Exam (elaborations) NURS 1102 PASSPOINT NEONATE

NURS 1102 PASSPOINT NEONATE Question 1 See full question A neonate weighing 3 lb, 5 oz (1,503 g) is born at 32 weeks' gestation. During an assessment 12 hours after birth, a nurse notices these signs and symptoms: hyperactivity, a persistent shrill cry, frequent yawning and sneezing, and jitteriness. These symptoms indicate: You Selected:  hypoglycemia. Correct response:  drug dependence. Explanation: Remediation: Question 2 See full question Just after delivery, a nurse measures a neonate's axillary temperature at 94.1°F (34.5°C). What should the nurse do? You Selected:  Rewarm the neonate gradually. Correct response:  Rewarm the neonate gradually. Explanation: Remediation: Question 3 See full question Which complication is common in neonates who receive prolonged mechanical ventilation at birth? You Selected:  Bronchopulmonary dysplasia NURS 1102 PASSPOINT NEONATE Correct response:  Bronchopulmonary dysplasia Explanation: Remediation: Question 4 See full question A client in labor has meconium staining in the amniotic fluid. Which sequence of events will most effectively decrease the risk of meconium aspiration? You Selected:  Deliver the head, then suction the mouth and then the nose. Correct response:  Deliver the head, then suction the mouth and then the nose. Explanation: Remediation: Question 5 See full question A nurse is assisting with a circumcision. After the physician has started the procedure, the nurse reviews the neonate's medical record and notices that an informed consent form hasn't been signed. What should the nurse do? You Selected:  Tell the physician to stop the procedure immediately because an informed consent form hasn't been signed. Correct response:  Tell the physician to stop the procedure immediately because an informed consent form hasn't been signed. Explanation: Remediation: Question 6 See full question While caring for a neonate born at 32 weeks’ gestation, which finding would most suggest the infant is developing necrotizing enterocolitis (NEC)? You Selected:  abdominal distention Correct response:  abdominal distention Explanation: Remediation: Question 7 See full question The client who is breastfeeding asks the nurse if she should supplement breastfeeding with formula feeding. The nurse bases the response on which principle? You Selected:  Formula feeding should be avoided to prevent interfering with the breast milk supply. Correct response:  Formula feeding should be avoided to prevent interfering with the breast milk supply. Explanation: Remediation: Question 8 See full question During the first feeding, the nurse observes that the neonate becomes cyanotic after gagging on mucus. What should the nurse do first? You Selected:  Clear the neonate's airway with suction or gravity. Correct response:  Clear the neonate's airway with suction or gravity. Explanation: Remediation: Question 9 See full question A client is exclusively breastfeeding her 1-week-old infant and is concerned about her baby taking enough milk per day. The client tells the nurse that the infant has six wet diapers per day. Which of the following responses by the nurse is most appropriate? You Selected:  “That many wet diapers indicates your infant is adequately hydrated.” Correct response:  “That many wet diapers indicates your infant is adequately hydrated.” Explanation: Remediation: Question 10 See full question A neonate has been placed on cardiac and apnea monitoring in the neonatal nursery. The nurse notes that the apnea alarm repeatedly triggers. Place the following actions in the order in which they would be completed by the nurse. All options must be used. You Selected:  Silence the alarm to decrease environmental stimuli.  Check all connections on the apnea monitor.  Count the respiratory rate for 60 seconds.  Perform a focused assessment on the neonate.  Document the assessment findings, interventions, and neonate’s response. Correct response:  Perform a focused assessment on the neonate.  Count the respiratory rate for 60 seconds.  Silence the alarm to decrease environmental stimuli.  Check all connections on the apnea monitor.  Document the assessment findings, interventions, and neonate’s response. Explanation: Remediation: Question 1 See full question When teaching parents of a neonate the proper position for the neonate's sleep, a nurse stresses the importance of placing the neonate on his back to reduce the risk of: You Selected:  suffocation. Correct response:  sudden infant death syndrome (SIDS) Explanation: Remediation: Question 2 See full question A male neonate underwent circumcision. What nursing intervention is part of the initial care of a circumcised neonate? You Selected:  Apply petroleum gauze to the site for 24 hours. Correct response:  Apply petroleum gauze to the site for 24 hours. Explanation: Remediation: Question 3 See full question A neonate requires surgical repair of a patent ductus arteriosus. The neonate's 16- year-old mother is present along with her parents, the neonate's grandparents. The neonate's mother states that she "isn't with the father anymore." The nurse must obtain informed consent for the surgery from: You Selected:  the neonate's grandparents because his mother is a minor. Correct response:  the neonate's mother because she's considered an emancipated minor. Explanation: Remediation: Question 4 See full question A full-term neonate is admitted to the normal newborn nursery. When lifting the baby out of the crib the nurse notes the baby’s arms move sideways with the palms up and the thumbs flexed. What should the nurse do next? You Selected:  Identify this reflex as a normal finding. Correct response:  Identify this reflex as a normal finding. Explanation: Remediation: Question 5 See full question Which finding would the nurse most expect to find in a neonate born at 28 weeks’ gestation who is diagnosed with intraventricular hemorrhage (IVH)? You Selected:  bulging fontanels Correct response:  bulging fontanels Explanation: Remediation: Question 6 See full question A neonate born at 40 weeks' gestation admitted to the nursery is found to be hypoglycemic. At 4 hours of age, the neonate appears pale and his pulse oximeter is reading 75% on room air. The nurse should: You Selected:  provide supplemental oxygen Correct response:  provide supplemental oxygen Explanation: Remediation: Question 7 See full question The parents of a neonate born with congenital clubfoot express feelings