NURS368 Final Exam With Complete Solution
Surfactant replacement therapy is used in the medical management of:
A: Bronchopulmonary dysplasia (BPD)
B: Patent ductus arteriosus (PDA)
C: Respiratory distress syndrome (RDS)
D: Necrotizing enterocolitis (NEC) - ANSWER C: Respiratory distress syndrome (RDS)
Which intervention is the most important to prevent necrotizing enterocolitis?
A: Exclusive human milk feeding
B: Surfactant
C: Oxygen
D: Ventilator support - ANSWER A: Exclusive human milk feeding
Which type of IUGR has better developmental outcomes?
A: Asymmetric
B: Symmetric - ANSWER A: Asymmetric
Weight is the only abnormal measurement
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 pounds, 6 ounces). 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. - ANSWER d. Monitor blood glucose levels frequently and observe
closely for signs of hypoglycemia.
(This infant is macrosomic (more than 4000 g) and is at high risk for hypoglycemia.
Blood glucose levels should be monitored frequently, and the infant should be observed
closely for signs of hypoglycemia. Observation may occur in the nursery or in the
mother's room, depending on the condition of the fetus. Regardless of gestational age,
this infant is macrosomic.)
Infants of mothers with diabetes (IDMs) are at higher risk for developing:
a. Anemia.
b. Hyponatremia.
c. Respiratory distress syndrome.
d. Sepsis. - ANSWER c. Respiratory distress syndrome.
Extracorporeal membrane oxygenation is a highly technical way of oxygenating the
blood while bypassing the lungs, thus resting the infant's lungs and giving them an
opportunity to recover. It is likely that initially the infant will have been attached to a
ventilator. Insertion of a laryngoscope with tracheal suctioning is done after birth before
the infant takes the first breath. There will be an endotracheal tube in place to enable
deep tracheal suctioning and ventilation.
Treatment of the infant with PKU has what goal?
a. Cure mental retardation.
b. Prevention of central nervous system damage which leads to mental retardation.
c. Prevention of gastrointestinal symptoms.
,d. Cure the urinary tract infection. - ANSWER b. Prevention of central nervous system
damage which leads to mental retardation.
(CNS damage can occur as a result of toxic levels of phenylalanine. No known cure
exists for mental retardation. Digestive problems are a clinical manifestation of PKU.
PKU does not involve any urinary problems.)
A number of common drugs of abuse produce significant physiologic and behavioral
problems in infants who are breastfed by mothers currently using: (Select all that apply)
a. Amphetamine.
b. Heroin.
c. Nicotine.
d. PCP.
e. Morphine. - ANSWER a. Amphetamine.
b. Heroin.
c. Nicotine.
d. PCP.
(Amphetamine, heroin, nicotine, and PCP are contraindicated during breastfeeding
because of the reported effects on the infant. Morphine is a medication that often is
used to treat neonatal abstinence syndrome.)
Risk factors associated with NEC include (Select all that apply):
a. Polycythemia.
b. Anemia.
c. Congenital heart disease.
d. Bronchopulmonary dysplasia.
, e. Retinopathy. - ANSWER a. Polycythemia.
b. Anemia.
c. Congenital heart disease.
The risk factors for NEC include asphyxia, respiratory distress syndrome, umbilical
artery catheterization, exchange transfusion, early enteral feedings, patent ductus
arteriosus, congenital heart disease, polycythemia, anemia, shock, and gastrointestinal
infection.
Infants born between 34 0/7 and 36 6/7 weeks of gestation have been referred to as
late-preterm infants because they share many needs with preterm infants. Because they
are more stable than early-preterm infants, they may be cared for much like a full-term
baby. The mother-baby or nursery nurse knows these babies are at an increased risk for
(Select all that apply):
a. Problems with thermoregulation
b. Cardiac distress
c. Hyperbilirubinemia
d. Sepsis
e. Hyperglycemia - ANSWER a. Thermoregulation problems
b. Cardiac distress
d. Sepsis
Problems with thermoregulation, hyperbilirubinemia, and sepsis related to immaturity
also necessitate close observation. After discharge the infant is also at risk for
rehospitalization related to these problems. AWHONN initiated the Near-Term Infant
Initiative to research the problem and ways to ensure proper care for these infants. The
nurse should make sure this infant is feeding well before discharge and that parents are
taught the signs and symptoms of these complications. Late-preterm infants are also at
an increased risk for respiratory distress and hypoglycemia.
