Developmental Care of the High Risk Neonate and Family Q & A w/ Rationales, Exams of Nursing

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NURSING 7304

Developmental Care of

the High Risk Neonate

and Family

Q & A w/ Rationales

1. A nurse is caring for a preterm infant who was born at 28 weeks gestation and weighs 1200 grams. The nurse observes that the infant has episodes of apnea, bradycardia, and cyanosis. What is the most appropriate nursing intervention for this infant? a) Stimulate the infant by rubbing the back or feet. b) Administer oxygen via nasal cannula or mask. c) Suction the infant's mouth and nose with a bulb syringe. d) Place the infant in a prone position with the head elevated. Answer: A. Stimulating the infant by rubbing the back or feet is a simple and effective way to interrupt apnea and bradycardia episodes in preterm infants. Oxygen administration may be indicated if the infant does not respond to stimulation, but it should be used with caution as it can cause oxygen toxicity and retinopathy of prematurity. Suctioning may be necessary if there is excessive secretions, but it can also trigger apnea and bradycardia by stimulating the vagus nerve. Prone positioning may improve oxygenation and ventilation, but it increases the risk of sudden infant death syndrome (SIDS) and should only be used when the infant is closely monitored.
2. A nurse is teaching a mother how to provide kangaroo care to her preterm infant who is stable but still requires supplemental oxygen and intravenous fluids. Which of the following statements by the mother indicates a need for further teaching?

supply from the mother is cut off, the infant may have low blood glucose levels that can cause neurological manifestations such as jitteriness, poor feeding, lethargy, and hypotonia. Hyperglycemia, hypocalcemia, and hyperbilirubinemia can also occur in infants of diabetic mothers, but they have different clinical features.* B:

1. What is the primary goal of developmental care for high- risk neonates and their families? a) To improve physical growth and development. b) To enhance emotional bonding between the parents and the neonate. c) To decrease the length of hospital stay. d) To minimize developmental delays and optimize neurodevelopmental outcomes. Answer: d) To minimize developmental delays and optimize neurodevelopmental outcomes. Rationale: The primary goal of developmental care for high-risk neonates is to minimize or prevent developmental delays and optimize their long-term neurodevelopmental outcomes by providing appropriate support, stimulation, and interventions.
2. What is the role of the nurse in developmental care of

the high-risk neonate and family? a) Providing only basic care and monitoring. b) Educating parents on feeding techniques. c) Assessing and supporting the developmental needs of the neonate and family. d) Administering medication and performing medical procedures. Answer: c) Assessing and supporting the developmental needs of the neonate and family. Rationale: The nurse plays a crucial role in assessing the developmental needs of the high-risk neonate and family and providing appropriate support, guidance, and interventions to facilitate optimal development and family bonding.

3. Which of the following interventions is not a part of developmental care for high-risk neonates? a) Encouraging kangaroo care. b) Implementing a consistent daily care routine. c) Minimizing exposure to environmental stimuli. d) Limiting parental involvement in caregiving. Answer: d) Limiting parental involvement in caregiving. Rationale: Developmental care encourages active and meaningful parental involvement in the care of their high- risk neonate. Parental involvement promotes bonding, nurturance, and overall neonatal development.

been shown to promote neurodevelopment and enhance bonding between the parent and neonate. These interventions provide warmth, physical contact, and emotional support.

6. What is the significance of positioning the high-risk neonate in a flexed, midline position? a) It helps prevent pressure ulcers. b) It promotes optimal brain growth. c) It enhances visual stimulation and tracking. d) It facilitates adequate respiratory capacity. Answer: b) It promotes optimal brain growth. Rationale: Positioning the high-risk neonate in a flexed, midline position promotes optimal brain growth by positioning the head and neck in alignment, preventing asymmetrical pressure points, and minimizing cranial deformities.
7. Which intervention supports and encourages optimal cognitive development in high-risk neonates? a) Limiting touch and interaction. b) Providing exposure to ambient background noise. c) Minimizing parental involvement in the neonate's care. d) Promoting reading aloud to the neonate. Answer: d) Promoting reading aloud to the neonate. Rationale: Reading aloud to the high-risk neonate promotes

language development, early literacy skills, and cognitive stimulation. It also enhances bonding between the parent and the neonate.

8. How does kangaroo care benefit the high-risk neonate and family? a) It helps in weight gain and better sleep patterns. b) It reduces the need for medical interventions. c) It increases the risk of infection transmission. d) It replaces the need for breastfeeding or bottle-feeding. Answer: a) It helps in weight gain and better sleep patterns. Rationale: Kangaroo care promotes weight gain, improves sleep patterns, enhances breastfeeding success, and facilitates parent-infant bonding. It also has positive effects on the parent's well-being and satisfaction.
9. What is an appropriate intervention to support the social- emotional development of a high-risk neonate? a) Limiting parental interaction during hospitalization. b) Encouraging peer interaction in the neonatal intensive care unit (NICU). c) Using devices and screens for entertainment. d) Providing a consistent, nurturing caregiving relationship. Answer: d) Providing a consistent, nurturing caregiving relationship. Rationale: Providing a consistent, nurturing caregiving

Rationale: Individualized developmental care plans enable healthcare professionals to tailor care and interventions based on each high-risk neonate's unique needs, ensuring optimal developmental support, and promoting personalized growth.

