SGA 36.A nurse is performing an admission assessment on a small for gestational age term infant.

The nurse observes tachypnea, grunting, retractions, and nasal flaring.The nurse interprets that these symptoms are likely the result of: A. Hypoglycemia B.Meconium aspiration syndrome C.Respiratory distress syndrome D.Transient tachypnea of the newborn 37.The small-for-gestation neonate is at increased risk during the transitional period for which complication? A.Anemia probably due to chronic fetal hypoxia B.Hyperthermia due to decreased glycogen stores C.Hyperglycemia due to decreased glycogen stores D.Polycythemia probably due to chronic

fetal hypoxia

LGA 38.A nurse is teaching a mother with diabetes mellitus who delivered a large for gestational age male infant about the care of the infant.Which statement, if made by the mother, indicates further teaching is necessary? A.I will talk to my baby when he is in a quiet alert state. B.I will watch my baby closely, because I know he may not be as mature in motor development. C.I will breastfeed my baby every 2 1/2to 3 hours, and will implement arousing techniques. D.I will allow my baby to sleep throughout the night, because he needs his rest. 39.Which of the following characteristics is most commonly associated with a large for

gestational age newborn? A.Weight under 4000g C.Risk for birth injury B. Dysmorphic features D. Hypothermia Endocrine 40.Neonates of mothers with diabetes are at risk for which complication following birth? A. Atelectasis C. Microcephaly B. Pneumothorax D. Macrosomia 41.Which of the following infants would be at lowest risk for hypoglycemia? A.A 2-hour old, full-term neonate whose mothers blood glucose level was 350mg/dl during labor B.A large for gestational age neonate 10 hours after birth whose hemogluco test shows a reading of 60mg/dl C.A 32-week-gestation neonate 5 hours

after birth D.A small-for-gestational age neonate, 12 hours after birth, who is NPO because of respiratory distress 42.Which of the following orders would be included when planning care for an infant of a diabetic mother? A.Provide extra stimulation B.Use oil on the body after bathing C.Give early feeding of glucose and water D.Start early infusion of insulin 43.When caring for an infant of a mother with diabetes, which physiological finding is most indicative of a hypoglycemic episode? A. Hyperalert state B. Jitteriness C.Positive Babinski reflex D.Serum glucose level of 60mg/dl PRETERM/POSTERM 44.A nurse is performing an assessment on a postmature neonate.Which physical characteristic would the nurse expect to

observe? A.Vernix that covers the body in a thick layer B.Desquamation over the body C.Smooth soles without creases D.Lanugo covering the entire body initiation of breathing 48.The physician orders betamethasone (Celestone) for a 34-year old multigravid client at 32 weeks gestation who is experiencing preterm labor. The nurse explains that this drug is given for which of the following reasons? A.Enhance fetal lung maturity B.To counter the effects of tocolytic therapy C. To treat chorioamnionitis D.To decrease neonatal production of surfactant Respiratory 49.Which symptom would indicate the neonate was adapting appropriately to extrauterine life without difficulty? A. Nasal flaring

B.Light audible grunting C.Respiratory rate 40-60 breaths/minute D.Respiratory rate 60-80 breaths/minute 50.Which condition or treatment best ensures lung maturity in a neonate? A.Meconium in the amniotic fluid B.Glucocorticoid treatment just before delivery C.Lecithin to sphingomyelin ration more than 2:1 D.Absence of phosphatidylglycerol in amniotic fluid 51.After reviewing the clients maternal history of magnesium sulfate during labor, which condition would the nurse anticipate as a potential problem in the neonate? A. Hypoglycemia C. Respiratory depression B. Jitteriness D. Tachycardia 52.Which circumstance of delivery would

