the neonate Questions With Complete Solutions
.The nurse prepares to obtain a neonatal screening test for
phenylketonuria (PKU). The nurse understands that the neonate
must have been fed what to ensure reliable results?
iron-rich formula
initial formula or breast milk at least 24 hours before the test
nothing by mouth for 4 hours before the test
glucose water Correct Answer initial formula or breast milk at
least 24 hours before the test
Explanation:
PKU is an autosomal recessive disorder involving the absence of
an enzyme needed to metabolize the essential amino acid
phenylalanine to tyrosine. To ensure reliable results, the neonate
must have ingested sufficient protein, such as breast milk or
formula, for at least 24 hours. Testing the infant before that time,
excessive vomiting, or poor intake can yield false-negative
results. The infant does not need to fast 4 hours before the test.
A loading dose of glucose water does not affect test values.
A 29-week gestation client arrives in the labor and birth suite for
an emergency cesarean section. The neonate is born and
artificial surfactant is administered. Which action best explains
the main function and goal of surfactant use?
promotes mucous production lubricating the respiratory tract
helps maintain a rhythmic breathing pattern reducing tachypnea
helps lungs remain expanded after the initiation of breathing
improving oxygenation
,assists with ciliary body maturation in the upper airways
eliminating mucous Correct Answer helps lungs remain
expanded after the initiation of breathing improving oxygenation
Explanation:
Surfactant works by reducing surface tension in the lung. It
allows the lung to remain slightly expanded, decreasing the
amount of work required for inspiration. Improved oxygenation,
as determined by arterial blood gases, is noted. Surfactant has
not been shown to influence ciliary body maturation, regulate
the neonate's breathing pattern, or lubricate the respiratory tract.
A client gives birth to a neonate prematurely at 28 weeks'
gestation. The neonate's Apgar score is 5 at 1 minute. What is
the nurse's most important intervention for this premature
neonate?
Assess the vital signs.
Stimulate the neonate to cry.
Warm the neonate.
Administer oxygen. Correct Answer Administer oxygen.
Explanation:
The preterm neonate lacks surfactant. Surfactant lowers the
surface tension in the alveoli and stabilizes them to prevent their
collapse. Even if the premature neonate can initiate respirations,
there is limited ability to retain air due to insufficient surfactant.
This leads to hypoxemia and hypoxia. Therefore, it is most
essential for the nurse to make sure the head is in the sniff
position and oxygen is administered. The neonate should be
evaluated for respiratory distress and poor respiratory effort. In
most premature births, a neonatologist or pediatrician is in the
delivery room. The premature neonate born at 28 weeks'
,gestation would most likely be intubated and ventilated shortly
after birth, but oxygen needs to continue to be delivered until
intubation occurs. The neonate also needs to be kept warm
because cold stress leads to respiratory distress. A premature
neonate born at 28 weeks' gestation would automatically have
poor tone and reflexes from the premature development; this is a
neonate who should not be stimulated. The vital signs are
important, but they are not as important as initiating and
maintaining respirations.
A client is concerned that her 2-day-old, breast-feeding neonate
isn't getting enough to eat. The nurse should teach the client that
breast-feeding is effective if:
the neonate loses 10% to 15% of the birth weight within the first
2 days after birth.
the neonate latches onto the areola and swallows audibly.
the neonate voids once or twice every 24 hours.
the neonate breast-feeds four times in 24 hours. Correct Answer
the neonate latches onto the areola and swallows audibly.
Explanation:
Breast-feeding is effective if the infant latches onto the mother's
areola properly and if swallowing is audible. A breast-feeding
neonate should void at least 6 to 8 times per day and should
breast-feed every 2 to 3 hours. Over the first few days after
birth, an acceptable weight loss is 5% to 10% of the birth
weight.
A client who used heroin during her pregnancy gives birth to a
neonate. When assessing the neonate, the nurse expects to find
lethargy 2 days after birth.
a flattened nose, small eyes, and thin lips.
, congenital defects such as limb anomalies.
irritability and poor sucking. Correct Answer irritability and
poor sucking.
Explanation:
Neonates of heroin-addicted mothers are physically dependent
on the drug and experience withdrawal when the drug is no
longer supplied. Signs of heroin withdrawal include irritability,
poor sucking, and restlessness. Lethargy isn't associated with
neonatal heroin addiction. A flattened nose, small eyes, and thin
lips are seen in neonates with fetal alcohol syndrome. Heroin
use during pregnancy hasn't been linked to specific congenital
anomalies.
A client with a history of drug abuse gives birth to a low-birth-
weight neonate who is experiencing drug withdrawal. Which
intervention is helpful for this neonate?
Dress the neonate in loose-fitting clothing.
Place the isolette close to the nurse's station.
Withhold medications until liver function improves.
Place the isolette in a quiet area of the nursery. Correct Answer
Place the isolette in a quiet area of the nursery.
Explanation:
The neonate experiencing drug withdrawal should be placed in a
quiet area of the nursery to minimize stimuli; the nurses' station
is typically not a quiet area. The neonate should be swaddled to
prevent him from stimulating himself with movement.
Medications should be administered as needed.
