Neonatal substance withdrawal
A newborn is experiencing signs and symptoms of substance withdrawl. What nursing action would you prioritize?
a. initiate phototherapy
b. swaddle and reduce environmental stimuli
c. offer feedings every 3 hours
d. encourage frequent stimulation
b. swaddle and reduce environmental stimuli
What is the primary cause of transient tachypnea in a newborn?
a. surfactant deficiency
b. aspiration of meconium
c. sepsis
d. delayed clearance of the lung
d. delayed clearance of the lung
What is the primary cause of RDS in newborns?
a. low birth weight
b. surfactant deficiency
c. post term pregnancy
d. maternal hypertension
b. surfactant deficiency
How do we confirm hypoglycemia in a newborn?
a. capillary blood glucose test (CBG)
b. urine analysis
c. assessment
d. by having 3 risk factors
a. capillary blood glucose test (CBG)
Presentations of SGA babies include all of the following except:
a. wasted appearance of extremities
b. thin umbilical cord
c. increased subcutaneous tissue
d. wide skull sutures
c. increased subcutaneous tissue
a newborn is being evaluated for substance withdrawl. What lab would you expect the provider to order?
a. blood glucose
b. bilirubin
c. meconium/urine drug screen
d. occult stool
c. meconium/urine drug screen
What is the most appropriate nursing intervention for a newborn with transient tachypnea?
a. surfactant replacement
b. antibiotics
c. oxygen and monitoring
d. do not allow any visitors
c. oxygen and monitoring
What is a risk factor for RDS in newborns?
a. hypervolemia
b. genetics: white females
c. maternal diabetes mellitus
d. vaginal birth
c. maternal diabetes mellitus
Which of the following ranges indicate hypoglycemia in a newborn?
a. 60mg/dl-70mg/dl
b. 75mg/dl-90mg/dl
c. 30mg/dl-45mg/dl
d. 90mg/dl-105mg/dl
c. 30mg/dl-45mg/dl
Which complication is more closely associated with a baby who is small for gestational age?
a. macrosomia
b. hyperthermia
c. hypoglycemia
d. birth trauma
c. hypoglycemia
Which of the following are common assessment findings in a newborn with substance withdrawl? Select all that apply:
a. high pitched cry
b. yellowing of the skin
c. apnea
d. sneezing
e. decreased DTR
f. tremors
a. high pitched cry
c. apnea
d. sneezing
f. tremors
What is not typically seen in a newborn with TTN?
a. bradycardia
b. cyanosis
c. grunting
d. nasal flaring
a. bradycardia
Which of the following is an appropriate nursing intervention for a newborn with RDS?
a. provide suction to the newborn's mouth, trachea, and nose as needed
b. correct metabolic acidosis with ventilatory support
c. administer albuterol via nebulizer for 15-20 minutes as needed
d. correct respiratory acidosis by administering sodium bicarbonate
a. provide suction to the newborn's mouth, trachea, and nose as needed
Which of the following is NOT a symptom of hypoglycemia in a newborn?
a. lethargy
b. jitteriness
c. tachycardia
d. hypertension
d. hypertension
You're teaching the parents of an SGA baby. Which teaching would you include?
a. "It's important to monitor blood sugar regularly"
b. "Thermal stability is not a concern for your baby"
c. "Your baby's size means they're less likely to develop jaundice"
d. "You should limit feedings to avoid overstimulation"
a. "It's important to monitor blood sugar regularly"
A nurse is conducting an in-service for newly licensed nurses about neonatal opioid withdrawal syndrome in newborns. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?
a. "the newborn will have decreased muscle tone"
b. "the newborn will sleep for 2-3 hours after feeding"
c. "the newborn will have a continuous high pitched cry"
d. "the newborn will have mild tremors when disturbed"
c. "the newborn will have a continuous high pitched cry"
Which of the following is a primary risk factor for developing transient tachypnea of the newborn?
a. Vaginal delivery after prolonged labor
b. Cesarean section without preceding labor
c. Maternal hypertension
d. Premature rupture of membranes
b. Cesarean section without preceding labor
A newborn is born at term and does not cry immediately. The infant is floppy, pale, and has poor muscle tone. What is the nurse’s first action?
A. Administer oxygen via face mask
B. Begin chest compressions
C. Warm, dry, and stimulate the infant
D. Suction the mouth and nose with a bulb syringe
C. Warm, dry, and stimulate the infant
A 32-week gestation newborn is placed in an incubator. The nurse knows thermoregulation is a priority due to:
A. Immature renal function
B. Increased brown fat stores
C. Decreased subcutaneous fat
D. Elevated metabolic rate
c. decreased subcutaneous fat
Which of the following is the most priority nursing intervention for a baby large for gestational age?
a. delay glucose monitoring until after feedings
b. monitor baby's temperature
c. avoid the administration of IV fluids
d. assess for signs of birth trauma
d. assess for signs of birth trauma
Which of the following is NOT a long-term complication from neonatal substance withdrawl?
a. cerebral palsy
b. attention deficit disorder
c. hydrocephalus
d. language abnormalities
c. hydrocephalus
A nurse is educating new parents about TTN. Which statement by the parents indicates a correct understanding of the condition?
a. "Our baby will need antibiotics to treat this infection."
b. "This condition is serious and will have long-term effects."
c. "Our baby's breathing should improve within a few days."
d. "We should avoid holding our baby to prevent worsening symptoms."
c. "Our baby's breathing should improve within a few days."
A nurse is explaining meconium-stained amniotic fluid to new parents. Which statement by the parents indicates understanding?
A. “It means our baby may have a genetic condition.”
B. “It’s a normal sign that the baby is ready to eat.”
C. “It can happen when the baby is stressed before or during labor.”
D. “It means our baby will need surgery.”
C. “It can happen when the baby is stressed before or during labor.”
A nurse is caring for a newborn who was born at 32 weeks of gestation. The newborn’s birth weight is 1,100 g. Which of the following are expected findings in this newborn? Select all that apply:
a. lanugo
b. weak grasp reflex
c. plump face
d. long nails
e. translucent skin
a. lanugo
b. weak grasp reflex
e. translucent skin
Which of the following findings is anticipated in a newborn whose mother has uncontrolled gestational diabetes?
a. weight below the 10th percentile
b. increased risk of meconium aspiration
c. birth weight over 4,000 grams
d. scaphoid abdomen
c. birth weight over 4,000 grams