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CCRN Neonatal Questions with Accurate
Answers
A 29 week gestation infant who displays symptoms of a pulmonary hemorrhage should be evaluated for correct answer patent ductus arteriosus. A 38-week gestation neonate presents to the NICU with respiratory distress symptoms and anuria. On physical examination, she is found to have hypertension, bilateral flank masses, and hypoplastic lungs. The best diagnosis for this presentation is correct answer polycystic kidney disease. A 7-day-old neonate with an unremarkable hospital course who now presents with increasing episodes of hypoglycemia, severe metabolic acidosis, recurrent vomiting, and high ammonia levels should be evaluated for what disorder? correct answer ✓ An inborn error of metabolism A clinical feature commonly found in a neonate with Down syndrome is correct answer hypotonia. A common organism responsible for early onset sepsis is correct answer E. coli. MOST common is GBS A communicating hydrocephalus results from damage to the correct answer arachnoid granulations. arachnoid granulations over the surface of the brain A deformation is a(n) correct answer abnormality caused by unusual mechanical forces on normal tissue.
A deformation is a(n) correct answer abnormality caused by unusual mechanical forces on normal tissue. A discrepancy greater than 10 mm Hg between the blood pressure in the upper and lower extremities is indicative of which defect? correct answer Coarctation of the aorta A fluid accumulation in the dermal layer of the skin would be described as a correct answer wheal. A full term neonate who presents at six hours of age with increasingly labile oxygenation that appears disproportionate to the pulmonary disease should be evaluated for correct answer pulmonary hypertension of the newborn. A GI series may reveal a "transition zone" in which of the following clinical conditions? correct answer Hirschprung's disease A hemorrhage associated with birth trauma that does NOT cross suture lines is called a correct answer cephalohematoma. A low birth weight infant's temperature increases during skin-to-skin care. This is an example of heat transfer by correct answer conduction. A meconium plug is associated with of the following conditions? correct answer Uncontrolled maternal diabetes A mother is concerned regarding the safety of her medications and breastfeeding. What is the best nursing intervention to reassure and support the woman's
A papule is defined as a correct answer solid, elevated lesion with distinct borders less than 0.5 cm in size. solid or fluid filled lesions that are elevated with distinct borders; less than 1 cm in diameter A post-op infant is exhibiting tachycardia, oxygen desaturations, and elevated blood pressure. She received a dose of Fentanyl 1.5 hours ago. Which of the following is the MOST appropriate action? correct answer Reposition the infant with arms and legs flexed. A preterm birth may delay the following steps of attachment from occurring EXCEPT correct answer accepting the pregnancy. A priority of management for the neonate diagnosed with polycystic kidney disease is correct answer treatment of systemic hypertension. monitoring and treatment of hypertension, nephrectomy sometimes indicated, peritoneal dialysis A right-to-left shunt will be seen with correct answer pulmonary stenosis. A sign that parents are experiencing acute stress disorder includes correct answer having flashbacks of the trauma. A subgaleal hemorrhage is treated as a medical emergency because correct answer large blood loss may lead to hypovolemic shock. According to the AAP, intubation attempts should be limited to ______seconds. correct answer 30 seconds
According to the Synactive Theory of Development, the autonomic subsystem is responsible for which of the following? correct answer Regulating cardiopulmonary activity regulates cardiopulmonary activity, GI peristalsis, peripheral skin blood flow All late preterm infants are at risk for hypoglycemia due to which of the following? correct answer Impaired ability to generate glucose from glycogen stores and increased glucose utilization All of the following are guidelines for basic skin care of the neonate except correct answer bathe with mild soap and warm water once per day. All of the following have had an impact on the rising late preterm birth rate EXCEPT correct answer decreasing maternal age. All of the following increase parental confidence in caring for the late preterm infant EXCEPT correct answer open visitation so others can help with newborn care. All of the following interventions promote positive maturation of the auditory system EXCEPT correct answer sterile hospital workspace or environment. All of the following may predispose an infant to a subdural hemorrhage EXCEPT correct answer prematurity. shoulder dystocia, vaginal breech, instrument assisted All of the following neonatal pain scoring tools have been tested on newborns EXCEPT correct answer PIPP (Premature Infant Pain Profile), NIPS (Neonatal Infant
An underpenetrated x-ray may result in over diagnosis of correct answer respiratory distress syndrome. Anemia due to decreased red blood cell survival should be anticipated in the neonate with a history of correct answer isoimmune-mediated hemolysis. Antenatal steroids enhance lung maturation by correct answer increasing the number of type II pneumocytes in the lung. Appropriate nutritional management of the neonate with congestive heart failure is best achieved by which of the following? correct answer Individualizing to minimize energy consumption At approximately _____ weeks of gestation the heart has developed a fully functioning electrical conduction system. correct answer 10 At how many weeks gestation is suck-swallow-breathe coordination present? correct answer 34- At the 14-day-old pediatric visit for a preterm Baby, her mother states she is pumping four times a day, and her 24-hour milk volume is 300 milliliters. What would be the best response? correct answer "Let's talk about how to increase the number of pumping sessions to 8 or more in a 24-hour period." At the onset of labor the release of catecholamines stimulates correct answer increased absorption of lung fluid.
