CRITICAL CARE REGISTERED NURSE {CCRN} NEONATAL & LATE
PRETERM INFANT CARE STUDY GUIDE | 2025–2026
COMPREHENSIVE NCLEX-PN/NICU REVIEW |300 VERIFIED
QUESTIONS & CORRECT CLINICAL ANSWERS
This comprehensive guide focuses on the care of late preterm infants and
common neonatal complications. Learn how to manage asymptomatic and
symptomatic hypoglycemia, understand the rationale for delayed discharge,
recognize early signs of brain trauma, and educate parents on safe sleep and
thermoregulation. It also explains essential protocols like oral glucose dosing,
D10W administration, and skin-to-skin conduction heat transfer. A must-have
resource for students, new nurses, or those in maternal-child health,
pediatrics, or NICU rotations.
A deformation is a(n) - CORRECT ANSWER-abnormality caused by unusual mechanical forces on
normal tissue.
A low birth weight infant's temperature increases during skin-to-skin care. This is an example of heat
transfer by - CORRECT ANSWER-conduction.
At the onset of labor the release of catecholamines stimulates - CORRECT ANSWER-increased
absorption of lung fluid.
An edematous, bruised lesion on the right anterior scalp where the vacuum was applied. This lesion
has clearly demarcated edges, is firm to touch, and does not cross the suture line. This is best
described as a - CORRECT ANSWER-cephalohematoma.
Which of the following protocols is used to treat a dobutamine extravasation? Administer -
CORRECT ANSWER-5 subcutaneous injections of phentolamine (Regitine) around the periphery
of the site within one hour of infiltration. phentolamine s/b used to reverse vasoconstricting effects
of dopamine; administer hyaluronudase in 4-5 0.2 ml sc injections around ther periphery of the
injury; tx most effective when done w/in one hour, but may still be beneficial if done in 12 hours.
,Which of the following statements about hemangiomas is TRUE? - CORRECT ANSWER-Some
hemangiomas are permanent, and others will resolve. nodules, solid, elevated lesions; arise from
deeper layers of the skin > 1 cm; more common in preterm infants, females, caucasian, multiples;
referred to as stork bite; blanches w pressure; darkens when crying; includes port wine stains
Which of the following statements does not accurately describe the stratum corneum? The stratum
corneum - CORRECT ANSWER-is the outermost layer of cells that form the dermal layer.
All late preterm infants are at risk for hypoglycemia due to which of the following? - CORRECT
ANSWER-Impaired ability to generate glucose from glycogen stores and increased glucose
utilization
All of the following have had an impact on the rising late preterm birth rate EXCEPT - CORRECT
ANSWER-decreasing maternal age.
All of the following increase parental confidence in caring for the late preterm infant EXCEPT -
CORRECT ANSWER-open visitation so others can help with newborn care.
If the neonate is symptomatic with a plasma glucose value of less than 40mg/dl (2.2 mmol/L) and is
refusing or NOT tolerating feedings, the nurse should request orders for the following interventions:
- CORRECT ANSWER-an intravenous bolus of 2 ml/kg D10W and an intravenous D10W infusion
initiated at 80 ml/kg/day.
In contrast to term newborns, bilirubin levels in late preterm newborns typically peak at -
CORRECT ANSWER-5-7 days of life
Late preterm infants may need additional time to meet the criteria recommended for discharge.
Therefore, late preterm infants should NOT be discharged prior to - CORRECT ANSWER-48
hours of life.
Parents should be taught to assess their infant's _________ temperature. - CORRECT ANSWER-
axillary
,Routine nursing interventions to prevent hypoglycemia in the late preterm infant should include -
CORRECT ANSWER-initiation of breastfeeding of all late preterm infants within the first hour of
life.
The components of safe sleep include the following EXCEPT - CORRECT ANSWER-sharing a sleep
surface with parents.
The dose for oral glucose gel for asymptomatic neonatal hypoglycemia is _____mg/kg body weight. -
CORRECT ANSWER-200
The late preterm infant population is currently defined as infants who are born between -
CORRECT ANSWER-34 to 36 6/7 weeks of gestation.
The late preterm infant should meet the following discharge criteria: Successful feedings for -
CORRECT ANSWER-24 hours and vital signs within normal limits for 12 hours prior to discharge.
The late preterm newborn is at risk of developing hypothermia because of - CORRECT ANSWER-
decreased ability to flex extremities
The nurse should utilize the following interventions to promote successful breastfeeding in the late
preterm infant EXCEPT - CORRECT ANSWER-providing supplementation after every feeding.
