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ABC Practice test newborn

ABC Practice test newborn

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Published by Marcus, RN

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Published by: Marcus, RN on Aug 27, 2008
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04/14/2014

 
PRACTICE TEST 2:
High Risk Newborn
Assessment
1. The nurse conducts a physicalassessment of the neonate as the initial bathis given several hours after birth. Inassessing the baby’s skin, which of thefollowing observations most likely requirespecial attention?A. Cyanosis of the hands and feetB. Vernix caseosaC. Harlequin signD. Jaundice2. In comparing the newborn’s head andchest measurements, which of the followingobservations would the nurse expect to find?A. The chest circumference is approximately1 inch smaller than the head circumferenceB. The chest circumference is approximately1 inch larger than the head circumferenceC. The head and chest circumference areequalD. The chest circumference is approximately3 inches smaller than the headcircumference3. The nurse assesses a 1-hour-oldnewborn’s eyes. Which condition, if found,would most likely require additionalassessment?A. Transient strabismusB. Subconjunctival hemorrhageC. Lack of tears when cryingD. Opacity of a pupil4. The nurse assessing a neonate’s trunkshortly after birth makes the followingobservations. Which one would alert thenurse to the need for further assessment?A. Breast engorgementB. Audible bowel soundsC. Palpable liver and kidneysD. Umbilical cord with one artery and onevein5. Which of the following assessmentswould the nurse report to the physicianconcerning a 1-hour old infant’s ears?A. The upper parts of the ears are on a planewith the angle of the eyes.B. The upper parts of the ears are wellbelow a line extending through the inner andouter canthi of the eyesC. There is incurving of the pinna andinstant recoilD. The infant responds to sound with astartle or blink6. The parents of a newborn ask the nursehow much their new baby can see. Thenurse’s response is based on the knowledgethat the newborn’s visual capacity shortlyafter birth is primarilyA. Long-distance vision C. Convergenceof the eyesB. Short-distance fixation D. Coordinatedperipheral vision7. To check the grasp reflex in thenewborn, the nurse would implement whichof the following actions?A. Lightly touch either corner of the baby’s9. To check the sucking reflex in thenewborn, the nurse would implement whichof the following actions?A. Lightly touch either corner of the baby’smouthB. Stroke the lateral aspect of the soleupward across the ball of the footC. Rotate the head to one side and then theotherD. Exert pressure on the palm at the base of the digits10. To elicit Moro’s reflex, the nurse wouldimplement which of the following actions?A. Shake the infant rapidly from head to toeB. Hold the infant in both hands and lowerboth hands rapidly about an inchC. Place the infant in the prone position andobserve postureD. Turn the infant’s head to one side whilehe or she is in a supine position11. When examining the inside of anewborn’s mouth, the nurse notices a small,raised white bump on the palate; it does notcome off nor does it bleed when touched.Which of the following is the most likelydiagnosis?A. Milia C. ThrushB. Epstein’s pearls D. Milk curd12. Neonates often “spit up” smallquantities following feedings. Which of thefollowing conditions offers the bestexplanation for this behavior?A. Immature cardiac sphincterB. OverfeedingC. Activity of the infant during feedingD. Inadequate concentration of enzymes13. In examining the newborn’s head duringthe initial physical assessment, the nursepalpates the posterior fontanel. The nurseknows that this fontanel is formed by whichof the following bones?A. Frontal and parietal C. Temporaland frontalB. Parietal and occipital D. Frontal andoccipital14. While assessing a 2-hour-old neonate,the nurse observes the neonate to haveacrocyanosis. Which of the following actionsshould be performed initially?A. Activate the code blue or emergencysystemB. Do nothing because acrocyanosis isnormal in the neonateC. Immediately take the neonate’stemperatureD. Notify the physician of the need for acardiac consult15. When performing a neurologicassessment, which sign is considered anormal finding in a neonate?A. Doll eyes C. PositiveBabinski’s signB. “Sunset” eyes D. Pupils thatdon’t react to light
 