Autoregulation is a process that correct answer maintains steady-state cerebral blood flow despite changes in cerebral perfusion pressure. the ability to maintain steady-state cerebral blood flow despite changes in cerebral perfusion pressure; allows body to divert blood to where it is most needed; Baby Beatrice is a preterm infant who is now 14 days old. The infant's mother was discharged home at 72 hours. How much milk should the mother be producing per 24 hours by day 14? correct answer 500-600 ml Baby Eduardo was born with anencephaly, a serious type of neural tube defect (NTD), and he died in the NICU two days after birth. His grieving parents ask the nurse if the risk of this birth defect can be reduced in a future pregnancy. Which is the BEST reply? correct answer "By taking a prescription dose of 4.0 milligrams of folic acid before a future pregnancy, you can reduce the risk of NTDs." Barriers to normal development include all of the following correct answer separation from parents,numerous care providers, medically necessary equipment, medications and adverse effects, artificial schedules, continuous sensory stimulation Benefits of human milk for the NICU infant include which of the following? correct answer Decreased number of days of IV nutrition Benefits of skin-to-skin (kangaroo) care include correct answer improved thermoregulation and cardio function, decreased incidence/severity of infections, increased weight gain, non pharmacologic intervention, enhanced physiologic organization, improved breastfeeding outcomes, increased alertness and exploration of the environment
Clinical presentation of acute renal failure includes all of the following EXCEPT correct answer serum creatinine <1.5 mg/dl (132.6 μmol/L). oliguria, normal urine output, elevated creat, polyuria, hematuria, proteinuria, fluid overloead, dehydration, vomiting, poor eating, elevated medication levels Clinical presentation of renal vein thrombosis includes correct answer hematuria and anemia. hematuria, flank mass, thrombocytopenia, transient hypertenion, urine output of <1 ml/kg/hr, anemia Clinical presentation of subarachnoid hemorrhage correct answer increasing OFC, shock, vacuum-assisted delivery Clinical presentation of subdural hemorrhage correct answer increased ICP, instrumented delivery, coma Clinical presentation of subgaleal hemorrhage correct answer sever asphyxia, birth trauma, often asympotomatic, seizures on 2nd or 3rd day of life Compared to full term formulas, preterm formulas contain correct answer more calories and increased protein. Complement works with the immune system to correct answer opsonize bacteria to facilitate phagocytosis. Complex/multifactorial anomalies correct answer have a recurrence risk dependent upon how closely related the affected person is to the neonate.
complication of chest tube insertion correct answer the tip of the tube (or introducer if used) can cause damage to the lung tissue complication of ET intubation correct answer hypoxia, especially if the attempt is prolonged complication of gastric tube insertion correct answer the tip can perforate the esophagus during insertion complication of umbilical line insertion correct answer if the tip of the catheter enters the heart, it can erode through the heart muscle, allowing fluid to accumulate in the pericardial space. Complications of percutaneous central venous lines correct answer catheter migration. Continuous positive airway pressure (CPAP) improves oxygenation by correct answer improving the ventilation-perfusion ratio. Damage to the calcaneus is more likely when a heel stick is performed using what part of the foot? correct answer End of the heel Depending on the amount of weight loss, electrolyte values, and markers of renal function, fluid is usually administered at which rate in the first 48 hours of life? correct answer 60-100 ml/kg/day Development of the visual system requires correct answer use and visual experience for eye function to mature. ensure opportunities for quiet sleep and
During which phase of fetal pulmonary development do the type II pneumocytes become numerous and begin to produce and store surfactant? correct answer Canalicular phase Ebony is a 28 week gestation infant in the NICU on ventilatory support. During a routine shift assessment, you find that the IV has infiltrated. After application of hyaluronidase, you might consider which of the following interventions? correct answer Instilling multiple puncture holes with a 23 gauge needle. Education for parents of a male neonate diagnosed with an X-linked recessive single gene disorder would include correct answer ✓ all of his daughters will be obligate carriers. Education for the parents of a neonate diagnosed with phenylketonuria (PKU) includes which of the following? correct answer ✓ A low protein formula (diet) is necessary to avoid/ameliorate developmental delay. Effects of excessive handling include all of the following correct answer disturbance of sleep inhibits healing, decreased secretion of growth hormone, increased secretion of cortisol and adrenaline; fluctuations in BP/cerebral boodflow (IVH); oxygen desats Evidence that the psychological task of acknowledging guilt about the birth of a 26-week gestational age neonate has become pathologic includes correct answer not responding to the neonate's progress because the infant represents failure. Expected findings in a neonate born to a mother who received magnesium sulfate in labor include correct answer hypotonia.
