WorksheetsSick Newborn
Total questions: 42
Worksheet time: 22mins
Which of the following is the newborn at risk for during delivery when the amniotic fluid is stained greenish?
atelectasis
meconium aspiration
bronchopulmonary dysplasia
patent ductus arteriosus
What term best describes an infant born with a birth weight under the 10th percentile for gestational age?
appropriate for gestational age
failure to thrive
small for gestational age
infant born to a mother with diabetes
Based on the following risk factors, which newborn is least at risk for developing persistant pulmonary hypertension?
late or postdates delivery
born to a mother with gestational diabetes
appropriate for gestational age
meconium aspiration
Surfactant administration causes which of the following?
increased pulmonary vascular resistance
increased cerebral blood flow
decreased surface tension with increased lung compliance
increased blood viscosity
If the nurse is suspicious of necrotizing enterocolitis (NEC) in the infant, which intervention should take place first?
stop feedings
obtain a blood gas
call the MD/NNP
check electrolytes
Which causes infants of diabetic mothers to be large for gestational age?
maternal insulin crosses the placenta & makes the baby large
blood flow across the placenta is greater than normal
maternal doses of insulin are absorbed by the infant & cause increased body growth
maternal glucose crosses the placenta & causes the infant to produce more insulin than usual, resulting in greater body growth
Which factor places the premature infant at greatest risk for retinopathy of prematurity?
34 weeks of gestation
a weight of 2 kg
having bronchopulmonary dysplasia
erythromycin eye ointment was not given at birth
Which clinical sign is most concerning immediately following the delivery of a high-risk neonate?
axillary temperature of 97.8 deg. F
blood glucose of 35 g/dL
oxygen saturation of 90%
blue-tinged hands and feet
Which maternal risk factor places the high-risk infant at greatest risk of developing sepsis during or after delivery?
rupture of membranes at delivery
father has the flu
maternal fever
history of herpes simplex treated with valacyclovir
Which infant is at greatest risk of developing hypoglycemia after delivery?
severe small for gestational age infant
appropriate for gestational age infant
infant of a diabetic mother with good maternal blood glucose control
cold-stressed term infant
A mother is on methadone. She has been told by her OB that her infant will not withdraw from this medication. At 3 days of life, the infant is jittery, inconsolable, feeding poorly, and having diarrhea. What is the most appropriate statement for the RN to make to the mother at this time?
infants are often fussy during the newborn period
your baby is showing signs & symptoms of withdrawal from methadone & may need medication
your baby probably has hypoglycemia. I will get the doctor.
your baby is showing signs of colic & difficult temperment
Immediate conditions that pose nursing concerns for the small-for-gestational age newborn include which of the following?
long-term chronic care or end-of-life care
bronchopulmonary dysplasia & ischemia
muscle contractures & hyperthermia
hypothermia & pain management
A baby is being treated for hyperbilirubinemia with phototherapy. The baby is in an incubator, fully undressed. Which of the following nursing actions are inconsistent with best practice for this type of infant?
apply eye patches and a covering over the genital area
administer proper nutrition to ensure the clearance of bilirubin
apply a stockinet hat to prevent heat loss
maintain adequate hydration to promote bilirubin excretion
A nurse is caring for a premature infant in the NICU. When does the nurse begin discharge planning?
on the baby's admission to NICU
1 week prior to the planned discharge
when parents are able to learn about care
when the baby is medically stable
A nurse documents that a newborn is post-term based on the understanding that he was born after:
38 weeks' gestation
40 weeks' gestation
42 weeks' gestation
44 weeks' gestation
SGA and LGA babies have an excessive number of red blood cells because of:
hypoxia
hypoglycemia
hypocalcemia
hypothermia
Because subcutaneous and brown fat stores were used for survivial in utero, the nurse would assess an SGA newborn for which of the following?
hyperbilirubinemia
hypoglycemia
hypocalcemia
hypothermia
In assessing a preterm newborn, which of the following findings would be of greatest concern?
milia over the bridge of the nose
thin transparent skin
poor muscle tone
heart murmur
The RN is providing care to several newborns with different gestational ages & birth weights. When developing the plan of care for these newborns, the nurse focuses on energy conservation to promote growth & development. Which measures would the nurse include in the plan of care? Select all that apply.
keep handling of the newborn to a minimum
maintain a neutral thermal environment
decreasing environemental stimuli
initiating early oral feedings
prevent the parents from visiting their babies
Which of the following concepts would the nurse incorporate into the plan of care when assessing pain in a newborn with special needs?
newborns experience pain primarily with surgical procedures
preterm newborns in NICU are at the least risk for pain
pain assessment needs to be comprehensive & frequent
a newborn's facial expression is the primary indicator of pain
A preterm infant is placed under the radiant warmer after birth. The nurse evaluates the temperature frequently to prevent which of the following:
cold stress
respiratory depression
tachycardia
thermogenesis
Which of the following lab values needs to be monitored by the nurse when providing care for a large for gestational age infant?
