NNP Practice Exam with correct
solutions
Indication of a plugged endotracheal tube is
a. condensation in the endotracheal tube
b. sudden decrease in chest wall movement
c. tachycardia - ** VERIFIED ANSWERS **✔✔b. sudden decrease in chest wall movement
A neonate has a low T4 and elevated TSH. The appropriate next step would be
a. begin thyroid hormone replacement therapy
b. monitor the infant for lethargy, hypotonia and feeding difficulties
c. recheck T4 and TSH levels at two months of age - ** VERIFIED ANSWERS **✔✔a. begin thyroid
hormone replacement therapy
A 32 week gestational age male neonate has a 4 cm nontender mass in the right testicle. Differential
diagnosis can be faciliated by
a. palpation
b. transillumination
c. ultrasound evaluation - ** VERIFIED ANSWERS **✔✔b. transillumination
A neonate who has been in the NICU for two weeks is demonstrating habituation in response to
environmental stimuli. Habituation is best defined as
a. decreasing responsivity to external stimuli
b. increasing attention to a new stimulus
c. reacting vigorously to repeated stimuli - ** VERIFIED ANSWERS **✔✔a. decreasing
responsivity to external stimuli
Which sense becomes the neurodevelopmental interface between the infant and the world at birth?
,a. Auditory
b. Tactile
c. Visual - ** VERIFIED ANSWERS **✔✔b. Tactile
A newborn with respiratory distress has a chest x-ray that reveals unilateral or bilateral streaky
densities and confluent mottled, opacified areas. The nurse should anticipate that initial intervention
should be
a. initiation of antibiotics
b. sepsis workup
c. surfactant administration - ** VERIFIED ANSWERS **✔✔b. sepsis workup
A neonate born to a mother given Demerol three hours prior to delivery is apneic and cyanotic with
heart rate of 74 at one hour after birth. The initial intervention should be
a. administration of naloxone 0.1mg/kg
b. bag and mask ventilation
c. placement of endotracheal tube - ** VERIFIED ANSWERS **✔✔b. bag and mask ventilation
The best recommendation for treatment of intraventricular hemorrhage is
a. management of ensuing problems
b. fluid restriction
c. Dopamine for blood pressure support - ** VERIFIED ANSWERS **✔✔a. management of ensuing
problems
Which congenital heart defect is suspected when a systolic murmur is heard at the location noted on
the diagram?
a. Atrial septal defect
b. Pulmonary valve stenosis
c. Ventricular septal defect - ** VERIFIED ANSWERS **✔✔c. Ventricular septal defect
A two day old neonate has an abdominal mass. The most likely cause is
,a. adrenal hemorrhage
b. polycystic kidney
c. volvulur - ** VERIFIED ANSWERS **✔✔b. polycystic kidney
Nasal septum dislocation can be differentiated from normal variant of a misshapened nose by
performing
a. a compression test
b. sinus transillumination
c. x-ray - ** VERIFIED ANSWERS **✔✔a. a compression test
Orotracheal intubation is preferable to nasotracheal intubation during acute neonatal resuscitation
because
a. a smaller size endotracheal tube can be utilized
b. it can be performed without additional equipment
c. the endotracheal tube is easier to stabilize - ** VERIFIED ANSWERS **✔✔b. it can be performed
without additional equipment
Following a traumatic delivery, a neonate's arm falls motionless along the side of the body and is
rotated inwards. Extension of the forearm is present but there is no limitation on the movement of
the hand. Once localized edema and pain diminished, the neonate should be referred for
a. casting of the affected limb
b. physical therapy
c. surgical repair - ** VERIFIED ANSWERS **✔✔b. physical therapy
On physical examination of a 4100 gm male neonate, a firm scrotal mass is palpated. The next step in
the evaluation is
a. transillumination
b. ultrasound
c. x-ray - ** VERIFIED ANSWERS **✔✔a. transillumination
, The absence of which reflex distinguishes total brachial plexus palsy from Erb's palsy?
a. Grasp
b. Moro
c. Radical - ** VERIFIED ANSWERS **✔✔a. Grasp
A Neuromuscular development characteristic of prematurity includes increased
a. heel to ear resistance
b. hip flexion and adduction
c. popliteal angle - ** VERIFIED ANSWERS **✔✔c. popliteal angle
An infant is noted to have vertebral anomalies, a single umbilical artery, and a tracheoesophageal
fistula. What studies should you consider obtaining?
