NGN HESI 2025/2026 With Complete Questions And
Correct Detailed Answers (Verified Answers) |Already
Graded A+||Brand New Version!!
NGN: (Nurses Notes)
1800: The client is a female neonate born at 37 weeks of gestation to a G 2 P 1
mother, who was diagnosed with gestational diabetes. Following a spontaneous
vaginal birth, she received Apgar scores of seven at one minute and eight at five
minutes. The client weighs 4036.97g (8lbs 9oz) and appears pink with
acrocyanosis and a moderate amount of subcutaneous fat. She is noted to be
slightly jittery at 30min of age. Axillary temperature 96F, pulse 140, RR 80. Blood
glucose 35, Billy Rubin seven, fontanelles soft, mongolian spot noted on lower
back, Ballard maturity rating 37 weeks. (For each assessment finding, click to
indicate whether the findings are associated with an infant of a diabetic mother or
normal presentation.)
Soft Fontanelles
Blood Glucose 35
Axillary temp. 96F
Acrocyanosis
Ballard score maturity rating 37term-0
Soft Fontanelles:This is a normal finding in the newborn. Soft fontanelles indicate that
the cranial sutures and fontanelles are not tense, which is a healthy and expected
finding in neonates.Classification: Normal
Blood Glucose 35:A blood glucose level of 35 mg/dL is lower than the expected range
for a newborn and is a classic finding in infants of diabetic mothers. Maternal
hyperglycemia leads to fetal hyperinsulinemia and subsequent neonatal hypoglycemia
shortly after birth.Classification: Infant of a diabetic mother
Axillary Temperature 96°F:An axillary temperature of 96°F is below the normal range
for neonates and indicates hypothermia. Infants of diabetic mothers are at risk for
temperature instability, in part because of metabolic disturbances (including
hypoglycemia) that they experience after birth.Classification: Infant of a diabetic
mother
Acrocyanosis:Acrocyanosis—color changes in the hands and feet—is a common and
normal finding in newborns, reflecting the normal transition in circulation after birth. It is
not specifically associated with being an infant of a diabetic
mother.Classification: Normal
Ballard Maturity Rating 37 (weeks):A Ballard score that indicates a maturity of 37
weeks is consistent with a near-term or early-term newborn. This is a normal finding and
confirms that the infant’s physical and neuromuscular maturity matches the gestational
age expected at birth.Classification: Normal
Summary
Infant of a Diabetic Mother:• Blood Glucose 35• Axillary Temperature 96°F
Normal Newborn Presentation:• Soft Fontanelles• Acrocyanosis• Ballard Maturity
Rating 37 weeks
,NGN: (Nurses Notes)
1800: The client is a female neonate born at 37 weeks of gestation to a G 2 P 1
mother, who was diagnosed with gestational diabetes. Following a spontaneous
vaginal birth, she received Apgar scores of seven at one minute and eight at five
minutes. The client weighs 4036.97g (8lbs 9oz) and appears pink with
acrocyanosis and a moderate amount of subcutaneous fat. She is noted to be
slightly jittery at 30min of age. Axillary temperature 96F, pulse 140, RR 80. Blood
glucose 35, Billy Rubin seven, fontanelles soft, mongolian spot noted on lower
back, Ballard maturity rating 37 weeks.
The nurse recognizes that the infant of a diabetic mother is at risk for _________ ,
_____________ , and _________________
Hyperbilirubinemia, Respiratory Distress Syndrome and Cardiomyopathy
✅ Hyperbilirubinemia
Due to polycythemia (increased RBCs caused by chronic intrauterine hypoxia).
When these excess RBCs break down, bilirubin levels rise, increasing the risk for
jaundice.
✅ Respiratory Distress Syndrome (RDS)
High fetal insulin levels can inhibit surfactant production, which is essential for lung
maturity.
This puts the infant at greater risk for atelectasis and respiratory difficulties after birth.
✅ Cardiomyopathy
Most commonly hypertrophic cardiomyopathy, where the heart muscle (especially
the interventricular septum) becomes thickened.
