Chapter 30: The High-Risk Newborn:
Acquired and Congenital Conditions
McKinney: Evolve Resources for
Maternal-Child Nursing, 5th Edition
Test Bank Questions with Quality
Answers 2025\2026 Version.
The infant of a mother with diabetes is hypoglycemic. What type of feeding should be instituted
first?
a. Glucose water in a bottle
b. D5W intravenously
c. Formula via nasogastric tube
d. Breast milk - Answer ANS: D
Breast milk is metabolized more slowly and provides longer normal glucose levels. Breast milk is
best for nearly all babies. High levels of dextrose correct the hypoglycemia but will stimulate the
production of more insulin. Oral feedings are tried first; intravenous lines should be a later
choice if the hypoglycemia continues. Formula does provide longer normal glucose levels but
would be administered via bottle, not by tube feeding unless the baby is unable to take oral
feedings.
The nurse learns that the most common cause of pathologic hyperbilirubinemia is which of the
following?
a. Hepatic disease
b. Hemolytic disorders in the newborn
c. Postmaturity
d. Congenital heart defect - Answer ANS: B
Hemolytic disorders in the newborn are the most common cause of pathologic jaundice.
Hepatic damage and prematurity may be causes of pathologic hyperbilirubinemia, but they are
not the most common cause. Congenital heart defect is not a common cause of pathologic
hyperbilirubinemia in neonates.
An infant with severe meconium aspiration syndrome (MAS) is not responding to conventional
treatment. Which treatment may be necessary for this infant?
a. Extracorporeal membrane oxygenation
, Extracorporeal membrane oxygenation is a highly technical method that oxygenates the blood
while bypassing the lungs, allowing the infant's lungs to rest and recover. The infant is most
likely intubated and on a ventilator already. Laryngoscope insertion and tracheal suctioning are
performed after birth before the infant takes the first breath.
Four hours after delivery of a healthy neonate of an insulin-dependent diabetic woman, the
baby appears jittery, irritable, and has a high-pitched cry. Which nursing action has top priority?
a. Start an intravenous line with D5W.
b. Notify the clinician stat.
c. Document the event in the nurses' notes.
d. Test for blood glucose level. - Answer ANS: D
These are signs of hypoglycemia in the newborn. The nurse should test the infant's blood
glucose level and then feed the infant if it is low. It is not common practice to give intravenous
glucose to a newborn prior to feeding. Feeding the infant is preferable because the formula or
breast milk will last longer. The provider needs to be notified after corrective action has been
taken. Documentation should occur but is not the priority.
A nurse is participating in a neonatal resuscitation. What action by the nurse takes priority?
a. Suction the mouth and nose.
b. Stimulate the infant by rubbing the back.
c. Perform the Apgar test.
d. Place the infant in a preheated warmer. - Answer ANS: D
In a resuscitation situation, the nurse places the newborn in a preheated warmer immediately
to reduce cold stress. Next position the infant in a "sniffing" position. Suctioning is the third
step. Drying the infant is fourth, although if more than one health care provider is present,
drying can occur simultaneously with the other actions.
A neonate has white patches in her mouth that bled when the mother tried wiping them away.
What action by the nurse is best?
a. Tell the mother to leave the patches alone.
b. Assess the mother for a perineal rash.
c. Give the infant medicated pacifiers.
d. Test the infant for toxoplasmosis. - Answer ANS: B
These patches are characteristic of maternal infection with candidiasis or yeast. The nurse
assesses the mother's perineal area for a rash. Telling the mother to leave the rash alone may
be appropriate information but does not get to the bottom of the issue. The nurse should not
Acquired and Congenital Conditions
McKinney: Evolve Resources for
Maternal-Child Nursing, 5th Edition
Test Bank Questions with Quality
Answers 2025\2026 Version.
The infant of a mother with diabetes is hypoglycemic. What type of feeding should be instituted
first?
a. Glucose water in a bottle
b. D5W intravenously
c. Formula via nasogastric tube
d. Breast milk - Answer ANS: D
Breast milk is metabolized more slowly and provides longer normal glucose levels. Breast milk is
best for nearly all babies. High levels of dextrose correct the hypoglycemia but will stimulate the
production of more insulin. Oral feedings are tried first; intravenous lines should be a later
choice if the hypoglycemia continues. Formula does provide longer normal glucose levels but
would be administered via bottle, not by tube feeding unless the baby is unable to take oral
feedings.
The nurse learns that the most common cause of pathologic hyperbilirubinemia is which of the
following?
a. Hepatic disease
b. Hemolytic disorders in the newborn
c. Postmaturity
d. Congenital heart defect - Answer ANS: B
Hemolytic disorders in the newborn are the most common cause of pathologic jaundice.
Hepatic damage and prematurity may be causes of pathologic hyperbilirubinemia, but they are
not the most common cause. Congenital heart defect is not a common cause of pathologic
hyperbilirubinemia in neonates.
An infant with severe meconium aspiration syndrome (MAS) is not responding to conventional
treatment. Which treatment may be necessary for this infant?
a. Extracorporeal membrane oxygenation
, Extracorporeal membrane oxygenation is a highly technical method that oxygenates the blood
while bypassing the lungs, allowing the infant's lungs to rest and recover. The infant is most
likely intubated and on a ventilator already. Laryngoscope insertion and tracheal suctioning are
performed after birth before the infant takes the first breath.
Four hours after delivery of a healthy neonate of an insulin-dependent diabetic woman, the
baby appears jittery, irritable, and has a high-pitched cry. Which nursing action has top priority?
a. Start an intravenous line with D5W.
b. Notify the clinician stat.
c. Document the event in the nurses' notes.
d. Test for blood glucose level. - Answer ANS: D
These are signs of hypoglycemia in the newborn. The nurse should test the infant's blood
glucose level and then feed the infant if it is low. It is not common practice to give intravenous
glucose to a newborn prior to feeding. Feeding the infant is preferable because the formula or
breast milk will last longer. The provider needs to be notified after corrective action has been
taken. Documentation should occur but is not the priority.
A nurse is participating in a neonatal resuscitation. What action by the nurse takes priority?
a. Suction the mouth and nose.
b. Stimulate the infant by rubbing the back.
c. Perform the Apgar test.
d. Place the infant in a preheated warmer. - Answer ANS: D
In a resuscitation situation, the nurse places the newborn in a preheated warmer immediately
to reduce cold stress. Next position the infant in a "sniffing" position. Suctioning is the third
step. Drying the infant is fourth, although if more than one health care provider is present,
drying can occur simultaneously with the other actions.
A neonate has white patches in her mouth that bled when the mother tried wiping them away.
What action by the nurse is best?
a. Tell the mother to leave the patches alone.
b. Assess the mother for a perineal rash.
c. Give the infant medicated pacifiers.
d. Test the infant for toxoplasmosis. - Answer ANS: B
These patches are characteristic of maternal infection with candidiasis or yeast. The nurse
assesses the mother's perineal area for a rash. Telling the mother to leave the rash alone may
be appropriate information but does not get to the bottom of the issue. The nurse should not
