Neonatal Care

The nurse is providing preoperative teaching to the parents of a neonate diagnosed with short-segment Hirschsprung disease. Which statement by the patient’s mother indicates an understanding of the education?

Which neonate must be most closely monitored for signs of Hirschsprung disease?

The infant with chronic constipation has undergone a rectal biopsy for diagnosis of Hirschsprung disease. The absence of which type of cell conforms the diagnosis?

The 39-week-gestation neonate is born to a mother with chorioamnionitis. The provider has ordered ampicillin 75 mg/kg/day in divided doses every 8 hours and administered intravenously. The neonate weighs 4.2 kg. How many milligrams does the nurse administer with each dose? Enter your answer using a whole number.

The 25-week-gestation neonate is ordered to receive ampicillin 100 mg/kg/day intravenously divided into doses every 12 hours immediately after birth. The neonate weighs 745 grams. The pharmacy dispenses ampicillin in a 5 mL vial that contains 125 mg. How many milliliters will the nurse administer with each dose? Round your answer to the nearest tenth decimal.

The 32-week-gestation, 1.9 kg neonate has been prescribed intravenous ampicillin for concerns for sepsis. The dose is 150 mg/kg/d divided into 2 doses administered over 15 minutes. The pharmacy dispenses the medication in a 5 mL vial that contains 250 mg of medication. At what rate will the nurse program the medication to infuse? Round your answer to the nearest tenth decimal.

The nurse is caring for the 3.7 kg neonate who was born at 38 weeks gestation after an uncomplicated pregnancy and delivery in the newborn nursery. Which immunization does the nurse administer to the patient prior to discharge from the hospital?

The nurse is performing an assessment of an infant born 8 hours ago. The infant’s POC blood glucose level is 25 mg/dL. Which action does the nurse take first?

The woman who delivered her first baby will be discharged tomorrow. After a bedside education program in the hospital, the patient tells the nurse that she does not have a crib, bottles, or diapers to care for her new baby. Which action is most appropriate?

Which physiologic event causes the functional closure of the foramen ovale after birth?

The nurse is in the delivery room of a full-term neonate who requires additional stimulation to begin spontaneous respirations. The nurse removes wet blankets from below the baby to decrease cold stress due to which form(s) of heat loss? Select all that apply. 

The nurse is preparing for the delivery of a 35-week gestation neonate being born via cesarean section for maternal preeclampsia with severe features. The nurse sets the fraction of inspired oxygen (FiO2) for the flow-inflating bag to which percentage?

Which normal characteristic of the preterm infant places them at a higher risk for evaporative heat loss via the respiratory tract?

The 7-day-old neonate born at 32-weeks’ gestation has an axillary temperature of 38.9°C. The nurse notes the infant is lethargic, with pale extremities and flash central capillary refill. Which nursing action is appropriate?

The 23-week gestation neonate is being cared for in a double-walled, heated isolette with ambient humidity set to 85%. The patient is at risk for sepsis due to which organism related to the care environment?

The baby born at 32 weeks’ gestation to a mother who is hepatitis B surface antigen negative (HBsAg-negative) is taken to the Neonatal Intensive Care Unit (NICU) for care. The neonate, who weighs 1.8 kg, requires continuous positive airway pressure of 7 cm H20, intravenous fluids containing dextrose, and intravenous caffeine. After getting consent from the mother, when is the most appropriate time to administer the hepatitis B vaccine to the baby?

The 34-week-gestation neonate is born weighing 1.7 kg to a mother who is hepatitis B surface antigen (HBsAg) positive; all other infectious disease serologies are negative. Which orders are appropriate for this patient? Select all that apply.

The 1.9 kg neonate is born precipitously via vaginal delivery to a 32-year-old mother who received no prenatal care or infectious disease serology testing before delivery. The mother has a history of intravenous drug use. Which intervention does the nurse perform first?

The nurse receives report on four patients at the start of the shift. Which patient does the nurse visit first?

The nurse educates parents on the care of their 3-day-old infant prior to discharge from the hospital. Which instruction does the nurse include in the teaching?

The nurse planning care for the neonate with myelomeningocele plans interventions to ensure the child does not develop an allergy to which substance?

The nurse is supervising the student nurse preparing for the return of a neonate from surgery to repair a myelomeningocele. Which item, if brought into the room by the student nurse, does the nurse remove immediately?

The nurse learns in shift report the 1-year-old with respiratory distress due to parainfluenza virus has had increased nasal and oral secretions and has had increased coughing fits. Which personal protective equipment does the nurse don prior to caring for the patient? Select all that apply.