mouthB. Stroke the lateral aspect of the soleupward across the ball of the footC. Rotate the head to one side and then theotherD. Exert pressure on the palm at the base of the digits8. To check the Babinski reflex in thenewborn, the nurse would implement whichof the following actions?A. Lightly touch either corner of the baby’smouthB. Stroke the lateral aspect of the soleupward across the ball of the footC. Rotate the head to one side and then theotherD. Exert pressure on the palm at the base of the digits16. A mother of a term neonate asks whatthe thick, white, cheesy coating is on hisskin. Which correctly describes this finding?A. Lanugo C. NevusflammeusB. Milia D. Vernix 17. Which of the following fetal circulatorystructures close and become nonfunctioningafter birth?A. Ductus arteriosus, umbilical arteries,pulmonary artery, and hypogastric arteriesB. Ductus venosus, foramen ovale, portalvein, and ductus arteriosusC. Foramen ovale, pulmonary artery, ductusvenosus, and umbilical veinD. Umbilical vein, foramen ovale, ductusvenosus, and ductus arteriosus18. A neonate has been diagnosed withcaput succedaneum. Which statement iscorrect about caput succedaneum?A. It usually resolves in 3-6 weeksB. It doesn’t cross the cranial suture lineC. It is a collection of blood between theskull and the periosteumD. It involves swelling of the tissue over thepresenting part of the fetal head19. The nurse is teaching a postpartumclient about the normal stooling pattern of aneonate. Which color and consistency bestdescribes the typical appearance of meconium?A. Soft, pale yellow C. Stickygreen, blackB. Hard, pale brown D. Loose,golden yellow20. A nurse is assessing a neonate. Whichof the following findings is consideredcommon in the healthy neonate?A. Simian creaseB. Conjunctival hemorrhagesC. Cystic hygromaD. Bulging fontanelle21. When assessing a neonate’s skin, thenurse observes small, white papulessurrounded by erythematous dermatitis. This finding is characteristic of whichcondition?A. Cutis marmorata C. ErythematoxicumB. Epstein’s pearls D. Mongolianspots22. A postpartum client asks the nurse,“Why does my baby have those red areas onhis eyelids?” Which response is appropriate?A. “They’re called milia. They’re clogged oilglands, which are normal in a neonate.”B. “They’re called telangiectasia or storkbites. They usually disappear within 1 year.”C. “ We’ll watch them closely. They couldindicate a bleeding disorder.”D. “ They’re nothing to worry about. Thephysician will order topical cream to help27. The nurse is assigned to care for anewly delivered primiparous client and herterm neonate 1 hour after a vaginal delivery. The nurse observes that the neonate’s Apgarscore at 5 minutes was 9. The nurseinterprets this as indicating which of thefollowing about the neonate?A. Vigorous resuscitation was neededB. The neonate was cyanotic at birthC. Oxygen administration was necessary atbirthD. The neonate is in stable condition28. One minute after birth, a neonate has aheart rate of 60 beats/minute. Five minutesafter birth, his heart rate is 80 beats/minute.Which Apgar heart rate score should hereceive?A. 0 C. 2B. 1 D. 3
General Care
29. Terramycin or erythromycin ointment isadministered to the neonate’s eyes shortlyafter birth to prevent which disorder?A. Cataract C.Ophthalmia neonatorumB. Diabetic retinopathy D.Strabismus30. The neonate is vulnerable to heat lossbecause of which anatomic characteristic?A. Immature liverB. Immature brainC. Large skin surface area to body weightratioD. More brown fat (adipose tissue) than anadult31. During the transition period, a neonatecan lose heat in many different ways. Aneonate who isn’t completely driedimmediately after birth or a bath loses heatthrough which of the following methods?A. Conduction C.EvaporationB. Convection D. Radiation32. Maintaining thermoregulation in the
 
