NEONATAL NURSING EXAM WITH COMPLETE
SOLUTIONS
1.Neonatal mPeriod: m-Defined mas mthe mfirst m28 mdays mafter mbirth
-Newborn madapts mto ma mbrighter m& mcooler menvironment
-Physiologic m& mbehavioral mchanges moccur mquickly
-The mnurse m& mparents mmust mbe maware mof many mdeviations mfrom mthe
mnorm mfor mearly midentification m& mprompt minterventions
2.Assessment mFindings: m-Transition
-6-10 mhours
-Physiological mchanges
-Periods mof mreactivity
-Physical massessments
-Reflexes
3.Umbilical mcord: mVein mcarries moxygenated mblood mfrom mplacenta mto
muterus
4.Ductus mVenosus: mpermits mmost mof mumbilical mvein mblood mto
mbypass mliver m& mmerge mwith mblood min mvena mcava
-Reaches mheart msooner
5.Foramen movale: mallows mblood mentering mright matrium mto mcross mto mle
1 m/
m28
, m atrium
6.Ductus mArteriosus: mconnects mthe mpulmonary martery mto mthe
maorta, mallowing mfor mbypass mof mthe mpulmonary mcircuit
7.Placenta: msupplies moxygen, mnutrients m& mremoves mwaste mproducts
8.Cardiovascular mAdaptations:
9.At mbirth: m-Fetal mcirculation mmust mconvert mto mnewborn
-Placental mpulmonary mexchange
-Release mof mepinephrine m& mnorepinephrine
-Stimulate mincreased mcardiac moutput
10.Cont..: m-Umbilical mcord mis mclamped
-First mbreath mtaken m& mlungs mbegin mto mfunction
-Pressure mchanges moccur
-Left matrium> mright matrium
-Foramen movale mcloses
-Oxygenated m& mnon-oxygenated mblood mno mlonger mmixes
11.Cont..: m-Ductus mArteriosus mbecomes mfunctionally mclosed mwithin
mthe mfirst mfew mhours mafter mbirth
-Closure mis msignaled mby mhigh moxygen mcontent mof maortic mblood
-Results mfrom mgas mexchange min mthe mlungs
-Pulmonary mvascular mresistance mdecreases
-Pulmonary mblood mflow mincreases m& moxygen mexchange moccurs min mth
mlungs
12.Cont..: m-Ductus mVenosus mcloses mwithin ma mfew mdays mafter mbirth
-Due mto mactivation mof mfunctional mliver
2 m/
m28
, -Liver mtakes mover mfunctions mof mplacenta
-Two mumbilical marteries m& mone mvein mconstrict mat mbirth m& mbecome
mligaments
13.Additional mCV mChanges:
14.After mbirth: m-Heart mRate- m120-180bpm
-Will mdecrease mto m120-130bpm
-Crying, mmovement m& mwakefulness mwill mcause man mincrease min mHR m&
mblood mpressure
15.Cont..: m-Difficulty mcompensating
-Tachycardia mmay mreflect:
-Dehydration, mCV mdisease, mdrug mwithdrawal
-Bradycardia mmay mreflect:
-Apnea, mhypoxia
-Delayed mcord mclamping mmay mimprove mnewborn's mCV/pulmonary
madaptation
16.Respiratory mAdaptations: m-Hypercapnia, mhypoxia m& macidosis mfrom
mnormal mlabor mtrigger m1st mbreath m& msubsequent mrespirations
-Also menvironmental mfactors me.g. mnoise m& mlight
-Surfactant mprovides mthe mlungs mwith mstability mfor mgas mexchange
-Tension-reducing mlipoprotein
-Prevents malveolar mcollapse
-Reduces mthe mrisk mof matelectasis
17.Cont...: m-Chest mwall mis m"floppy"
-Passage mthrough mbirth mcanal mhelps mto meliminate mamniotic mfluid min
mlungs
-Thorax mis mintermittently mcompressed
-If mfluid mis mnot mremoved, mwill mresult min mtachypnea
-RR> m60bpm
-E.g. mCesarean mSection
18.After mbirth: m-Respirations mare mshallow m& mirregular
-30-60bpm m(may mhave mshort mperiod mof mapnea; m<15 msec.)
