NUR401 Exam Questions with Answers
Initiation of Respiration: Lung Development - ✔✔Fetal lung fluid is reabsorbed and expelled
before, during, and after birth
surfactant production at 34-36 weeks
Initiation of Respiration: Respiratory Center Stimulation - ✔✔Chemical: decreased oxygen and
pH, increased CO2 stimulates the respiratory center
Mechanical: release of thoracic pressure from exiting the birth canal provides negative pressure
to initiate respiration
Thermal: exposure to decreased temperature upon delivery
Sensory: dry/warm rubbing the infant
What is an expected respiratory finding in a freshly born neonate? - ✔✔Moist lung sounds
Cardiovascular Adaptations - ✔✔Increased oxygen and shifts in pressure facilitate the closure
of fetal blood vessels
Ductus arteriosus: gradual closure from hours to days from increased oxygen
Foramen Ovale: cord clamping increases left ventricular pressure, preventing right ventricular
to left ventricular shunting
Ductus Venosus: closes within 1-2 weeks of life
What can cause the Foramen Ovale to stay open? - ✔✔Pulmonary Hypertension, Asphyxia
What are causes of infant heat loss? - ✔✔little subcutaneous fat, blood vessels close to the
surface, large skin surface area
Methods of heat loss - ✔✔Evaporation, Conduction, Convection, Radiation
,Evaporation - ✔✔Moisture on the skin air drys
Dry the infant immediately upon delivery
Conduction - ✔✔pulling heat away from the body by putting skin in contact with a cold surface
(ex. stethoscope, scale)
Warm surfaces before use
Convection - ✔✔transfer of heat occurring through moving air
place infant in a warm, draft free room
Radiation - ✔✔transfer of heat to a cooler object that is not in direct contact
Keep infants away from windows
Thermogenesis of the Infant - ✔✔restlessness, crying, flexion, increased metabolism, increased
activity, vasoconstriction, brown fat (nonshivering thermogenesis)
Cold Stress - ✔✔respiratory distress, hypoglycemia, decreased surfactant, acidosis, jaundice
Hematologic Adaptation - ✔✔Increased RBC turnover and increased H+H in the neonate
Leukocytosis is a typical finding in newborns
Clotting: lack of gut microbiome to produce vitamin K for clotting factors; give vitamin K to
prevent hemorrhagic disease of the newborn
Infant signs of infection - ✔✔Decreased WBC count and temperature
, Gastrointestinal Adaptations - ✔✔Stomach has a capacity of 6mL/kg at birth
Intestines have a long length to increase surface area for absorption (increased risk for fluid
loss)
Bowel sounds within one hour of birth
Stool progression in neonates - ✔✔Meconium: first stool passed within 12-48 hours; should be
black, tarry, and sticky
Transition Stool: greenish brown
Milk Stool: more frequent, seedy mustard color and consistency
Hyperbilirubinemia - ✔✔Jaundice; either physiologic (greater than 24 hours after birth) or
pathologic (less than 24 hours after birth)
Physiologic Jaundice - ✔✔Due to hemolysis of RBCs and liver immaturity
Pathologic Jaundice - ✔✔excess RBC production/breakdown, liver immaturity, ABO
incompatibility, preterm, delayed/poor feeding, trauma, hypoglycemia, infection, maternal DM,
some drugs
Urinary Adaptations - ✔✔Kidneys have lower ability to filter, reabsorb, and maintain
fluid/electrolyte balance (mature by 1-2yrs)
first void within 24 hours
normal diuresis after birth causes weight loss (5-10%)
Immune Adaptations - ✔✔IgG: crosses placenta to provide passive, temporary immunity
IgM: begins production to produce against gram negative bacteria
IgA: does not cross the placenta; must be produced by the infant
Initiation of Respiration: Lung Development - ✔✔Fetal lung fluid is reabsorbed and expelled
before, during, and after birth
surfactant production at 34-36 weeks
Initiation of Respiration: Respiratory Center Stimulation - ✔✔Chemical: decreased oxygen and
pH, increased CO2 stimulates the respiratory center
Mechanical: release of thoracic pressure from exiting the birth canal provides negative pressure
to initiate respiration
Thermal: exposure to decreased temperature upon delivery
Sensory: dry/warm rubbing the infant
What is an expected respiratory finding in a freshly born neonate? - ✔✔Moist lung sounds
Cardiovascular Adaptations - ✔✔Increased oxygen and shifts in pressure facilitate the closure
of fetal blood vessels
Ductus arteriosus: gradual closure from hours to days from increased oxygen
Foramen Ovale: cord clamping increases left ventricular pressure, preventing right ventricular
to left ventricular shunting
Ductus Venosus: closes within 1-2 weeks of life
What can cause the Foramen Ovale to stay open? - ✔✔Pulmonary Hypertension, Asphyxia
What are causes of infant heat loss? - ✔✔little subcutaneous fat, blood vessels close to the
surface, large skin surface area
Methods of heat loss - ✔✔Evaporation, Conduction, Convection, Radiation
,Evaporation - ✔✔Moisture on the skin air drys
Dry the infant immediately upon delivery
Conduction - ✔✔pulling heat away from the body by putting skin in contact with a cold surface
(ex. stethoscope, scale)
Warm surfaces before use
Convection - ✔✔transfer of heat occurring through moving air
place infant in a warm, draft free room
Radiation - ✔✔transfer of heat to a cooler object that is not in direct contact
Keep infants away from windows
Thermogenesis of the Infant - ✔✔restlessness, crying, flexion, increased metabolism, increased
activity, vasoconstriction, brown fat (nonshivering thermogenesis)
Cold Stress - ✔✔respiratory distress, hypoglycemia, decreased surfactant, acidosis, jaundice
Hematologic Adaptation - ✔✔Increased RBC turnover and increased H+H in the neonate
Leukocytosis is a typical finding in newborns
Clotting: lack of gut microbiome to produce vitamin K for clotting factors; give vitamin K to
prevent hemorrhagic disease of the newborn
Infant signs of infection - ✔✔Decreased WBC count and temperature
, Gastrointestinal Adaptations - ✔✔Stomach has a capacity of 6mL/kg at birth
Intestines have a long length to increase surface area for absorption (increased risk for fluid
loss)
Bowel sounds within one hour of birth
Stool progression in neonates - ✔✔Meconium: first stool passed within 12-48 hours; should be
black, tarry, and sticky
Transition Stool: greenish brown
Milk Stool: more frequent, seedy mustard color and consistency
Hyperbilirubinemia - ✔✔Jaundice; either physiologic (greater than 24 hours after birth) or
pathologic (less than 24 hours after birth)
Physiologic Jaundice - ✔✔Due to hemolysis of RBCs and liver immaturity
Pathologic Jaundice - ✔✔excess RBC production/breakdown, liver immaturity, ABO
incompatibility, preterm, delayed/poor feeding, trauma, hypoglycemia, infection, maternal DM,
some drugs
Urinary Adaptations - ✔✔Kidneys have lower ability to filter, reabsorb, and maintain
fluid/electrolyte balance (mature by 1-2yrs)
first void within 24 hours
normal diuresis after birth causes weight loss (5-10%)
Immune Adaptations - ✔✔IgG: crosses placenta to provide passive, temporary immunity
IgM: begins production to produce against gram negative bacteria
IgA: does not cross the placenta; must be produced by the infant
