Nokea
How often will the nurse caring for a preterm infant in an incubator record the temperature of the infant and the incubator?
- A. Every hour
- B. Every 2 hours
- C. Every 4 hours
- D. Every 8 hours
Correct Answer: B
Rationale: The temperature of the incubator is adjusted to a level that will maintain an optimal body temperature in the infant. The nurse records the temperature of the infant and the incubator every 2 hours.
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What nursing action will the nurse implement for a preterm infant who is being gavage fed and has a bloody stool?
- A. Assess for abdominal distention.
- B. Decrease the amount of the next feeding.
- C. Institute enteric precautions.
- D. Get a culture of the next stool.
Correct Answer: A
Rationale: Bloody stools, abdominal distention, diarrhea, and bilious vomitus are signs of necrotizing enterocolitis. Specific nursing responsibilities include measuring the abdomen and listening to bowel sounds.
What would the nurse assess for in a preterm infant receiving an intravenous infusion containing calcium gluconate?
- A. Seizures
- B. Bradycardia
- C. Dysrhythmias
- D. Tetany
Correct Answer: B
Rationale: The infant receiving intravenous calcium gluconate should be monitored for bradycardia.
What occurrence results from obstruction within the ventricles of the brain or inadequate reabsorption of cerebrospinal fluid?
- A. Meningitis
- B. Meningocele
- C. Spina bifida occulta
- D. Hydrocephalus
Correct Answer: D
Rationale: Hydrocephalus is characterized by an increase in cerebrospinal fluid in the ventricles of the brain.
The nurse explains to a patient in preterm labor that what may be ordered by the physician to accelerate fetal lung maturity?
- A. Prostaglandins
- B. Oxytocin
- C. Magnesium sulfate
- D. Corticosteroids
Correct Answer: D
Rationale: Surfactant production can be increased by administering corticosteroids to the mother before delivery.
An infant receives surfactant via endotracheal (ET) tube at birth for symptoms of respiratory distress syndrome (RDS). When will the nurse anticipate seeing improvement of lung function?
- A. Immediately
- B. Within 3 days
- C. 1 to 2 weeks
- D. At least 1 month
Correct Answer: B
Rationale: In preterm newborns, surfactant can be administered via ET tube at birth or when symptoms of RDS occur, with improvement of lung function seen within 72 hours.