Chapter 19: Caring for the Newborn at Risk

Chapter 19: Caring for the Newborn at Risk

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The pediatric nurse prepares a newborn for phototherapy. The nurse explains to the parents that certain organs need to be protected during treatment. Which organs are these?

A.	Eyes and ears
B.	Eyes and hands
C.	Eyes and genitals
D.	Genitals and hands

 

 

ANS:  C

Phototherapy uses daylight and cool white, blue, or “special blue” fluorescent light tubes. These lights are the most effective form of phototherapy and are placed around and above the newborn. The eyes and genitals of the newborn are always covered to prevent tissue and retinal damage. The hands and ears of the newborn are not damaged by phototherapy.

 

Cognitive Level: Comprehension/Understanding

Content Area: Pediatrics/Maternity

Patient Needs: Safe and Effective Care Environment: Safety and Infection Control

Integrated Process: Teaching/Learning

Difficulty: Easy

 

PTS:   1

 

2. The pediatric nurse is receiving a morning report via phone call on an infant who will be arriving in the neonatal intensive care unit. The report indicates that shoulder dystocia may have occurred during the birth process. The nurse assesses the neonate as at risk for which additional condition?

A.	Brachial plexus injury
B.	Hyperbilirubinemia
C.	Hypoglycemia
D.	Intracranial hemorrhage

 

 

ANS:  A

Risk factors for a brachial plexus injury include LGA or macrosomic newborns, newborns with a diabetic mother, instrument delivery, prolonged labor, shoulder dystocia, and multiparity.

 

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Physiological Integrity: Reduction of Risk Potential

Integrated Process: Nursing Process: Assessment

Difficulty: Moderate

 

PTS:   1

 

3. The pediatric nurse explains to the nursing student that respiratory distress syndrome results from a developmental lack of which substance?

A.	Calcium
B.	Lecithin
C.	Magnesium
D.	Surfactant

 

 

ANS:  D

Respiratory distress syndrome (RDS) is a developmental respiratory disorder that affects preterm newborns due to lack of lung surfactant. The other substances are not related to this disorder.

 

Cognitive Level: Knowledge/Remembering

Content Area: Pediatrics/Maternity

Patient Needs: Physiological Integrity: Physiological Adaptation

Integrated Process: Teaching/Learning

Difficulty: Easy

 

PTS:   1

 

4. A baby with brachial plexus injury is being discharged home. What information should the nurse include on the teaching plan?

A.	Encourage the baby to move the arm by holding out toys to reach for.
B.	Keep the baby’s arm in the sling for 23 out of every 24 hours.
C.	Perform passive range-of-motion exercises to affected extremity.
D.	Return to the hospital on day 7 for microsurgical repair.

 

 

ANS:  C

Brachial plexus injuries (BPI) manifest by lack of movement of an arm, elbow, wrist, or hand. The arm is initially rested, then after 5 to 10 days, passive range of motion (ROM) is started. Parents are taught to do the passive ROM several times a day. This baby is too young to reach for toys and active movement is not encouraged. The baby does not need a sling. Microsurgical repair is indicated if repair is needed, but day 7 would be too early.

 

Cognitive Level: Comprehension/Understanding

Content Area: Pediatrics/Maternity

Patient Needs: Health Promotion and Maintenance

Integrated Process: Teaching/Learning

Difficulty: Moderate

 

PTS:   1

 

5. A postterm baby is born, and the nurse notes that the baby has dirty-looking skin and nails. The baby has moderate respiratory distress with rales and rhonchi noted. What nursing care does the nurse anticipate providing for this infant?

A.	Giving the baby oxygen via an oxygen hood
B.	Increasing oxygenation by using CPAP
C.	Providing chest physiotherapy every 8 hours
D.	Sitting the infant upright to feed and sleep

 

 

ANS:  B

This baby has a “dirty” appearance because he or she was born in meconium-stained amniotic fluid, and the respiratory manifestations signal meconium aspiration syndrome. To improve oxygenation, treatment often involves CPAP. Less invasive means of providing oxygen (the hood) are usually not adequate. Chest physiotherapy is usually done every 3 to 4 hours. Sleeping and feeding in an upright position is helpful for GERD.

 

Cognitive Level: Analysis/Analyzing

Content Area: Pediatrics/Maternity

Patient Needs: Physiological Integrity: Physiological Adaptation

Integrated Process: Nursing Process: Implementation

Difficulty: Moderate

 

PTS:   1