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NUR335: Exam 4 (STUDY GUIDE #1) 100q

Total questions: 100

Worksheet time: 53mins

Name
Class
Date
1.

A newborn is showing nasal flaring, grunting, and intercostal retractions. These findings indicate:

a)

Normal transition to extrauterine life

b)

Hyperbilirubinemia

c)

Respiratory distress

d)

Hypoglycemia

2.

Which reflex is expected in a 1-year-old infant?

a)

Moro reflex

b)

Babinski reflex

c)

Stepping reflex

d)

Palmar grasp

3.

Which of the following are expected reflexes in a 3–4-month-old infant? (SATA)

a)

Sucking/rooting

b)

Tonic neck/fencing

c)

Stepping/walking

d)

Babinski

e)

Plantar grasp

4.

Which infant finding is associated with Trisomy 21?

a)

Webbed fingers

b)

Hypertonia

c)

Low-set ears

d)

Long limbs

5.

A newborn is placed under phototherapy. Which nursing action is appropriate?

a)

Apply lotion to prevent dryness

b)

Keep lights 5 inches from the infant

c)

Cover the infant’s eyes

d)

Limit feedings

6.

Which is a risk of improper swaddling?

a)

Hyperthermia

b)

Hip dysplasia

c)

Polycythemia

d)

Failure to thrive

7.

Which assessment indicates a possible circumcision infection? (SATA)

a)

Swelling

b)

Warmth

c)

Yellow crust formation

d)

Purulent drainage

e)

Slight redness around the glans

8.

Which newborn finding is expected after a vaginal delivery?

4 lines
9.

A nurse is assessing hydration in a newborn. What is the best method?

a)

Weighing diapers

b)

Checking skin turgor

c)

Assessing fontanels

d)

Monitoring crying tone

10.

Which finding is associated with neonatal abstinence syndrome (NAS)?

a)

Hypotonia

b)

Decreased respirations

c)

High-pitched cry

d)

Bradycardia

11.

Which three conditions are infants of diabetic mothers at risk for? (SATA)

a)

Macrosomia

b)

Hypoglycemia

c)

Hyperbilirubinemia

d)

Hyperthermia

e)

Bradycardia

12.

Which is the leading cause of newborn infection?

a)

CMV

b)

Hepatitis B

c)

RSV

d)

Group B Streptococcus

13.

A newborn delivered by cesarean has tachypnea and mild retractions. The nurse suspects:

a)

RDS

b)

Moist lungs from extra fluid

c)

Hypoglycemia

d)

Hyperbilirubinemia

14.

Which is a complication of respiratory distress syndrome (RDS)?

a)

Dehydration

b)

Pulmonary edema

c)

Hypothermia

d)

Hypercalcemia

15.

Which APGAR components are assessed? (SATA)

a)

Respiratory effort

b)

Reflex irritability

c)

Blood glucose

d)

Muscle tone

e)

Color

16.

When are APGAR scores recorded?

a)

0 and 10 minutes

b)

1 and 5 minutes

c)

Only at 5 minutes

d)

Every 10 minutes

17.

Where is the safest place for an infant car seat?

a)

Front passenger seat

b)

Back seat behind driver

c)

Back seat middle

d)

Front seat middle

18.

Which newborn RR requires further assessment?

a)

32

b)

45

c)

60

d)

72

19.

A newborn has jitteriness, lethargy, and poor feeding. The nurse suspects:

a)

RDS

b)

Hypothermia

c)

Hypoglycemia

d)

Hyperbilirubinemia

20.

Which newborn findings indicate NEC? (SATA)

a)

Abdominal distention

b)

Lethargy

c)

High-pitched cry

d)

Blood in stool

e)

Hyperactivity

21.

A preterm newborn has flaccid posture and translucent skin. The nurse identifies this newborn as:

a)

SGA

b)

LGA

22.

Which temperature indicates newborn hypothermia?

a)

99.2°F

b)

98.4°F

c)

97.2°F

d)

97.8°F

23.

A newborn should void by:

a)

6 hours

b)

12–24 hours

c)

48 hours

d)

72 hours

24.

Which newborn discharge is normal?

a)

Brown mucus

b)

Green streaks

c)

Orange urate crystals

d)

Bright-red blood

25.

The nurse prepares to give vitamin K. Which site is correct?

a)

Deltoid

b)

Ventrogluteal

c)

Vastus lateralis

d)

Dorsogluteal

26.