2. Which of the following neonates is at highest risk for cold stress syndrome?
Surfactant replacement therapy is used in the medical management of:
A: Bronchopulmonary dysplasia (BPD)
B: Patent ductus arteriosus (PDA)
C: Respiratory distress syndrome (RDS)
D: Necrotizing enterocolitis (NEC) - ANSWER C: Respiratory distress syndrome (RDS)
Which intervention is the most important to prevent necrotizing enterocolitis?
A: Exclusive human milk feeding
B: Surfactant
C: Oxygen
D: Ventilator support - ANSWER A: Exclusive human milk feeding
Which type of IUGR has better developmental outcomes?
A: Asymmetric
B: Symmetric - ANSWER A: Asymmetric
Weight is the only abnormal measurement
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 pounds, 6 ounces). 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. - ANSWER d. Monitor blood glucose levels frequently and observe
closely for signs of hypoglycemia.
(This infant is macrosomic (more than 4000 g) and is at high risk for hypoglycemia.
Blood glucose levels should be monitored frequently, and the infant should be observed
closely for signs of hypoglycemia. Observation may occur in the nursery or in the
mother's room, depending on the condition of the fetus. Regardless of gestational age,
this infant is macrosomic.)
Infants of mothers with diabetes (IDMs) are at higher risk for developing:
a. Anemia.
b. Hyponatremia.
c. Respiratory distress syndrome.
d. Sepsis. - ANSWER c. Respiratory distress syndrome.
Extracorporeal membrane oxygenation is a highly technical way of oxygenating the
blood while bypassing the lungs, thus resting the infant's lungs and giving them an
opportunity to recover. It is likely that initially the infant will have been attached to a
ventilator. Insertion of a laryngoscope with tracheal suctioning is done after birth before
the infant takes the first breath. There will be an endotracheal tube in place to enable
deep tracheal suctioning and ventilation.
Treatment of the infant with PKU has what goal?
a. Cure mental retardation.
b. Prevention of central nervous system damage which leads to mental retardation.
c. Prevention of gastrointestinal symptoms.
,d. Cure the urinary tract infection. - ANSWER b. Prevention of central nervous system
damage which leads to mental retardation.
(CNS damage can occur as a result of toxic levels of phenylalanine. No known cure
exists for mental retardation. Digestive problems are a clinical manifestation of PKU.
PKU does not involve any urinary problems.)
A number of common drugs of abuse produce significant physiologic and behavioral
problems in infants who are breastfed by mothers currently using: (Select all that apply)
a. Amphetamine.
b. Heroin.
c. Nicotine.
d. PCP.
e. Morphine. - ANSWER a. Amphetamine.
b. Heroin.
c. Nicotine.
d. PCP.
(Amphetamine, heroin, nicotine, and PCP are contraindicated during breastfeeding
because of the reported effects on the infant. Morphine is a medication that often is
used to treat neonatal abstinence syndrome.)
Risk factors associated with NEC include (Select all that apply):
a. Polycythemia.
b. Anemia.
c. Congenital heart disease.
d. Bronchopulmonary dysplasia.
, e. Retinopathy. - ANSWER a. Polycythemia.
b. Anemia.
c. Congenital heart disease.
The risk factors for NEC include asphyxia, respiratory distress syndrome, umbilical
artery catheterization, exchange transfusion, early enteral feedings, patent ductus
arteriosus, congenital heart disease, polycythemia, anemia, shock, and gastrointestinal
infection.
Infants born between 34 0/7 and 36 6/7 weeks of gestation have been referred to as
late-preterm infants because they share many needs with preterm infants. Because they
are more stable than early-preterm infants, they may be cared for much like a full-term
baby. The mother-baby or nursery nurse knows these babies are at an increased risk for
(Select all that apply):
a. Problems with thermoregulation
b. Cardiac distress
c. Hyperbilirubinemia
d. Sepsis
e. Hyperglycemia - ANSWER a. Thermoregulation problems
b. Cardiac distress
d. Sepsis
Problems with thermoregulation, hyperbilirubinemia, and sepsis related to immaturity
also necessitate close observation. After discharge the infant is also at risk for
rehospitalization related to these problems. AWHONN initiated the Near-Term Infant
Initiative to research the problem and ways to ensure proper care for these infants. The
nurse should make sure this infant is feeding well before discharge and that parents are
taught the signs and symptoms of these complications. Late-preterm infants are also at
an increased risk for respiratory distress and hypoglycemia.
2. Which of the following neonates is at highest risk for cold stress syndrome?
