CCPR (19) UPDATED ACTUAL Exam
Questions and CORRECT Answers
A term neonate who was born to an HBsAg positive mother is being discharged three months
after birth following surgery for a cardiac condition. The mother asks when the next Hep b
immunization should be given. The NP should advise that it be given at:
a. four months
b. six months
c. twelve months - CORRECT ANSWER - b. six months
A term, small for gestational age neonate at 4 hours of life is tachypneic, plethoric, lethargic, and
has a blood sugar of 53 mg/dL and a central hematrocrit of 70%. The most likely diagnosis is:
a. hyperviscosity
b. hypocalcemia
c. hypoglycemia - CORRECT ANSWER - a. hyperviscosity
A factor that would result in increased insensible water loss in neonates is:
a. hypothermia
b. phototherapy
c. postmaturity - CORRECT ANSWER - b. phototherapy
A neonate has a flat reddish birthmark with sharply delineated edges on the nape of the neck.
When pressure is applied to the birthmark, there is minimal blanching. This finding is consistent
with:
a. infantile hemangioma
b. nevus simplex
c. port wine stain - CORRECT ANSWER - c. port wine stain
nevus simplex does blanch.
,A neonate is born to a mother with a positive TB test but no signs of active disease. Management
of this neonate should include:
a. initiate medication therapy on mother and infant
b. no special evaluation or therapy
c. separate mother and neonate until status can be confirmed - CORRECT ANSWER - b. no
special evaluation or therapy
The standard of care for neonatal nursing is judged according to the standard of care:
a. locally
b. nationally
c. regionally - CORRECT ANSWER - b. nationally
Which of the following is a contraindication to breastfeeding?
a. maternal hepatitis B
b. maternal HIV
c. maternal HSV - CORRECT ANSWER - b. maternal HIV
A newborn presents at birth with a palpable, distended bladder and poor urinary stream. Based
on these symptoms, which of the following renal defects should be considered?
a. polycystic kidney disease
b. posterior urethral valves
c. ureteropelvic junction obstruction - CORRECT ANSWER - b. posterior urethral valves
A 3 day old neonate has hematuria, decreased urine output, and a platelet count of 60,000. Which
of the following is the most likely diagnosis?
a. renal parenchyma disease
b. renal tubular acidosis
c. renal vein thrombosis - CORRECT ANSWER - c. renal vein thrombosis
,A preterm neonate had a prolonged resuscitation at birth. The infant is still experiencing
respiratory distress and an arterial blood gas reveals the following: pH 7.30, CO2 60, O2 60,
HCO3 24, -2. When interpreting this arterial blood gas, it should be recognized that
a. the metabolic component is abnormal
b. the primary problem is respiratory
c. tissue oxygen supply is inadequate - CORRECT ANSWER - b. the primary problem is
respiratory
When both proximal and distal arm weakness occur it is termed:
a. Erb's palsy
b. Klumpke's palsy
c. Total plexus palsy - CORRECT ANSWER - c. total plexus palsy
A 32 week gestation infant with decreased renal function develops systemic candidiasis. The best
choice of antifungal therapy for this baby is:
a. Amphotericin B lipid complex
b. fluconazole
c. flucytosine - CORRECT ANSWER - a. amphotericin B lipid complex
A 12 hour old male infant appears hypotonic with generalized muscle weakness and absent deep
tendon reflexes. There is no family history of neuromuscular disease. Which of the following
would be the first step in diagnostic evaluation?
a. creatinine phosphokinase (CPK) level
b. electromyography
c. muscle biopsy - CORRECT ANSWER - a. CPK level
A 2 day old male is persistently bleeding 12 hours post circumcision. The cause of this bleeding
is most likely
a. factor VIII deficiency
, b. factor V deficiency
c. poor technique - CORRECT ANSWER - a. factor VIII deficiency
hemophilia
A 780g infant has a bilirubin level of 17 mg/dL at 24 hours of age. The treatment of choice is:
a. exchange transfusion
b. exchange transfusion and phototherapy
c. phototherapy - CORRECT ANSWER - b. exchange transfusion and phototherapy
A 8 hour old neonate is irritable and tremulous. These findings are consistent with withdrawal
from in utero exposure to:
a. cocaine
b. heroin
c. methadone - CORRECT ANSWER - b. heroin --> quickly seen after birth
The x-ray of a neonate with suspected necrotizing enterocolitis shows pneumoperitoneum. This
finding is consistent with
a. air in the portal venous system
b. bowel perforation
c. diffuse gaseous intestinal distention - CORRECT ANSWER - b. bowel perforation
Infants born to mothers with myasthenia gravis
a. are at risk for respiratory failure
b. will have symptoms resolve spontaneously around 6 months of age
c. will present with symptoms within first 12 hours of life - CORRECT ANSWER - a. are at
risk for respiratory failure
give anticholinesterase --> neostigmine methylsulfate
Questions and CORRECT Answers
A term neonate who was born to an HBsAg positive mother is being discharged three months
after birth following surgery for a cardiac condition. The mother asks when the next Hep b
immunization should be given. The NP should advise that it be given at:
a. four months
b. six months
c. twelve months - CORRECT ANSWER - b. six months
A term, small for gestational age neonate at 4 hours of life is tachypneic, plethoric, lethargic, and
has a blood sugar of 53 mg/dL and a central hematrocrit of 70%. The most likely diagnosis is:
a. hyperviscosity
b. hypocalcemia
c. hypoglycemia - CORRECT ANSWER - a. hyperviscosity
A factor that would result in increased insensible water loss in neonates is:
a. hypothermia
b. phototherapy
c. postmaturity - CORRECT ANSWER - b. phototherapy
A neonate has a flat reddish birthmark with sharply delineated edges on the nape of the neck.