This is due to fetal hyperinsulinemia acting like a growth hormone.
It can lead to decreased cardiac output and even heart failure in severe cases.
NGN: Orders
Breast-feed immediately once stable then on demand. If unstable, may feed
breastmilk via orogastric tube. If two feeding attempts failed to increase the
glucose levels or if symptoms of hypoglycemia develop, apply dextrose gel
inside the babies cheek. If the above are ineffective, IV glucose should be
administered to maintain glucose levels above 45. Bolus of 2mL/kg glucose 10%
IV, hello by a continuous glucose perfusion of 6 to 8mg/kg/min, maintain
glycemic levels over 40.
Which 6 orders take priority?
A) Feed Immediately
B) Monitor for respiratory distress
C) Apply dextrose gell inside the baby's cheek
D) Keep in warmer with bilirubin lights
E) Monitor temp every 30 min
F) Bolus 2 mL/kg glucose 10% IV
G) Contact RT for ABG and oxygen therapy
H) Echo
I) Transfer to NICU
J) Blood glucose level
,A) Feed Immedicately
B) Monitor for Respiratory Distress
C) Apply Dextrose Gel Inside the Baby's Cheek
E) Monitor temp q30min
F) Bolus 2 mL/kg Glucose 10% IV
J) Blood glucose level
A) Feed Immediately:If the infant is stable, the first line of management is to initiate
breastfeeding (or administer expressed breast milk via orogastric tube if unstable) to
provide an immediate source of glucose.
B) Monitor for Respiratory Distress:Continuous assessment of the infant’s respiratory
status is crucial as hypoglycemia can be associated with systemic instability, including
respiratory compromise.
C) Apply Dextrose Gel Inside the Baby's Cheek:If two feeding attempts do not
improve the blood glucose levels or symptoms of hypoglycemia develop, dextrose gel is
the next step before advancing to intravenous therapy.
E) Monitor Temperature Every 30 Minutes:Maintaining thermal regulation is important
in the neonatal period as temperature instability can exacerbate metabolic issues,
including hypoglycemia.
F) Bolus 2 mL/kg Glucose 10% IV:Should feeding and dextrose gel be ineffective, the
next priority is to administer intravenous glucose (beginning with a bolus) to rapidly
correct hypoglycemia.
J) Blood Glucose Level:Checking the blood glucose level is essential. It establishes a
baseline and helps determine whether the infant is truly hypoglycemic and if further
interventions are required.
NGN Laboratory Results (same case of patient who just gave birth)
Which actions are appropriate for the nurse to take at this time? SATA
A) Keep infant in warmer with bili lights to maintain temp of 97.6F
B) Monitor Temp
C) Continue to monitor glucose level
D) Tell the mother that she will need to discuss this with the neonatologist
E) Explain to the mother that the baby's RR needs to be below 60
F) Inform the mother that the baby is stable enough to take out of the warmer
G) Observe for signs of respiratory distress and monitor O2 with pulse ox
B) Monitor Temp
C) Continue to monitor glucose level
G) Observe for signs of respiratory distress and monitor O2 with pulse
B) Monitor Temp Maintaining thermal stability is essential. The neonatal temperature is
labile and can affect metabolic functions. Close monitoring is needed to determine if
interventions (such as warming) continue to be required.
C) Continue to monitor glucose levelGiven that the infant had a low blood glucose
(35 mg/dL) initially, it is important to continue checking glucose levels. Hypoglycemia
can have serious consequences if not corrected and monitored closely, especially in
infants at risk (e.g., infants of diabetic mothers).
G) Observe for signs of respiratory distress and monitor O2 with pulse oxThe
infant’s respiratory rate was noted to be 80 breaths per minute, which is above the
typical range (40–60 breaths per minute). This, combined with the possibility of other
, symptoms of distress, makes ongoing assessment of respiratory status, including
oxygen saturation, crucial.
NGN: (The day shift nurse reviews the nurses notes, labs, and flow sheet from the
night before. The nurse plans on providing health teaching for the client and her
family in preparation for discharge.)
