WorksheetsPEDS exam questions
Total questions: 56
Worksheet time: 29mins
Part of the health assessment of a newborn is observing the infant‘s breathing pattern. A
full-term newborn‘s breathing pattern is predominantly
abdominal with synchronous chest movements
chest breathing with nasal flaring
diaphragmatic with chest retraction
deep with a regular rhythm.
While assessing the newborn, the nurse should be aware that the average expected apical pulse range of a full-term, quiet, alert newborn is
80 to 100 beats/min
100 to 120 beats/min
120 to 160 beats/min
150 to 180 beats/min
A new mother states that her infant must be cold because thebaby‘s hands and feet are blue.
thenurse explains that this is a common and temporary condition called
acrocyanosis
erythema neonatorum
harlequin color
vernix caseosa
While evaluating the reflexes of a newborn, the nurse notes that with a loud noise the newborn
symmetrically abducts and extends his arms, his fingers fan out and form a C with the thumb
and forefinger, and he has a slight tremor. The nurse would document this finding as a positive
tonic neck reflex
glabellar (Myerson) reflex
Babinski reflex
Moro reflex
While evaluating the reflexes of a newborn, the nurse strokes the sole of the foot upward along the lateral aspect of the sole and then across the ball of the foot. The toes hyperextend, with dorsiflexion of the big toe. The nurse would document this finding as a positive
tonic neck reflex
glabellar (Myerson) reflex
Babinski reflex
Moro reflex
Which newborn reflex is elicited by stroking the lateral sole of the infant‘s foot from the heel to
the ball of the foot?
tonic neck reflex
glabellar (Myerson) reflex
Babinski reflex
Moro reflex
A first-time father is changing the diaper of his 1-day-old daughter. He asks the nurse, What is this black, sticky stuff in her diaper? The nurse‘s best response is
That‘s meconium, which is your baby‘s first stool. It‘s normal
That‘s transitional stool
That means your baby is bleeding internally
Oh, don‘t worry about that. It‘s okay
As related to the normal functioning of the renal system in newborns, nurses should be aware
that
the pediatrician should be notified if the newborn has not voided in 24 hours.
breastfed infants likely will void more often during the first days after birth
Brick dust‖ or blood on a diaper is always a cause to notify the physician
weight loss from fluid loss and other normal factors should be made up in 4 to 7
days
A first-time dad is concerned that his 3-day-old daughter‘s skin looks yellow. In the nurse‘s
explanation of physiologic jaundice, what fact should be included?
Physiologic jaundice occurs during the first 24 hours of life.
Physiologic jaundice is caused by blood incompatibilities between the mother and
infant blood types
The bilirubin levels of physiologic jaundice peak between 72 to 96 hours of life
This condition is also known as ―breast milk jaundice
A meconium stool can be differentiated from a transitional stool in the newborn because
the meconium stool is
seen at age 3 days
the residue of a milk curd
passed in the first 12 hours of life
lighter in color and looser in consistency
The parents of a newborn ask thenurse how much thenewborn can see. theparents specifically
want to know what type of visual stimuli they should provide for their newborn. the nurse
responds to the parents by telling them
Infants can see very little until about 3 months of age
Infants can track their parent‘s eyes within 12 inches and distinguish patterns; they prefer complex patterns
The infant‘s eyes must be protected. Infants enjoy looking at brightly colored
stripes
It‘s important to shield the newborn‘s eyes. Overhead lights help them see better
With regard to the newborn‘s developing cardiovascular system, nurses should be aware that
the heart rate of a crying infant may rise to 120 beats/min
heart murmurs heard after the first few hours are cause for concern
the point of maximal impulse (PMI) often is visible on the chest wall
persistent bradycardia may indicate respiratory distress syndrome (RDS)
The nurse caring for the newborn should be aware that the sensory system least mature at
the time of birth is
vision
hearing
smell
taste
An infant boy was born just a few minutes ago. the nurse is conducting the initial assessment.