WBC
direct Coombs test
blood glucose
potassium level
Which of the following would the RN expect to see in a newborn who has respiratory distress syndrome?
abdominal distention
acrocyanosis
depressed fontanels
nasal flaring
When assessing the substance-exposed newborn, which finding would the nurse expect?
calm facial appearance
daily weight gain
increasing irritability
feeding & sleeping well
The nurse would be alert for the development of transient tachypnea of the newborn who:
was born by cesarean birth
received no sedation
has a mother with heart disease
is small for gestational age
Which finding would the nurse expect to assess in an infant with developmental dysplasia of the hip?
symmetrical thigh folds
even knee height
full abduction of the hip
audible clunk on hip abduction
A 30-week preterm male developed tachypnea during the first few hours of life. Oxygen at 100% via face mask doesn't improve his oxygenation saturation level. Which of the following substances, if administered to the mother prenatally, could have prevented respiratory distress syndrome?
insulin
lecithin
folic acid
betamethasone
A newborn suffering from respiratory distress syndrome is given supplemental oxygen. Which of the following is a possible consequence of oxygen therapy?
cardiac anomalies
blindness
anosomia
atelectasis
A 27 wk old baby is now 3 wks old. He's on O2 by nasal cannula & feedings are by gavage, 12 mL each. On assessment, you note his abdomen is slightly distended, his activity is decreased from the previous assessment, & there is a prefeeding gastric residual of 6 mL. His temperature has dropped from 36.2 to 35.8. What are your priority interventions now? Select all that apply.
obtain a full set of VS, including BP & O2 saturation
withhold the feeding that is due now
discuss the findings with the nurse practitioner
observe the baby closely while giving the next feeding
measure the baby's abdominal girth
A 27 wk old baby is now 3 wks old. He's on O2 by nasal cannula & feedings are by gavage, 12 mL each. On assessment, you note his abdomen is slightly distended, his activity is decreased from the previous assessment, & there is a prefeeding gastric residual of 6 mL. His temperature has dropped from 36.2 to 35.8. The nurse recognizes that these symptoms most likely mean:
transient feeding intolerance
respiratory distress syndrome
necrotizing enterocolitis
bronchopulmonary dysplasia
In addition to hypoglycemia, the infant of a diabetic mother should be observed for:
hydrocephalus
hyperglycemia
respiratory distress
sepsis
Nursing care that reduces the risk for periventricular or intraventricular hemorrhage includes:
assessing for abnormal heart rhythms or murmurs
handling the infant minimally & gently
providing stimulation to enhance brain function
supplementing with high levels of oxygen
An infant is born cyanotic, with poor muscle tone & gasping respirations. He has been positioned under a radiant warmer, suctioned, dried, & stimulated. There is little improvement. What should be done next?
determine the Apgar score
try flicking the feet to stimulate the infant
begin resuscitation
reposition the baby
The nurse notes that a 24-hour-old infant is lethargic & his temperature is below normal, a change from an earlier assessment, which was normal. His mother states he didn't breastfeed well & that he spit up the small amount he'd ingested. The nurse's next action should be to:
reasssure the mom that infants are often sluggish this soon after birth
assess for signs of sepsis & report the assessments to the MD
determine whether there is jaundice over the thoracic & abdominal areas
feed the infant formula to determine the intake more accurately
The nurse notes that a 12-hour old infant is jittery, but his blood glucose level is normal. The infant seems hungry but takes only 0.25 oz of formula with difficulty. The nurse's next action should be to:
apply a bag to collect the next sample of urine
recheck the glucose level 30 minutes after the feeding
ask the mother to continue trying to feed the baby
swaddle the infant tightly and feed more formula
Which maternal factors should the nurse consider contributory to a newborn being large for gestational age? Select all that apply.
diabetes mellitus
postdates gestation
alcohol use
prepregnancy obesity
renal infection
The nurse is caring for a client in the early stages of labor. What maternal history factors will alert the nurse to plan for the possibility of a small-for-gestational-age infant? Select all that apply.
maternal smoking during pregnancy
hypotension on admission
asthma exacerbations during pregnancy
drug abuse
pregnancy weight gain of 25#
An infant is born 10 minutes prior & is brought into the nursery for a newborn admission assessment. The RN notes the infant's lip & palate are malformed. The father comes up to the door & asks if the baby is okay. What is the appropriate response by the nurse?
Oh yeah, the baby seems fine, you can see him soon
come on over and I'll explain your baby's exam & findings
wait outside, and we'll call you later
the baby is okay, just wait until your doctor talks to you
An infant is suspected of having persistant pulmonary hypertension (PPHN). What intervention implemented by the nurse would be most beneficial in treating this baby?
encourage the parents to hold the infant for bonding
place the baby in a cool environment to prevent overheating
administer anticonvulsants as ordered
provide oxygen by oxgyen hood or ventilator
A nurse is assigned to care for newborn with hyperbilirubinemia. The newborn is relatively large in size & shows signs of listlessness. What most likely occurred?
the labor was long
the mother probably had diabetes
the baby experienced birth trauma
the mother probably drank alcohol in the pregnancy
A nurse is caring for a newborn with necrotizing enterocolitis who is having surgery tomorrow for a bowel resection. The parents want to know the implications of the surgery. What information do you provide to the parents?
the operation is a short process
surgery will prevent long-term complications.
the surgery requires a proximal ostomy
the surgery causes most babies who have it to die afterward
Which complication or test result is a major sign of ABO blood incompatability that the nurse should look for when assessing a baby?
negative Coombs test
bleeding from the nose or ear
jaundice after the 1st 24 hours of life
jaundice within the 1st 24 hours of life
