NSNE 7200 Final Exam ACTUAL
QUESTIONS AND CORRECT ANSWERS
Critical congenital heart disease (CCHD) - CORRECT ANSWER - most severe and
often duct-dependent lesions that require intervention early in life for optimal outcomes
- they are the primary targets of our screening efforts
Why do we perform CCHD pulse-ox screening? - CORRECT ANSWER CCHD is the
leading cause of infant death in Canada --> diagnosis is cruccial for decreasing
mobidity/mortality rt delayed diagnosis
How do we perform CCHD pulse ox screening? - CORRECT ANSWER - within 24-
36hrs of age
- pulse ox measurement of preductal (rt hand) and postductal (either foot)
How do you pass/fail the pulse-ox screening? - CORRECT ANSWER PASS- If O2 sat
is 95% or greater in Rt hand and foot AND the difference is 3% points or less
FAIL- Immediately failed if O2 sat <90%
or If O2 sat is >90% in Rt hand and <95% in the right hand and foot, or there is >3% point
difference between the 2 --> repeat the testing in an hour
What happens if an infant fails pulse-ox screening? - CORRECT ANSWER - the infant
should be seem by MRP
- if cardiac diagnosis cannot be excluded- consult cardiologist and neonatologist to perform
an ECHO
Benjamin was born at 37+2 weeks GA and is 36 hours old. His Sp02 was 94% on his right
hand and 93% on his left foot. The next step is:
a. Send Benjamin home because he has passed the screening.
b. Contact the cardiologist on call.
c. Repeat the screening in one hour.
,d. Call the most responsible health care provider as Benjamin has failed his screening. -
CORRECT ANSWER c.
Sophia was born at 38+6 weeks GA and is 30 hours old. Her Sp02 is 95% on her right hand
and 96% on her right foot. Sophia has passed her CCHD screening.
a. True
b. False - CORRECT ANSWER a.
Spencer was born at 38+2 weeks GA and is now 24 hours old. His Sp02 was 90% on his right
hand and 94% on his right foot. Spencer's nurse repeats the screening in one hour and his
Sp02 is now 89% on his right hand and 88% on his right foot. The next step is to:
a. Request a STAT echocardiogram.
b. Send Spencer home and request follow-up in the community.
c. Repeat the screening in one hour.
d. Call the most responsible health care provider as Spencer has failed his screening. -
CORRECT ANSWER d.
What factors influence choice to BF? - CORRECT ANSWER - antenatal influences
- previous BF experience
- support
- challenging situations (ex. breast surgery)
- return to work outside the home
What are important topics of education r/t BF? - CORRECT ANSWER - benefits of BF
- anatomy of the breast
- physiology of BF
- sources of support and information
- alternative methods of feeding expressed BM
Formula-fed infants are at increased risk of health problems compared to breastfed infants.
,a. True
b. False - CORRECT ANSWER a. true
The main carbohydrate in breastmilk is:
a. Lactose
b. Sucrose
c. Indigestible
d. Casein - CORRECT ANSWER a. Lactose
Carbohydrates known as oligosaccharides in breastmilk promote:
a. Attachment
b. Weight gain
c. Growth of probiotics in the infant's gut
d. Growth and development - CORRECT ANSWER c. Growth of probiotics in the
infant's gut
Babies will feed most effectively when they are in which of the following states?
a. Active alert
b. Crying
c. Quiet alert
d. Drowsy state of awake - CORRECT ANSWER c. Quiet alert
Which hormone is responsible for the milk-ejection reflex?
a. Prolactin
b. Cortisol
c. Beta endorphins
d. Oxytocin - CORRECT ANSWER d. oxytocin (prolactin is responsible for the
supply-demand principle and emptying/refilling)
, The rate of milk synthesis is influenced by:
a. Regular and thorough emptying of the breast
b. The birthweight and gestational age of the infant
c. The size of the woman's breast
d. The woman's diet - CORRECT ANSWER a. Regular and thorough emptying of the
breast
When is the best time to establish the first feed?
a. When the infant has demonstrated organization
b. In the first hour of life
c. In the first six hours of life
d. When the woman is settled in her room - CORRECT ANSWER b. in the first hour of
life
Which of the following has been shown to improve both breastfeeding initiation and duration
rates?
a. Encouraging women to persevere through challenges
b. Offering breastfeeding classes prenatally
c. Educating women on the benefits of breastfeeding
d. Unrestricted skin-to-skin contact - CORRECT ANSWER d. Unrestricted skin-to-
skin contact
A correct latch may appear asymmetrical, with more areola visible at the top of the breast.
a. True
b. False - CORRECT ANSWER a. true
When there is an effective latch, the infant should suck continuously with no breaks.
