OB High Risk Newborn Final Practice 53 Questions with Verified Answers,100% CORRECT

OB High Risk Newborn Final Practice 53 Questions with Verified Answers A 1-day-old neonate, 32 weeks' gestation, is in an overhead warmer. The nurse assesses the morning axillary temperature as 96.9ºF. Which of the following could explain this assessment finding? 1. This is a normal temperature for a preterm neonate. 2. Axillary temperatures are not valid for preterm babies. 3. The supply of brown adipose tissue is incomplete. 4. Conduction heat loss is pronounced in the baby. - CORRECT ANSWER 3. The supply of brown adipose tissue is incomplete. Which of the following neonates is at highest risk for cold stress syndrome? 1. Infant of diabetic mother. 2. Infant with Rh incompatibility. 3. Postdates neonate. 4. Down syndrome neonate. - CORRECT ANSWER 3. Postdates neonate. Per they already metabolized their brown fat. Which of the following would lead the nurse to suspect cold stress syndrome in a newborn with a temperature of 96.5ºF? 1. Blood glucose of 50 mg/dL. 2. Acrocyanosis. 3. Tachypnea. 4. Oxygen saturation of 96%. - CORRECT ANSWER 3. Tachypnea. A 6-month-old child developed kernicterus immediately after birth. Which of the following tests should be done to determine whether or not this child has developed any sequelae to the illness? 1. Blood urea nitrogen and serum creatinine. 2. Alkaline phosphotase and bilirubin. 3. Hearing and vision assessments. 4. Peak expiratory flow and blood gas assessments. - CORRECT ANSWER 3. Hearing and vision assessments. A baby is born with erythroblastosis fetalis. Which of the following signs/symptoms would the nurse expect to see? 1. Ruddy complexion. 2. Anasarca. 3. Alopecia. 4. Erythema toxicum. - CORRECT ANSWER 2. Anasarca. Per CHF -- will demonstration anasarca. A baby with hemolytic jaundice is being treated with fluorescent phototherapy. To provide safe newborn care, which of the following actions should the nurse perform? 1. Cover the baby's eyes with eye pads. 2. Turn the lights on for ten minutes every hour. 3. Clothe the baby in a shirt and diaper only. 4. Tightly swaddle the baby in a baby blanket. - CORRECT ANSWER 1. Cover the baby's eyes with eye pads. A baby's blood type is B negative. The baby is at risk for hemolytic jaundice if the mother has which of the following blood types? 1. Type O negative. 2. Type A negative. 3. Type B positive. 4. Type AB positive. - CORRECT ANSWER 1. Type O negative. ABO incompatibility is rarely seen when the maternal blood type is anything other than type O. A newborn admitted to the nursery has a positive direct Coombs' test. Which of the following is an appropriate action by the nurse? 1. Monitor the baby for jitters. 2. Assess the blood glucose level. 3. Assess the rectal temperature. 4. Monitor the baby for jaundice. - CORRECT ANSWER 4. Monitor the baby for jaundice. A newborn nursery nurse notes that a baby's body is jaundiced at 36 hours of life. Which of the following nursing interventions will be most therapeutic? 1. Maintain a warm ambient environment. 2. Have the mother feed the baby frequently. 3. Have the mother hold the baby skin to skin. 4. Place the baby naked by a closed sunlit window. - CORRECT ANSWER 2. Have the mother feed the baby frequently. Per bilirubin excreted via bowel. A neonate is under phototherapy for elevated bilirubin levels. The baby's stools are now loose and green. Which of the following actions should the nurse take at this time? 1. Discontinue the phototherapy. 2. Notify the health care practitioner. 3. Take the baby's temperature. 4. Assess the baby's skin integrity. - CORRECT ANSWER 4. Assess the baby's skin integrity. The stools can be very caustic to the baby's delicate skin. A nursing diagnosis for a 5-day-old newborn under phototherapy is: Risk for fluid volume deficit. For which of the following client outcomes should the nurse plan to monitor the baby? 1. 6 saturated diapers in 24 hours. 2. Breastfeeds 6 times in 24 hours. 3. 12% weight loss since birth. 4. Apical heart rate of 176 bpm. - CORRECT ANSWER 1. 