Question 1

The nurse is planning care for four infants who were born on this shift.Which infant will require the most detailed assessment? The infant whose mother:

Accepted Answer

The infant whose mother has Chlamydia will require the most detailed assessment as this infection can cause serious complications in newborns, such as eye infections, pneumonia, and sepsis. The other conditions listed may require some attention, but are not as immediately concerning for the infant's health.

Question 2

The nurse is caring for a newborn with jaundice.The parents question why the newborn is not under the phototherapy lights.The nurse explains that the fiberoptic blanket is beneficial because: (Select all that apply. )

Accepted Answer

Fiberoptic blankets for treating newborn jaundice offer several advantages: they can be used continuously (A), do not require eye protection since the light does not shine directly into the newborn's eyes (B), prevent overheating which is a risk with traditional phototherapy lights (D), and do not contribute to weight loss, a concern with other jaundice treatments (E). Unlike traditional phototherapy, where the baby might need to be removed for feedings (C), the fiberoptic blanket allows for more consistent treatment without interruption.

Question 3

A client in labor is found to have meconium-stained amniotic fluid upon rupture of membranes.At delivery,the nurse finds the infant to have depressed respirations and a heart rate of 80.The nurse anticipates which of the following to occur?

Accepted Answer

Direct tracheal suctioning by specially trained personnel is anticipated because the infant has depressed respirations and a low heart rate, indicating possible meconium aspiration syndrome, which requires immediate intervention to clear the airway.

Question 4

The nurse assesses that a newborn's skin has a ruddy appearance and the peripheral pulses are decreased.The nurse suspects polycythemia.Which of the following lab reports might indicate that the newborn has polycythemia?

Accepted Answer

A central venous hematocrit level greater than 65% is indicative of polycythemia, which is an abnormal increase in the number of red blood cells in the circulation. Bilirubin level, venous hemoglobin level, and blood glucose level do not directly indicate polycythemia.

Question 5

A nursing instructor is demonstrating how to perform a heel stick on a newborn.To obtain an accurate capillary hematocrit reading,the nursing instructor tells the students to:

Accepted Answer

Warming the heel prior to obtaining blood will increase blood flow and make it easier to obtain an accurate capillary hematocrit reading. Using a previous puncture site may not produce enough blood for a reading and could cause infection. Cooling the heel could cause vasoconstriction and make it more difficult to obtain enough blood. Using a sterile needle and aspirating is not necessary for a heel stick, as capillary blood can be obtained with a lancet.

Question 6

A newborn is receiving phototherapy.Which intervention would be most important?

Accepted Answer

Assessment of hydration status is crucial in a newborn receiving phototherapy as dehydration can increase the risk of kernicterus. It is important to monitor urine output, mucous membrane moisture, and fontanelle tension. Measurement of head circumference and stool guaiac testing are not directly related to phototherapy. Encouraging the mother to stop breastfeeding is not recommended as breast milk can actually help with the elimination of bilirubin.

Question 7

During newborn resuscitation,effectiveness of bag-and-mask ventilations can be determined by:

Accepted Answer

The rise and fall of the chest is the most reliable indication of effective ventilation during newborn resuscitation. It indicates that the air is being pushed into the lungs and that gas exchange is occurring. Sudden wakefulness, urinary output, and adequate thermoregulation are not reliable indicators of effective bag-and-mask ventilations.

Question 8

Antibiotics have been ordered for a newborn with an infection.Which of the following interventions would the nurse prepare to implement? Select all that apply.

Accepted Answer

The nurse should prepare to obtain skin cultures to identify the infection, evaluate bilirubin levels as antibiotics can affect liver function, administer oxygen if the newborn has respiratory issues, and observe for signs of hypoglycemia as infections can affect glucose levels. Restricting parental visits is not a standard intervention for newborn infections.

Question 9

A nurse is caring for a newborn on a ventilator who has respiratory distress syndrome (RDS).The nurse informs the parents that the newborn is improving.Which of the following data supports the nurse's assessment?

Accepted Answer

Increased urination is a sign of improvement in RDS as it indicates that the baby is able to clear excess fluid from their lungs and is therefore requiring less help from the ventilator. Decreased urination would indicate worsening RDS. Pulmonary vascular resistance and increased Pco2 are both negative signs and would indicate worsening RDS.

Question 10

The nurse prepares to admit to the nursery a newborn whose mother had meconium-stained amniotic fluid.The nurse knows this newborn might require:

Accepted Answer

Meconium-stained amniotic fluid indicates that the baby may have passed stool in utero, which can lead to respiratory distress and compromise their ability to oxygenate. Therefore, initial resuscitation may be needed. The other choices are not necessarily indicated based solely on meconium-stained amniotic fluid.

Question 11

The nurse notes that a 36-hour-old newborn's serum bilirubin level has increased from 14 mg/dL to 16.6 mg/dL in an 8-hour period.What nursing intervention would be included in the plan of care for this newborn?

Accepted Answer

The increasing serum bilirubin level indicates the development of jaundice, and the newborn may benefit from phototherapy to reduce the bilirubin level. Continuing to observe may lead to further complications, and halting breastfeeding is not necessary unless there are other indications of a problem with breastfeeding. Blood exchange transfusion is a more invasive intervention that may be necessary for severe hyperbilirubinemia, but it is not indicated at this time.

Question 12

The nurse is evaluating the effectiveness of phototherapy on a newborn.Which of the following evaluations indicates a therapeutic response to phototherapy?

Accepted Answer

Maintaining a normal temperature indicates that the newborn is not experiencing adverse effects from phototherapy, which is a sign of effective treatment.

Question 13

Which of the following assessment findings by the nurse would require obtaining a blood glucose level on the newborn?

Accepted Answer

Jitteriness in newborns can be a sign of hypoglycemia and should prompt the nurse to obtain a blood glucose level. Sucking on fingers and having a lusty cry are normal newborn behaviors. An axillary temperature of 98 is within the normal range for a newborn.

Question 14

The parents of a preterm newborn desire to visit their baby in the NICU.All of the following statements by the nurse will support the parents as they visit their newborn except:

Accepted Answer

This statement may create additional stress for the parents as they try to coordinate their visits around feeding schedules. Instead, the nurse should offer flexibility and encourage the parents to visit as often and for as long as they desire, while following any necessary infection control precautions. The other statements provide helpful information and support for the parents during their visit.

Question 15

A nurse explains to new parents that their newborn has developed respiratory distress syndrome (RDS).The nurse bases this assessment on all of the following data except:

Accepted Answer

A respiratory rate of 40 during sleep is not necessarily indicative of respiratory distress syndrome. However, grunting respirations, nasal flaring, and chest retractions are all signs of RDS.

Quiz 29: The Newborn at Risk: Birth-Related Stressors