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A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?
- A. The drug keeps your infant from requiring too much sedation.
- B. Surfactant improves the ability of your infant’s lungs to exchange oxygen and carbon dioxide.
- C. Surfactant is used to reduce episodes of periodic tachycardia.
- D. Your infant needs this medication to fight a possible respiratory tract infection.
Correct Answer: B
Rationale: The correct answer is B because artificial surfactant improves the ability of the infant's lungs to exchange oxygen and carbon dioxide. Surfactant reduces surface tension in the alveoli, preventing collapse and helping with gas exchange. This explanation directly relates to the purpose of surfactant therapy in treating RDS. Choices A, C, and D are incorrect because they do not accurately describe the mechanism or purpose of surfactant therapy. Choice A is incorrect as surfactant does not affect sedation needs, choice C is incorrect as surfactant is not used to address tachycardia, and choice D is incorrect as surfactant is not used to treat respiratory tract infections.
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Which nursing action is especially important for an SGA newborn?
- A. Promote bonding.
- B. Observe for and prevent dehydration.
- C. Observe for respiratory distress syndrom
- D. Prevent hypoglycemia with early and frequent feedings.
Correct Answer: D
Rationale: The correct answer is D because preventing hypoglycemia is crucial for Small for Gestational Age (SGA) newborns due to their decreased glycogen stores. Early and frequent feedings help maintain stable blood sugar levels. Option A, promoting bonding, is important for all newborns but not particularly crucial for SGA babies. Option B, preventing dehydration, is essential for all newborns but not specific to SGA. Option C, observing for respiratory distress syndrome, is important but not the most critical concern for SGA newborns.
The nurse is providing support to parents of a premature neonate in NICU. Which actions by the nurse will best provide psychosocial support to the parents? Select all that apply.
- A. Assess the parents’ ability to care for their neonate.
- B. Ask the parents how they are coping with the experience.
- C. Provide equipment for breast pumping and storage of milk.
- D. Provide equipment for breast pumping and storage of milk.
Correct Answer: B
Rationale: The correct answer is B. Asking the parents how they are coping with the experience is crucial for providing psychosocial support. This action shows empathy, encourages open communication, and helps the nurse understand the parents' emotional state. By actively listening, the nurse can offer appropriate support and resources.
Assessing the parents' ability to care for their neonate (Choice A) is important but does not directly address their psychosocial needs. Providing equipment for breast pumping and storage of milk (Choices C and D) is more focused on the physical aspects of care rather than the emotional support needed by the parents.
The nurse has access to the results of a karyotype sent out for their patient via an electronic medical record. The parents have accessed the results on their MyChart phone application and have asked the nurse what the results 45, X mean. What is the best response from the nurse?
- A. The results indicate your child may have Turner syndrome.
- B. Your results are 45, X; you will have to wait to talk with the geneticist.
- C. Your results indicate that your daughter has a serious lifelong disease.
- D. I’m not sure; I’ll call the provider.
Correct Answer: A
Rationale: The correct answer is A: The results indicate your child may have Turner syndrome. This is the best response because 45, X is the karyotype typically associated with Turner syndrome, a genetic condition where a female is missing part or all of one X chromosome. This response shows the nurse's knowledge of genetics and ability to interpret karyotype results accurately.
Summary of incorrect choices:
B: Your results are 45, X; you will have to wait to talk with the geneticist - This response delays providing crucial information to the parents and does not address their immediate concerns.
C: Your results indicate that your daughter has a serious lifelong disease - This choice is too vague and alarming, lacking specificity about the condition associated with the karyotype results.
D: I’m not sure; I’ll call the provider - This response shows a lack of knowledge on the nurse's part and does not offer any immediate information or reassurance to the parents.
An infant weight is documented as being in the 90th percentile. What does the RN understand about this measurement?
- A. The infant’s weight is appropriate or average.
- B. The 90th percentile indicates LGA.
- C. Infants in the 90th percentile will be overweight as adults.
- D. The infant’s weight is less than 90% of all other infants’ weights.
Correct Answer: C
Rationale: The correct answer is C because being in the 90th percentile for weight as an infant does not necessarily mean the weight is appropriate or average (choice A) or that the infant is LGA (choice B). Choice D is incorrect because being in the 90th percentile means the infant's weight is greater than 90% of other infants, not less. Choice C is correct because research shows that infants in the 90th percentile for weight are more likely to be overweight as adults due to potential genetic factors and lifestyle habits developed early in life.
The nurse in NICU is assessing a neonate delivered at 32 weeks gestation. Which pathophysiological manifestation is the nurse’s greatest concern?
- A. Absent or weak reflexes
- B. Presence of a heart murmur
- C. Apnea 20 seconds or longer
- D. Low hemoglobin lab level
Correct Answer: C
Rationale: The correct answer is C: Apnea 20 seconds or longer. In a neonate delivered at 32 weeks gestation, apnea lasting 20 seconds or longer is the greatest concern as it indicates immature respiratory control and potential for respiratory distress or failure. Absent or weak reflexes (A) may be common in premature infants but are not as critical as respiratory issues. A heart murmur (B) may be present due to structural heart defects, but apnea poses a more immediate threat. Low hemoglobin (D) may indicate anemia, which can be managed with appropriate interventions, unlike compromised respiratory function.