them go away.”23. When performing an assessment on aneonate, which assessment finding is mostsuggestive of hypothermia?A. Bradycardia C. MetabolicalkalosisB. Hyperglycemia D. Shivering24. An initial assessment of a femaleneonate shows pink-streaked vaginaldischarge. Which factor is the probablecause?A. CystitisB. Birth traumaC. Neonatal candidiasisD. Withdrawal of maternal hormones25. While performing an initial assessmenton a term neonate with an Asian mother, abluish marking is observed across theneonate’s lower back. What is thesignificance of this finding?A. It’s probably a sigh of birth traumaB. It’s probably a telangiectatic hemangiomaC. It’s probably a typical marking in dark-skinned racesD. It probably indicates thathyperbilirubinemia may follow26. The mother of a newborn asks thenurse why the neonate’s head is cone-shaped. Which response is accurate?A. “It results from caput succedaneum. Thedifficult labor caused bruising and swelling of the neonate’s head.”B. “It results from molding. Overriding of the cranial sutures allows the neonate’s headto pass through the birth canal.”C. “It results from cephalhematoma. Someblood has collected between the skull boneand periosteum.”D. “It results from hydrocephalus. Either toomuch cerebrospinal fluid is being formed ortoo little is being absorbed.”neonate is an important nursing interventionbecause cold stress in the neonate can leadto which condition?A. AnemiaB. HyperlgycemiaC. Metabolic alkalosisD. Increased oxygen consumption33. When teaching umbilical cord care to anew mother, the nurse would include whichinformation?A. Apply peroxide to the cord with eachdiaper changeB. Cover the cord with petroleum jelly afterbathingC. Keep the cord dry and open to airD. Wash the cord with soap and water eachday during a tub bath34. When assessing a male neonate, thenurse notices that the urinary meatus islocated on the ventral surface of the penis.How should the nurse document this finding?A. As the normal location for the urinarymeatusB. As epispadiasC. As hypospadiasD. As cryptorchidism35. A home health nurse assesses aneonate who is 48 hours old and wasdischarged from the hospital 24 hours ago.Which assessment finding indicates apotential problem?A. The neonate cries but no tears appearB. Small papules appear all over theneonate’s skinC. The neonate doesn’t turn his head in thedirection that his cheek is strokedD. The neonate produces a greenish, tarrystool
SGA
36. A nurse is performing an admissionassessment on a small for gestational ageterm infant. The nurse observes tachypnea,grunting, retractions, and nasal flaring. Thenurse interprets that these symptoms arelikely the result of:A. HypoglycemiaB.
 
Meconium aspiration syndromeC. Respiratory distress syndromeD. Transient tachypnea of the newborn37. The small-for-gestation neonate is atincreased risk during the transitional periodfor which complication?A. Anemia probably due to chronic fetalhypoxiaB. Hyperthermia due to decreased glycogenstoresC. Hyperglycemia due to decreasedglycogen storesD. Polycythemia probably due to chronicfetal hypoxia
LGA
38. A nurse is teaching a mother withdiabetes mellitus who delivered a large for45. A woman delivers a 3,250g neonate at42 weeks’ gestation. Which physical findingis expected during an examination of thisneonate?A. Noticeable veinsB. Absence of sole creasesC. Breast bud of 1-2 mm in diameterD. Leathery, cracked and wrinkled skin46. A 34-week-gestation neonate in anIsolette experiences sudden apnea. Thenurse would firstA. Administer oxygen with positive pressureB. Call the pediatricianC. Increase the humidity in the incubatorD. Gently stimulate the infant47. Which action best explains the mainrole of surfactant in the neonate?A. Assists with ciliary body maturation in theupper airwaysB. Helps maintain a rhythmic breathingpatternC. Promotes clearing mucus from therespiratory tractD. Helps the lung remain expanded after the

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