OB Week 11+12 PP

A nurse is assessing four newborns in the nursery. Which newborn should the nurse identify as small for gestational age (SGA)?

39-week newborn weighing 2,200 g (4 lb 14 oz)

A newborn weighs 1,350 g (2 lb 15 oz) immediately after birth.

How should the nurse classify this infant?

Very low birth weight (VLBW)

The nurse is caring for a term SGA newborn.

Which complication is the highest priority during the first few hours after birth?

Hypoglycemia

The nurse is assessing an SGA newborn.

Which assessment finding is expected?

Scaphoid abdomen with loose skin

A nurse is caring for an SGA newborn.

Which nursing intervention has the highest priority?

Monitor blood glucose frequently

Which maternal condition places the newborn at greatest risk for being large for gestational age (LGA)?

Diabetes mellitus

A nurse is assessing a newborn of a mother with diabetes.

Which complication requires the nurse to monitor most closely during the first few hours?

Hypoglycemia

A nurse is teaching a newly hired nurse about infants of diabetic mothers.

Which finding should the nurse expect?

Massive shoulders

Which newborn requires intervention first?

SGA infant with blood glucose of 34 mg/dL

A nurse is assessing four newborns.

Which newborn is at greatest risk for polycythemia?

Infant of diabetic mother

A nurse is assessing a newborn born at 30 weeks' gestation. Which assessment finding is expected in this preterm infant?

Poor muscle tone with plentiful lanugo

A preterm newborn suddenly develops:

• Tachypnea

• Nasal flaring

• Expiratory grunting

• Sternal retractions

Which complication should the nurse suspect first?

Respiratory distress syndrome (RDS)

The nurse understands that the primary cause of respiratory distress syndrome is:

Deficiency of surfactant

A premature infant with RDS is receiving surfactant.

How is surfactant administered?

Endotracheal tube

A preterm newborn has been receiving high concentrations of oxygen for several weeks.

The nurse recognizes the infant is at greatest risk for:

Retinopathy of prematurity

A nurse is caring for a premature newborn with poor temperature regulation.

Which intervention is most appropriate?

Keep the infant in a double-walled incubator

A preterm newborn has increasing gastric residuals, abdominal distention, absent bowel sounds, and bloody stools.

Which complication should the nurse suspect?

Necrotizing enterocolitis (NEC)

The nurse suspects NEC.

Which nursing action should be performed first?

Stop all enteral feedings

Which newborn is at highest risk for an intracranial hemorrhage?

31-week infant weighing 1,200 g

A nurse is planning feedings for a stable premature infant.

Which intervention is appropriate?

Use breast milk whenever possible.

A nurse is assessing a 12-hour-old term newborn. The infant has visible jaundice extending to the chest. Which action should the nurse take first?

Notify the provider because jaundice within the first 24 hours is abnormal.

Which newborn is experiencing physiologic jaundice?

A 36-hour-old newborn with bilirubin of 6 mg/dL

A nurse is reviewing risk factors for neonatal hyperbilirubinemia.

Which newborn has the greatest risk?

Premature infant

A newborn has a bilirubin level of 27 mg/dL.

The nurse recognizes the infant is at greatest risk for:

Kernicterus

A newborn is receiving phototherapy.

Which nursing intervention is most appropriate?

Cover the newborn's eyes during therapy.

A nurse is caring for a newborn born through meconium-stained amniotic fluid.

Which assessment finding suggests Meconium Aspiration Syndrome (MAS)?

Tachypnea with nasal flaring and retractions

A newborn is delivered through meconium-stained fluid.

Which intervention is the priority immediately after birth according to your class notes?

Suction the nose and mouth before the first breath if indicated.

A newborn delivered by scheduled cesarean birth develops:

• Respiratory rate of 90/min

• Mild retractions

• Expiratory grunting

• Barrel-shaped chest

Which condition is most likely?

Transient Tachypnea of the Newborn (TTN)

A nurse is caring for a newborn with suspected neonatal sepsis.

Which assessment finding requires immediate attention?

Lethargy and poor feeding

A newborn has an Apgar score of 3 at one minute and is gasping with a heart rate of 55 beats/min.

Which nursing action is the priority?

Initiate neonatal resuscitation immediately.

A nurse is assessing a newborn after a difficult vaginal delivery involving shoulder dystocia. Which finding requires the nurse to suspect a brachial plexus injury?

One arm is limp with an asymmetric Moro reflex

A nurse assesses a newborn with scalp swelling that crosses suture lines shortly after birth.

Which condition should the nurse suspect?

Caput succedaneum

A newborn is diagnosed with Fetal Alcohol Syndrome (FAS).

Which physical finding should the nurse expect?

Thin upper lip with flattened midface

A nurse is caring for a newborn experiencing Neonatal Abstinence Syndrome (NAS).

Which nursing intervention is most appropriate?

Swaddle the infant and reduce noise.

A newborn has excessive drooling, choking with the first feeding, and cyanosis.

Which congenital disorder should the nurse suspect?

Esophageal atresia with tracheoesophageal fistula (EA/TEF)

A newborn is diagnosed with esophageal atresia.

Which nursing intervention is the highest priority before surgery?

Keep the infant NPO and elevate the head of the bed

A nurse is assessing a newborn with abdominal contents protruding without a protective sac.

Gastroschisis

The nurse is caring for a newborn with gastroschisis immediately after birth.

Which intervention has the highest priority?

Protect the exposed bowel with sterile coverings and prevent heat loss.

A nurse is caring for parents after a stillbirth.

Which nursing response is most therapeutic?

Sit quietly with the parents, encourage expression of feelings, and remain nonjudgmental.

A nurse is assessing a newborn following a difficult birth.

Which finding requires immediate provider notification?

Unilateral arm paralysis with absent movement

A nurse is caring for a preterm newborn who is receiving phototherapy for hyperbilirubinemia.

Cover the infant's eyes and monitor temperature regularly.

A nurse is assessing a newborn whose mother had poorly controlled diabetes during pregnancy.

Blood glucose of 28 mg/dL

A nurse is assessing a newborn for signs of pathologic jaundice.

Which assessment finding is most concerning?

Jaundice develops within the first 12 hours after birth.

A preterm infant receiving gavage feedings develops abdominal distention, absent bowel sounds, and bloody stools.

Which complication should the nurse suspect?

Necrotizing enterocolitis

A nurse is teaching new parents how to reduce the risk of cold stress in their preterm infant.

Which parent statement indicates correct understanding?

"I'll dry my baby thoroughly and keep a cap on the head."