12. How does developmental care facilitate successful transition from NICU to home for high-risk neonates? a) By minimizing parental involvement during NICU stay. b) By providing specialized equipment for home use. c) By educating parents on appropriate caregiving practices. d) By delaying the transition to home until full-term age. Answer: c) By educating parents on appropriate caregiving practices. Rationale: Developmental care prepares parents for the transition from the NICU to home by providing education on appropriate caregiving practices, addressing the individual needs of the high-risk neonate, and equipping parents with the necessary skills and guidance.
13. Which behavior is a red flag for potential developmental delays in a high-risk neonate? a) Frequent crying during caregiving activities. b) Initiating eye contact and social smiles. c) Reaching out and grasping objects. d) Sleeping through the night without disturbance.

Answer: a) Frequent crying during caregiving activities. Rationale: Frequent crying during caregiving activities in a high-risk neonate may indicate discomfort, pain, or an early sign of developmental delay. This behavior warrants further assessment and intervention.

14. What is the recommended duration of kangaroo care for high-risk neonates? a) 30 minutes per day. b) 2 hours per week. c) 4 hours per day. d) As long as it is comfortable for both the parent and the neonate. Answer: d) As long as it is comfortable for both the parent and the neonate. Rationale: The duration of kangaroo care for high-risk neonates depends on the comfort level of both the parent and the neonate. There is no predetermined time limit, but it should be adjusted to accommodate the needs and preferences of both parties.
15. Which intervention promotes optimal feeding and nutrition for high-risk neonates? a) Implementing strict feeding schedules. b) Providing breast milk or age-appropriate formula. c) Limiting parent participation in feeding routines.

Answer: Modify the environment to decrease stimuli and provide swaddling during care. Rationale: Modifying the environment to reduce stimuli and providing swaddling can help decrease stress and promote a sense of security for the high-risk neonate. Question: A parent expresses concern about the infant's pain management during procedures. What strategy should the nurse recommend to the parent to support developmental care? Answer: Encouraging kangaroo care and skin-to-skin contact during painful procedures. Rationale: Kangaroo care and skin-to-skin contact have been shown to provide comfort and pain relief for neonates during painful procedures, promoting developmental care principles. Question: A high-risk neonate is scheduled to undergo surgery. How can the nurse support the family in preparing the infant for the procedure? Answer: Educating the family about the benefits of preoperative kangaroo care and promoting parental involvement in care. Rationale: Preoperative kangaroo care has been shown to reduce stress and stabilize vital signs in high-risk neonates, and involving the parents in care promotes family-centered developmental care. Question: A nurse is providing care for a high-risk neonate with a history of prenatal substance exposure. What

approach is most appropriate to support the infant's neurodevelopmental care? Answer: Implementing a quiet environment and providing non-nutritive sucking opportunities. Rationale: Quiet environments and non-nutritive sucking opportunities support neurodevelopment and self- regulation for high-risk neonates with prenatal substance exposure. Question: A high-risk neonate is experiencing feeding difficulties. What intervention aligns with developmental care principles to support feeding? Answer: Allowing the infant to self-regulate the feeding pace and minimizing external stimuli during feeding. Rationale: Allowing the infant to self-regulate the feeding pace and minimizing external stimuli supports the development of feeding skills and reduces stress during feeding. Question: A nurse is providing care for a neonate who is experiencing sleep disturbances. What action promotes developmental care principles to support sleep? Answer: Implementing a consistent environmental routine and providing containment holding during sleep. Rationale: Consistent environmental routines and containment holding during sleep promote self-regulation and improve sleep patterns for high-risk neonates. Question: A preterm infant is demonstrating signs of sensory overload. Which action supports developmental

Answer: Providing containment holding and reducing environmental stimuli. Rationale: Containment holding and reducing environmental stimuli support behavioral organization and self-regulation for high-risk neonates. Question: A nurse is caring for a high-risk neonate with a history of traumatic birth. What intervention promotes developmental care principles to address the effects of the traumatic birth? Answer: Encouraging kangaroo care and providing positive touch experiences. Rationale: Kangaroo care and positive touch experiences have been shown to mitigate the effects of traumatic birth and promote developmental care for high-risk neonates. Question: A high-risk neonate is experiencing respiratory distress. What intervention supports developmental care principles to address respiratory needs? Answer: Providing non-nutritive sucking opportunities and minimizing handling during respiratory distress. Rationale: Non-nutritive sucking opportunities and minimizing handling support respiratory stability and developmental care for high-risk neonates in respiratory distress. Question: A family expresses concerns about the long-term outcomes of their high-risk neonate. What education should the nurse provide to support family-centered developmental care?

Answer: Educating the family about developmental milestones and involving them in developmental care activities. Rationale: Providing education about developmental milestones and involving the family in care activities promotes family-centered developmental care and addresses long-term outcomes for high-risk neonates. Question: A nurse is providing care for a high-risk neonate with a history of intrauterine growth restriction. What intervention aligns with developmental care principles to support growth and development? Answer: Implementing individualized positioning and providing parent-infant interaction opportunities. Rationale: Individualized positioning and parent-infant interaction opportunities support growth and development while aligning with developmental care principles for high- risk neonates with intrauterine growth restriction.