When pressure is applied to the birthmark, there is minimal blanching. This finding is consistent
with:
a. infantile hemangioma
b. nevus simplex
c. port wine stain - CORRECT ANSWER - c. port wine stain
nevus simplex does blanch.
,A neonate is born to a mother with a positive TB test but no signs of active disease. Management
of this neonate should include:
a. initiate medication therapy on mother and infant
b. no special evaluation or therapy
c. separate mother and neonate until status can be confirmed - CORRECT ANSWER - b. no
special evaluation or therapy
The standard of care for neonatal nursing is judged according to the standard of care:
a. locally
b. nationally
c. regionally - CORRECT ANSWER - b. nationally
Which of the following is a contraindication to breastfeeding?
a. maternal hepatitis B
b. maternal HIV
c. maternal HSV - CORRECT ANSWER - b. maternal HIV
A newborn presents at birth with a palpable, distended bladder and poor urinary stream. Based
on these symptoms, which of the following renal defects should be considered?
a. polycystic kidney disease
b. posterior urethral valves
c. ureteropelvic junction obstruction - CORRECT ANSWER - b. posterior urethral valves
A 3 day old neonate has hematuria, decreased urine output, and a platelet count of 60,000. Which
of the following is the most likely diagnosis?
a. renal parenchyma disease
b. renal tubular acidosis
c. renal vein thrombosis - CORRECT ANSWER - c. renal vein thrombosis
,A preterm neonate had a prolonged resuscitation at birth. The infant is still experiencing
respiratory distress and an arterial blood gas reveals the following: pH 7.30, CO2 60, O2 60,
HCO3 24, -2. When interpreting this arterial blood gas, it should be recognized that
a. the metabolic component is abnormal
b. the primary problem is respiratory
c. tissue oxygen supply is inadequate - CORRECT ANSWER - b. the primary problem is
respiratory
When both proximal and distal arm weakness occur it is termed:
a. Erb's palsy
b. Klumpke's palsy
c. Total plexus palsy - CORRECT ANSWER - c. total plexus palsy
A 32 week gestation infant with decreased renal function develops systemic candidiasis. The best
choice of antifungal therapy for this baby is:
a. Amphotericin B lipid complex
b. fluconazole
c. flucytosine - CORRECT ANSWER - a. amphotericin B lipid complex
A 12 hour old male infant appears hypotonic with generalized muscle weakness and absent deep
tendon reflexes. There is no family history of neuromuscular disease. Which of the following
would be the first step in diagnostic evaluation?
a. creatinine phosphokinase (CPK) level
b. electromyography
c. muscle biopsy - CORRECT ANSWER - a. CPK level
A 2 day old male is persistently bleeding 12 hours post circumcision. The cause of this bleeding
is most likely
a. factor VIII deficiency
, b. factor V deficiency
c. poor technique - CORRECT ANSWER - a. factor VIII deficiency
hemophilia
A 780g infant has a bilirubin level of 17 mg/dL at 24 hours of age. The treatment of choice is:
a. exchange transfusion
b. exchange transfusion and phototherapy
c. phototherapy - CORRECT ANSWER - b. exchange transfusion and phototherapy
A 8 hour old neonate is irritable and tremulous. These findings are consistent with withdrawal
from in utero exposure to:
a. cocaine
b. heroin
c. methadone - CORRECT ANSWER - b. heroin --> quickly seen after birth
The x-ray of a neonate with suspected necrotizing enterocolitis shows pneumoperitoneum. This
finding is consistent with
a. air in the portal venous system
b. bowel perforation
c. diffuse gaseous intestinal distention - CORRECT ANSWER - b. bowel perforation
Infants born to mothers with myasthenia gravis
a. are at risk for respiratory failure
b. will have symptoms resolve spontaneously around 6 months of age
c. will present with symptoms within first 12 hours of life - CORRECT ANSWER - a. are at
risk for respiratory failure
give anticholinesterase --> neostigmine methylsulfate