Part of the assessment includes the Apgar score. the Apgar assessment is performed
only if the newborn is in obvious distress.
once by the obstetrician, just after the birth.
at least twice, 1 minute and 5 minutes after birth
every 15 minutes during the newborn‘s first hour after birth
A new father wants to know what medication was put into his infant‘s eyes and why it is
needed. the nurse explains to the father that the purpose of the erythromycin ophthalmic
ointment is to
destroy an infectious exudate caused by Staphylococcus that could make the infant
blind
prevent gonorrheal and chlamydial infection of the infant‘s eyes potentially
acquired from the birth canal
prevent potentially harmful exudate from invading the tear ducts of the infant‘s
eyes, leading to dry eyes
prevent the infant‘s eyelids from sticking together and help the infant see
A newborn is jaundiced and receiving phototherapy via ultraviolet bank lights. An appropriate
nursing intervention when caring for an infant with hyperbilirubinemia and receiving
phototherapy by this method would be to
apply an oil-based lotion to the newborn's skin to prevent dying and cracking
limit the newborn's intake of milk to prevent nausea, vomiting, and diarrhea
place eye shields over the newborn's closed eyes
change the newborn's position every 4 hours
The nurse‘s initial action when caring for an infant with a slightly decreased temperature is to
notify the physician immediately
place a cap on the infant's head
tell the mother that the infant must be kept in the nursery and observed for the next 4
hours
change the formula because this is a sign of formula intolerance
An Apgar score of 10 at 1 minute after birth would indicate a(n)
infant having no difficulty adjusting to extrauterine life and needing no further
testing
infant in severe distress who needs resuscitation
prediction of a future free of neurologic problems
infant having no difficulty adjusting to extrauterine life but who should be assessed
again at 5 minutes after birth
A mother expresses fear about changing her infant‘s diaper after he is circumcised. What does
the woman need to be taught to take care of the infant when she gets home?
Cleanse the penis with prepackaged diaper wipes every 3 to 4 hours
Apply constant, firm pressure by squeezing the penis with the fingers for at least 5
minutes if bleeding occurs
Cleanse the penis gently with water and put petroleum jelly around the glans after
each diaper change
Wash off the yellow exudate that forms on the glans at least once every day to
prevent infection
With regard to umbilical cord care, nurses should be aware that
the stump can easily become infected
a nurse noting bleeding from the vessels of the cord should immediately call for
assistance
the cord clamp is removed at cord separation
the average cord separation time is 5 to 7 days
As part of their teaching function at discharge, nurses should educate parents regarding safe
sleep. Which statement is incorrect?
Prevent exposure to people with upper respiratory tract infections
Keep the infant away from secondhand smoke
Avoid loose bedding, water beds, and beanbag chairs
Place the infant on his or her abdomen to sleep
The normal term infant has little difficulty clearing the airway after birth. Most secretions are
brought up to the oropharynx by the cough reflex. However, if the infant has excess secretions,
the mouth and nasal passages can be cleared easily with a bulb syringe. When instructing
parents on the correct use of this piece of equipment, it is important that the nurse teach them to
avoid suctioning the nares
insert the compressed bulb into the center of the mouth
suction the mouth first
remove the bulb syringe from the crib when finished
Pain should be assessed regularly in all newborn infants. If theinfant is displaying physiologic
or behavioral cues indicating pain, measures should be taken to manage thepain. Examples of
nonpharmacologic pain management techniques include (Select all that apply.)
swaddling
nonnutritive sucking
skin-to-skin contact with the mother
sucrose
acetaminophen
Hearing loss is one of thegenetic disorders included in theuniversal screening program.
Auditory screening of all newborns within thefirst month of life is recommended by
theAmerican Academy of Pediatrics. Reasons for having this testing performed include
(Select all that apply.)
prevention or reduction of developmental delay
reassurance for concerned new parents
early identification and treatment
helping the child communicate better
recommendation by the Joint Committee on Infant Hearing.