For each teaching point, click to indicate whether it is indicated or
contraindicated. Only one right option per row.
A.) "You will need to keep track of how many times your baby wets the diaper and
how many stools to determine the effectiveness of breastfeeding"
B.) "You will need to abstain from sexual activities until you see your
obstetrician"
C.) "Contact the pediatrician if the baby is not breastfeeding well or has few wet
diapers and stools"
A) Indicated
B) Indicated
C) Indicated
ou will need to keep track of how many times your baby wets diapers and has
stools to determine the effectiveness of breastfeeding.”
Indicated
Tracking wet diapers and stools is a standard, important method to assess adequate
breastfeeding and hydration in a newborn.
Normal output: 6–8 wet diapers and at least 3 stools/day by day 4–5 of life.
You will need to abstain from sexual activities until you see your obstetrician.”
Indicated
It's recommended to wait for the postpartum checkup (typically around 6 weeks)
before resuming sexual activity to allow healing of the perineum, lochia cessation, and
reduce risk of infection
“Contact the pediatrician if the baby is not breastfeeding well or has few wet
diapers and stools.”
Indicated
These can be signs of dehydration, poor feeding, or other underlying issues.
Prompt pediatric evaluation is critical.
NGN: 1800:
(Click to highlight notes that demonstrate a positive outcome)
Day 2, 0630: Vitals have remained stable throughout the night. oxygen 98% on
0.25 L per/minute oxygen via nasal cannula. Mother to breastfeed in nursery on
demand. Able to tolerate breast milk. Glucose after feeding was 60 mg/dL (3.3
mmol/L), temp 97.8° F (36.6° C) axillary when returned to warmer and bilirubin
light. Chest x-ray and echocardiogram results were normal. Calcium and
magnesium within normal limits. Direct bilirubin 5 mg/dL (5 micromol/L).
Discharge teaching indicated with goal of discharging infant and mother on day
3.
“Vitals have remained stable throughout the night“
"Oxygen 98% on nasal canal.”
Correct Detailed Answers (Verified Answers) |Already
Graded A+||Brand New Version!!
NGN: (Nurses Notes)
1800: The client is a female neonate born at 37 weeks of gestation to a G 2 P 1
mother, who was diagnosed with gestational diabetes. Following a spontaneous
vaginal birth, she received Apgar scores of seven at one minute and eight at five
minutes. The client weighs 4036.97g (8lbs 9oz) and appears pink with
acrocyanosis and a moderate amount of subcutaneous fat. She is noted to be
slightly jittery at 30min of age. Axillary temperature 96F, pulse 140, RR 80. Blood
glucose 35, Billy Rubin seven, fontanelles soft, mongolian spot noted on lower
back, Ballard maturity rating 37 weeks. (For each assessment finding, click to
indicate whether the findings are associated with an infant of a diabetic mother or
normal presentation.)