6 saturated diapers in 24 hours. There is a baby in the neonatal intensive care unit (NICU) who is exhibiting signs of neonatal abstinence syndrome. Which of the following medications is contraindicated for this neonate? 1. Morphine. 2. Opium. 3. Narcan. 4. Phenobarbital. - CORRECT ANSWER 3. Narcan. A baby is in the NICU whose mother was addicted to heroin during the pregnancy. Which of the following nursing actions would be appropriate? 1. Tightly swaddle the baby. 2. Place the baby prone in the crib. 3. Provide needed stimulation to the baby. 4. Feed the baby half-strength formula. - CORRECT ANSWER A newborn in the nursery is exhibiting signs of neonatal abstinence syndrome. Which of the following signs/symptoms is the nurse observing? Select all that apply. 1. Hyperphagia. 2. Lethargy. 3. Prolonged periods of sleep. 4. Hyporeflexia. 5. Persistent shrill cry. - CORRECT ANSWER 1. Hyperphagia. 5. Persistent shrill cry. Signs of hunger, hyperactive, sleep probs, hyperreflexia, shrill cry Based on maternal history of alcohol addiction, a baby in the neonatal nursery is being monitored for signs of fetal alcohol syndrome (FAS). The nurse should assess this baby for which of the following? 1. Poor suck reflex. 2. Ambiguous genitalia. 3. Webbed neck. 4. Absent Moro reflex. - CORRECT ANSWER 1. Poor suck reflex. A baby was born 24 hours ago to a mother who received no prenatal care. The infant has tremors, sneezes excessively, constantly mouths for food, and has a shrill, high-pitched cry. The baby's serum glucose levels are normal. For which of the following should the nurse request an order from the pediatrician? 1. Urine drug toxicology test. 2. Biophysical profile test. 3. Chest and abdominal ultrasound evaluations. 4. Oxygen saturation and blood gas assessments. - CORRECT ANSWER 1. Urine drug toxicology test. A nurse makes the following observations when admitting a full-term, breastfeeding baby into the neonatal nursery: 9 lbs 2 oz, 21 inches long, TPR: 96.6ºF, 158, 62, jittery, pink body with bluish hands and feet, crying. Which of the following actions should the nurse perform first? 1. Swaddle the baby to provide warmth. 2. Assess the glucose level of the baby. 3. Take the baby to the mother for feeding. 4. Administer the neonatal medications. - CORRECT ANSWER 2. Assess the glucose level of the baby. An infant admitted to the newborn nursery has a blood glucose level of 35 mg/dL. The nurse should monitor this baby carefully for which of the following? 1. Jaundice. 2. Jitters. 3. Erythema toxicum. 4. Subconjunctival hemorrhages. - CORRECT ANSWER 2. Jitters. A 42-week-gestation baby, 2400 grams, whose mother had no prenatal care, is admitted into the NICU. The neonatalogist orders blood work. Which of the following laboratory findings would the nurse expect to see? 1. Blood glucose 30 mg/dL. 2. Leukocyte count 1000 cells/mm3. 3. Hematocrit 30%. 4. Serum pH 7.8. - CORRECT ANSWER 1. Blood glucose 30 mg/dL. A baby has been admitted to the neonatal intensive care unit with a diagnosis of postmaturity. The nurse expects to find which of the following during the initial newborn assessment? 1. Abundant lanugo. 2. Flat breast tissue. 3. Prominent clitoris. 4. Wrinkled skin. - CORRECT ANSWER 4. Wrinkled skin. A woman who received an intravenous analgesic 4 hours ago has had prolonged late decelerations in labor. She will deliver her baby shortly. Which of the following is the priority action for the delivery room nurse to take? 1. Preheat the overhead warmer. 2. Page the neonatalogist on call. 3. Draw up Narcan (naloxone) for injection. 4. Assemble the neonatal eye prophylaxis. - CORRECT ANSWER 2. Page the neonatalogist on call. A 42-week-gestation baby has been admitted to the neonatal intensive care unit. At delivery, thick green amniotic fluid was noted. Which of the following actions by the nurse is critical at this time? 1. Bath to remove meconium-contaminated fluid from the skin. 2. Ophthalmic assessment to check for conjunctival irritation. 3. Rectal temperature to assess for septic hyperthermia. 