Exam (elaborations)
Chapter 30 The High-Risk Newborn Acquired and Congenital Conditions
- Course
- Nursing
- Institution
- University At Buffalo
Chapter 30 The High-Risk Newborn Acquired and Congenital Conditions
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Chapter 30: The High-Risk Newborn: Acquired and Congenital ConditionsTest Bank
MULTIPLE CHOICE
1. The infant of a mother with diabetes is hypoglycemic. What type of feeding should be
instituted first?
a. Glucose water in a bottle
b. D5W intravenously
c. Formula via nasogastric tube
d. Breast milk
ANS: D
Feedback
A High levels of dextrose correct the hypoglycemia but will stimulate the
production of more insulin.
B Oral feedings are tried first; intravenous lines should be a later choice if the
hypoglycemia continues.
C Formula does provide longer normal glucose levels but would be administered
via bottle, not by tube feeding.
D Breast milk is metabolized more slowly and provides longer normal glucose
levels.
PTS: 1 DIF: Cognitive Level: Application REF: p. 729
OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
2. The most common cause of pathologic hyperbilirubinemia is
a. Hepatic disease
b. Hemolytic disorders in the newborn
c. Postmaturity
d. Congenital heart defect
ANS: B
Feedback
A Hepatic damage may be a cause of pathologic hyperbilirubinemia, but it is not
the most common cause.
B Hemolytic disorders in the newborn are the most common cause of pathologic
jaundice.
C Prematurity is a potential cause of pathologic hyperbilirubinemia in neonates,
but it is not the most common cause.
D Congenital heart defect is not a common cause of pathologic hyperbilirubinemia
in neonates.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 721
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
, 3. An infant with severe meconium aspiration syndrome (MAS) is not responding to
conventional treatment. Which highly technical method of treatment may be necessary for an
infant who does not respond to conventional treatment?
a. Extracorporeal membrane oxygenation
b. Respiratory support with ventilator
c. Insertion of laryngoscope and suctioning of the trachea
d. Insertion of an endotracheal tube
ANS: A
Feedback
A Extracorporeal membrane oxygenation is a highly technical method that
oxygenates the blood while bypassing the lungs, allowing the infant's lungs to
rest and recover.
B The infant is likely to have been first connected to a ventilator.
C Laryngoscope insertion and tracheal suctioning are performed after birth before
the infant takes the first breath.
D An endotracheal tube will be in place to facilitate deep tracheal suctioning and
ventilation.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 720
OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity
4. Four hours after delivery of a healthy neonate of an insulin-dependent diabetic woman, the
baby appears jittery, irritable, and has a high-pitched cry. Which nursing action has top
priority?
a. Start an intravenous line with D5W.
b. Notify the clinician stat.
c. Document the event in the nurses' notes.
d. Test for blood glucose level.
ANS: D
Feedback
A It is not common practice to give intravenous glucose to a newborn. Feeding the
infant is preferable because the formula or breast milk will last longer.
B Test blood glucose level according to agency policy, treat symptoms with
standing orders protocol, and notify the physician with the results.
C Documentation can wait until the infant has been tested and treated if a problem
is present.
D These symptoms are signs of hypoglycemia in the newborn. Permanent damage
can occur if glucose is not constantly available to the brain, but it is not common
practice to give intravenous glucose to a newborn. Feeding the infant is
preferable because the formula or breast milk will last longer.
PTS: 1 DIF: Cognitive Level: Application REF: p. 728
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
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