Chapter 29: High-Risk Newborn: Complications Associated with Gestational Age and Development

Foundations Of Maternal Newborn and Women's Health Nursing, 6th Edition by Sharon Smith Murray

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Chapter 29: High-Risk Newborn: Complications Associated with Gestational Age and Development

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. Which is most helpful in preventing premature birth?
a. High socioeconomic status
b. Adequate prenatal care
c. Aid to Families with Dependent Children
d. Women, Infants, and Children (WIC) nutritional program

 

 

ANS:  B

Prenatal care is vital for identifying possible problems. People with higher socioeconomic status are more likely to seek adequate prenatal care, which is the most helpful for prevention. Lower socioeconomic groups do not seek out health care, and that puts them at risk for preterm labor. Aid to Families with Dependent Children and WIC aid in the nutritional status of the pregnant woman, but the most helpful aid for the prevention of premature births is adequate prenatal care.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   623

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Health Promotion and Maintenance

 

  1. In comparison with the term infant, the preterm infant has:
a. More subcutaneous fat.
b. Well-developed flexor muscles.
c. Few blood vessels visible through the skin.
d. Greater surface area in proportion to weight.

 

 

ANS:  D

Preterm infants have greater surface area in proportion to their weight. More subcutaneous fat, well-developed flexor muscles, and few blood vessels visible through the skin are more characteristic of a term infant.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   623

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

 

  1. Decreased surfactant production in the preterm lung is a problem because:
a. Surfactant keeps the alveoli open during expiration.
b. Surfactant causes increased permeability of the alveoli.
c. Surfactant dilates the bronchioles, decreasing airway resistance.
d. Surfactant provides transportation for oxygen to enter the blood supply.

 

 

ANS:  A

Surfactant prevents the alveoli from collapsing each time the infant exhales, thus reducing the work of breathing. It does not affect the bronchioles. By keeping the alveoli open, it permits better oxygen exchange, but that is not its main purpose.

 

PTS:   1                    DIF:    Cognitive Level: Understanding       REF:   623

OBJ:   Nursing Process Step: Assessment   MSC:  Client Needs: Physiologic Integrity

 

  1. A preterm infant is on a respirator, with intravenous lines and much equipment. When the parents come to visit for the first time, which is an important response by the nurse?
a. Encourage the parents to touch their infant.
b. Reassure the parents that the infant is progressing well.
c. Discuss the care they will give their infant when the infant goes home.
d. Suggest that the parents visit for only a short time to reduce their anxiety.

 

 

ANS:  A

Touching the infant will increase the development of attachment. It is important to keep the parents informed about the infant’s progress, but the nurse needs to be honest with the explanations. Discussing home care is an important part of parent teaching but is not the most important priority during the first visit. Bonding needs to occur, and this can be fostered by encouraging the parents to spend time with the infant.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   641

OBJ:   Nursing Process Step: Implementation

MSC:  Client Needs: Psychosocial Integrity

 

  1. Which preterm infant should receive gavage feedings instead of bottle feedings?
a. Sucks on a pacifier during gavage feedings
b. Sometimes gags when a feeding tube is inserted
c. Has a sustained respiratory rate of 70 breaths/min
d. Has an axillary temperature of 98.4° F, an apical pulse of 149 beats/min, and respirations of 54 breaths/min

 

 

ANS:  C

Infants less than 34 weeks of gestation or those who weigh less than 1500 g generally have difficulty with bottle feeding. Gavage feedings should be initiated if the respiratory rate is above 60 breaths/min. Providing a pacifier during gavage feedings gives positive oral stimulation and helps the infant associate the comfortable feeling of fullness with sucking. The presence of the gag reflex is important before initiating bottle feeding. Axillary temperature of 98.4° F, an apical pulse of 149 beats/min, and respirations of 54 breaths/min are within expected limits and an indication that the infant is not having respiratory problems at that time.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   631

OBJ:   Nursing Process Step: Evaluation     MSC:  Client Needs: Physiologic Integrity

 

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