CCPR 2023 NNP Test | 150 Questions with 100% Correct Answers | Verified | 41 Pages

Limited horizontal nystagmus resolves by: a. 1-2 months of age b. 2-3 months of age c. 3-4 months of age - correct answer c. 3-4 months of age Infants with bronchopulmonary dysplasia have increased energy needs, often as much as: a. 10-20% b. 20-40% c. 40-60% - correct answer b. 20-40% What are the protein requirements for term infants? a. 2 g/kg/day b. 3 g/kg/day c. 4 g/kg/day - correct answer b. 3 g/kg/day Preterm may require 3.5-4 g/kg/day. Minimum is 2 g/kg/day A normal blood finding in the term neonate on day one of life is: a. a hematocrit of 65% b. a hemoglobin level of 18 g/dL c. erythrocyte count of 3 million - correct answer b. a hemoglobin level of 18 g/dL The principle action of volume expanders during resuscitation is to: a. address myocardial decompensation b. facilitate peripheral vasoconstriction c. maintain cardiac output and blood pressure - correct answer c. maintain cardiac output and blood pressure A two day old neonate has an abdominal mass. The most likely cause is: a. adrenal hemorrhage b. polycystic kidney c. volvulus - correct answer b. polycystic kidney Renal is the most frequent cause of abdominal masses in newborns. There is an increased risk of hypochloremia in neonates who: a. are asphyxiated at birth b. had prolonged diarrhea c. have been over-treated with diuretics - correct answer c. have been over-treated with diuretics A decision to provide morphine to a dying infant is framed by the principle of: a. autonomy b. nonmaleficence c. justice - correct answer b. nonmaleficence justice = equal opportunity to all autonomy = allowed to take direction in accordance to own/best self interest The first sign of hypothermia in a critically ill neonate is a drop in which temperature? a. axillary b. rectal c. skin - correct answer c. skin A preterm infant is born with cutaneous pinkish-gray granulomas. This finding is characteristic of infection with: a. candida albicans b. listeria monocytogenes c. toxoplasma gondii - correct answer b. listeria monocytogenes Rib fractures are noted on routine chest x-ray on a 3 month old premature infant. The most likely cause of this finding is: a. congenital hypoparathyroidism b. inadequate calcium and phosphorus intake c. vitamin D deficiency due to malabsorption - correct answer b. inadequate calcium and phosphorus intake The drug of choice when treating opioid withdrawal is: a. diazepam b. oral morphine c. pheobarbital - correct answer b. oral morphine A neonate with acute renal failure requires short acting narcotic analgesic. The best drug to use in this situation is: a. fentanyl b. morphine c. sufentanil - correct answer a. fentanyl 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 A factor that usually differentiates the pathophysiology between meconium ileus and meconium plug syndrome is a. bilious vomiting b. enzymatic deficiency c. intestinal obstruction - correct answer b. enzymatic deficiency A neonate has had several episodes of vomiting. The arterial blood gas results are: pH 7.53; PCO2 42 mmHg; PO2 56 mmHg; Base excess 33 mEq/L. This blood gas represents: a. borderline normal findings b. compensated metabolic acidosis c. metabolic alkalosis - correct answer c. metabolic alkalosis A late preterm infant presents with recurrent oral thrush. The most likely source would be a. breast b. nipple c. pacifier - correct answer a. breast A neonate with coarctation of the aorta develops intractable congestive heart failure, acidosis, oliguria, and hypertension. The appropriate action is immediate: a. cardiac catherization b. IV digoxin c. place neonate in a knee chest position - correct answer a. cardiac catherization A common complication of percutaneous central line include a. cardiac perforation b. catheter entrapment c. extravasation - correct answer c. extravastation A risk factor for bronze baby syndrome is a. cholestasis b. hypothyroidism c. galactosemia - correct answer a. cholestasis The mandatory diagnostic test for infants suspected of having congenital syphilis is: a. CSF VDRL b. fluorescent treponemal antibody absorption c. serum VDRL - correct answer a. CSF VDRL An increase in cerebral blood flow can be expected in association with: a. decreased pCO2 b. decreased PaO2 c. decreased K+ level - correct answer b. decreased PaO2 --> trying to get blood to brain Infants with Beckwith-Wiedemann Syndrome are at risk for: a. detached retinas b. failure to thrive c. Wilm's tumor - correct answer c. Wilm's tumor A characteristic that is present