a. echocardiogram
b. eye exam
c. renal ultrasound - ** VERIFIED ANSWERS **✔✔c. renal ultrasound
The decreased ability of the preterm neonate to produce heat to maintain normal body temperature
is most related to
a. decreased thermal receptors in the skin
b. large surface skin area relative to body mass
c. limited subcutaneous tissue and brown fat stores - ** VERIFIED ANSWERS **✔✔c. limited
subcutaneous tissue and brown fat stores
The nurse should recognize that the auditory sounds of the NICU can compromise a neonate's
neurobehavioral development and that most noise is produced by
a. equipment
b. exogenous sources
c. staff - ** VERIFIED ANSWERS **✔✔c. staff
Pro-coagulation factors II, VII, IX and X are activated by
solutions
Indication of a plugged endotracheal tube is
a. condensation in the endotracheal tube
b. sudden decrease in chest wall movement
c. tachycardia - ** VERIFIED ANSWERS **✔✔b. sudden decrease in chest wall movement
A neonate has a low T4 and elevated TSH. The appropriate next step would be
a. begin thyroid hormone replacement therapy
b. monitor the infant for lethargy, hypotonia and feeding difficulties
c. recheck T4 and TSH levels at two months of age - ** VERIFIED ANSWERS **✔✔a. begin thyroid
hormone replacement therapy
A 32 week gestational age male neonate has a 4 cm nontender mass in the right testicle. Differential
diagnosis can be faciliated by
a. palpation
b. transillumination
c. ultrasound evaluation - ** VERIFIED ANSWERS **✔✔b. transillumination
A neonate who has been in the NICU for two weeks is demonstrating habituation in response to
environmental stimuli. Habituation is best defined as
a. decreasing responsivity to external stimuli
b. increasing attention to a new stimulus
c. reacting vigorously to repeated stimuli - ** VERIFIED ANSWERS **✔✔a. decreasing
responsivity to external stimuli
Which sense becomes the neurodevelopmental interface between the infant and the world at birth?
,a. Auditory
b. Tactile
c. Visual - ** VERIFIED ANSWERS **✔✔b. Tactile
A newborn with respiratory distress has a chest x-ray that reveals unilateral or bilateral streaky
densities and confluent mottled, opacified areas. The nurse should anticipate that initial intervention
should be
a. initiation of antibiotics
b. sepsis workup
c. surfactant administration - ** VERIFIED ANSWERS **✔✔b. sepsis workup
A neonate born to a mother given Demerol three hours prior to delivery is apneic and cyanotic with
heart rate of 74 at one hour after birth. The initial intervention should be
a. administration of naloxone 0.1mg/kg
b. bag and mask ventilation
c. placement of endotracheal tube - ** VERIFIED ANSWERS **✔✔b. bag and mask ventilation
The best recommendation for treatment of intraventricular hemorrhage is
a. management of ensuing problems
b. fluid restriction
c. Dopamine for blood pressure support - ** VERIFIED ANSWERS **✔✔a. management of ensuing
problems
Which congenital heart defect is suspected when a systolic murmur is heard at the location noted on
the diagram?
a. Atrial septal defect
b. Pulmonary valve stenosis
c. Ventricular septal defect - ** VERIFIED ANSWERS **✔✔c. Ventricular septal defect
A two day old neonate has an abdominal mass. The most likely cause is
,a. adrenal hemorrhage
b. polycystic kidney
c. volvulur - ** VERIFIED ANSWERS **✔✔b. polycystic kidney
Nasal septum dislocation can be differentiated from normal variant of a misshapened nose by
performing
a. a compression test
b. sinus transillumination
c. x-ray - ** VERIFIED ANSWERS **✔✔a. a compression test
Orotracheal intubation is preferable to nasotracheal intubation during acute neonatal resuscitation
because
a. a smaller size endotracheal tube can be utilized
b. it can be performed without additional equipment
c. the endotracheal tube is easier to stabilize - ** VERIFIED ANSWERS **✔✔b. it can be performed
without additional equipment
Following a traumatic delivery, a neonate's arm falls motionless along the side of the body and is
rotated inwards. Extension of the forearm is present but there is no limitation on the movement of
the hand. Once localized edema and pain diminished, the neonate should be referred for
a. casting of the affected limb
b. physical therapy
c. surgical repair - ** VERIFIED ANSWERS **✔✔b. physical therapy
On physical examination of a 4100 gm male neonate, a firm scrotal mass is palpated. The next step in
the evaluation is
a. transillumination
b. ultrasound
c. x-ray - ** VERIFIED ANSWERS **✔✔a. transillumination
, The absence of which reflex distinguishes total brachial plexus palsy from Erb's palsy?
a. Grasp
b. Moro
c. Radical - ** VERIFIED ANSWERS **✔✔a. Grasp
A Neuromuscular development characteristic of prematurity includes increased
a. heel to ear resistance
b. hip flexion and adduction
c. popliteal angle - ** VERIFIED ANSWERS **✔✔c. popliteal angle
An infant is noted to have vertebral anomalies, a single umbilical artery, and a tracheoesophageal
fistula. What studies should you consider obtaining?
a. echocardiogram
b. eye exam
c. renal ultrasound - ** VERIFIED ANSWERS **✔✔c. renal ultrasound
The decreased ability of the preterm neonate to produce heat to maintain normal body temperature
is most related to
a. decreased thermal receptors in the skin
b. large surface skin area relative to body mass
c. limited subcutaneous tissue and brown fat stores - ** VERIFIED ANSWERS **✔✔c. limited
subcutaneous tissue and brown fat stores
The nurse should recognize that the auditory sounds of the NICU can compromise a neonate's
neurobehavioral development and that most noise is produced by
a. equipment
b. exogenous sources
c. staff - ** VERIFIED ANSWERS **✔✔c. staff
Pro-coagulation factors II, VII, IX and X are activated by
