Question 1

To meet the nutritional needs of a neonate with congenital heart disease, the nurse should teach the mother to:

Accepted Answer

To meet the nutritional needs of a neonate with congenital heart disease, the nurse should teach the mother to feed the baby slowly while allowing for rest. Because of fatigue, the baby may become too tired to feed; allowing for rest and feeding slowly limits the fatigue associated with feeding.

Question 2

A breastfeeding mother who is seven days post-partum calls the nurse complaining of a reddened, painful breast and elevated body temperature. Which of the following responses by the nurse would be most appropriate?

Accepted Answer

The response by the nurse that would be most appropriate is "Notify the physician because you may need medication." Mastitis is an infection of the breast that presents with fever, chills, and a painful reddened area on the breast. It is generally unilateral in nature. It requires antibiotic therapy and is usually caused by bacteria.

Question 3

A nurse is caring for a patient who is receiving chemotherapy. The patient's mother asks the nurse why the neonate has developed sores in his mouth. She asks the nurse why this happened. What is the nurse's best response?

Accepted Answer

The nurse's best response is "The cells in the mouth are sensitive to the chemotherapy." The epithelial cells in the mouth are very sensitive to chemotherapy due to their high rate of cell turnover.

Question 4

The mother of a newly diagnosed neonate with Type I diabetes mellitus asks the purpose of a test measuring glycosylated hemoglobin. The nurse should explain that the purpose of this test is to determine:

Accepted Answer

The nurse should explain that the purpose of this test is to determine the average blood glucose for the past two to three months. By testing the portion of the hemoglobin that absorbs glucose, it is possible to determine the average blood glucose over the life span of the red cell, 120 days.

Question 5

A mother asks the nurse why her baby needs to have a vitamin K (Aquamephyton) injection. The nurse should inform the mother that vitamin K:

Accepted Answer

The nurse should inform the mother that vitamin K prevents bleeding problems. A single parenteral dose of vitamin K given soon after birth prevents hemorrhagic disorder. Vitamin K is produced in the gastrointestinal tract soon after microorganisms are introduced.

Question 6

Which of the following nursing diagnoses would be given priority in the nursing care plan of a newborn at one hour of age?

Accepted Answer

A nursing diagnosis that would be given priority in the nursing care plan of a newborn at one hour of age is ineffective thermoregulation. During all procedures with the newborn, care must be taken to avoid heat loss. Cold stress is detrimental to the newborn. It increases the need for oxygen and can upset the acid-base balance.

Question 7

During nursing rounds, which of these assessments would require immediate corrective action and further instruction to the practical nurse (PN) about proper care?

Accepted Answer

Assessment that would require immediate corrective action and further instruction to the practical nurse (PN) about proper care is if a patient with a hip prosthesis one day post operatively is lying in bed with internal rotation and adduction of the affected leg. This position should be prevented in order to prevent dislodgment of the hip prosthesis, especially in the first forty-eight to seventy-two hours post-op. The other assessments are not of concern.

Question 8

A nurse manager teaches a group of NICU nurses about approaches in patient and family health teaching. The nurse manager explains that there are several theories that can be considered in teaching and learning. One of these is utilizing the Bloom's taxonomy that describes three types of learning. Which of the following does not belong to these types?

Accepted Answer

The one that does not belong to these three types is physiologic. Blooms taxonomy outlines behaviors that are necessary for learning, all of which can be applied to healthcare. The theory describes cognitive (Knowledge, Comprehension, Application, Analysi, Synthesis, and Evaluation); affective (Recognizing five categories of feelings and values from simple to Complex); and psychomotor (Mastering the motor skills necessary for independence. This follows a progression from simple to complex.).

Question 9

The nurse is teaching parents of a patient with chronic renal failure (CRF) about medication. The mother questions the purpose of aluminum hydroxide (Amphojel) in the child's medication regimen. What is the best explanation for the nurse to give the mother about the therapeutic effects of this medication?

Accepted Answer

The best explanation for the nurse to give the mother about the therapeutic effects of this medication is that it decreases serum phosphate. Aluminum binds phosphates that tend to accumulate in the patient with chronic renal failure due to decreased filtration capacity of the kidney. Antacids such as Amphojel are commonly used to accomplish this.

Question 10

When discharging a one-year-old child who has laryngotracheobronchitis (LTB), a nurse would give the parents which of the following instructions for home care?

Accepted Answer

When discharging a one-year-old child who has laryngotracheobronchitis (LTB), a nurse would give the parents instructions to situate the child in a cool, mist-filled environment if the symptoms recur. High humidity with cool mist is a therapeutic management; it provides symptomatic relief for most children.