in both omphalocele and gastroschisis is: a. high incidence of congenital malformations b. nonrotation of the infant c. peritoneal sac covering the defect - correct answer b. non-rotation of the intestine A & C both traits of omphalocele On gestational age examination, a neonate falls below the expected range for weight, length, and head circumference. A likely antecedent for this growth aberration is: a. intrauterine congenital infection b. nutritional deficiency c. uteroplacental insufficiency - correct answer a. intrauterine congenital infection --> cause of symmetric IUGR. Brain reperfusion injury occurs after oxygenation of perfusion has been restored for a. 4-7 hours b. 8-16 hours c. 24 hours - correct answer b. 8-16 hours An increased incidence of low serum calcium levels occur in neonates who are: a. dehydrated b. have a history of asphyxia c. have adrenal insufficiency - correct answer b. have a history of asphyxia Also, inadequate stores and IDM Glucose use by the brain is greater in infants who are a. asymmetrically growth restricted b. jaundiced c. post-term - correct answer a. asymmetrically growth restricted Which milk protein is easiest to digest? a. casein b. lysozyme c. whey - correct answer c. whey milk initially 80:20 whey:casein then 60:40 Cystic Fibrosis is characterized by: a. foul smelling meconium b. meconium ileus c. mucous plug - correct answer b. meconium ileus Increased left atrial pressure is responsible for what circulatory change at birth? a. constriction of the ductus arteriosus b. elimination of right-to-left shunting at the foramen ovale c. increased systemic pressure - correct answer b. elimination of right-to-left shunting at the foramen ovale What size endotracheal tube should be available to resuscitate a 36 week 2500gm newborn? a. 2.5 mm b. 3.0 mm c. 3.5 mm - correct answer c. 3.5 mm The correct position for cardiac compressions during neonatal resuscitation is shown at point a. A b. B c. C - correct answer c. C The recommendation regarding thee administration of Narcan (naloxone) to the newborn with respiratory depression secondary to maternal administration of narcotics is to a. administer at 15 minutes after birth b. administer as soon as possible c. avoid administration - correct answer c. avoid administration Agenesis of the corpus callosum commonly occurs with which of the following disorders of brain formation? a. Baritser-Winter syndrome b. Dandy-Walker syndrome c. Zellweger syndrome - correct answer b. Dandy-Walker syndrome What process of pharmacokinetics is most important to consider when prescribing a drug that has a narrow therapeutic range? a. bioavailability b. distribution c. metabolism - correct answer a. bioavailability --> amount of drug dose that reaches the systemic circulation A term, healthy infant, who has been breastfeeding well develops jaundice on day 5 of life. The bilirubin peaks on day 14. This type of jaundice is called a. breast milk jaundice b. cholestasis c. physiologic jaundice - correct answer a. breast milk jaundice The preferred method of diagnosing HIV infection in the neonate is a. DNA PCR b. plasma viral RNA c. viral culture - correct answer a. DNA PCR The best management of a neonate with a symptomatic patent ductus arteriosus at 2 days of age is: a. fluid restriction b. ibuprofen lysine c. surgical ductal ligation - correct answer b. ibuprofen lysine if asymptomatic, could do fluid restriction Expected muscle tone development in a 28 week neonate would include a. good extension with a tendency to adduct b. palmar grasp reflex c. tonic neck reflex - correct answer b. palmar grasp reflex A benefit of habituation is a. hand to mouth coordination b. language development c. protection from overstimulation - correct answer c. protection from overstimulation For newborns with meconium aspiration syndrome, treatment would be directed at a. improving oxygenation b. suctioning meconium from trachea c. surfactant replacement therapy - correct answer a. Improving oxygenation A term neonate at three days of age has unequal pupils, slow response to light, and tense fontanelles. Labored retractions are present. These finding are consistent with a. intracerebellar hemorrhage b. subarachnoid hemorrhage c. subdural hemorrhage - correct answer c. subdural hemorrhage Infants at risk for a false negative when screened for congenital adrenal hyperplasia are a. 1-2 days old b. females c. small for gestational age - correct answer a. 1-2 days old The preferred approach for evaluation of the anatomy of the obstructing tissue in choanal