-More mactive= mthe mhigher mthe mRR
19.Signs mof mRespiratory mCompromise: m-Cyanosis
-Tachypnea
-Expiratory mgrunting
-Sternal mretractions
-Nasal mflaring
-Labored mbreathing
20.Periodic mBreathing: mcessation mof mbreathing mthat mlasts m5-10
3 m/
m28
SOLUTIONS
1.Neonatal mPeriod: m-Defined mas mthe mfirst m28 mdays mafter mbirth
-Newborn madapts mto ma mbrighter m& mcooler menvironment
-Physiologic m& mbehavioral mchanges moccur mquickly
-The mnurse m& mparents mmust mbe maware mof many mdeviations mfrom mthe
mnorm mfor mearly midentification m& mprompt minterventions
2.Assessment mFindings: m-Transition
-6-10 mhours
-Physiological mchanges
-Periods mof mreactivity
-Physical massessments
-Reflexes
3.Umbilical mcord: mVein mcarries moxygenated mblood mfrom mplacenta mto
muterus
4.Ductus mVenosus: mpermits mmost mof mumbilical mvein mblood mto
mbypass mliver m& mmerge mwith mblood min mvena mcava
-Reaches mheart msooner
5.Foramen movale: mallows mblood mentering mright matrium mto mcross mto mle
1 m/
m28
, m atrium
6.Ductus mArteriosus: mconnects mthe mpulmonary martery mto mthe
maorta, mallowing mfor mbypass mof mthe mpulmonary mcircuit
7.Placenta: msupplies moxygen, mnutrients m& mremoves mwaste mproducts
8.Cardiovascular mAdaptations:
9.At mbirth: m-Fetal mcirculation mmust mconvert mto mnewborn
-Placental mpulmonary mexchange
-Release mof mepinephrine m& mnorepinephrine
-Stimulate mincreased mcardiac moutput
10.Cont..: m-Umbilical mcord mis mclamped
-First mbreath mtaken m& mlungs mbegin mto mfunction
-Pressure mchanges moccur
-Left matrium> mright matrium
-Foramen movale mcloses
-Oxygenated m& mnon-oxygenated mblood mno mlonger mmixes
11.Cont..: m-Ductus mArteriosus mbecomes mfunctionally mclosed mwithin
mthe mfirst mfew mhours mafter mbirth
-Closure mis msignaled mby mhigh moxygen mcontent mof maortic mblood
-Results mfrom mgas mexchange min mthe mlungs
-Pulmonary mvascular mresistance mdecreases
-Pulmonary mblood mflow mincreases m& moxygen mexchange moccurs min mth
mlungs
12.Cont..: m-Ductus mVenosus mcloses mwithin ma mfew mdays mafter mbirth
-Due mto mactivation mof mfunctional mliver
2 m/
m28
, -Liver mtakes mover mfunctions mof mplacenta
-Two mumbilical marteries m& mone mvein mconstrict mat mbirth m& mbecome
mligaments
13.Additional mCV mChanges:
14.After mbirth: m-Heart mRate- m120-180bpm
-Will mdecrease mto m120-130bpm
-Crying, mmovement m& mwakefulness mwill mcause man mincrease min mHR m&
mblood mpressure
15.Cont..: m-Difficulty mcompensating
-Tachycardia mmay mreflect:
-Dehydration, mCV mdisease, mdrug mwithdrawal
-Bradycardia mmay mreflect:
-Apnea, mhypoxia
-Delayed mcord mclamping mmay mimprove mnewborn's mCV/pulmonary
madaptation
16.Respiratory mAdaptations: m-Hypercapnia, mhypoxia m& macidosis mfrom
mnormal mlabor mtrigger m1st mbreath m& msubsequent mrespirations
-Also menvironmental mfactors me.g. mnoise m& mlight
-Surfactant mprovides mthe mlungs mwith mstability mfor mgas mexchange
-Tension-reducing mlipoprotein
-Prevents malveolar mcollapse
-Reduces mthe mrisk mof matelectasis
17.Cont...: m-Chest mwall mis m"floppy"
-Passage mthrough mbirth mcanal mhelps mto meliminate mamniotic mfluid min
mlungs
-Thorax mis mintermittently mcompressed
-If mfluid mis mnot mremoved, mwill mresult min mtachypnea
-RR> m60bpm
-E.g. mCesarean mSection
18.After mbirth: m-Respirations mare mshallow m& mirregular
-30-60bpm m(may mhave mshort mperiod mof mapnea; m<15 msec.)
-More mactive= mthe mhigher mthe mRR
19.Signs mof mRespiratory mCompromise: m-Cyanosis
-Tachypnea
-Expiratory mgrunting
-Sternal mretractions
-Nasal mflaring
-Labored mbreathing
20.Periodic mBreathing: mcessation mof mbreathing mthat mlasts m5-10
3 m/
m28
