with diabetes are at higher risk for developing:

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

Answer 3

Respiratory distress syndrome

Question 4

During a prenatal examination a 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 questions the nurse as to why,the nurse's best response is:

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

Question 5

When planning care for an infant with a fractured clavicle,the nurse should recognize that in addition to gentle handling:

A)Prone positioning facilitates bone alignment
B)No special treatment is necessary
C)Parents should be taught range-of-motion exercises
D)The shoulder should be immobilized with a splint

Question 6

The most important nursing action in preventing neonatal infection is:

A)Good handwashing
B)Isolation of infected infants
C)Separate gown technique
D)Standard Precautions

Question 7

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

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

Question 8

A careful review of the literature on the various recreational and illicit drugs reveals that:

A)More,longer-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 placenta;marijuana,cocaine,and PCP do not
C)Mothers should get off heroin (detoxification)any time they can during pregnancy
D)Methadone withdrawal for infants is less severe and shorter than heroin withdrawal

Question 9

With regard to skeletal injuries sustained by a neonate during labor or birth,nurses should be aware that:

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 10

A macrosomic infant is born after a difficult forceps-assisted delivery.After stabilization,the infant is weighed,and the birth weight is 4550 g (9 lb,6 oz).The nurse's most appropriate action is to:

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 11

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

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

Question 12

A plan of care for an infant experiencing symptoms of drug withdrawal should include:

A)Administering chloral hydrate for sedation
B)Feeding every 4 to 6 hours to allow extra rest
C)Swaddling the infant snugly and holding the baby tightly
D)Playing soft music during feeding

Question 13

Human immunodeficiency virus (HIV)may be perinatally transmitted:

A)Only in the third trimester from the maternal circulation
B)From the use of unsterile instruments
C)Only through the ingestion of amniotic fluid
D)Through the ingestion of breast milk from an infected mother

Question 14

With regard to the understanding and treatment of infants born to mothers who are substance abusers,nurses should be aware that:

A)Infants born to addicted mothers are also addicted
B)Mothers who abuse 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 can identify the intrauterine drug exposure of the infant

Question 15

The abuse of which substance during pregnancy is a significant cause of mental retardation in the United States?

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

Question 16

A 3.8-kg infant was delivered vaginally at 39 weeks after a 30-minute second stage.There was a nuchal cord.After birth the infant is noted to have petechiae over the face and upper back.Information given to the infant's parents should be based on the knowledge that petechiae:

A)Are benign if they disappear within 48 hours of birth
B)Result from increased blood volume
C)Should always be further investigated
D)Usually occur with forceps delivery

Question 17

A pregnant woman presents in labor 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.Based on 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 18

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

A)Escherichia coli infection
B)Tuberculosis
C)Candidiasis
D)Group B streptococci (GBS)infection

Question 19

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team.Nursing care for this infant requires a multisystem approach.The first step in the provision of this care is:

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

Question 20

With regard to central nervous system injuries to the infant during labor and birth,nurses should be aware that:

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

Question 21

In the neonatal intensive care unit (NICU)setting,artificial and long fingernails worn by nurses have been associated with serious neonatal infection and morbidity.Is this statement true or false?

Question 22

____________________,a synthetic opiate,has been the therapy of choice for heroin addiction.It crosses the placenta,leading to significant neonatal abstinence syndrome after birth.