Extravasation injury is more common when IV solutions containing _________ are infused. correct answer calcium Eye prophylaxis with a single-use dose of sterile ophthalmic ointment containing 1% tetracycline or 0.5% erythromycin is usually administered within the first few hours of birth to prevent an eye infection caused by correct answer gonorrhea. Facilitated tucking is a strategy to decrease the pain sensation experienced by preterm infants is to correct answer flex the extremities and hold them close to the trunk. Fetal alcohol syndrome is the most serious form of fetal alcohol spectrum disorder. Which is NOT TRUE about fetal alcohol syndrome? correct answer Fetal alcohol syndrome only happens if the mother is an alcoholic. Following a birth complicated by shoulder dystocia, the neonate should be assessed for correct answer Erb's palsy. For an infant who is displaying signs of neonatal abstinence syndrome, an accurate score assessment is best completed when? correct answer immediately after a feeding. Function of erythrocyte correct answer transports oxygen and carbon dioxide Function of granulocyte correct answer infection response Function of hemoglobin correct answer oxygen carrying protein
How soon after birth should a mother ideally initiate pumping and with what type of pump? correct answer within 1 hour Hydrogel dressings such as Vigilon may be correct answer used after irrigation of an infected wound. Hyperpigmented or blue-gray macules are correct answer benign. Hyperthermia is defined as an axillary temperature greater than 99.5ºF (37.5ºC). The MOST common cause of hyperthermia in the newborn is correct answer environmental. If a NICU infant is unable to sustain a latch to the breast, what would be an appropriate intervention? correct answer Educate the mother on the use of a nipple shield. If the neonate is symptomatic with a plasma glucose value of less than 40mg/dl (2.2 mmol/L) and is refusing or NOT tolerating feedings, the nurse should request orders for the following interventions: correct answer an intravenous bolus of 2 ml/kg D10W and an intravenous D10W infusion initiated at 80 ml/kg/day. Immediate responses to unmanaged pain include the following correct answer increased HR, increased BP, decreased sats, increased ICP, increased cortisol release In contrast to term newborns, bilirubin levels in late preterm newborns typically peak at correct answer 5-7 days of life
In order to create a developmentally-friendly healing environment, the nurse should not correct answer assessing vital signs when infant is sleeping. In order to pass a pulse oximetry screening for critical congenital heart disease (CCHD), which oxygenation and percentage of variance is required in the right hand and foot? correct answer Less than 95% O2 saturation and greater than 3% variance In the immediate newborn transition period, the ability to maintain functional residual lung capacity is most dependent upon correct answer an adequate amount of alveolar surfactant. In the nine steps of attachment, "confirming the pregnancy" refers to the correct answer beginning of the mother's psychological acceptance that she is pregnant. In which of the following conditions is the neonate MOST at risk for hypokalemia? correct answer Increased gastrointestinal losses Insensible water losses occur primarily through correct answer respiratory and cutaneous routes. Interventions for the family in crisis include which of the following? correct answer Holding discussions when the mother and father are together It is important to evaluate the neonate with critical pulmonary stenosis for correct answer symptoms of right-sided congestive heart failure.
Mean airway pressure is defined as the correct answer pressure transmitted to the lung throughout the respiratory cycle. Most respiratory disorders result in a ventilation-perfusion mismatch. Ideally, the ventilation-perfusion ratio should be correct answer 1 to 1 Nastassia is a one-hour-old neonate, born at 39 weeks gestation by primary cesarean birth for fetal bradycardia. She was hypotonic at birth with gasping respirations and a heart rate of 80. She was provided bulb suctioning and bag mask ventilation and recovered by five minutes of life. On admission to the NICU, her temperature was 36° C. After admission to the NICU, her arterial blood gas is pH: 7.19, PCO2: 63, HCO3: 14. The correct interpretation of this blood gas is correct answer mixed respiratory and metabolic acidosis. Neonates at risk of hypoglycemia should have their glucose levels evaluated within 2 hours of life because correct answer blood glucose levels reach their lowest point within one to two hours after delivery. Neonates receiving surfactant are at increased risk of developing correct answer pulmonary hemorrhage. NICU nurses who experience secondary traumatic stress may benefit from correct answer participating in a case review or debriefing. Nondisjunction is defined as correct answer the failure of paired chromosomes to separate equally during cell division. Nursing care for the infant with surgical repair of an abdominal wall defect would include correct answer observing for signs of increased intra-abdominal pressure.
Of the following veins, which would be the best choice for inserting a peripheral IV? correct answer Dorsum of the hand One of the advantages human milk has over formula is that it correct answer contains very long-chain fatty acids. One of the medications given to cause constriction and closure of the ductus arteriosus in the neonate is correct answer indomethacin. Parallel circulations in which there are separate pulmonary and systemic circulatory systems occur in correct answer transposition of the great vessels. Parents should be taught to assess their infant's _________ temperature. correct answer axillary Patient care management for the neonate with hypernatremia often includes correct answer monitoring for hyperglycemia and hypocalcemia. Patient care management for the recently delivered NICU infant's mother should include all of the following EXCEPT? correct answer Delaying breast pumping to allow for maternal rest Periventricular leukomalacia may be caused by all of the following physiologic conditions EXCEPT correct answer treatment with extracorporeal membrane oxygenation.