Which of the following statements about the late preterm infant is TRUE? - CORRECT ANSWER-
Body mass and fat stores are low and may impact the infant's ability to maintain normal
temperatures.
The MOST common screening tests for Down Syndrome offered to parents in the first trimester -
CORRECT ANSWER-maternal serum alpha fetoprotein.
Education for the parents of a neonate diagnosed with phenylketonuria (PKU) includes which of the
following? - CORRECT ANSWER-✓ A low protein formula (diet) is necessary to avoid/ameliorate
developmental delay.
, Which of the following is TRUE about neonates with achondroplasia? - CORRECT ANSWER-✓
The disorder can be inherited as an autosomal dominant condition.
Education for parents of a male neonate diagnosed with an X-linked recessive single gene disorder
would include - CORRECT ANSWER-✓ all of his daughters will be obligate carriers.
The predominant difference between single-gene disorders and multifactorial disorders is that in
multifactorial disorders - CORRECT ANSWER-✓ they are caused by a combination of genetic and
environmental influences.
A deformation is a(n) - CORRECT ANSWER-abnormality caused by unusual mechanical forces on
normal tissue.
Blood specimens placed on filter paper for newborn screening should be - CORRECT ANSWER-
dried in air at room temperature for three hours before being placed in the envelope.
Fetal alcohol syndrome is the most serious form of fetal alcohol spectrum disorder. Which is NOT
TRUE about fetal alcohol syndrome? - CORRECT ANSWER-Fetal alcohol syndrome only happens
if the mother is an alcoholic.
Nondisjunction is defined as - CORRECT ANSWER-the failure of paired chromosomes to
separate equally during cell division.
A 7-day-old neonate with an unremarkable hospital course who now presents with increasing
episodes of hypoglycemia, severe metabolic acidosis, recurrent vomiting, and high ammonia levels
should be evaluated for what disorder? - CORRECT ANSWER-✓ An inborn error of metabolism
Complex/multifactorial anomalies - CORRECT ANSWER-have a recurrence risk dependent upon
how closely related the affected person is to the neonate.
An infant born at 36 weeks gestation is small for gestational age and hypotonic. Her physical exam
yields low set, "fawn-like" ears and micrognathia. A renal ultrasound shows horseshoe shaped
kidneys. She also has a loud, audible murmur and an echocardiogram yields a large VSD. Which
congenital anomaly do you suspect? - CORRECT ANSWER-Edwards syndrome
PRETERM INFANT CARE STUDY GUIDE | 2025–2026
COMPREHENSIVE NCLEX-PN/NICU REVIEW |300 VERIFIED
QUESTIONS & CORRECT CLINICAL ANSWERS
This comprehensive guide focuses on the care of late preterm infants and
common neonatal complications. Learn how to manage asymptomatic and
symptomatic hypoglycemia, understand the rationale for delayed discharge,
recognize early signs of brain trauma, and educate parents on safe sleep and
thermoregulation. It also explains essential protocols like oral glucose dosing,
D10W administration, and skin-to-skin conduction heat transfer. A must-have
resource for students, new nurses, or those in maternal-child health,
pediatrics, or NICU rotations.
A deformation is a(n) - CORRECT ANSWER-abnormality caused by unusual mechanical forces on
normal tissue.
A low birth weight infant's temperature increases during skin-to-skin care. This is an example of heat
transfer by - CORRECT ANSWER-conduction.
At the onset of labor the release of catecholamines stimulates - CORRECT ANSWER-increased
absorption of lung fluid.
An edematous, bruised lesion on the right anterior scalp where the vacuum was applied. This lesion
has clearly demarcated edges, is firm to touch, and does not cross the suture line. This is best
described as a - CORRECT ANSWER-cephalohematoma.
Which of the following protocols is used to treat a dobutamine extravasation? Administer -
CORRECT ANSWER-5 subcutaneous injections of phentolamine (Regitine) around the periphery
of the site within one hour of infiltration. phentolamine s/b used to reverse vasoconstricting effects
of dopamine; administer hyaluronudase in 4-5 0.2 ml sc injections around ther periphery of the
injury; tx most effective when done w/in one hour, but may still be beneficial if done in 12 hours.
,Which of the following statements about hemangiomas is TRUE? - CORRECT ANSWER-Some
hemangiomas are permanent, and others will resolve. nodules, solid, elevated lesions; arise from
deeper layers of the skin > 1 cm; more common in preterm infants, females, caucasian, multiples;
referred to as stork bite; blanches w pressure; darkens when crying; includes port wine stains
Which of the following statements does not accurately describe the stratum corneum? The stratum
corneum - CORRECT ANSWER-is the outermost layer of cells that form the dermal layer.