4. Respiratory evaluation to monitor for respiratory distress. - CORRECT ANSWER 4. Respiratory evaluation to monitor for respiratory distress A 42-week gravida is delivering her baby. A nurse and pediatrician are present at the bith. The amniotic fluid is green and thick. The baby fails to breathe spontaneously. Which of the following actions should the nurse take next? 1. Stimulate the baby to breathe. 2. Assess neonatal heart rate. 3. Assist with intubation. 4. Place the baby in the prone position. - CORRECT ANSWER 3. Assist with intubation. During neonatal cardiopulmonary resuscitation, which of the following actions should be performed? 1. Provide assisted ventilation at 40 to 60 breaths per minute. 2. Begin chest compressions when heart rate is 0 to 20 beats per minute. 3. Compress the chest using the three-finger technique. 4. Administer compressions and breaths in a 5 to 1 ratio. - CORRECT ANSWER 1. Provide assisted ventilation at 40 to 60 breaths per minute. Compressions 3:1 ratio A nurse in the newborn nursery suspects that a new admission, 42 weeks' gestation, was exposed to meconium in utero. What would lead the nurse to suspect this? 1. The baby is bradycardic. 2. The baby's umbilical cord is green. 3. The baby's anterior fontanel is sunken. 4. The baby is desquamating. - CORRECT ANSWER 2. The baby's umbilical cord is green. The birth of a baby, weight 4500 grams, was complicated by shoulder dystocia. Which of the following neonatal complications should the nursery nurse observe for? 1. Leg deformities. 2. Brachial palsy. 3. Fractured radius. 4. Buccal abrasions. - CORRECT ANSWER 2. Brachial palsy. A neonate, whose mother is HIV positive, is admitted to the NICU. A nursing diagnosis: Risk for infection related to perinatal exposure to HIV/AIDS is made. Which of the following interventions should the nurse make in relation to the diagnosis? 1. Monitor daily viral load laboratory reports. 2. Check the baby's viral antibody status. 3. Obtain an order for antiviral medication. 4. Place the baby on strict precautions. - CORRECT ANSWER 3. Obtain an order for antiviral medication. A baby was just born to a mother who had positive vaginal cultures for group B streptococcus. The mother was admitted to the labor room 2 hours before the birth. For which of the following should the nursery nurse closely observe this baby? 1. Hypothermia. 2. Mottling. 3. Omphalocele. 4. Stomatitis. - CORRECT ANSWER 1. Hypothermia in a neonate may be indicative of sepsis. Four full-term babies were admitted to the neonatal nursery. The mothers of each of the babies had labors of 4 hours or less. The nursery nurse should carefully monitor which of the babies for hypothermia? 1. The baby whose mother cultured positive for group B strep during her third trimester. 2. The baby whose mother had gestational diabetes. 3. The baby whose mother was hospitalized for 3 months with complete placenta previa. 4. The baby whose mother previously had a stillbirth. - CORRECT ANSWER 1. The baby whose mother cultured positive for group B strep during her third trimester. Group B streptococcus causes severe infections in the newborn. A sign of neonatal sepsis is hypothermia. Four 38-week-gestation gravidas have just delivered. Which of the babies should be monitored closely by the nurse for respiratory distress? 1. The baby whose mother has diabetes mellitus. 2. The baby whose mother has lung cancer. 3. The baby whose mother has hypothyroidism. 4. The baby whose mother has asthma. - CORRECT ANSWER 1. The baby whose mother has diabetes mellitus. A client is seeking preconception counseling. She has type 1 diabetes mellitus and is found to have an elevated glycosylated hemoglobin (HgbA1c) level. Before actively trying to become pregnant, she is strongly encouraged to stabilize her blood glucose to reduce the possibility of her baby developing which of the following? 1. Port wine stain. 2. Cardiac defect. 3. Hip dysplasia. 4. Intussusception. - CORRECT ANSWER 2. Cardiac defect. A macrosomic infant of a non-insulin dependent diabetic mother has been admitted to the neonatal nursery. The baby's glucose level on admission to the nursery is 25 mg/dL and after a feeding of mother's expressed breast milk is 35 mg/dL. Which of the following actions should the nurse take at this time? 1. Nothing because the glucose level is normal for an infant of a diabetic mother. 