25.10.1: Review Questions
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Review Questions
1 .
Edward, a newborn delivered at 41 weeks' gestation, weighs 10 lb 4 oz. Vaginal delivery for this G1P1 mother was assisted with forceps. The nurse is completing her assessment and notes a sharply demarcated swelling over the parietal bones. The occipital and frontal skull bones are not affected. The neck does not appear edematous and is soft to the touch with full mobility. The infant is awake and active and has been breast-feeding well. What is the most probable cause of the swelling?
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cephalohematoma
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subgaleal hemorrhage
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caput succedaneum
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skull fracture
2 .
The nurse is caring for an infant with FAS. What symptoms would the nurse expect to see when assessing the infant?
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widely spaced nipples and a webbed neck
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flattened bridge of the nose, a short neck, small ears, a large tongue that may protrude
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small eyes, thin upper lip, and smooth skin between the nose and upper lip
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acyanotic with a murmur a few weeks after birth
3 .
The nurse has access to the results of a karyotype sent out for their patient via an electronic medical record. The parents have accessed the results on their MyChart phone application and have asked the nurse what the results 45, X mean. What is the best response from the nurse?
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The results indicate your child may have Turner syndrome.
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Your results are 45, X; you will have to wait to talk with the geneticist.
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Your results indicate that your daughter has a serious lifelong disease.
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I’m not sure; I’ll call the provider.
4 .
The family with a newborn diagnosed with cleft lip and palate is concerned about what will happen in the future. The birthing parent asks if they will be able to breast-feed the infant. What is the best response from the nurse?
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Newborns with cleft lip and palate require a special nipple and setup to receive full nutrition.
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Newborns with cleft lip and palate are unable to breast-feed but can have breast milk.
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Newborns with a cleft lip and palate may be able to breast-feed because latching may fill the gap.
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Newborns with cleft lip and palate are able to breast-feed only after surgical repair of their cleft.
5 .
A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?
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“The drug keeps your infant from requiring too much sedation.”
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“Surfactant improves the ability of your infant’s lungs to exchange oxygen and carbon dioxide.”
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“Surfactant is used to reduce episodes of periodic tachycardia.”
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“Your infant needs this medication to fight a possible respiratory tract infection.”
6 .
A premature newborn requires assistance with ventilation and oxygenation. What method of respiratory support is most likely to be utilized if the newborn requires PPV at birth and continues to need assistance?
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bag mask positive pressure ventilation (PPV)
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extracorporeal membrane oxygenation (ECMO)
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continuous positive airway pressure (CPAP)
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nasal cannula at 1 L
7 .
The newborn is having occasional gasping respirations with a heart rate of 90 beats per minute. Skin color is cyanotic with poor muscle tone. Interpreting relevant clinical data in this scenario, what problems are possible? Select all that apply.
- The newborn is hypothermic.
- The newborn is full term.
- The newborn is experiencing respiratory distress.
- The newborn is anemic.
- The newborn is sleepy.
- The newborn is ready to direct breast-feed.
8 .
The birthing parent has been watched closely by their health-care team because of their risk factors for delivering prematurely. What items in this patient’s medical history and current diagnosis increase their risk for delivering prematurely? Select all that apply.
- hypertension
- obesity
- 27 years of age
- history of premature delivery
- history of fibroid removal
- history of seizures
- current use of tobacco and alcohol
9 .
A premature infant has been admitted to the NICU for both respiratory and nutritional support. When should the nurse begin discharge teaching to the family?
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after the infant has met goals of a mature breathing pattern and their percentile on the growth chart
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as the infant is extubated and transitioned to nasal cannula
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when the family shows interest in caring for their neonate independently
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as early as possible and throughout the admission
10 .
A newborn was prenatally diagnosed with trisomy 13 along with an unrepairable cardiac anomaly. Genetic testing and cardiac imaging after birth have confirmed both findings. What discharge planning should be included for this infant?
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cardiology follow-up
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genetic testing for the family
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home hospice care
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lactation consultant
11 .
A 3-month-old has pulled out their NG tube at home, and the mother is now speaking with the on-call nurse. What recommendation should the nurse provide her?
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drive the infant to the nearest ER
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Call 911 and wait for EMS to arrive
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attempt to replace the NG tube yourself following discharge training
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feed the infant by mouth as there is not an NG tube to use
12 .
An infant with a congenital cardiac disorder is receiving postsurgical palliation and nearing time for discharge. What findings would be indicators that the infant is ready for discharge?
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The infant is medically ready, has had all routine discharge screenings, and is up to date on their vaccinations.
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The home caregiver has not been able to come to the hospital and has not received either CPR or needed NG tube training.
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The respiratory therapist has done a home evaluation, which showed the home environment was appropriate, but the DME has not shipped the ventilator or oxygen delivery equipment.
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The infant is escalating on oxygen requirements and unable to maintain their temperature between 36.6° C and 38° C.
13 .
A family who immigrated to the United States in the past year is preparing to take their infant home with both oxygen and G-tube feeds. How does the nurse know discharge education has prepared them for success?
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The caregiver has been able to demonstrate a G-tube feed successfully at the correct feeding times throughout the day.
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The caregiver was unable to safely administer all medications at the prescribed times during the day and night.
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The family has cultural concerns that have not been addressed at this time regarding home-going care for the infant, but a social worker has been consulted.
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Oral feeding is important to the caregiver for the infant, and they continue to attempt PO feedings after both the nurse and attending physician have explained the infant’s need for G-tube feedings.