predispose a neonate to respiratory distress syndrome? A. Premature birth C. First born of twins B. Vaginal delivery D. Post date pregnancy 53.Which assessment finding would be the most unlikely risk factor for respiratory distress syndrome? A.Second born of twins B.Neonate of a diabetic mother C.Neonate born at 34 weeks D.Chronic maternal hypertension 54.A nurse is monitoring a newborn infant for signs of respiratory distress syndrome. The nurse monitors the infant for A.Cyanosis, tachypnea, retractions, grunting respirations, and nasal flaring B.Acrocyanosis, apnea, pneumothorax, and grunting C.Barrel-shaped chest, hypotension, and

bradycardia D.Acrocyanosis, emphysema, and interstitial edema 55.A nurse is assessing a 3-day-old neonate with a diagnosis of respiratory 64.A nurse is caring for a term newborn. Which assessment finding would alert the

distress syndrome.Which assessment finding indicates that the neonates respiratory status is improving? A.Presence of systolic murmur B.Respiratory rate between 60 and 70 breaths/min C.Edema of the hands and feet D.Urine output of 1-3ml/kg/hr 56.Which complication is common in neonates who receive prolonged mechanical ventilation at birth? A. Bronchopulmonary dysplasia B. Esophageal atresia C. Hydrocephalus D. Renal failure MAS 57.When a neonate is delivered with

meconium staining in the amniotic fluid, which sequence of events will most effectively decrease the risk of meconium aspiration? A.Deliver the thorax, then suction the mouth B.Clamp the umbilical cord, then suction the neonates mouth C.Deliver the head and then suction the mouth and then the nose D.Deliver the thorax, then suction the nose then the mouth 58.Which of the following positions is recommended for placing an infant to sleep? A. Prone position B. Supine position C. Side-lying position D.With head of bed elevated 30 degrees 59.Which of the following definitions best describes the etiology of sudden infant death syndrome? A. Cardiac arrhythmias B.Apnea of prematurity

C.Unexplained death of an infant D.Apparent life-threatening event 60.Which of the following children has an increased risk of sudden infant death syndrome? A.Premature infant with low birth weight B.A healthy 1 year old C.Infant hospitalized for fever D.First born child 61.Sudden infant death syndrome is confirmed by which of the following procedures? A. Autopsy C. Skeletal survey B. Chest X-ray D. Laboratory analysis 62.Which of the following reactions are usually exhibited by the family of an infant who has died from sudden infant death syndrome? A.Feelings of blame or guilt B.Acceptance of the diagnosis

C.Requests for the infants belongings D.Questions regarding the etiology of the diagnosis nurse to suspect the occurrence of jaundice in this newborn? A.A negative result to a direct Coombs test B.Birth weight of 8lb 6oz C.Presence of a cephalhematoma D.Infant blood type of O negative 65.A client with group AB blood whose husband has group O blood has just given birth.The major sign of ABO blood incompatibility in the neonate is which complication or test result? A.Negative Coombs test B.Bleeding from nose or ear C.Jaundice after the first 24 hours of life D.Jaundice within the first 24 hours of life 66.Which clinical finding is most suggestive of physiologic hyperbilirubinemia in a neonate?

A.Clinical jaundice before 36 hours of age B.Clinical jaundice lasting beyond 14 days C.Bilirubin levels of 12 mg/dlby 3 days of life D.Serum bilirubin level increasing by more than 5mg/dl/day 67.On the second day of life, a neonate develops hyperbilirubinemia and is placed under phototherapy.Which of the following would be included in the nurses care plan for this infant? A.Keep the infant swaddled in a blanket B.Record the type and amount of stools C.Maintain continuous eye patches D.Limit fluid intake 68.A 3-day-old neonate needs phototherapy for hyperbilirubinemia. Nursery care of a neonate receiving phototherapy would include which nursing intervention? A. Tube feedings

B.Feeding the neonate under phototherapy lights C.Mask over the eyes to prevent retinal damage DTemperature monitored every 6 hours during phototherapy 69.On the first postpartum day, a neonate diagnosed with an ABO incompatibility has a bilirubin level of 10 mg/dl.After teaching the parents about this condition, which of the following statements by the parents about the neonate indicates the need for additional teaching? A.Phototherapy causes the babys stools to be bright green. B.Breastfeeding may need to be stopped temporarily. C.The baby will need an exchange transfusion with type A blood. D.The baby may become anemic over the next 2 weeks.