Soft Fontanelles
Blood Glucose 35
Axillary temp. 96F
Acrocyanosis
Ballard score maturity rating 37term-0
Soft Fontanelles:This is a normal finding in the newborn. Soft fontanelles indicate that
the cranial sutures and fontanelles are not tense, which is a healthy and expected
finding in neonates.Classification: Normal
Blood Glucose 35:A blood glucose level of 35 mg/dL is lower than the expected range
for a newborn and is a classic finding in infants of diabetic mothers. Maternal
hyperglycemia leads to fetal hyperinsulinemia and subsequent neonatal hypoglycemia
shortly after birth.Classification: Infant of a diabetic mother
Axillary Temperature 96°F:An axillary temperature of 96°F is below the normal range
for neonates and indicates hypothermia. Infants of diabetic mothers are at risk for
temperature instability, in part because of metabolic disturbances (including
hypoglycemia) that they experience after birth.Classification: Infant of a diabetic
mother
Acrocyanosis:Acrocyanosis—color changes in the hands and feet—is a common and
normal finding in newborns, reflecting the normal transition in circulation after birth. It is
not specifically associated with being an infant of a diabetic
mother.Classification: Normal
Ballard Maturity Rating 37 (weeks):A Ballard score that indicates a maturity of 37
weeks is consistent with a near-term or early-term newborn. This is a normal finding and
confirms that the infant’s physical and neuromuscular maturity matches the gestational
age expected at birth.Classification: Normal
Summary
Infant of a Diabetic Mother:• Blood Glucose 35• Axillary Temperature 96°F
Normal Newborn Presentation:• Soft Fontanelles• Acrocyanosis• Ballard Maturity
Rating 37 weeks
,NGN: (Nurses Notes)
1800: The client is a female neonate born at 37 weeks of gestation to a G 2 P 1
mother, who was diagnosed with gestational diabetes. Following a spontaneous
vaginal birth, she received Apgar scores of seven at one minute and eight at five
minutes. The client weighs 4036.97g (8lbs 9oz) and appears pink with
acrocyanosis and a moderate amount of subcutaneous fat. She is noted to be
slightly jittery at 30min of age. Axillary temperature 96F, pulse 140, RR 80. Blood
glucose 35, Billy Rubin seven, fontanelles soft, mongolian spot noted on lower
back, Ballard maturity rating 37 weeks.
The nurse recognizes that the infant of a diabetic mother is at risk for _________ ,
_____________ , and _________________
Hyperbilirubinemia, Respiratory Distress Syndrome and Cardiomyopathy
✅ Hyperbilirubinemia
Due to polycythemia (increased RBCs caused by chronic intrauterine hypoxia).
When these excess RBCs break down, bilirubin levels rise, increasing the risk for
jaundice.
✅ Respiratory Distress Syndrome (RDS)
High fetal insulin levels can inhibit surfactant production, which is essential for lung
maturity.
This puts the infant at greater risk for atelectasis and respiratory difficulties after birth.
✅ Cardiomyopathy
Most commonly hypertrophic cardiomyopathy, where the heart muscle (especially
the interventricular septum) becomes thickened.
This is due to fetal hyperinsulinemia acting like a growth hormone.
It can lead to decreased cardiac output and even heart failure in severe cases.
NGN: Orders
Breast-feed immediately once stable then on demand. If unstable, may feed
breastmilk via orogastric tube. If two feeding attempts failed to increase the
glucose levels or if symptoms of hypoglycemia develop, apply dextrose gel
inside the babies cheek. If the above are ineffective, IV glucose should be
administered to maintain glucose levels above 45. Bolus of 2mL/kg glucose 10%
IV, hello by a continuous glucose perfusion of 6 to 8mg/kg/min, maintain
glycemic levels over 40.
Which 6 orders take priority?
A) Feed Immediately
B) Monitor for respiratory distress
C) Apply dextrose gell inside the baby's cheek
D) Keep in warmer with bilirubin lights
E) Monitor temp every 30 min
F) Bolus 2 mL/kg glucose 10% IV
G) Contact RT for ABG and oxygen therapy
H) Echo
I) Transfer to NICU
J) Blood glucose level
,A) Feed Immedicately
B) Monitor for Respiratory Distress
C) Apply Dextrose Gel Inside the Baby's Cheek
E) Monitor temp q30min
F) Bolus 2 mL/kg Glucose 10% IV
J) Blood glucose level
A) Feed Immediately:If the infant is stable, the first line of management is to initiate
breastfeeding (or administer expressed breast milk via orogastric tube if unstable) to
provide an immediate source of glucose.
B) Monitor for Respiratory Distress:Continuous assessment of the infant’s respiratory
status is crucial as hypoglycemia can be associated with systemic instability, including
respiratory compromise.
C) Apply Dextrose Gel Inside the Baby's Cheek:If two feeding attempts do not
improve the blood glucose levels or symptoms of hypoglycemia develop, dextrose gel is
the next step before advancing to intravenous therapy.
E) Monitor Temperature Every 30 Minutes:Maintaining thermal regulation is important
in the neonatal period as temperature instability can exacerbate metabolic issues,
including hypoglycemia.