Which newborn care intervention helps reduce the risk of SIDS?

a)

Placing infant on stomach to sleep

b)

Using loose blankets

c)

Back-to-sleep positioning

d)

Using stuffed animals for comfort

27.

A newborn genetic screening heel stick should be performed:

a)

Immediately after birth

b)

Within 12 hours

c)

At 24 hours of age

d)

On day 3

28.

What is the purpose of erythromycin (EES) eye ointment?

a)

Prevent blindness from congenital cataracts

b)

Prevent bacterial infection acquired during birth

c)

Improve tear production

d)

Prevent glaucoma

29.

Which infant is at greatest risk for hypoglycemia?

a)

Infant born at 41 weeks

b)

Infant of diabetic mother

c)

Infant born vaginally

d)

Infant with mild jaundice

30.

Which actions are included in the Golden Hour? (SATA)

a)

A) Early breastfeeding

b)

B) Skin-to-skin contact

c)

C) Delayed cord clamping

d)

D) Immediate bathing

e)

E) Continuous phototherapy

31.

Which finding is normal for the umbilical cord?

a)

One artery and two veins

b)

Two arteries and one vein

c)

Three arteries only

d)

Single vein only

32.

When caring for the umbilical cord, the parent should:

a)

Clean with alcohol every diaper change

b)

Cover it tightly with the diaper

c)

Keep it clean and dry

d)

Remove crust with cotton swabs

33.

Which assessment finding indicates possible PPHN?

a)

Hyperthermia

b)

Tachypnea

34.

Which long-term complication is associated with PPHN?

a)

Dehydration

b)

Sensorineural hearing loss

c)

Growth hormone deficiency

d)

Hypothyroidism

35.

Which assessment requires immediate intervention in a newborn with RDS?

a)

Respirations of 58

b)

Mild nasal flaring

c)

Skin color gray/dusky

d)

Heart rate 140

36.

A newborn has an APGAR score of 5 at 5 minutes. What should the nurse do next?

a)

Document only

b)

Repeat APGAR at 10 minutes

c)

Call rapid response

d)

Begin chest compressions

37.

Which infant finding is normal?

a)

HR 200 while crying

b)

RR 75

c)

Blue lips

d)

No suck reflex

38.

Which newborn is at risk for NEC?

a)

Full-term, vaginal delivery

b)

Preterm infant

c)

Infant with hypoglycemia

d)

Infant of GBS-negative mother

39.

Which feeding cue appears before crying?

a)

Frantic motions

b)

Arching the back

c)

Rooting

d)

Gasping

40.

Which actions help wake a newborn for breastfeeding?

a)

Un-swaddle

b)

Dim the lights

c)

Allow infant to smell the breast

d)

Gently rub feet

e)

Turn on light

41.

Which milk is higher in fat content?

a)

Foremilk

b)

Hindmilk

c)

Transitional milk

d)

Donor milk

42.

A nurse notes a newborn’s fontanel is full and tense along with bradycardia. This may indicate:

a)

Increased intracranial pressure

b)

Dehydration

c)

Hypoglycemia

d)

Normal variation

43.

What is the correct action for worsening IVH signs?

a)

Frequent stimulation

b)

Administer fluids rapidly

c)

Maintain quiet environment

d)

Increase handling

44.

A premature infant with PDA and BPD is likely to receive which management?

a)

Increased fluids

b)

Water restriction

c)

Frequent bathing

d)

Vitamin D supplementation

45.

Which is an expected finding in Down Syndrome newborns? (SATA)

a)

Protruding tongue

b)

Simian crease

c)

Hypertonia

d)

Low-set ears

e)

Square eyes

46.

Which selection indicates pathological jaundice?

a)

Appears after 24 hours

b)

Resolves within a week

c)

Caused by liver immaturity

d)

Related to disease or blood disorder

47.

Which newborn injection requires support of the leg?

a)

Hepatitis B

b)

Vitamin K

c)

HBIG

d)

Erythromycin

48.

Which finding suggests respiratory distress syndrome? (SATA)

a)

Gray/dusky skin

b)

Grunting

c)

Tachypnea

d)

RR 35

e)

HR 100

49.

Which infant behavior may indicate colic?

a)

Sleeping longer than usual

b)

Flexing legs when crying

c)

Quiet during feedings

d)

Comforted easily

50.

A newborn has temp 36.3°C (97.3°F). Which action prevents further hypothermia?

a)

Delay drying after birth

b)

Remove hat

c)

Skin-to-skin with parent

d)

Give feeding first

51.

