Question: A mother of a premature infant in the neonatal intensive care unit (NICU) asks the nurse when her baby will begin oral feedings. The nurse is aware that multiple criteria must first be met. Which criterion is most essential?
Answer Options:
A. Birth weight of at least 2,500 g
B. Presence of a strong, coordinated suck and swallow reflex
C. Absence of respiratory distress
D. Ability to maintain body temperature without an incubator
Answer: B — Presence of a strong, coordinated suck and swallow reflex
Question: A prenatal nurse reviews the files of four patients. Which patient is at highest risk for complications during pregnancy?
Answer Options:
A. The patient who is 16 years of age, just diagnosed with gestational diabetes
B. The patient who is 37 years of age, obese, experiencing gestational hypertension, and has an unresolved headache.
C. The patient who is 28 years of age, who delivered a premature neonate 3 years prior
D. The patient with chronic hypertension, who is currently pregnant with twins
Answer: B — The patient who is 37 years of age, obese, experiencing gestational hypertension, and has an unresolved headache.
Question: The nurse understands adequate output is a good indicator that the baby is getting enough breast milk. Which information is important for the nurse to provide to parents on the number of wet diapers and stools in a 24-hour period?
Answer Options:
A. By day 10, the baby should have at least 5 to 6 wet diapers and 5 to 6 stools.
B. By day 5, the baby should have at least 2 to 3 wet diapers and 2 to 3 stools.
C. By day 6, the baby should have at least 6 to 8 wet diapers and 3 to 4 stools.
D. By day 1, the baby should have at least 3 to 4 wet diapers and 3 to 4 stools.
Answer: C — By day 6, the baby should have at least 6 to 8 wet diapers and 3 to 4 stools.
Question: The nurse assesses four newborns. Which of the following assessment findings would place a newborn at risk for developing physiologic jaundice?
Answer Options:
A. A newborn who is bottle-feeding every 2–3 hours with stable weight.
B. A newborn who is exclusively breastfeeding and has lost 8% of birth weight.
C. A newborn who had a spontaneous vaginal delivery at 40 weeks gestation.
D. A newborn with a strong cry, active movement, and pink skin color.
Answer: B — A newborn who is exclusively breastfeeding and has lost 8% of birth weight.
Question: A newborn delivered at 37 weeks gestation is exhibiting mild respiratory distress, with tachypnea (RR 70/min), nasal flaring, and mild grunting shortly after a cesarean section birth. Which of the following is the most likely diagnosis?
Answer Options:
A. Meconium aspiration syndrome
B. Respiratory distress syndrome
C. Congenital diaphragmatic hernia
D. Transient Tachypnea of the Newborn (TTN)
Answer: D — Transient Tachypnea of the Newborn (TTN)
Question: A 40-week gestation neonate is in the first period of reactivity. Which of the following actions should the nurse take at this time?
Answer Options:
A. Notify the neonatologist of the finding
B. Place the baby under the overhead warmer
C. Perform the gestational age assessment
D. Encourage the parents to bond with their baby
Answer: D — Encourage the parents to bond with their baby
Question: The nurse is planning care for a newborn. Which nursing intervention would best protect the newborn from the most common and immediate form of heat loss?
Answer Options:
A. Drying the newborn thoroughly
B. Placing the newborn away from air currents
C. Pre-warming the examination table
D. Removing wet linens from the isolette
Answer: A — Drying the newborn thoroughly
Question: Scenario: You’re the nurse weighing a newborn who registers 6 lb 2 oz on the infant scale. Directions: Convert this weight into grams.
Answer Options:
N/A (computation question)
Answer: 2,781 g
Question: Scenario: You’re the nurse weighing a newborn who registers 6 lb 2 oz on the infant scale. Directions: Convert this weight into grams.
Answer Options:
N/A (computation-based)
Answer: 2,781 g
Question: (Select All That Apply) Which actions by the neonatal intensive care unit (NICU) nurse best provide psychosocial support to the parents of a premature neonate?
Answer Options:
A. Praise parents for their involvement in the care of their baby.
B. Inform parents that they should ask any questions they have.
C. Discourage parents to take photos to share with family and friends until the newborn is stable.
D. Assess the parents’ readiness to care for their neonate.
E. Ask the parents how they are coping with the experience.
Answer: A, B, D, E
Question: A newborn is admitted to the nursery, and the nurse records the baby’s weight as 3,450 grams. Convert this weight into pounds and ounces.
Answer Options:
N/A (computation question)
Answer: 7 lb 10 oz
Question: A mother has a child who is 4 years old and is expecting another child. She expresses concern about how the older sibling will receive the newborn. Which intervention shared by the mother does the nurse discourage?
Answer Options:
A. “I let him pick out a gift for the baby, and have one for him from the baby.”
B. “I plan to let him hear the baby’s heartbeat at the next prenatal visit.”
C. “I have enrolled him in a sibling preparation class at the hospital.”
D. “I think that I will just bring the new baby home as a surprise.”
Answer: D — “I think that I will just bring the new baby home as a surprise.”
Question: A mother that is American and lives in the United States is HIV-positive. She has given birth to a term female. What plan of care is most appropriate for this infant?
Answer Options:
A. Provide 4–5 large feedings throughout the day.
B. Begin prophylactic ART (Zidovudine) administration.
C. Test with an anti-HIV-1 antibody assay at 8 months.
D. Encourage the mother to breastfeed the child.
Answer: B — Begin prophylactic ART (Zidovudine) administration.
Question: The nurse is assisting a newborn’s primary care provider (PCP) with the performance of a circumcision. Which intervention is used to manage the neonate’s pain?
Answer Options:
A. A Velcro tourniquet is loosely wrapped around the penis.
B. The neonate is given acetaminophen 3 hours before the procedure.
C. The foreskin is numbed with ice before the nerve block
D. A sucrose-dipped pacifier is offered during the nerve block.
Answer: D — A sucrose-dipped pacifier is offered during the nerve block.
Question: Scenario: A newborn receives formula (25 mL), expressed breast milk (3 oz), and IV fluids (15 mL). Output includes two wet diapers (72 g and 68 g, with dry weight 28 g), stool (10 g), and emesis (20 mL). What are the total intake and output?
Answer Options:
N/A (computation question)
Answer: Intake = 130 mL, Output = 114 mL
Question: For an infant experiencing symptoms of drug withdrawal, which intervention should be included in the plan of care?
Answer Options:
A. Administering chloral hydrate for sedation
B. Playing soft music during feeding
C. Feeding every 4 to 6 hours to allow extra rest between feedings
D. Swaddling the infant and frequent holding of the baby
Answer: D — Swaddling the infant and frequent holding of the baby