Nokea
The nurse is caring for an infant born at 42 weeks. What would the physical assessment reveal?
- A. Dry, peeling skin
- B. Minimal hair on the head
- C. Short, rough nails
- D. Abundant lanugo on the body
Correct Answer: A
Rationale: Loss of vernix caseosa leaves the skin dry, causing peeling.
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The nurse caring for a preterm infant will record the intake and output. The nurse is aware that what is the optimum output for this infant?
- A. 1 to 3 mL/kg/hr
- B. 4 to 6 mL/kg/hr
- C. 7 to 9 mL/kg/hr
- D. 10 to 14 mL/kg/hr
Correct Answer: A
Rationale: The optimum output for a preterm infant is 1 to 3 mL/kg/hr.
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.
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.
The nurse in a pediatrician's office is preparing to do a developmental assessment on a 3-month-old infant who was born at 36 weeks. The nurse knows that the infant should be evaluated in what month of achievement to adjust for the preterm birth?
- A. 1st
- B. 2nd
- C. 3rd
- D. 4th
Correct Answer: B
Rationale: The growth and development of a preterm infant are based on the current age minus the number of weeks before term that the infant was born.
What deficiency causes a preterm infant respiratory distress syndrome?
- A. Protein
- B. Estrogen
- C. Hyaline
- D. Surfactant
Correct Answer: D
Rationale: The production of surfactant, necessary for the absorption of oxygen by the lungs, is deficient in the preterm infant.