A new mother recalls from prenatal class that she should try to feed her newborn daughter
when she exhibits feeding readiness cues rather than waiting until her infant is crying
frantically. On the basis of this information, this woman should feed her infant about every 2.5
to 3 hours when she
waves her arms in the air
makes sucking motions
has hiccups
stretches her legs out straight
A new father is ready to take his wife and newborn son home. He proudly tells the nurse who
is discharging them that within the next week he plans to start feeding the infant cereal between breastfeeding sessions. the nurse can explain to him that beginning solid foods before 4 to 6 months may
decrease the infant‘s intake of sufficient calories
lead to early cessation of breastfeeding
help the infant sleep through the night
limit the infant‘s growth
A pregnant woman wants to breastfeed her infant; however, her husband is not convinced that
there are any scientific reasons to do so. thenurse can give thecouple printed information
comparing breastfeeding and bottle-feeding. Which statement is most accurate? Bottle-feeding using commercially prepared infant formulas
increases the risk that the infant will develop allergies
helps the infant sleep through the night
ensures that the infant is getting iron in a form that is easily absorbed
requires that multivitamin supplements be given to the infant
A after birth woman telephones about her 4-day-old infant. She is not scheduled for a weight
check until the infant is 10 days old, and she is worried about whether breastfeeding is going
well. Effective breastfeeding is indicated by the newborn who
sleeps for 6 hours at a time between feedings
has at least one breast milk stool every 24 hours
gains 1 to 2 ounces per week
has at least 6 to 8 wet diapers per day
A breastfeeding woman develops engorged breasts at 3 days after birth. What action would
help this woman achieve her goal of reducing the engorgement? the woman
skips feedings to let her sore breasts rest
avoids using a breast pump
breastfeeds her infant every 2 hours
reduces her fluid intake for 24 hours
A primiparous woman is delighted with her newborn son and wants to begin breastfeeding as
soon as possible. the nurse can facilitate the infant's correct latch-on by helping the woman hold the infant
with his arms folded together over his chest
curled up in a fetal position
with his head cupped in her hand
with his head and body in alignment
A new mother wants to be sure that she is meeting her daughter‘s needs while feeding her
commercially prepared infant formula. the nurse should evaluate the mother‘s knowledge about appropriate infant care. the mother meets her child‘s needs when she
adds rice cereal to her formula at 2 weeks of age to ensure adequate nutrition
warms the bottles using a microwave oven
burps her infant during and after the feeding as needed
refrigerates any leftover formula for the next feeding
The nurse is discussing storage of breast milk with a mother whose infant is preterm and in
the special care unit. What statement would indicate that the mother needs additional teaching?
I can store my breast milk in the refrigerator for 3 months
I can store my breast milk in the freezer for 3 months
I can store my breast milk at room temperature for 8 hours
I can store my breast milk in the refrigerator for 3 to 5 days
According to the recommendations of the American Academy of Pediatrics on infant nutrition
infants should be given only human milk for the first 6 months of life
infants fed on formula should be started on solid food sooner than breastfed
infants
if infants are weaned from breast milk before 12 months, they should receive
cow‘s milk, not formula
after 6 months mothers should shift from breast milk to cow‘s milk
The nurse is explaining the benefits associated with breastfeeding to a new mother. Which
statement by the nurse would be inaccurate and provide conflicting information to the patient?
Women who breastfeed have a decreased risk of breast cancer
Breastfeeding is an effective method of birth control
Breastfeeding increases bone density
Breastfeeding may enhance after birth weight loss
With regard to the nutrient needs of breastfed and formula-fed infants, nurses should
understand that
breastfed infants need extra water in hot climates
during the first 3 months breastfed infants consume more energy than do
formula-fed infants
breastfeeding infants should receive oral vitamin D drops daily at least during
the first 2 months
vitamin K injections at birth are not needed for infants fed on specially enriched
formula
In assisting the breastfeeding mother position the baby, nurses should keep in mind that
the cradle position usually is preferred by mothers who had a cesarean birth
women with perineal pain and swelling prefer the modified cradle position
whatever the position used, the infant is belly to belly with the mother
while supporting the head, the mother should push gently on the occiput
The process whereby parents awaken the infant to feed every 3 hours during the day and at
least every 4 hours at night is
known as demand feeding
necessary during the first 24 to 48 hours after birth
used to set up the supply-meets-demand system
a way to control cluster feeding
To prevent nipple trauma, the nurse should instruct the new mother to
limit the feeding time to less than 5 minutes
position the infant so the nipple is far back in the mouth
assess the nipples before each feeding
wash the nipples daily with mild soap and water
A nurse is discussing thesigns and symptoms of mastitis with a mother who is breastfeeding.
What signs and symptoms should the nurse include in her discussion? (Select all that apply.)
Breast tenderness
Warmth in the breast
An area of redness on the breast often resembling the shape of a pie wedge
A small white blister on the tip of the nipple
Fever and flu-like symptoms
A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization
the infant is weighed, and the birth weight is 4550 g (9 lbs, 6 ounces). the nurse‘s most
appropriate action is to
leave the infant in the room with the mother.
