Chapter 14: The Newborn with a Perinatal
Injury or Congenital Malformation
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. The nurse is advising parents about feeding their infant with phenylketonuria. What formula
and/or diet should the nurse suggest?
a. Lifelong high-protein diet
b. A formula that is low in the amino acid leucine
c. A soy-based formula
d. Substitute Lofenalac for some protein foods
ANS: D
A synthetic food providing enough protein for growth and tissue repair, but little
phenylalanine, is substituted for natural protein foods.
DIF: Cognitive Level: Comprehension REF: p. 350 OBJ: 10
TOP: PKU KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. Parents of a 2-month-old infant with Down syndrome are attending a well visit at the pediatric
clinic. What should they be instructed to provide special attention to in regard to the generalized
hypotonicity of the child?
a. Preventing hyperthermia
b. Respiratory care
c. Prevention of diarrhea
d. Incontinence care
ANS: B
The child with Down syndrome has generalized hypotonicity, which caused mucus
accumulation and respiratory problems.
, DIF: Cognitive Level: Application REF: p. 353 OBJ: 11
TOP: Down Syndrome KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
3. What would the nurse include when instructing parents about positioning their toddler who has
just had a body spica cast applied?
a. Prop the child upright with pillows for meals.
b. Use the bar between the legs to turn the child.
c. Put the child on her abdomen to sleep.
d. Change the child‘s position frequently.
ANS: D
The child‘s position must be changed frequently to relieve pressure and promote circulation.
DIF: Cognitive Level: Application REF: p. 348 OBJ: 9
TOP: Developmental Hip Dysplasia KEY: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity
4. The nurse is caring for an Rh-negative mother on the labor and birth unit. What scenario
indicates this patient will require RhoGAM administration?
a. She has had one Rh-negative child and is pregnant with an Rh-negative child.
b. She has had an Rh-positive infant and is pregnant with an Rh-positive fetus.
c. She has had an O-negative child and is pregnant with a B-negative child.
d. She is a primipara with an O-negative child.
ANS: B
The only woman with antibodies against the Rh-positive infant is the Rh-negative woman
who has had one Rh-positive child and is now pregnant with another.
DIF: Cognitive Level: Analysis REF: p. 354 OBJ: 12
TOP: Rh Concerns KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
5. Parents ask the nursery staff what the light does for their jaundiced infant. What is the nurse‘s
best response?
a. “The light increases the infant‘s metabolism.”
, b. “The light stimulates liver function.”
c. “The light dilates blood vessels.”
d. “The light breaks down bilirubin.”
ANS: D
Severe jaundice can cause kernicterus, an accumulation of bilirubin in the brain tissue, which
can lead to serious brain damage. The light breaks down excess bilirubin so that it can be
excreted.
DIF: Cognitive Level: Application REF: p. 355 OBJ: 14
TOP: Hemolytic Disease of the Newborn
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. Parents of a newborn with a unilateral cleft lip are concerned about having the defect repaired.
The nurse explains that a child with a cleft lip usually undergoes surgical repair at which time?
a. Immediately after birth
b. By 3 months of age
c. After 12 months of age
d. Varies in every case
ANS: B
A cleft lip is repaired by 3 months of age when weight gain is established and the infant is
free of infection.
DIF: Cognitive Level: Comprehension REF: p. 343 OBJ: 8
TOP: Cleft Lip KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
7. What occurrence results from obstruction within the ventricles of the brain or inadequate
reabsorption of cerebrospinal fluid?
a. Meningitis
b. Meningocele
c. Spina bifida occulta
d. Hydrocephalus
Injury or Congenital Malformation
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. The nurse is advising parents about feeding their infant with phenylketonuria. What formula
and/or diet should the nurse suggest?
a. Lifelong high-protein diet
b. A formula that is low in the amino acid leucine
c. A soy-based formula
d. Substitute Lofenalac for some protein foods
ANS: D
A synthetic food providing enough protein for growth and tissue repair, but little
phenylalanine, is substituted for natural protein foods.
DIF: Cognitive Level: Comprehension REF: p. 350 OBJ: 10
TOP: PKU KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
2. Parents of a 2-month-old infant with Down syndrome are attending a well visit at the pediatric
clinic. What should they be instructed to provide special attention to in regard to the generalized
hypotonicity of the child?
a. Preventing hyperthermia
b. Respiratory care
c. Prevention of diarrhea
d. Incontinence care
ANS: B
The child with Down syndrome has generalized hypotonicity, which caused mucus
accumulation and respiratory problems.
, DIF: Cognitive Level: Application REF: p. 353 OBJ: 11
TOP: Down Syndrome KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
3. What would the nurse include when instructing parents about positioning their toddler who has
just had a body spica cast applied?
a. Prop the child upright with pillows for meals.
b. Use the bar between the legs to turn the child.
c. Put the child on her abdomen to sleep.
d. Change the child‘s position frequently.
ANS: D
The child‘s position must be changed frequently to relieve pressure and promote circulation.
DIF: Cognitive Level: Application REF: p. 348 OBJ: 9
TOP: Developmental Hip Dysplasia KEY: Nursing Process Step:
Implementation MSC: NCLEX: Physiological Integrity
4. The nurse is caring for an Rh-negative mother on the labor and birth unit. What scenario
indicates this patient will require RhoGAM administration?
a. She has had one Rh-negative child and is pregnant with an Rh-negative child.
b. She has had an Rh-positive infant and is pregnant with an Rh-positive fetus.
c. She has had an O-negative child and is pregnant with a B-negative child.
d. She is a primipara with an O-negative child.
ANS: B
The only woman with antibodies against the Rh-positive infant is the Rh-negative woman
who has had one Rh-positive child and is now pregnant with another.
DIF: Cognitive Level: Analysis REF: p. 354 OBJ: 12
TOP: Rh Concerns KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
5. Parents ask the nursery staff what the light does for their jaundiced infant. What is the nurse‘s
best response?
a. “The light increases the infant‘s metabolism.”
, b. “The light stimulates liver function.”
c. “The light dilates blood vessels.”
d. “The light breaks down bilirubin.”
ANS: D
Severe jaundice can cause kernicterus, an accumulation of bilirubin in the brain tissue, which
can lead to serious brain damage. The light breaks down excess bilirubin so that it can be
excreted.
DIF: Cognitive Level: Application REF: p. 355 OBJ: 14
TOP: Hemolytic Disease of the Newborn
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
6. Parents of a newborn with a unilateral cleft lip are concerned about having the defect repaired.
The nurse explains that a child with a cleft lip usually undergoes surgical repair at which time?
a. Immediately after birth
b. By 3 months of age
c. After 12 months of age
d. Varies in every case
ANS: B
A cleft lip is repaired by 3 months of age when weight gain is established and the infant is
free of infection.
DIF: Cognitive Level: Comprehension REF: p. 343 OBJ: 8
TOP: Cleft Lip KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development
7. What occurrence results from obstruction within the ventricles of the brain or inadequate
reabsorption of cerebrospinal fluid?
a. Meningitis
b. Meningocele
c. Spina bifida occulta
d. Hydrocephalus