F) Bolus 2 mL/kg Glucose 10% IV:Should feeding and dextrose gel be ineffective, the
next priority is to administer intravenous glucose (beginning with a bolus) to rapidly
correct hypoglycemia.
J) Blood Glucose Level:Checking the blood glucose level is essential. It establishes a
baseline and helps determine whether the infant is truly hypoglycemic and if further
interventions are required.
NGN Laboratory Results (same case of patient who just gave birth)
Which actions are appropriate for the nurse to take at this time? SATA
A) Keep infant in warmer with bili lights to maintain temp of 97.6F
B) Monitor Temp
C) Continue to monitor glucose level
D) Tell the mother that she will need to discuss this with the neonatologist
E) Explain to the mother that the baby's RR needs to be below 60
F) Inform the mother that the baby is stable enough to take out of the warmer
G) Observe for signs of respiratory distress and monitor O2 with pulse ox
B) Monitor Temp
C) Continue to monitor glucose level
G) Observe for signs of respiratory distress and monitor O2 with pulse
B) Monitor Temp Maintaining thermal stability is essential. The neonatal temperature is
labile and can affect metabolic functions. Close monitoring is needed to determine if
interventions (such as warming) continue to be required.
C) Continue to monitor glucose levelGiven that the infant had a low blood glucose
(35 mg/dL) initially, it is important to continue checking glucose levels. Hypoglycemia
can have serious consequences if not corrected and monitored closely, especially in
infants at risk (e.g., infants of diabetic mothers).
G) Observe for signs of respiratory distress and monitor O2 with pulse oxThe
infant’s respiratory rate was noted to be 80 breaths per minute, which is above the
typical range (40–60 breaths per minute). This, combined with the possibility of other
, symptoms of distress, makes ongoing assessment of respiratory status, including
oxygen saturation, crucial.
NGN: (The day shift nurse reviews the nurses notes, labs, and flow sheet from the
night before. The nurse plans on providing health teaching for the client and her
family in preparation for discharge.)
For each teaching point, click to indicate whether it is indicated or
contraindicated. Only one right option per row.
A.) "You will need to keep track of how many times your baby wets the diaper and
how many stools to determine the effectiveness of breastfeeding"
B.) "You will need to abstain from sexual activities until you see your
obstetrician"
C.) "Contact the pediatrician if the baby is not breastfeeding well or has few wet
diapers and stools"
A) Indicated
B) Indicated
C) Indicated
ou will need to keep track of how many times your baby wets diapers and has
stools to determine the effectiveness of breastfeeding.”
Indicated
Tracking wet diapers and stools is a standard, important method to assess adequate
breastfeeding and hydration in a newborn.
Normal output: 6–8 wet diapers and at least 3 stools/day by day 4–5 of life.
You will need to abstain from sexual activities until you see your obstetrician.”
Indicated
It's recommended to wait for the postpartum checkup (typically around 6 weeks)
before resuming sexual activity to allow healing of the perineum, lochia cessation, and
reduce risk of infection
“Contact the pediatrician if the baby is not breastfeeding well or has few wet
diapers and stools.”
Indicated
These can be signs of dehydration, poor feeding, or other underlying issues.
Prompt pediatric evaluation is critical.
NGN: 1800:
(Click to highlight notes that demonstrate a positive outcome)
Day 2, 0630: Vitals have remained stable throughout the night. oxygen 98% on
0.25 L per/minute oxygen via nasal cannula. Mother to breastfeed in nursery on
demand. Able to tolerate breast milk. Glucose after feeding was 60 mg/dL (3.3
mmol/L), temp 97.8° F (36.6° C) axillary when returned to warmer and bilirubin
light. Chest x-ray and echocardiogram results were normal. Calcium and
magnesium within normal limits. Direct bilirubin 5 mg/dL (5 micromol/L).
Discharge teaching indicated with goal of discharging infant and mother on day
3.
“Vitals have remained stable throughout the night“
"Oxygen 98% on nasal canal.”