of helplessness and guilt and are exhibiting anxiety about how the neonate will be treated. Which action by the nurse would be most appropriate initially? You Selected:  Discuss the problem with the parents and the current feelings that they are experiencing. Correct response:  Discuss the problem with the parents and the current feelings that they are experiencing. Explanation: Remediation: Question 8 See full question A preterm neonate admitted to the neonatal intensive care unit at about 30 weeks’ gestation is placed in an oxygenated isolette. The neonate’s mother tells the nurse that she was planning to breastfeed the neonate. Which instructions about breastfeeding would be most appropriate? You Selected:  Gavage feedings using breast milk can be given until the neonate can coordinate sucking and swallowing. Correct response:  Gavage feedings using breast milk can be given until the neonate can coordinate sucking and swallowing. Explanation: Remediation: Question 9 See full question During the initial assessment, the nurse notes that the neonate’s hands and feet appear blue while the neonate’s torso appears pale pink. What should the nurse do next? You Selected:  Wrap the neonate in a warm blanket. Correct response:  Wrap the neonate in a warm blanket. Explanation: Remediation: Question 10 See full question The nurse is administering vitamin K (phytonadione) to a newborn and instructs the mother on the medication. Which of the following comments made by the mother indicates that the instruction was effective? You Selected:  “This medication is to help my newborn start to make clotting factors.” Correct response:  “This medication is to help my newborn start to make clotting factors.” Question 1 See full question A client in labor has meconium staining in the amniotic fluid. Which sequence of events will most effectively decrease the risk of meconium aspiration? You Selected:  Deliver the head, then suction the mouth and then the nose. Correct response:  Deliver the head, then suction the mouth and then the nose. Explanation: Remediation: Question 2 See full question How should a nurse assess a neonate's rooting reflex? You Selected:  Stroke the neonate's cheek. Correct response:  Stroke the neonate's cheek. Explanation: Remediation: Question 3 See full question Which action is the best precaution against transmission of infection? You Selected:  Eye prophylaxis with antibiotics for a neonate whose mother has gonorrhea infection Correct response:  Eye prophylaxis with antibiotics for a neonate whose mother has gonorrhea infection Explanation: Remediation: Question 4 See full question Which assessment finding would lead a nurse to suspect dehydration in a preterm neonate? You Selected:  Urine output below 1 ml/hour Correct response:  Urine output below 1 ml/hour Explanation: Remediation: Question 5 See full question A nurse notices that a newborn has a swelling in the scrotal area. The nurse interprets this swelling as indicative of hydrocele if what else occurs? You Selected:  The increase in scrotal size is bilateral. Correct response:  The scrotal sac can be transilluminated. Explanation: Remediation: Question 6 See full question When assessing a postterm neonate, what is considered a normal finding? You Selected:  wrinkled, peeling skin Correct response:  wrinkled, peeling skin Explanation: Remediation: Question 7 See full question The client who is breastfeeding asks the nurse if she should supplement breastfeeding with formula feeding. The nurse bases the response on which principle? You Selected:  Formula feeding should be avoided to prevent interfering with the breast milk supply. Correct response:  Formula feeding should be avoided to prevent interfering with the breast milk supply. Explanation: Remediation: Question 8 See full question When formulating a plan of care for the postterm neonate at discharge, which outcome would be most appropriate? You Selected:  maintenance of a normal bilirubin level Correct response:  maintenance of normal body temperature Explanation: Remediation: Question 9 See full question On the second postpartum day, the nurse enters the room and notices that the client is holding her crying baby and lightly rubbing the infant’s back. The client states, “I don’t know why she won’t stop crying all the time.” Which of the following is the most appropriate nursing intervention? You Selected:  Tell the client that her baby is hungry and that she needs to breastfeed. Correct response:  Demonstrate ways that the client can comfort her baby. Explanation: Remediation: Question 10 See full question While changing her newborn’s diaper, a mother states: “there is some bleeding from the vagina.” Which of the following is the nurse's appropriate response? You Selected:  “This is in response to your hormones and will stop within a week of life.” Correct response:  “This is in response to your hormones and will stop within a week of life.” Question 1 See full question A neonate weighing 3 lb, 5 oz (1,503 g) is born at 32 weeks' gestation. During an assessment 12 hours after birth, a nurse notices these signs and symptoms: hyperactivity, a persistent shrill cry, frequent yawning and sneezing, and jitteriness. These symptoms indicate: You Selected:  drug dependence. Correct response:  drug dependence. Explanation: Remediation: Question 2 See full question When assessing a neonate who was born at 30 weeks' gestation, a nurse notes bounding femoral pulses, a palpable thrill over the suprasternal notch, tachycardia, tachypnea, and crackles. The nurse suspects: You Selected:  tetralogy of Fallot. Correct response:  patent ductus arteriosus. Explanation: Remediation: Question 3 See full question An alarm signals, indicating that a neonate's security identification band requires attention. The nurse responds immediately and finds that the parents removed the identification bands from the neonate. Which action should the nurse take next? You Selected:  Compare the information on the neonate's identification bands with that of the mother's, then reattach the identification bands to one of the neonate's extremities. Correct response:  Compare the information on the neonate's identification bands with that of the mother's, then reattach the identification bands to one of the neonate's extremities. Explanation: Remediation: Question 4 See full question A primiparous client expresses concern, asking the nurse why her neonate's eyes are crossed. Which information would