Which is a normal newborn blood sugar?

a)

20 mg/dL

b)

32 mg/dL

c)

>40 mg/dL

d)

25 mg/dL

52.

Which bilirubin level is considered normal?

a)

16 mg/dL

b)

12 mg/dL

c)

<12 mg/dL

d)

14 mg/dL

53.

Which newborn temperature is normal?

a)

96.9°F

b)

97.2°F

c)

97.4–99.4°F

d)

100.2°F

54.

A baby born at <26 weeks in the NICU is likely to receive which medication via ET tube?

a)

Glucose gel

b)

Erythromycin

c)

Surfactant

d)

Vitamin K

55.

Which medication is required if the mother is Hepatitis B positive?

a)

Vitamin D

b)

Penicillin

c)

HBIG

d)

Azithromycin

56.

A newborn showing grunting, nasal flaring, and retractions is at risk for:

a)

Hypoglycemia

b)

RDS

c)

Jaundice

d)

NEC

57.

Which discharge is normal in a newborn’s diaper? (SATA)

a)

Orange crystals

b)

Red discharge from maternal hormones

c)

Bright red blood

d)

Brown mucus

e)

Green streaks

58.

What is the FIRST step when resuscitating a newborn?

a)

Provide PPV

b)

Warm infant

59.

Which reflex is normal for an 8-month-old infant?

a)

Moro reflex

b)

Rooting

c)

Palmar–plantar grasp

d)

Stepping reflex

60.

Which condition causes jaundice after 24 hours of age and resolves within a week?

a)

Pathological jaundice

b)

Physiological jaundice

c)

Biliary atresia

d)

Liver failure

61.

A newborn with jaundice is started on fluids and phototherapy. These treatments are used for:

a)

Hypothermia

b)

Hyperbilirubinemia

c)

NEC

d)

RDS

62.

A nurse notes the infant has a weak cry, flaccid posture, and thin translucent skin. This is most consistent with:

a)

Term infant

b)

LGA infant

c)

Preterm infant

d)

SGA infant

63.

Which activity can a CNA perform?

a)

Administer medications

b)

Perform newborn assessment

c)

Weigh baby

d)

Teach breastfeeding

64.

Which is a risk factor for neonatal hypoglycemia? (SATA)

a)

Cold stress

b)

Infant of diabetic mother

c)

Prematurity

d)

Maternal hypertension

e)

Phototherapy

65.

Which newborn behavior indicates illness?

a)

Sleeping quietly

b)

Refusal of two feedings in a row

c)

Crying during diaper change

d)

Mild spitting up

66.

A newborn presents with tremors, diaphoresis, and lethargy. The priority is to assess for:

a)

Hyperthermia

b)

Overfeeding

c)

Hypoglycemia

d)

NEC

67.

Which newborn voiding/stooling pattern is expected by day 3?

(a)  

68.

Which of the following is the expected number of wet diapers and stools for a healthy newborn?

a)

1 wet, 1 stool

b)

2 wets, 2 stools

c)

3 wets and 3 stools daily

d)

5 stools only

69.

The nurse teaches parents about circumcision care. Which is correct?

a)

Yellow crust should be scrubbed off

b)

Check for bleeding every 4 hours for 24 hours

c)

Remove gauze manually

d)

Avoid petroleum ointment

70.

Which is included in the LATCH breastfeeding assessment tool? (SATA)

a)

Latch

b)

Audible swallowing

c)

Nipple type

d)

Heart rate

e)

Baby weight

71.

Which finding indicates effective breastfeeding?

a)

Infant sleeps throughout feeding

b)

Audible swallowing

c)

Mother reports no breast sensation

d)

Baby only sucks intermittently

72.

Which is a characteristic of colic?

a)

Easily soothed

b)

Crying only when hungry

c)

Uncontrollable crying in infants under 5 months

d)

Constant sleeping

73.

Which symptoms indicate colic? (SATA)

a)

Curling legs

b)

Irritable after feeding

c)

Requires frequent cuddling

d)

Sleeping entire night

e)

Quiet during feedings

74.

Which is a sign of NEC?

a)

High-pitched cry

b)

Abdominal distention

c)

Hyperactivity

d)

Frequent stools

75.

Which infant care action helps manage nasal congestion?

a)

Tilting car seat

b)

Bulb syringe use

c)

Warm compress

d)

Extra formula

76.