70.A postpartum mother who is Rh negative is to receive RhoGAM after the delivery of an Rh positive baby.Before receiving the medication, she asks the nurse how the drug works.Which fo the following best describes how RhoGAM acts in the

Hyperbilirubinemia/Isoimmunization 63.Which statement is the best explanation for physiologic hyperbilirubinemia? A.The neonate usually also has a medical problem B.In term neonates, it usually appears after 24 hours C.It is caused by elevated conjugated bilirubin levels D.It is usually progressive from the neonates feet to his head expectant mothers body? A.RhoGAM attaches to maternal antiRh antibodies and directly destroys them B.RhoGAM suppresses the production of

maternal antibodies C.RhoGAM destroys fetal Rh positive red blood cells in the maternal circulation before sensitization occurs D.RhoGAM prevents fetal-maternal bleeding episodes from occurring at the former placenta site 71.Rh isoimmunization in a pregnant client develops during which of the following conditions? A.Rh-positive maternal blood crosses into fetal blood, stimulating fetal antibodies B. Rh-positive fetal blood crosses into maternal blood, stimulating maternal antibodies C.Rh-negative fetal blood crosses into maternal blood, stimulating maternal antibodies D.Rh-negative maternal blood crosses into fetal blood, stimulating fetal antibodies Hemolytic Disease of the Newborn 72.A postpartum client asks why her

newborn is getting an injection of vitamin K. Which statement best explains why this drug is given to neonates? A.Vitamin K assists with coagulation B.Vitamin K assists with the gut to mature C.Vitamin K initiates the immunization process D.Vitamin K protects the brain from excess fluid production Cardiovascular 73.Which is the most common cause of heart failure in children? A. Myocarditis C. Severe hypoxia B.Complete heart block D. Congenital heart disease 74.Which of the following factors indicating a cardiac defect might be found when assessing a 1-month-old infant? A. Weight gain C. Poor nutritional intake

B. Hyperactivity D. Pink mucous membranes 75.Which of the following signs may be seen in a child with ventricular septal defect? A.Cyanosis of the nailbeds B.Above average height on a growth chart C.Above average weight gain on growth chart D.Pink nailbeds with capillary refill less than 2 seconds 76.Which of the following conditions best describes ventricular septal defect? A.Narrowing of the aortic arch 81.A nurse is teaching parents about tricuspid atresia.Which of the following statements indicates the parents understand? A.Theres a narrowing at the aortic outflow tract. B.The pulmonary veins dont return to the left atrium.

C.Theres a narrowing at the entrance of the pulmonary artery. D.Theres no communication between the right atrium and right ventricle. 82.Which of the fallowing statements best describes transposition of the great arteries? A.The body receives only saturated blood B.It is classified as an acyanotic defect with increased pulmonary blood flow C.The pulmonary artery leaves the left ventricle, and the aorta exits from the right ventricle D.It is a condition in which the right atrium and the left atrium empty into one ventricular chamber 83.Which of the following cardiovascular disorders is considered acyanotic? A.Patent ductus arteriosus C. Tricuspid atresia B.Tetralogy of Fallot D. Truncus

arteriosus NEC 84.A nurse assessing a client with necrotizing enterocolitis would expect which of the following findings? A.Abdominal distention and gastric retention B.Gastric retention and Guaiacnegative stools C.Metabolic alkalosis and abdominal distention D.Guaiac-negative stools and metabolic alkalosis Maternal Infection 85.The most common neonatal sepsis and meningitis infections seen within 24 hours after birth are caused by which organism? A. Candida albicans B. Chlamydia trachomatis C. Escherichia coli D.Group B beta-hemolytic streptococcus 86.A pregnant woman, 36 weeks