2. Administer intravenous glucagon slowly over five minutes. 3. Feed the baby a bottle of dextrose and water and reassess the glucose level. 4. Notify the neonatalogist of the abnormal glucose levels. - CORRECT ANSWER 4. Notify the neonatalogist of the abnormal glucose levels A baby has just been born to a type 1 diabetic mother with retinopathy and nephropathy. Which of the following neonatal findings would the nurse expect to see? 1. Hyperalbuminemia. 2. Polycythemia. 3. Hypercalcemia. 4. Hypoinsulinemia. - CORRECT ANSWER 2. Polycythemia. Per poor placental perfusion from DM mom. A baby is born to a type 1 diabetic mother. Which of the following lab values would the nurse expect the neonate to exhibit? 1. Plasma glucose 30 mg/dL. 2. Red blood cell count 1 million/mm3. 3. White blood cell count 2000/mm3. 4. Hemoglobin 8 g/dL. - CORRECT ANSWER 1. Plasma glucose 30 mg/dL. A baby has just been admitted into the neonatal intensive care unit with a diagnosis of intrauterine growth restriction (IUGR). Which of the following maternal factors would predispose the baby to this diagnosis? Select all that apply. 1. Hyperopia. 2. Gestational diabetes. 3. Substance abuse. 4. Chronic hypertension. 5. Advanced maternal age. - CORRECT ANSWER 3. Substance abuse. 4. Chronic hypertension. 5. Advanced maternal age. A 6-month-old child is being seen in the pediatrician's office. The child was born preterm and remained in the neonatal intensive care unit for the first 5 months of life. The child is being monitored for 5 chronic problems. Which of the following problems are directly related to the prematurity? Select all that apply. 1. Bronchopulmonary dysplasia. 2. Cerebral palsy. 3. Retinopathy. 4. Hypothyroidism. 5. Seizure disorders. - CORRECT ANSWER 1. Bronchopulmonary dysplasia. 2. Cerebral palsy. 3. Retinopathy. 5. Seizure disorders. A neonate is being assessed for necrotizing enterocolitis (NEC). Which of the following actions by the nurse is appropriate? Select all that apply. 1. Perform hemoccult test on stools. 2. Monitor for an increase in abdominal girth. 3. Measure gastric contents before each feed. 4. Assess bowel sounds before each feed. 5. Assess for anal fissures daily. - CORRECT ANSWER 1. Perform hemoccult test on stools. 2. Monitor for an increase in abdominal girth. 3. Measure gastric contents before each feed. 4. Assess bowel sounds before each feed. A woman whose 32-week-gestation neonate is to begin oral feedings is expressing breast milk (EBM) for the baby. The neonatalogist is recommending that fortifier be added to the milk because which of the following needs of the baby are not met by EBM? 1. Need for iron and zinc. 2. Need for calcium and phosphorus. 3. Need for protein and fat. 4. Need for sodium and potassium. - CORRECT ANSWER 2. Need for calcium and phosphorus. The nurse is providing discharge teaching to the parents of a baby born with a cleft lip and palate. Which of the following should be included in the teaching? 1. Correct technique for the administration of a gastrostomy feeding. 2. Need to watch for the appearance of blood-stained mucus from the nose. 3. Optimal position for burping after nasogastric feedings. 4. Need to give the baby sufficient time to rest during each feeding. - CORRECT ANSWER 4. Need to give the baby sufficient time to rest during each feeding. A baby is suspected of having esophageal atresia. The nurse would expect to see which of the following signs/symptoms? 1. Frequent vomiting. 2. Excessive mucus. 3. Ruddy complexion. 4. Abdominal distention. - CORRECT ANSWER 2. Excessive mucus. Vomiting is impossible. The nurse is teaching a couple about the special health care needs of their newborn child with Down syndrome. The nurse knows that the teaching was successful when the parents state that the child will need which of the following? 1. Yearly three-hour glucose tolerance testing. 2. Immediate intervention during bleeding episodes. 3. A formula that is low in lactose and phenylalanine. 