All late preterm infants are at risk for hypoglycemia due to which of the following? - CORRECT
ANSWER-Impaired ability to generate glucose from glycogen stores and increased glucose
utilization
All of the following have had an impact on the rising late preterm birth rate EXCEPT - CORRECT
ANSWER-decreasing maternal age.
All of the following increase parental confidence in caring for the late preterm infant EXCEPT -
CORRECT ANSWER-open visitation so others can help with newborn care.
If the neonate is symptomatic with a plasma glucose value of less than 40mg/dl (2.2 mmol/L) and is
refusing or NOT tolerating feedings, the nurse should request orders for the following interventions:
- CORRECT ANSWER-an intravenous bolus of 2 ml/kg D10W and an intravenous D10W infusion
initiated at 80 ml/kg/day.
In contrast to term newborns, bilirubin levels in late preterm newborns typically peak at -
CORRECT ANSWER-5-7 days of life
Late preterm infants may need additional time to meet the criteria recommended for discharge.
Therefore, late preterm infants should NOT be discharged prior to - CORRECT ANSWER-48
hours of life.
Parents should be taught to assess their infant's _________ temperature. - CORRECT ANSWER-
axillary
,Routine nursing interventions to prevent hypoglycemia in the late preterm infant should include -
CORRECT ANSWER-initiation of breastfeeding of all late preterm infants within the first hour of
life.
The components of safe sleep include the following EXCEPT - CORRECT ANSWER-sharing a sleep
surface with parents.
The dose for oral glucose gel for asymptomatic neonatal hypoglycemia is _____mg/kg body weight. -
CORRECT ANSWER-200
The late preterm infant population is currently defined as infants who are born between -
CORRECT ANSWER-34 to 36 6/7 weeks of gestation.
The late preterm infant should meet the following discharge criteria: Successful feedings for -
CORRECT ANSWER-24 hours and vital signs within normal limits for 12 hours prior to discharge.
The late preterm newborn is at risk of developing hypothermia because of - CORRECT ANSWER-
decreased ability to flex extremities
The nurse should utilize the following interventions to promote successful breastfeeding in the late
preterm infant EXCEPT - CORRECT ANSWER-providing supplementation after every feeding.
Which of the following statements about the late preterm infant is TRUE? - CORRECT ANSWER-
Body mass and fat stores are low and may impact the infant's ability to maintain normal
temperatures.
The MOST common screening tests for Down Syndrome offered to parents in the first trimester -
CORRECT ANSWER-maternal serum alpha fetoprotein.
Education for the parents of a neonate diagnosed with phenylketonuria (PKU) includes which of the
following? - CORRECT ANSWER-✓ A low protein formula (diet) is necessary to avoid/ameliorate
developmental delay.
, Which of the following is TRUE about neonates with achondroplasia? - CORRECT ANSWER-✓
The disorder can be inherited as an autosomal dominant condition.
Education for parents of a male neonate diagnosed with an X-linked recessive single gene disorder
would include - CORRECT ANSWER-✓ all of his daughters will be obligate carriers.
The predominant difference between single-gene disorders and multifactorial disorders is that in
multifactorial disorders - CORRECT ANSWER-✓ they are caused by a combination of genetic and
environmental influences.
A deformation is a(n) - CORRECT ANSWER-abnormality caused by unusual mechanical forces on
normal tissue.
Blood specimens placed on filter paper for newborn screening should be - CORRECT ANSWER-
dried in air at room temperature for three hours before being placed in the envelope.
Fetal alcohol syndrome is the most serious form of fetal alcohol spectrum disorder. Which is NOT
TRUE about fetal alcohol syndrome? - CORRECT ANSWER-Fetal alcohol syndrome only happens
if the mother is an alcoholic.
Nondisjunction is defined as - CORRECT ANSWER-the failure of paired chromosomes to
separate equally during cell division.
A 7-day-old neonate with an unremarkable hospital course who now presents with increasing
episodes of hypoglycemia, severe metabolic acidosis, recurrent vomiting, and high ammonia levels
should be evaluated for what disorder? - CORRECT ANSWER-✓ An inborn error of metabolism
Complex/multifactorial anomalies - CORRECT ANSWER-have a recurrence risk dependent upon
how closely related the affected person is to the neonate.
An infant born at 36 weeks gestation is small for gestational age and hypotonic. Her physical exam
yields low set, "fawn-like" ears and micrognathia. A renal ultrasound shows horseshoe shaped
kidneys. She also has a loud, audible murmur and an echocardiogram yields a large VSD. Which
congenital anomaly do you suspect? - CORRECT ANSWER-Edwards syndrome
