Chapter 28 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 28 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 28_LO01_Q01

The nurse is caring for pregnant clients. Which of these clients should the nurse anticipate is most likely to have a newborn at risk for mortality or morbidity?

1. 37-year-old G8 P2323, works in a chemical factory.
2. 23-year-old primip, low socioeconomic status, unmarried
3. 16-year-old primip, began prenatal care at 30 weeks.
4. 28-year-old G2 P1001, history of gestational diabetes

Correct Answer: 1

Rationale:

1. This client is at greatest risk because she has multiple risk factors: age over 35, high parity, history of preterm birth, and exposure to chemicals that might be toxic.
2. The main risk factor for this client is her low socioeconomic status.
3. This client has two risk factors: young age, and late onset of prenatal care.
4. This client has gestational diabetes history as her only risk factor.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 28.1 Explain factors present at birth that indicate an at-risk newborn.

Chapter 28_LO02 _Q02

The nurse is caring for an infant born at 37 weeks that weighs 1,750 g (3 pounds, 10 ounces). The head circumference and length are at the 25^th percentile. What statement would the nurse expect to find in the chart?

1. Preterm appropriate for gestational age, symmetrical IUGR
2. Term small for gestational age, symmetrical IUGR
3. Preterm small for gestational age, asymmetrical IUGR
4. Preterm appropriate for gestational age, asymmetrical IUGR

Correct Answer: 3

Rationale:

1. The infant is preterm at 37 weeks. Because the weight is below the 10^th percentile, the infant is not appropriate for gestational age, but is considered small for gestational age. Head circumference and length between the 10^th and 90^th percentiles indicate asymmetrical IUGR. Symmetrical IUGR would have head circumference below the 10^th
2. The infant is preterm at 37 weeks. Because the weight is below the 10^th percentile, the infant is small for gestational age. Head circumference and length between the 10^th and 90^th percentiles indicate asymmetrical IUGR. Symmetrical IUGR would have head circumference below the 10^th
3. The infant is preterm at 37 weeks. Because the weight is below the 10^th percentile, the infant is small for gestational age. Head circumference and length between the 10^th and 90^th percentiles indicate asymmetrical IUGR.
4. The infant is preterm at 37 weeks. Because the weight is below the 10^th percentile, the infant is not appropriate for gestational age, he is considered small for gestational age. Head circumference and length between the 10^th and 90^th percentiles indicate asymmetrical IUGR.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 28.2 Compare the underlying etiologies of the physiologic complications of small-for-gestational-age (SGA) newborns and preterm appropriate-for-gestational-age (Pr AGA) newborns, and the nursing care management for each.

Chapter 28_LO02 _Q03

A 38-week newborn is found to be small for gestational age. Which of the following nursing interventions should be included in the care of this newborn?

1. Monitor for feeding difficulties.
2. Assess for facial paralysis.
3. Monitor for signs of hyperglycemia.
4. Maintain a warm environment.

Answer: 4

Rationale:

1. LGA newborns are more difficult to arouse to a quiet alert state, and can have feeding difficulties.
2. LGA newborns often are prone to birth trauma, such as facial paralysis, due to cephalopelvic disproportion.
3. SGA newborns are more prone to hypoglycemia.
4. Hypothermia is a common complication of the SGA newborn; therefore, the newborn’s environment must remain warm, to decrease heat loss.

Cognitive Level: Analysis

Category of Client Need: Physiological Integrity: Reduction of Risk Potential

Nursing Process: Implementation

Learning Outcome: 28.2 Compare the underlying etiologies of the physiologic complications of small-for-gestational-age (SGA) newborns and preterm appropriate-for-gestational-age (Pr AGA) newborns, and the nursing care management for each.

Chapter 28_LO03 _Q04

A 7 pound, 14 ounce girl was born to an insulin-dependent type II diabetic mother two hours ago. The infant’s blood sugar is 45. The best nursing action is:

1. Recheck the blood sugar in four hours.
2. Begin an IV of 10% dextrose.
3. Feed the baby one ounce of formula.
4. Document the findings in the chart.

Correct Answer:  4

Rationale:

1. Infants of diabetic mothers should be fed frequently, and should have their blood sugar assessed frequently. Four hours is too long a time frame.
2. 45 is considered a normal blood sugar reading for a neonate. No IV is needed.
3. Feeding would be appropriate if the infant’s blood sugar were below 40, but this infant’s reading is 45.
4. A blood sugar of 45 is a normal finding; documentation is an appropriate action.

Cognitive level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 28.3 Explain the impact, common complications, and clinical therapy of maternal diabetes mellitus on the newborn in nursing care management.