Nokea
The nurse is providing care for a premature neonate in the NICU nursery. The neonate is diagnosed with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA). Which specific intervention does the nurse expect for this neonate?
- A. Monitor of hemoglobin and hematocrit levels.
- B. Obtain blood glucose levels.
- C. Maintain fluid restrictions.
- D. Administer enteral feedings.
Correct Answer: C
Rationale: The correct answer is C: Maintain fluid restrictions. For a neonate with BPD and PDA, fluid restrictions are essential to prevent fluid overload and worsening of the conditions. Excessive fluid can exacerbate pulmonary edema in BPD and increase cardiac workload in PDA. Monitoring hemoglobin and hematocrit levels (A) is important but not specific to these conditions. Obtaining blood glucose levels (B) is important for monitoring overall health but not specific to BPD and PDA. Administering enteral feedings (D) may be necessary but does not directly address the primary concern of fluid management in these conditions.
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If the neonatal nurse is suspicious of necrotizing enterocolitis in the infant, which intervention should take place first?
- A. Stop feeds
- B. Obtain a blood gas
- C. Call the practitioner
- D. Check electrolytes
Correct Answer: A
Rationale: The correct answer is A: Stop feeds. This is the first intervention because neonatal necrotizing enterocolitis is a serious condition that requires immediate action to prevent further complications. Stopping feeds helps reduce intestinal inflammation and allows the bowel to rest. This step is crucial in managing NEC and preventing perforation. Obtaining a blood gas or checking electrolytes can provide valuable information but are not as urgent as stopping feeds. Calling the practitioner is important but should come after initiating the immediate intervention of stopping feeds.
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.
Which characteristics are typically found in a patient diagnosed with Down syndrome? Select all that apply.
- A. Low-set ears
- B. Broad nasal bridge
- C. Round occiput
- D. Small tongue
Correct Answer: C
Rationale: The correct answer is C: Round occiput. In Down syndrome, individuals often exhibit a round-shaped head at the back (occiput) due to the abnormal growth patterns of the skull bones. This characteristic is a common physical feature seen in individuals with Down syndrome.
A: Low-set ears - While low-set ears can be a feature in some cases of Down syndrome, it is not a defining characteristic and not always present.
B: Broad nasal bridge - Broad nasal bridge is a common feature in Down syndrome, but it is not specific enough to be a defining characteristic.
D: Small tongue - While individuals with Down syndrome may have slightly smaller tongues compared to the general population, it is not a prominent characteristic and not typically used for diagnosis.
Which infant is at greatest risk for developing hypoglycemia after birth?
- A. Severe small for gestational age infant
- B. Appropriate for gestational age infant
- C. Infant of a diabetic mother with maternal glucose control
- D. Cold-stressed term infant
Correct Answer: A
Rationale: The correct answer is A: Severe small for gestational age (SGA) infant, as they have limited glycogen stores and are at higher risk for hypoglycemia. SGA infants often have poor growth in utero, leading to decreased nutrient reserves. This puts them at increased risk for low blood sugar levels after birth.
Incorrect choices:
B: Appropriate for gestational age infants typically have adequate glycogen stores and are at lower risk for hypoglycemia.
C: Infants of diabetic mothers with good maternal glucose control are less likely to have hypoglycemia due to stable blood sugar levels in utero.
D: Cold-stressed term infants may have transient hypoglycemia, but they are not at the greatest risk compared to severe SGA infants.
Which factor does not influence bilirubin levels in the infant?
- A. Prematurity
- B. Maternal diabetes
- C. Exclusively breastfeeding
- D. Birth trauma
Correct Answer: D
Rationale: The correct answer is D: Birth trauma. Birth trauma does not directly influence bilirubin levels in infants. Prematurity can lead to immature liver function affecting bilirubin metabolism. Maternal diabetes can lead to increased risk of neonatal jaundice. Exclusively breastfeeding can lead to breastfeeding jaundice due to inadequate milk intake. Therefore, birth trauma is the only option that does not directly impact bilirubin levels in infants.