The neonate is diagnosed with congenital parvovirus. The nurse requests an order for which transmission prevention precaution?

The nurse is counseling the parents of an 8-month-old child born with myelomeningocele on appropriate baby foods to introduce to the child. Which foods, if selected by the parents, indicate teaching was effective? Select all that apply.

The first-time mom requests information from the nurse about providing foods other than breast milk to her 3-month-old child. Which response by the nurse is most appropriate?

The mother of a 1-month-old child tells the nurse, “I’m concerned because my child does not hold his head up during tummy time.” Which response by the nurse is appropriate?

The nurse is preparing for the well-baby visit for a 4-month-old baby and expects which behaviors from the patient? Select all that apply.

Which symptom can occur following vertical transmission of Neisseria gonorrhoeae?

Which mother is at highest risk for passing herpes simplex virus (HSV) to her fetus/neonate?

The full-term neonate (3.2 kg) born precipitously to a mother of unknown infectious disease status has had a positive rapid plasma reagin (RPR) test. The nurse plans care to perform which intervention first?

The nurse is teaching a woman ways to prevent mastitis. Which statement by the patient indicates that more teaching is needed?

The extremely low birth weight neonate born at 22 weeks gestation is not expected to live through the night. The family has described to the nurse the importance of their church and Christian faith. Which action by the nurse demonstrates the nurse's ability to recognize and address the family's grief? 

At the 2-month checkup, the baby’s mother tells the nurse that the 4.1 kg baby eats 3 ounces of expressed breast milk every 3 hours. How many kilocalories/kg/day is the baby receiving? Input your answer using a whole number.

The very low birth weight infant was born at 0.9 kg and now weighs 1.3 kg. The neonate is on full feeds receiving 24 kcal/oz formula with a daily kcal goal of 120 kcal/kg/day. The patient eats every 3 hours around the clock. How many milliliters does the nurse administer with each feeding? Enter your answer using a whole number.

Which statement is true regarding the neonate's immune system?

The baby requires phototherapy for moderate hyperbilirubinemia, but the baby’s mother wants to breastfeed. Which response by the nurse is most appropriate?

During the initial examination of the full-term baby, the nurse notes an irregular red reflex. The nurse reports the finding to the provider and reviews the mother’s chart for which information?

The fetuses of mothers with which infections during pregnancy are at an increased risk for hearing loss? Select all that apply.

Which phonocardiogram tracing indicates a common heart condition associated with prematurity?

The nurse is creating a presentation on rickets in the community. The nurse focuses on which group of individuals for this teaching?

The 1.5-kg preterm neonate in the neonatal intensive care unit is intubated and mechanically ventilated. The ventilator is set to deliver a tidal volume of 6 mL with each breath. On day of life 1, the patient’s peak inspiratory pressure was 15 mm Hg. On day of life 3, the patient’s peak inspiratory pressure is 22 mm Hg. How does the nurse interpret this information?

The nurse is assigned to care for a large for gestational age neonate with respiratory distress and significant tachypnea that is requiring continuous positive airway pressure at 12 hours of life. The nurse notes the patient has good muscle tone with flexed bilateral legs and a flexed right arm. The left arm is extended and adducted. The nurse is MOST concerned about which condition?

The mother of the healthy baby born 12 hours ago at 42 weeks’ gestation asks the nurse why the baby’s arms and legs quiver when she cries. Which response by the nurse is most appropriate?

The mother of a 1-month-old neonate brings the child to the clinic with concerns that the child’s head seems large. The nurse measures the occipitofrontal circumference (OFC) and notes a 4 cm increase in the OFC since birth. When reporting this information to the provider, the nurse requests which test?

On the initial assessment after birth, the neonate is found to have a 1 cm x 0.5 cm hemangioma on the right cheek. Which additional assessment does the nurse make related to this finding?

The nurse is caring for the infant hospitalized prior to surgery for intussusception. The nurse anticipates the patient’s stool will have which appearance?

The 6-month-old neonate is brought to the emergency department (ED). The parents state, “She is just so lethargic. Anything she eats, she vomits. Her vomit was normal initially, but now it’s dark green. Also, her stool has turned to a dark red, jelly-like consistency.” The nurse palpates the patient’s abdomen, expecting to make which assessment?

Which is the best action by the nurse in the neonatal intensive care unit (NICU) in response to a tornado warning?

Which interventions does the nurse include in the plan of care for the 2-day-old infant who requires phototherapy for hyperbilirubinemia? Select all that apply.