Question 11

Hypothermia is common in newborn because of their inability to control heat. The following would be an appropriate parent teaching to prevent heat loss except:

Accepted Answer

The listed items would be appropriate parent teachings to prevent heat loss except placing the crib beside the wall. This can cause heat loss by radiation.

Question 12

A student nurse asks a nurse about conditions that are caused by heat loss. The nurse answers correctly by saying all of the following except:

Accepted Answer

The nurse answers correctly by saying all of the above except increased intracranial pressure. Newborns with severe hypothermia are in high risk for kernicterus (too much bilirubin in the brain), which can lead to cerebral palsy. Hypoglycemia may occur due to an increased metabolic rate and because of newborns are born slightly acidic, they catabolize brown fat, which will produce ketones, causing metabolic acidosis.

Question 13

An infant is admitted to the unit with a diagnosis of suspected meningococcal meningitis. One of the newly hired staff nurses ask you which of the following nursing measures should she do first. You should suggest:

Accepted Answer

You should suggest to place the infant in respiratory isolation. The initial therapeutic management of acute bacterial meningitis includes isolation precautions, initiation of antimicrobial therapy, and maintenance of optimum hydration. Nurses should take necessary precautions to protect themselves and others from possible infection.

Question 14

The mother of a neonate with clubfoot feels guilty because she believes she did something to cause the condition. You should explain that the cause of clubfoot is:

Accepted Answer

You should explain that the cause of clubfoot is unknown. In some families, there's an increased incidence. Some postulate that anomalous embryonic development or restricted fetal movements are the reasons. Currently, there's no way to predict the onset of clubfoot.

Question 15

Which of the following instructions would you include in discharge teaching for the parents of a newborn diagnosed with sickle-cell anemia?

Accepted Answer

The instruction that you would include in discharge teaching for the parents of a newborn diagnosed with sickle-cell anemia is how to palpate the abdomen and take a temperature. Acute splenic sequestration is a serious complication of sickle-cell anemia. Early detection of splenomegaly by parents is an important aspect of patient management. A temperature of 101.3 °F to 102.2 °F calls for emergency evaluation, even if the child appears well. The need for folic acid increases injections, so supplementation is prudent. Vitamin B12 and iron supplements aren't necessary. The Pneumococcal vaccine is used because children with sickle-cell anemia are prone to infection with Streptococcus pneumoniae.

Question 16

A patient is diagnosed with multiple myeloma and the patient's mother asks the nurse about the diagnosis. The nurse bases the response on which description of this disorder?

Accepted Answer

The nurse should describe this disorder as malignant proliferation of plasma cells within the bone. Multiple myeloma is a B-cell neoplastic condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow.

Question 17

The oncology nurse specialist provides an educational session to nursing staff regarding the characteristics of Hodgkin's disease. The nurse determines that further teaching is needed if a nursing staff member states that which of the following is a characteristic of the disease?

Accepted Answer

The nurse determines that further teaching is needed if a nursing staff member states that a characteristic of the disease is that it occurs most often in the older patient. Hodgkin's disease is a disorder of young adults. Options A, C, and D are characteristics of this disease.

Question 18

When teaching the parents of an infant with cystic fibrosis about the type of diet the child should consume, which of the following would be most appropriate?

Accepted Answer

When teaching the parents of an infant with cystic fibrosis about the type of diet the child should consume, the most appropriate would be a high calorie diet. Cystic fibrosis affects the exocrine glands. Mucus is thick and tenacious, sticking to the walls of the pancreatic and bile ducts and eventually causing obstruction; a moderate fat, high calorie diet is indicated.

Question 19

A student nurse is caring for a child diagnosed with croup and the nurse asks the student about the clinical manifestations associated with the illness. Which statement by the student indicates a need for further assessment?

Accepted Answer

A statement by the student that indicates a need for further assessment is symptoms usually worsen during the day and are relieved during sleep. Croup often begins at night and may be preceded by several days of upper respiratory infection symptoms. Croup is characterized by a sudden onset of a harsh, brassy cough; sore throat; and inspiratory stridor. Symptoms usually worsen at night and are better in the day. Croup is usually accompanied by a low-grade fever, but occasionally the temperature may be as high as 104° F.

Question 20

A nurse assesses the communication patterns of a five-month-old infant. The nurse determines that the infant is demonstrating the highest level of developmental achievement expected if the infant:

Accepted Answer

The nurse determines that the infant is demonstrating the highest level of developmental achievement expected if the infant uses monosyllabic babbling. Using monosyllabic babbling occurs between three and six months of age. Using simple words such as "mama" occurs between nine and twelve months of age. Linking syllables together when communicating occurs between six and nine months of age. Cooing begins at birth and continues until two months of age.

Quiz 2: Neonatal