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Chapter 19: Caring for the Newborn at Risk Nursing School Test Banks
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Chapter 19: CarŤng for the Search … Newborn at RŤsk NursŤng
School Test Banks
Chapter 19: Caring for the Newborn at Risk
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
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,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
2/36
,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 babys 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
3/36
, 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
6. An infant who is possibly infected with herpes simplex
infection is being dismissed. What medication should the
nurse anticipate instructing the parents on giving?
A. Acyclovir (Avirax)
B. Ampicillin (Omnipen)
C. Cephtriaxone (Rocephin)
D. Hydroxyzine (Atarax)
ANS: A
Herpes simplex is a viral infection, so an antiviral such as
acyclovir is warranted. Antibiotics such as ampicillin and
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