Which action is correct when using a bulb syringe?

a)

Insert deeply into the nose

b)

Compress the syringe after inserting

c)

Compress before inserting

d)

Use it only on the lips

77.

A newborn is lethargic, tremoring, and not eating. The nurse suspects:

a)

Hyperbilirubinemia

b)

Hypoglycemia

c)

Colic

d)

Hypothermia

78.

When do infants typically develop hunger cues before crying?

a)

Immediately when hungry

b)

10 minutes before crying

c)

30 minutes before crying

d)

After crying begins

79.

Which is a classic sign of Trisomy 21?

a)

Long fingers

b)

Hypertonia

c)

Flat nasal bridge

d)

Large jaw

80.

Which finding requires immediate assessment in a newborn?

a)

Mild jaundice

b)

Difficulty awakening

c)

Irregular sucking

d)

Slight nasal congestion

81.

Which is the correct order for using a bulb syringe?

a)

Insert → Compress → Release

b)

Compress → Insert → Release

c)

Release → Insert → Compress

d)

Insert → Release → Compress

82.

Which infant finding suggests possible neurological trauma or infection?

a)

Flexed extremities

b)

Flaccid tone

c)

Vigorous cry

d)

Strong palmar grasp

83.

Which respiratory rate is normal for a newborn?

a)

20–30

b)

30–60

c)

50–80

d)

10–20

84.

Which newborn heart rate is normal?

a)

80 bpm

b)

98 bpm

c)

140 bpm

d)

200 bpm while sleeping

85.

An infant’s temperature is 97.4°F. The nurse interprets this as:

a)

Hyperthermia

b)

Hypothermia

c)

Low end of normal

d)

Requires ICU care

86.

Which signs indicate respiratory distress? (SATA)

a)

Nasal flaring

b)

Grunting

c)

Tachypnea

d)

Quiet, shallow respirations

e)

Pink, moist lips

87.

Which combination of findings indicates possible NEC?

a)

Normal bowel sounds, jaundice

b)

Vomiting and abdominal distention

c)

Frequent stools and crying

d)

Sneezing and coughing

88.

Which statement about physiological jaundice is correct?

a)

Appears immediately at birth

b)

Is caused by infection

c)

Appears after 24 hours

d)

Requires antibiotics

89.

A newborn with pathological jaundice differs because:

a)

It happens later in life

b)

It is caused by a disease process

c)

It is mild

d)

It always resolves without treatment

90.

Which newborn needs further evaluation?

a)

Resp. 40

b)

Temp 98.0°F

c)

Cyanosis while feeding

d)

HR 150

91.

Which finding is normal in the first days of life?

a)

Yellow crust on circumcision

b)

Persistent bright-red bleeding

c)

Purulent discharge

d)

Foul odor from site

92.

What should parents report immediately regarding cord care?

a)

Dryness

b)

Crusting

c)

Redness around skin

d)

Cord falling off

93.

Which is true about newborn head support?

a)

It's needed only during feeding

b)

It must be supported at all times

c)

It's optional once swaddled

d)

Support is needed only for preemies

94.

Which newborn injection is given in the vastus lateralis?

a)

Vitamin K

b)

Hep B

c)

HBIG

d)

RSV vaccine

95.

A newborn has tachypnea, cyanosis, and hypotension. These indicate:

a)

Breastfeeding difficulty

b)

PPHN

c)

Hyperbilirubinemia

d)

Tracheomalacia

96.

Which long-term outcomes are associated with PPHN? (SATA)

a)

A) Hearing loss

b)

B) Neurological deficits

c)

C) Chronic lung disease

d)

D) Diabetes

e)

E) Death

97.

Which diagnostic test evaluates right-to-left shunting and cardiac anomalies?

a)

CT Scan

b)

Echocardiogram

c)

Ultrasound abdomen

d)

Chest X-ray only

98.

Which newborn behavioral pattern requires follow-up?

a)

Crying during diaper change

b)

Sleeping >4 hours between feeds in early days

c)

Refusing two feeds in a row

d)

Sneezing occasionally

99.

Which is a key component of preventing hypothermia at birth?

a)

Immediate bath

b)

Skin-to-skin

c)

Removing the hat

d)

Leaving infant unwrapped

100.

A newborn has persistent grunting, retractions, and respiratory rate of 68. The nurse suspects:

a)

Hypothermia

b)

RDS

c)

NEC

d)

Colic

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