a. False
b. True - CORRECT ANSWER a. False
QUESTIONS AND CORRECT ANSWERS
Critical congenital heart disease (CCHD) - CORRECT ANSWER - most severe and
often duct-dependent lesions that require intervention early in life for optimal outcomes
- they are the primary targets of our screening efforts
Why do we perform CCHD pulse-ox screening? - CORRECT ANSWER CCHD is the
leading cause of infant death in Canada --> diagnosis is cruccial for decreasing
mobidity/mortality rt delayed diagnosis
How do we perform CCHD pulse ox screening? - CORRECT ANSWER - within 24-
36hrs of age
- pulse ox measurement of preductal (rt hand) and postductal (either foot)
How do you pass/fail the pulse-ox screening? - CORRECT ANSWER PASS- If O2 sat
is 95% or greater in Rt hand and foot AND the difference is 3% points or less
FAIL- Immediately failed if O2 sat <90%
or If O2 sat is >90% in Rt hand and <95% in the right hand and foot, or there is >3% point
difference between the 2 --> repeat the testing in an hour
What happens if an infant fails pulse-ox screening? - CORRECT ANSWER - the infant
should be seem by MRP
- if cardiac diagnosis cannot be excluded- consult cardiologist and neonatologist to perform
an ECHO
Benjamin was born at 37+2 weeks GA and is 36 hours old. His Sp02 was 94% on his right
hand and 93% on his left foot. The next step is:
a. Send Benjamin home because he has passed the screening.
b. Contact the cardiologist on call.
c. Repeat the screening in one hour.
,d. Call the most responsible health care provider as Benjamin has failed his screening. -
CORRECT ANSWER c.
Sophia was born at 38+6 weeks GA and is 30 hours old. Her Sp02 is 95% on her right hand
and 96% on her right foot. Sophia has passed her CCHD screening.
a. True
b. False - CORRECT ANSWER a.
Spencer was born at 38+2 weeks GA and is now 24 hours old. His Sp02 was 90% on his right
hand and 94% on his right foot. Spencer's nurse repeats the screening in one hour and his
Sp02 is now 89% on his right hand and 88% on his right foot. The next step is to:
a. Request a STAT echocardiogram.
b. Send Spencer home and request follow-up in the community.
c. Repeat the screening in one hour.
d. Call the most responsible health care provider as Spencer has failed his screening. -
CORRECT ANSWER d.
What factors influence choice to BF? - CORRECT ANSWER - antenatal influences
- previous BF experience
- support
- challenging situations (ex. breast surgery)
- return to work outside the home
What are important topics of education r/t BF? - CORRECT ANSWER - benefits of BF
- anatomy of the breast
- physiology of BF
- sources of support and information
- alternative methods of feeding expressed BM
Formula-fed infants are at increased risk of health problems compared to breastfed infants.
,a. True
b. False - CORRECT ANSWER a. true
The main carbohydrate in breastmilk is:
a. Lactose
b. Sucrose
c. Indigestible
d. Casein - CORRECT ANSWER a. Lactose
Carbohydrates known as oligosaccharides in breastmilk promote:
a. Attachment
b. Weight gain
c. Growth of probiotics in the infant's gut
d. Growth and development - CORRECT ANSWER c. Growth of probiotics in the
infant's gut
Babies will feed most effectively when they are in which of the following states?
a. Active alert
b. Crying
c. Quiet alert
d. Drowsy state of awake - CORRECT ANSWER c. Quiet alert
Which hormone is responsible for the milk-ejection reflex?
a. Prolactin
b. Cortisol
c. Beta endorphins
d. Oxytocin - CORRECT ANSWER d. oxytocin (prolactin is responsible for the
supply-demand principle and emptying/refilling)
, The rate of milk synthesis is influenced by:
a. Regular and thorough emptying of the breast
b. The birthweight and gestational age of the infant
c. The size of the woman's breast
d. The woman's diet - CORRECT ANSWER a. Regular and thorough emptying of the
breast
When is the best time to establish the first feed?
a. When the infant has demonstrated organization
b. In the first hour of life
c. In the first six hours of life
d. When the woman is settled in her room - CORRECT ANSWER b. in the first hour of
life
Which of the following has been shown to improve both breastfeeding initiation and duration
rates?
a. Encouraging women to persevere through challenges
b. Offering breastfeeding classes prenatally
c. Educating women on the benefits of breastfeeding
d. Unrestricted skin-to-skin contact - CORRECT ANSWER d. Unrestricted skin-to-
skin contact
A correct latch may appear asymmetrical, with more areola visible at the top of the breast.
a. True
b. False - CORRECT ANSWER a. true
When there is an effective latch, the infant should suck continuously with no breaks.
a. False
b. True - CORRECT ANSWER a. False
