Nokea
Which sign will the newborn experiencing respiratory obstruction often exhibit first?
- A. Gagging
- B. Vomiting
- C. Decreased heart rate
- D. Increased respiratory rate
Correct Answer: D
Rationale: The correct answer is D: Increased respiratory rate. When a newborn experiences respiratory obstruction, they will initially exhibit an increased respiratory rate as their body tries to compensate for the lack of oxygen. This is a natural response to try to increase oxygen intake. Gagging (choice A) and vomiting (choice B) may occur as secondary symptoms if the obstruction persists. Decreased heart rate (choice C) is unlikely to be the first sign, as the body typically prioritizes ensuring oxygen supply to vital organs such as the brain. Therefore, the increased respiratory rate is the most immediate and crucial sign to indicate respiratory obstruction in a newborn.
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A newborn assessment finding that would support the nursing diagnosis of postmaturity would be
- A. loose skin.
- B. ruddy skin color.
- C. presence of vernix.
- D. absence of lanugo.
Correct Answer: A
Rationale: The correct answer is A: loose skin. Postmaturity in newborns is characterized by dry, cracked, and peeling skin due to prolonged gestation. Loose skin is a classic sign of postmaturity, indicating reduced subcutaneous fat. Ruddy skin color (B) is not specific to postmaturity. Vernix (C) is present in newborns and decreases with gestational age, not directly related to postmaturity. Lanugo (D) is fine hair that covers a fetus and sheds before birth, not a specific indicator of postmaturity.
In caring for the preterm infant, which complication is thought to be a result of high arterial blood oxygen level?
- A. Necrotizing enterocolitis (NEC)
- B. Retinopathy of prematurity (ROP)
- C. Intraventricular hemorrhage (IVH)
- D. Bronchopulmonary dysplasia (BPD)
Correct Answer: C
Rationale: The correct answer is C: Intraventricular hemorrhage (IVH). High arterial blood oxygen levels can lead to IVH in preterm infants due to increased cerebral blood flow and disruption of immature blood vessels in the brain. This can cause bleeding into the brain's ventricles. NEC (A) is more associated with feeding issues, ROP (B) with high oxygen levels, and BPD (D) with prolonged use of mechanical ventilation.
Which data should alert the nurse caring for an SGA infant that additional calories may be needed?
- A. The latest hematocrit was 53%.
- B. The infant's weight gain is 40 g/day.
- C. The infant is taking 120 mL/kg every 24 hours.
- D. Three successive temperature measurements were 36.1ï‚°C, 35.5ï‚°C, and 36.1ï‚°C (97, 96, and 97ï‚°F).
Correct Answer: B
Rationale: The correct answer is B because weight gain is a direct indicator of nutritional status. A weight gain of 40 g/day may indicate inadequate caloric intake for an SGA (small for gestational age) infant, necessitating additional calories.
A: Hematocrit level might indicate dehydration or polycythemia, not necessarily inadequate caloric intake.
C: The volume of intake alone does not indicate the adequacy of caloric intake; concentration and composition of the feed are also essential.
D: Temperature measurements are not directly related to the need for additional calories in an SGA infant.
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.
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.