4. Prompt treatment of upper respiratory infections. - CORRECT ANSWER 4. Prompt treatment of upper respiratory infections. On admission to the nursery, a baby's head and chest circumferences are 39 cm and 32 cm, respectively. Which of the following actions should the nurse take next? 1. Assess the anterior fontanel. 2. Measure the abdominal girth. 3. Check the apical pulse rate. 4. Monitor the respiratory effort. - CORRECT ANSWER 1. Assess the anterior fontanel. A baby born by vacuum extraction has been admitted to the well baby nursery. The nurse should assess this baby for which of the following? 1. Pedal abrasions. 2. Hypobilirubinemia. 3. Hyperglycemia. 4. Cephalhematoma. - CORRECT ANSWER 4. Cephalhematoma. A macrosomic baby in the nursery is suspected of having a fractured clavicle from a traumatic delivery. Which of the following signs/symptoms would the nurse expect to see? Select all that apply. 1. Pain with movement. 2. Hard lump at the fracture site. 3. Malpositioning of the arm. 4. Asymmetrical Moro reflex. 5. Marked localized ecchymosis. - CORRECT ANSWER 1. Pain with movement. 2. Hard lump at the fracture site. 3. Malpositioning of the arm. 4. Asymmetrical Moro reflex. A baby exhibits weak rooting and sucking reflexes. Which of the following nursing diagnoses would be appropriate? 1. Risk for deficient fluid volume. 2. Activity intolerance. 3. Risk for aspiration. 4. Feeding self-care deficit. - CORRECT ANSWER 1. Risk for deficient fluid volume. Which finding would lead the nurse to suspect that a newborn is experiencing respiratory distress syndrome? a. Abdominal distention b. Acrocyanosis c. Depressed fontanels d. Nasal flaring - CORRECT ANSWER Nasal flaring When assessing the substance-exposed newborn, which finding would the nurse expect? a. Calm facial appearance b. Daily weight gain c. Increasing irritability d. Feeding and sleeping well - CORRECT ANSWER Increasing irritability A newborn with tracheoesophageal fistula is likely to present with which assessment finding? a. Subnormal temperature b. Absent Moro reflex c. Inability to swallow d. Drooling from mouth - CORRECT ANSWER Drooling from mouth The nurse is caring for term neonate who was exposed to cocaine throughout the pregnancy. What effect would this exposure have on the neonate's vital signs? a. They would be lower than normal. b. They would be higher than normal. c. They would not be affected at all. d. BP would be lower, pulse would higher. - CORRECT ANSWER They would be higher than normal. 6. Characteristics of a newborn with fetal alcohol syndrome would include which of the following? Select all that apply: a. Hypocalcium and hypokalemia b. Malformed ears and cataracts c. Microcephaly and thin upper lip d. Congenital cardiac defects and SGA e. Prominent cheekbones and LGA f. Hyperactive behavior and feeding problems - CORRECT ANSWER c. Microcephaly and thin upper lip d. Congenital cardiac defects and SGA f. Hyperactive behavior and feeding problems Because subcutaneous and brown fat stores were used for survival in utero, the nurse would assess an SGA newborn for which of the following? a. Hyperbilirubinemia b. Hypothermia c. Polycythemia d. Hypoglycemia - CORRECT ANSWER b. Hypothermia In assessing a preterm newborn, which of the following findings would be of greatest concern? a. Milia over the bridge of the nose b. Thin transparent skin c. Poor muscle tone d. Heart murmur - CORRECT ANSWER d. Heart murmur The nurse is providing care to several newborns with variations in gestational age and birthweight. When developing the plan of care for these newborns, the nurse focuses on energy conservation to promote growth and development. Which measures would the nurse include in the nursing plans of care? Select all that apply. a. Keeping the handling of the newborn to a minimum b. Maintaining a neutral thermal environment c. Decreasing environmental stimuli d. Initiating early oral feedings e. Using thermal warmers in all cribs - CORRECT ANSWER a. Keeping the handling of the newborn to a minimum b. Maintaining a neutral thermal environment c. Decreasing environmental stimuli