take the infant immediately to the nursery
perform a gestational age assessment to determine whether the infant is large for
gestational age
monitor blood glucose levels frequently and observe closely for signs of
hypoglycemia
Infants of mothers with diabetes (IDMs) are at higher risk for developing
anemia
hyponatremia
respiratory distress syndrome
sepsis
An infant was born 2 hours ago at 37 weeks of gestation and weighing 4.1 kg. theinfant
appears chubby with a flushed complexion and is very tremulous. the tremors are most likely
the result of
birth injury
hypocalcemia
hypoglycemia
seizures
A newborn was admitted to the neonatal intensive care unit after being delivered at 29 weeks
of gestation to a 28-year-old multiparous, married, Caucasian woman whose pregnancy was
uncomplicated until premature rupture of membranes and preterm birth. the newborn's parents arrive for their first visit after the birth. the parents walk toward the bedside but remain approximately 5 feet away from the bed. the nurse's most appropriate action would be to
wait quietly at the newborn's bedside until the parents come closer
go to the parents, introduce himself or herself, and gently encourage the parents to
come meet their infant; explain the equipment first, and then focus on the newborn
leave the parents at the bedside while they are visiting so they can have some
privacy
tell the parents only about the newborn's physical condition, and caution them to
avoid touching their baby
Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa.
the signs of NEC are nonspecific. Some generalized signs include
hypertonia, tachycardia, and metabolic alkalosis
abdominal distention, temperature instability, and grossly bloody stools
hypertension, absence of apnea, and ruddy skin color
scaphoid abdomen, no residual with feedings, and increased urinary output
A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure
dates. A nonstress test (NST) in the obstetrician‘s office revealed a nonreactive tracing. On
artificial rupture of membranes, thick, meconium-stained fluid was noted. the nurse caring for
the infant after birth should anticipate
meconium aspiration, hypoglycemia, and dry, cracked skin
excessive vernix caseosa covering the skin, lethargy, and respiratory distress
syndrome
golden yellow- to green stained–skin and nails, absence of scalp hair, and an
increased amount of subcutaneous fat
hyperglycemia, hyperthermia, and an alert, wide-eyed appearance
Necrotizing enterocolitis (NEC) is an acute inflammatory disease of thegastrointestinal
mucosa that can progress to perforation of thebowel. Care is supportive; however, known
interventions may decrease the risk of NEC. To develop an optimal plan of care for this infant,
the nurse must understand which intervention has the greatest effect on lowering the risk of
NEC
early enteral feedings
breastfeeding
exchange transfusion
prophylactic probiotics
A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A
cesarean section is performed for failure to progress. the fetal heart rate (FHR) before birth is
180 beats/min with limited variability. At birth the newborn has Apgar scores of 6 and 7 at 1
and 5 minutes and is noted to be pale and tachypneic. On the basis of the maternal history,
the cause of this newborn‘s distress is most likely to be
hypoglycemia
phrenic nerve injury
respiratory distress syndrome
sepsis
The most important nursing action in preventing neonatal infection is
good hand washing
isolation of infected infants
separate gown technique
Standard Precautions
A pregnant woman presents in labor at term, having had no prenatal care. After birth her
infant is noted to be small for gestational age with small eyes and a thin upper lip. theinfant
also is microcephalic. On thebasis of her infant‘s physical findings, this woman should be
questioned about her use of which substance during pregnancy?
Alcohol
Cocaine
Heroin
Marijuana
A plan of care for an infant experiencing symptoms of drug withdrawal should include
administering chloral hydrate for sedation
feeding every 4 to 6 hours to allow extra rest
swaddling the infant snugly and holding the baby tightly
playing soft music during feeding
Human immunodeficiency virus (HIV) may be perinatally transmitted
a. only in the third trimester from the maternal circulation.
by a needlestick injury at birth from unsterile instruments
only through the ingestion of amniotic fluid
through the ingestion of breast milk from an infected mother
The abuse of which of the following substances during pregnancy is the leading cause of
cognitive impairment in the United States?
Alcohol
Tobacco
Marijuana
Heroin
Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team. Nursing care for this infant requires a multisystem approach. the first step in the provision of this care is
pharmacologic treatment
reduction of environmental stimuli
neonatal abstinence syndrome scoring
adequate nutrition and maintenance of fluid and electrolyte balance
While completing a newborn assessment, the nurse should be aware that the most common
birth injury is
to the soft tissues
caused by forceps gripping the head on delivery
fracture of the humerus and femur
fracture of the clavicle
Which infant would be more likely to have Rh incompatibility?
Infant of an Rh-negative mother and a father who is Rh positive and homozygous
for the Rh factor.
Infant who is Rh negative and whose mother is Rh negative
Infant of an Rh-negative mother and a father who is Rh positive and heterozygous
for the Rh factor
Infant who is Rh positive and whose mother is Rh positive
The goal of treatment of the infant with phenylalanine hydroxylase deficiency (PAH) is to
cure mental retardation
prevent central nervous system (CNS) damage, which leads to mental retardation
prevent gastrointestinal symptoms
cure the urinary tract infection
