Nokea
Which laboratory value is important to check on a newborn with excessive bruising following delivery?
- A. White blood cells
- B. Glucose
- C. Bilirubin
- D. Potassium
Correct Answer: C
Rationale: The correct answer is C: Bilirubin. Excessive bruising in a newborn can indicate hemolysis, leading to elevated bilirubin levels and potential jaundice. Checking bilirubin levels is crucial to monitor for hyperbilirubinemia, which can lead to complications like kernicterus. White blood cells (A) are not typically associated with bruising. Glucose (B) levels are important in monitoring for hypoglycemia, not bruising. Potassium (D) levels are not directly related to bruising in a newborn.
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An infant delivered prematurely at 28 weeks' gestation weighs 1200 g. Based on this information the infant is classified as
- A. SG
- B. VLBW.
- C. ELBW.
- D. low birth weight at term.
Correct Answer: B
Rationale: The correct answer is B: VLBW (Very Low Birth Weight). This classification is based on the infant weighing less than 1500 g at birth, which applies to this scenario as the infant weighs 1200 g. VLBW infants are at higher risk for complications due to their low weight and prematurity.
A: SG (Small for Gestational Age) is incorrect because it refers to infants who are below the 10th percentile for weight at a specific gestational age, not based solely on weight.
C: ELBW (Extremely Low Birth Weight) is incorrect as it typically refers to infants weighing less than 1000 g at birth, which is lower than the infant in this scenario.
D: Low birth weight at term is incorrect as it does not accurately classify a premature infant like the one in the question.
The postnatal nurse is providing care for a neonate being treated with phototherapy for hyperbilirubinemia. For which side effects of phototherapy will the nurse contact the neonatal care provider? Select all that apply.
- A. Hyperthermia
- B. Lethargy
- C. Hypocalcemia
- D. Thrombocytopenia
Correct Answer: A
Rationale: The correct answer is A: Hyperthermia. During phototherapy, neonates are at risk for developing hyperthermia due to the heat generated by the lights. The nurse should contact the provider if the neonate shows signs of hyperthermia to prevent complications.
B: Lethargy is not a direct side effect of phototherapy but can be a result of other factors such as inadequate feeding or underlying medical conditions.
C: Hypocalcemia is not a common side effect of phototherapy. It is more often associated with other conditions or treatments.
D: Thrombocytopenia is not a typical side effect of phototherapy. It refers to low platelet levels and is usually not directly related to phototherapy treatment.
Which intervention should the nurse instruct the parents to do for their newborn who has acute diaper rash?
- A. Apply the diaper loosely to infant, allowing for better air circulation.
- B. Change the newborn every 4 hours to prevent a moist environment.
- C. Wash the newborn’s diaper area with an antibacterial soap and newborn wipes.
- D. Wipe off the diaper cream thoroughly between diaper changes.
Correct Answer: A
Rationale: The correct answer is A: Apply the diaper loosely to infant, allowing for better air circulation. This is the best intervention for acute diaper rash as it helps reduce moisture and promotes healing. Tight diapers trap moisture, worsening the rash. Choice B is incorrect as changing every 2-3 hours is recommended to maintain a dry environment. Choice C is incorrect as antibacterial soap can be harsh and disrupt the skin's natural flora. Choice D is incorrect as wiping off diaper cream thoroughly can irritate the skin further.
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.
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.