Hematology/
Immunology
Immunology
Which of the following measures is the most effective in preventing nosocomial infections in preterm infants?
A. Avoid overcrowding in NICU
B. Cohorting
C. Limiting parent/sibling contact
D. Hand hygiene
D. Hand hygiene
An infant's EKG shows V-tach, peaked T waves, and a widened QRS complex. Which of the following electrolyte abnormalities should the nurse assess for?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
B. Hyperkalemia
An infant with gastroschisis has cyanotic bowel. Placing the infant in which position would promote bowel perfusion?
A. Supine
B. Prone
C. HOB elevated
D. Lateral
D. Lateral
Maternal administration of betamethasone is given to promote:
A. Increased placental blood flow to support fetal lung development
B. Down regulation of sodium channels to hasten reabsorption of fetal lung fluid
C. Stimulation of type 2 pneumocytes to improve surfactant synthesis
D. Inhibition of adenosine receptors to increase respiratory responsiveness
C. Stimulation of type 2 pneumocytes to improve surfactant synthesis
Arterial blood gas results of pH 7.24, PCO2 51, PO2 40, and HCO3 17 represent:
A. Compensated metabolic acidosis and hypoxia
B. Mixed respiratory and metabolic acidosis and hypoxia
C. Partially compensated metabolic acidosis and hypoxia
D. Respiratory acidosis and hypoxia
B. Mixed respiratory and metabolic acidosis and hypoxia
A term infant has apnea at 10 hours of life. The most likely cause is:
A. Sepsis
B. Placement on back to sleep
C. Hyperglycemia
D. Apnea of prematurity
A. Sepsis
What is the most common renal congenital anomaly detected on prenatal ultrasound?
A. Hydronephrosis
B. Renal agenesis
C. Patent urachus
D. Hypospadias
A. Hydronephrosis
An infant is diagnosed with meconium ileus. This is commonly associated with:
A. Trisomy 18
B. Cystic fibrosis
C. DiGeorge syndrome
D. Hirschprung's
B. Cystic fibrosis
A term infant is delivered via vacuum extraction. A few hours after birth, the infant is noted to have respiratory distress, pallor, and increasing head circumference. This clinical presentation most closely matches:
A. surfactant deficiency
B. subgaleal hemorrhage
C. hypoxic-ischemic encephalopathy
D. caput succedaneum
B. subgaleal hemorrhage
The nurse is caring for an infant whose heart rate increases suddenly to 260. Blood pressure remains stable, but infant's capillary refill increases to 5 seconds after 30 minutes. What intervention should be anticipated?
A. Transesophageal probe placement
B. Defibrillation
C. Cardioversion
D. Initiation of chest compressions
C. Cardioversion
Which immunoglobulin crosses the placenta in significant amounts?
A. IgA
B. IgE
C. IgG
D. IgM
C. IgG
The potassium-sparing diuretic spironolactone (Aldactone) is not useful in emergent/urgent situations because:
A. high risk of allergic reaction
B. onset of action is about 60 hours
C. IV form is caustic to veins
D. high risk for hypokalemia and dysrhythmias
B. onset of action is about 60 hours
Postoperative complications for repair of an EA and distal TEF can include which of the following?
A. Leakage or stricture at anastomosis site
B. Short bowel syndrome
C. Renal dysfunction and urosepsis
D. Inferior vena cava compression
A. Leakage or stricture at anastomosis site
A term male develops tachypnea and grunting at 6 hours of life. A chest x-ray shows the infant has an enlarged heart with suspected cardiomyopathy. Which maternal condition could be associated with these findings?
A. Diabetes
B. Hypothyroidism
C. HELLP syndrome
D. Chronic hypertension
A. Diabetes
A 3-day old 25 weeker has a sudden drop in hematocrit. The nurse should initially assess for:
A. Anemia of prematurity
B. Intraventricular hemorrhage
C. Bloody drainage from nasogastric tube
D. Iatrogenic blood loss from laboratory testing
B. Intraventricular hemorrhage
A 34-week infant develops apnea, lethargy, and hypotension at 12 hours of life. Which of the following organisms should the nurse suspect as the most likely source of infection?
A. Group B streptococcus
B. Pseudomonas aeruginosa
C. Candida albicans
D. Staphylococcus aureus
A. Group B streptococcus
A 27 weeker on DOL 14 has a sodium of 136 mEq/L and a UOP of 2.3 mL/kg/hr. The total fluid goal is 120mL/kg/day of PN/Lipids. The provider increases the sodium level in the PN today. What is the physiologic rational?
A. Urine output is not within range
B. Preterm infants have immature renal concentration function
C. Infant is receiving too much free water in the PN
D. Additional sodium will prevent dilutional hyponatremia
B. Preterm infants have immature renal concentration function
An infant presents with bilious emesis. The nurse should suspect which of the following as a potential diagnosis?
A. Gastroesophageal reflux disease
B. Malrotation
C. Necrotizing enterocolitis
D. Tracheoesophageal fistula
B. Malrotation
After a crash C-section for cord prolapse, a term newborn's HR is 50 bpm at 12 minutes of age. The infant remains hypotonic and does not have spontaneous respiratory effort. The newborn is at risk for:
A. Hyperglycemia
B. Increased urinary output
C. Right ventricular hypertrophy
D. Hypoxic ischemic encephalopathy
D. Hypoxic ischemic encephalopathy
A term infant is noted to have low-set ears, a short neck with excess skin folds, a large tongue, and simian creases. This infant is at increased risk of:
A. Coarctation of the aorta
B. Duodenal atresia
C. Polycystic kidneys
D. Tracheoesophageal fistula
B. Duodenal atresia
An infant with E. coli bacteremia requires mechanical ventilation and hemodynamic support (dopamine and dobutamine). Petechiae cover the infant's trunk, and a pulmonary hemorrhage occurs. Which disease process is likely occurring?
A. Neonatal alloimmune thrombocytopenia
B. Maternal systemic lupus erythematosus
C. Disseminated intravascular coagulation
D. Maternal idiopathic thrombocytopenic purpura
C. Disseminated intravascular coagulation
An infant is delivered to a mother with a history of oligohydramnios. Which of the following conditions should the infant be evaluated for?
A. Renal agenesis
B. Esophageal atresia
C. Anencephaly
D. Omphalocele
A. Renal agenesis
An infant is diagnosed with congenital diaphragmatic hernia. The nurse should anticipate which common preoperative complication?
A. Bowel ischemia
B. Hepatic dysfunction
C. Pulmonary hypertension
D. Necrotizing Enterocolitis
C. Pulmonary hypertension
A term infant is resuscitated following a motor vehicle accident. Oxygen saturation is 95%, BP is 34/22 (28), glucose is 30 mg/dL, and infant is hypotonic. What action is the highest priority?
A. Give 30mL NS bolus
B. Give 6mL D10W bolus
C. Give 30mL of O- blood
D. Start D10W at 10mL/hr
A. Give 30mL NS bolus
A 3cm increase in abdominal girth, visible bowel loops, increased apnea episodes, and a 50% residual from the infant's last feed is noted upon clinical exam. The nurse should anticipate an order for which type of x-ray?
A. Anterior/posterior chest
B. Anterior/posterior abdomen
C. Anterior/posterior abdomen and cross-table lateral
D. Lateral decubitus and anterior/posterior chest
C. Anterior/posterior abdomen and cross-table lateral