A family has taken home their newborn and later received a call
from the child's health care provider (HCP) that the
phenylketonuria (PKU) levels for their newborn daughter are
.The nurse prepares to obtain a neonatal screening test for
phenylketonuria (PKU). The nurse understands that the neonate
must have been fed what to ensure reliable results?
iron-rich formula
initial formula or breast milk at least 24 hours before the test
nothing by mouth for 4 hours before the test
glucose water Correct Answer initial formula or breast milk at
least 24 hours before the test
Explanation:
PKU is an autosomal recessive disorder involving the absence of
an enzyme needed to metabolize the essential amino acid
phenylalanine to tyrosine. To ensure reliable results, the neonate
must have ingested sufficient protein, such as breast milk or
formula, for at least 24 hours. Testing the infant before that time,
excessive vomiting, or poor intake can yield false-negative
results. The infant does not need to fast 4 hours before the test.
A loading dose of glucose water does not affect test values.
A 29-week gestation client arrives in the labor and birth suite for
an emergency cesarean section. The neonate is born and
artificial surfactant is administered. Which action best explains
the main function and goal of surfactant use?
promotes mucous production lubricating the respiratory tract
helps maintain a rhythmic breathing pattern reducing tachypnea
helps lungs remain expanded after the initiation of breathing
improving oxygenation
,assists with ciliary body maturation in the upper airways
eliminating mucous Correct Answer helps lungs remain
expanded after the initiation of breathing improving oxygenation
Explanation:
Surfactant works by reducing surface tension in the lung. It
allows the lung to remain slightly expanded, decreasing the
amount of work required for inspiration. Improved oxygenation,
as determined by arterial blood gases, is noted. Surfactant has
not been shown to influence ciliary body maturation, regulate
the neonate's breathing pattern, or lubricate the respiratory tract.
A client gives birth to a neonate prematurely at 28 weeks'
gestation. The neonate's Apgar score is 5 at 1 minute. What is
the nurse's most important intervention for this premature
neonate?
Assess the vital signs.
Stimulate the neonate to cry.
Warm the neonate.
Administer oxygen. Correct Answer Administer oxygen.
Explanation:
The preterm neonate lacks surfactant. Surfactant lowers the
surface tension in the alveoli and stabilizes them to prevent their
collapse. Even if the premature neonate can initiate respirations,
there is limited ability to retain air due to insufficient surfactant.
This leads to hypoxemia and hypoxia. Therefore, it is most
essential for the nurse to make sure the head is in the sniff
position and oxygen is administered. The neonate should be
evaluated for respiratory distress and poor respiratory effort. In
most premature births, a neonatologist or pediatrician is in the
delivery room. The premature neonate born at 28 weeks'
,gestation would most likely be intubated and ventilated shortly
after birth, but oxygen needs to continue to be delivered until
intubation occurs. The neonate also needs to be kept warm
because cold stress leads to respiratory distress. A premature
neonate born at 28 weeks' gestation would automatically have
poor tone and reflexes from the premature development; this is a
neonate who should not be stimulated. The vital signs are
important, but they are not as important as initiating and
maintaining respirations.
A client is concerned that her 2-day-old, breast-feeding neonate
isn't getting enough to eat. The nurse should teach the client that
breast-feeding is effective if:
the neonate loses 10% to 15% of the birth weight within the first
2 days after birth.
the neonate latches onto the areola and swallows audibly.
the neonate voids once or twice every 24 hours.
the neonate breast-feeds four times in 24 hours. Correct Answer
the neonate latches onto the areola and swallows audibly.
Explanation:
Breast-feeding is effective if the infant latches onto the mother's
areola properly and if swallowing is audible. A breast-feeding
neonate should void at least 6 to 8 times per day and should
breast-feed every 2 to 3 hours. Over the first few days after
birth, an acceptable weight loss is 5% to 10% of the birth
weight.
A client who used heroin during her pregnancy gives birth to a
neonate. When assessing the neonate, the nurse expects to find
lethargy 2 days after birth.
a flattened nose, small eyes, and thin lips.
, congenital defects such as limb anomalies.
irritability and poor sucking. Correct Answer irritability and
poor sucking.
Explanation:
Neonates of heroin-addicted mothers are physically dependent
on the drug and experience withdrawal when the drug is no
longer supplied. Signs of heroin withdrawal include irritability,
poor sucking, and restlessness. Lethargy isn't associated with
neonatal heroin addiction. A flattened nose, small eyes, and thin
lips are seen in neonates with fetal alcohol syndrome. Heroin
use during pregnancy hasn't been linked to specific congenital
anomalies.
A client with a history of drug abuse gives birth to a low-birth-
weight neonate who is experiencing drug withdrawal. Which
intervention is helpful for this neonate?
Dress the neonate in loose-fitting clothing.
Place the isolette close to the nurse's station.
Withhold medications until liver function improves.
Place the isolette in a quiet area of the nursery. Correct Answer
Place the isolette in a quiet area of the nursery.
Explanation:
The neonate experiencing drug withdrawal should be placed in a
quiet area of the nursery to minimize stimuli; the nurses' station
is typically not a quiet area. The neonate should be swaddled to
prevent him from stimulating himself with movement.
Medications should be administered as needed.
A family has taken home their newborn and later received a call
from the child's health care provider (HCP) that the
phenylketonuria (PKU) levels for their newborn daughter are
