Nokea
The nurse is assessing the newborn and discovers a yellowing of the skin. What is true for jaundice that appears at birth?
- A. Within normal limits
- B. Pathologic
- C. A result of iron deficiency
- D. Indicating possible hepatitis
Correct Answer: B
Rationale: Jaundice observed at birth is considered an indicator of a pathologic condition, erythroblastosis fetalis. It is considered abnormal.
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Why is the fetus dependent on the mother for glucose control?
- A. The insulin requirements are higher.
- B. Insulin is destroyed by the placenta.
- C. Insulin does not cross the placenta.
- D. Insulin is absorbed by the fetus.
Correct Answer: C
Rationale: Insulin will not cross the placenta, but high glucose levels do. Therefore, it is imperative that the mother control glucose levels.
Compared to older infants of comparable weight how much higher is the morbidity and mortality rate for preterm infants?
- A. One to two times
- B. Two to three times
- C. Three to four times
- D. Four to five times
Correct Answer: C
Rationale: The morbidity and mortality rate for preterm infants is higher by three to four times that of an older infant of similar weight.
A pregnant patient with tuberculosis asks the nurse how the disease will affect her pregnancy and her newborn. What statements by the nurse are most appropriate?
- A. You have nothing to worry about. You will be disease free before you deliver.
- B. The tuberculosis can be transmitted to the fetus in rare occurrences.
- C. Your newborn will be tested for tuberculosis after delivery.
- D. There is no approved treatment for the infant if she tests positive for the disease.
- E. You will not be able to hold your newborn until you have been cleared according to the health department guidelines.
Correct Answer: B,C,E
Rationale: TB can be transmitted to a fetus in the womb. Newborns of infected mothers are skin tested for TB after birth and treated if the skin test is positive. Mothers who have TB are not allowed to have exposure to their newborn until they have been cleared according to the health department standards.
A patient with a history of rheumatic heart disease is being admitted to the labor and delivery unit. To prevent further stress on the heart what should the nurse anticipate to be ordered?
- A. Oxygen administration
- B. Administering large amount of IV fluids
- C. Positioning the patient on her back
- D. Encouraging activity between contractions
Correct Answer: A
Rationale: Oxygen is administered to increase blood oxygen saturation and decrease the stress on the heart. IV fluid administration is kept to a minimum to prevent fluid overload. The patient would be positioned in a semi-Fowler's position to improve circulation. The patient should be encouraged to rest between contractions to conserve energy.
Cognitive impairment facial abnormalities and growth retardation are characteristics of which abnormality in a fetus?
- A. Fetal dependency
- B. Fetal immaturity
- C. Malnutrition dependency
- D. Fetal alcohol syndrome
Correct Answer: D
Rationale: Use of alcohol may result in multiple anomalies called fetal alcohol syndrome. The fetus may also be born with alcohol dependency and immaturity, but the characteristics noted are specific for fetal alcohol syndrome.