B.Failure of a septum to develop completely between the atria C.Narrowing of the valves at the entrance of the pulmonary artery D.Failure of a septum to develop completely between the ventricles 77.Which of the following conditions best describes coarctation of the aorta? A.Absent tricuspid valve B.Narrowing in the area of the aortic valve C.Localized constriction or narrowing of the aortic wall D.Narrowing at some location along the right ventricular outflow tract 78.Which of the following assessments is expected when assessing a child with tetralogy of Fallot? A. Machine-like murmur B.Normal blood pressure C.Increasing cyanosis with crying or activity D.Higher pressures in the upper extremities than with the lower extremities

79.A child with tetralogy of Fallot has clubbing of fingers and toes, a finding related to which of the following conditions? A. Polycythemia C. Pansystolic murmur B. Chronic hypoxia D. Abnormal growth and development 80.A child with tetralogy of Fallot may assume which position of comfort during exercise? A. Prone C. SemiFowler B. Side-lying D. Squat gestation, learns that she is HIV positive. She asks the clinic nurse how this will affect her unborn baby.The nurse responds A.A cesarean delivery will prevent your baby from being infected. B.There is about 50% chance that your baby will be infected.

C.Because your pregnancy is past the first trimester, the baby will not be infected. D.If you are symptom-free, your baby will not be infected. 87.A nurse is developing a teaching plan for the mother of a newborn infant who is human immunodeficiency viruspositive. Which specific instruction should be included in the teaching plan? A.Instruct the mother to provide meticulous skin care of the newborn infant and to change the infants diaper after each voiding or stool B.Instruct the mother to feed the newborn infant in an upright position with the head and chest tilted slightly back to avoid aspiration C.Instruct the mother to feed the newborn infant with a special nipple and bubble the

infant frequently to decrease the tendency to swallow air D.Instruct the mother to check the anterior fontanel for bulging and sutures for widening each day 88.Which of the following best indicates that a neonate may have an infection? A.Respiratory rate of 65 at rest B.Weight increase of 1 lb on 2 successive days C.Axillary temperature of 37 degrees C D.Hemoglobin of 20 g/dl of blood Drug Addiction/FAS 89.With heroin addiction in the newborn, signs of withdrawal are most likely to A.Appear within the first 4 hours after birth B.Occur 1-2 days after delivery C.Be delayed up to 5 days postnatally D.Be eliminated or greatly reduced if the newborn receives a narcotic antagonist such as naloxone immediately after delivery

90.Which intervention is helpful for the neonate experiencing drug withdrawal? A.Place the isolette in a quiet area of the nursery B.Withhold all medication to improve the livers metabolization of drugs C.Dress the neonate in loose clothing so he wont feel restricted D.Place the isolette near the nurses station for frequent contact with health care workers 91.When attempting to interact with a neonate experiencing drug withdrawal, which behavior would indicate that the neonate is willing to interact? A. Gaze aversion C. Quiet alert state B. Hiccups D. Yawning 92.A nurse explains to a mother that her newborn is being admitted to the neonatal

intensive care unit with a probable diagnosis 93.A 36-week neonate born weighing 1,800g has microcephaly and microophthalmia.Based on these findings, which risk factor might be expected in the maternal history? A.Use of alcohol C. Gestational diabetes B.Use of marijuana D. Positive group B streptococci 94.Which neonatal behavior is most commonly associated with fetal alcohol syndrome? A. Hypoactivity C. Poor wake and sleep patterns B.High birth weight D. High threshold of stimulation

effectiveness of the explanation when the mother states: A.Withdrawal symptoms will occur after 3 days. B.Mental retardation is unlikely to happen. C.Withdrawal symptoms are tremors, crying, seizures, and reflexes that arent normal. D.The reason the child is so large is because of the fetal alcohol syndrome

of fetal alcohol syndrome.The nurse explains the expected effects of FAS to the mother. The nurse evaluates the