Question 1

Which of the following is the most appropriate nursing intervention for the neonate who is jittery and twitching and has a high-pitched cry?

Accepted Answer

Jitteriness, twitching, and a high-pitched cry in a neonate can be symptoms of hypoglycemia or hypocalcemia, making it important to check serum glucose and calcium levels to diagnose and treat the underlying cause.

Question 2

When should the nurse expect jaundice to be present in a newborn with hemolytic disease?

Accepted Answer

Jaundice in newborns with hemolytic disease typically appears during the first 24 hours after birth due to the rapid breakdown of red blood cells leading to increased bilirubin levels.

Question 3

A woman who is 18 weeks pregnant is diagnosed with isoimmunization. The nurse should know that:

Accepted Answer

Fetal transfusion may be required in cases of isoimmunization to treat fetal anemia. This condition occurs when the mother's immune system develops antibodies against the fetal blood cells, potentially leading to severe anemia in the fetus. Rho immune globulin is used to prevent isoimmunization, not treat it once it has occurred, and is typically administered earlier in pregnancy or after delivery if the mother is Rh-negative and the baby is or might be Rh-positive.

Question 4

Which of the following is the most common cause of anemia in preterm infants?

Accepted Answer

Frequent blood sampling is the most common cause of anemia in preterm infants due to the relatively large volume of blood taken for various tests in relation to their small total blood volume.

Question 5

To prevent Rh isoimmunization, Rho immune globulin (such as RhoGAM) is administered to all:

Accepted Answer

Rho immune globulin (RhoGAM) is administered to Rh-negative women who deliver an Rh-positive infant to prevent the mother's immune system from developing antibodies against Rh-positive blood, which could affect future pregnancies.

Question 6

Meconium aspiration syndrome is caused by which of the following?

Accepted Answer

Meconium aspiration syndrome occurs when a newborn inhales a mixture of meconium and amniotic fluid into the lungs around the time of delivery, which can cause breathing problems and lung inflammation.

Question 7

Which of the following is the central factor responsible for respiratory distress syndrome?

Accepted Answer

Deficient surfactant production is the central factor responsible for respiratory distress syndrome, particularly in premature infants, as it leads to increased surface tension in the lungs and difficulty in breathing.

Question 8

Which of the following is the primary treatment for hypoglycemia in neonates?

Accepted Answer

Intravenous (IV) infusion of glucose is the primary treatment for hypoglycemia in neonates because it provides a rapid and reliable way to raise blood glucose levels.

Question 9

Several types of seizures can occur in the neonate. Which of the following is characteristic of clonic seizures?

Accepted Answer

Clonic seizures are characterized by rhythmic jerking movements of the limbs or body, which distinguishes them from other types of seizures that may present with different symptoms.

Question 10

The nurse is caring for a male infant who was born 24 hours ago to a mother who received no prenatal care. The infant is a poor feeder but sucks avidly on his hands. Clinical manifestations also include loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating. The nurse should suspect which of the following?

Accepted Answer

The symptoms described are consistent with narcotic withdrawal, which can occur in newborns born to mothers who used narcotics during pregnancy. The symptoms such as poor feeding, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating are indicative of withdrawal.

Question 11

A preterm infant of 36 weeks' gestation is admitted to the NICU. Approximately 2 hours after birth, the neonate begins having difficulty breathing with grunting, tachypnea, and nasal flaring. The nurse should recognize that:

Accepted Answer

The symptoms described (difficulty breathing with grunting, tachypnea, and nasal flaring) in a preterm infant are indicative of respiratory distress and warrant further evaluation to determine the underlying cause and appropriate treatment.

Question 12

The nurse is planning care for a newborn receiving IV calcium gluconate for treatment of hypocalcemia. Which of the following interventions is the most appropriate during the acute phase?

Accepted Answer

Allowing the infant to sleep with a pacifier to decrease stimuli is the most appropriate intervention during the acute phase of treatment for hypocalcemia with IV calcium gluconate. This approach helps to minimize stress and potential for overstimulation, which can exacerbate symptoms of hypocalcemia.

Question 13

The nurse is caring for a neonate with respiratory distress syndrome. The infant has an endotracheal tube. Nursing considerations related to suctioning should include which of the following?

Accepted Answer

Suctioning should not be performed routinely but rather based on the neonate's clinical signs and symptoms indicating a need, such as visible secretions, increased respiratory effort, or changes in vital signs. Routine or frequent suctioning can cause trauma to the airways and decrease oxygenation.

Question 14

Neonates are highly susceptible to infection as a result of which of the following?

Accepted Answer

Neonates have immature immune systems, which results in diminished nonspecific (innate) and specific (adaptive) immunity, making them more susceptible to infections.

Question 15

The nurse is caring for a neonate receiving an exchange transfusion for hemolytic disease. Assessment of the infant reveals slight respiratory distress and tachycardia. The nurse's first action should be which of the following?

Accepted Answer

Stopping the transfusion is the first action the nurse should take when signs of distress, such as respiratory distress and tachycardia, are observed in a neonate during an exchange transfusion. This is to prevent further complications or worsening of the infant's condition.

Question 16

The nurse is caring for a neonate whose mother is diabetic. Which of the following clinical manifestations would the nurse expect to see?

Accepted Answer

Neonates born to diabetic mothers are at risk for being large-for-gestational-age due to the increased glucose they receive in utero. After birth, when the glucose supply from the mother stops abruptly, these neonates are prone to hypoglycemia as their insulin levels remain high in response to the previously high glucose levels.

Question 17

A newborn is diagnosed with retinopathy of prematurity. The nurse should know that:

Accepted Answer

Cryotherapy and laser therapy are effective treatments for retinopathy of prematurity. These treatments can help prevent progression of the disease and preserve vision.

Question 18

The nurse is caring for a preterm neonate who requires mechanical ventilation for treatment of respiratory distress syndrome. The nurse should recognize that, because of the mechanical ventilation, there is an increased risk of which of the following?

Accepted Answer

Mechanical ventilation, especially at high pressures, can increase the risk of alveolar rupture due to the excessive force applied to the lungs. This condition is also known as a pneumothorax, where air leaks into the space between the lung and chest wall.

Question 19

Which of the following are possible complications of the oxygen therapy and mechanical ventilation a premature infant often requires?

Accepted Answer

The answer of Which of the following are possible complications...

Question 20

Which of the following is the most descriptive of the clinical manifestations observed in neonatal sepsis?

Accepted Answer

Neonatal sepsis often presents with subtle, vague, and nonspecific physical signs, making it challenging to diagnose. Symptoms can include temperature instability, feeding difficulties, irritability, or lethargy, rather than more overt signs seen in older children and adults.

Quiz 9: Health Problems of Newborns