Review Questions

1.

The Apgar assessment tells the nurses and clinicians on the labor and delivery unit what information about the newborn?

1. The Apgar assessment and score tells the team how the newborn is doing neurologically and physically after the birth.
2. The Apgar assessment and score predicts the newborn’s overall morbidity and mortality moving forward after birth.
3. The Apgar assessment and score tells the team how the newborn is transitioning to the extrauterine world after birth.
4. The Apgar assessment and score tells the team how the newborn handled the birth overall.

2.

When thinking about scoring an Apgar assessment, the nurse knows that grimace is an assessment of what in a newborn?

1. Grimace is an assessment of a newborn’s response to taking their first breath.
2. Grimace is an assessment of the flexion of hips and legs in the newborn.
3. Grimace is an assessment of the response to seeing their birthing person’s face.
4. Grimace is an assessment of the response to stimulation from the nurse.

3.

What kind of muscle tone does a preterm newborn have compared to a full-term newborn?

1. firm
2. abnormal
3. normal
4. flaccid

4.

A nurse has just been asked to be the baby nurse for a coworker who is working with a birthing woman at 35 weeks, 3 days. The patient has preeclampsia, has had a very hard labor with multiple decelerations on her fetal heart monitor, and her amniotic fluid had meconium when her water was broken earlier in the day. In anticipation of this birth, what resources will the nurse need to gather? Select all that apply.

1. another baby nurse to help
2. Neonatal Intensive Care team
3. radiant warmer for the newborn
4. intubation kit
5. tracheotomy kit

5.

A full-term newborn has been delivered by a physician after a lengthy labor and delivery. The newborn has poor tone, minimal respiratory effort, and central cyanosis. The cord is cut, and the patient is placed in an infant warmer. What data does the nurse need to notice that are clinically significant? Select all that apply.

1. Assess ABCs in newborn.
2. Apgar score is determined.
3. Temperature is measured.
4. Vaccination is ready for administration.
5. Length is measured.
6. Head circumference is measured.
7. Single IM injection of vitamin K is ready for administration.

6.

Transient tachypnea of the neonate develops due to what pathophysiologic phenomenon?

1. failure to clear lung fluid by the usual mechanism
2. failure of the patent ductus arteriosus to close
3. insufficient surfactant production
4. aspiration of meconium during vaginal or cesarean birth that interferes with surfactant activity

7.

The most effective time to initiate breast-feeding is in which stage of reactivity for the neonate?

1. period of decreased reactivity
2. first period of reactivity
3. second period of reactivity
4. after the end of the second period of reactivity

8.

Of the three fetal shunts, which one moves fetal blood from the lungs through the right atrium to the left atrium?

1. ductus venosus
2. foramen ovale
3. ductus arteriosus
4. foramen venosus

9.

Blood flow connection between the systemic, aorta, pulmonary blood flow, and pulmonary artery is which fetal shunt?

1. ductus venosus
2. foramen ovale
3. ductus arteriosus
4. foramen venosus

10.

What assessment findings indicate abnormal transition in a neonate? Select all that apply.

1. prolonged apneic episodes
2. marked pallor
3. excessive oral secretions
4. crackles upon auscultation
5. blue hands and feet
6. poor capillary refill (longer than 3 seconds)

11.

A newborn at 20 minutes of age has an axillary temperature of 36° C (96.8° F). What intervention should the nurse perform?

1. ensure skin-to-skin contact until temperature is 37° C (98.6° F)
2. give the baby a warm bath and then return to the birthing parent for skin-to-skin contact.
3. place the baby under the radiant warmer until skin temperature is 37.5° C (99.5° F)
4. check the baby’s rectal temperature

12.

The nurse recommends skin-to-skin contact immediately following the birth of a newborn because it reduces what type of heat loss?

1. radiation
2. convection
3. conduction
4. evaporation

13.

After birth, the nurse immediately dries a neonate’s face and hair with a clean, prewarmed towel. After drying, the nurse covers the neonate’s hair with a cap. What type of heat loss is the nurse preventing?

1. convection
2. conduction
3. evaporation
4. radiation

14.

The nurse is caring for a neonate born at 36 weeks, 2 days by primary cesarean birth and weighing 6 pounds, 4 ounces. The infant cried at delivery, had flexion in all extremities, had a heart rate of 135, had acrocyanosis in hands and feet, and was pale. The infant was placed skin-to-skin with the birthing person and has been latching and cuddling for the past 15 minutes. At 45 minutes, the neonate is found grunting and cool to the touch. What are the nurse’s next steps?

1. Stimulate the neonate to take some deep breaths.
2. Ask the birthing person to wrap the baby in their blankets and cuddle them closer.
3. Take the neonate to the radiant warmer and check their temperature.
4. Call the NICU staff and activate the staff assist light in the birthing room.

15.

What steps are included in the QSEN steps for rewarming a neonate at risk for cold stress? Select all that apply.

1. placing the neonate under the radiant warmer
2. putting a pulse oximeter on the neonate
3. assessing a blood glucose level
4. calling the NICU team for assessment
5. making certain the neonate is dressed appropriately to ensure warmth in the birthing room
6. assessing respiratory status often

16.

What characteristics are directly related to the newborn’s decreased ability to maintain thermal stability?

1. A neonate has decreased subcutaneous fat and a large body surface-to-weight ratio.
2. The blood vessels in the neonate are farther from the skin than those of an adult.
3. Newborns are unable to rely on brown adipose tissue for heat production.
4. The newborn prefers to be in constant motion, increasing the surface area exposed to the environment.