NSG 233 Exam 4 UPDATED QUESTIONS
AND CORRECT ANSWERS
Asphyxia - CORRECT ANSWER Insufficient oxygen and excess carbon dioxide in the blood
and tissues.
Bilirubin encephalopathy - CORRECT ANSWER Acute manifestation of bilirubin toxicity
occurring in the first weeks after birth.
Erythroblastosis fetalis - CORRECT ANSWER Agglutination and hemolysis of fetal
erythrocytes caused by incompatibility between the maternal and fetal blood types, such as when the
fetus is Rh-positive and the mother is Rh-negative.
Esophageal atresia - CORRECT ANSWER Condition in which the esophagus is separated from
the stomach and ends in a blind pouch.
Gastroschisis - CORRECT ANSWER Protrusion of the intestines through a defect in the
abdominal wall. The intestines are not covered by a peritoneal sac or skin.
Hydrops fetalis - CORRECT ANSWER Heart failure and generalized edema in the fetus
secondary to severe anemia resulting from destruction of erythrocytes.
Kernicterus - CORRECT ANSWER Chronic and permanent result of bilirubin toxicity.
Meningocele - CORRECT ANSWER Protrusion of the meninges through a defect in the
vertebrae; a form of neural tube defect.
Myelomeningocele - CORRECT ANSWER Protrusion of the meninges and spinal cord through
a defect in the vertebrae; a form of neural tube defect.
Neonatal abstinence syndrome - CORRECT ANSWER A cluster of physical signs exhibited by
newborns exposed in utero to maternal use of substances such as heroin.
,Omphalocele - CORRECT ANSWER Protrusion of the intestines into the base of the umbilical
cord. The intestines are covered by a peritoneal sac.
Persistent pulmonary hypertension - CORRECT ANSWER Vasoconstriction of the infant's
pulmonary vessels after birth; may result in right-to-left shunting of blood flow through the ductus
arteriosus, the foramen ovale, or both.
Spina bifida - CORRECT ANSWER Defective closure of the bony spine that encloses the
spinal cord; a type of neural tube defect.
Tracheoesophageal fistula - CORRECT ANSWER Abnormal connection between the
esophagus and trachea.
Transient tachypnea of the newborn - CORRECT ANSWER Condition of rapid respirations
caused by inadequate absorption of fetal lung fluid.
How is TTN different from RDS? - CORRECT ANSWER Transient tachypnea of the newborn
is thought to be caused by failure of fetal lung fluid to be absorbed completely in late preterm, full-
term, or preterm infants. Respiratory distress syndrome (RDS) occurs in preterm infants as a result of
inadequate surfactant. It is less serious than RDS but is the most common respiratory cause of NICU
admission.
Why is there resistance of blood flow into the lungs in PPHN? - CORRECT ANSWER Infants
with PPHN have constriction of the pulmonary blood vessels from inadequate oxygen levels. This
increases resistance to blood flow into the lungs and causes blood to flow through the foramen ovale
and patent ductus arteriosus.
How can kernicterus be prevented? - CORRECT ANSWER Kernicterus can be prevented by
identifying women whose infants are at risk for blood incompatibilities, giving Rh-negative mothers
Rh immune globulin, recognizing infants with bilirubin levels that are not normal, and instituting
phototherapy when it is needed.
How can the nurse help reduce bilirubin levels in infants receiving phototherapy? - CORRECT
ANSWER Nurses can help reduce bilirubin level in an infant receiving phototherapy by
ensuring that the lights or blankets are functioning and positioned properly; reducing the infant's time
out of phototherapy; ensuring adequate intake to increase removal of bilirubin by frequent stools;
,preventing cold stress or hypoglycemia, which would decrease albumin-binding sites for bilirubin;
and turning the infant frequently to expose all areas to the lights.
What is the role of the nurse in caring for the infant with sepsis? - CORRECT ANSWER The
role of the nurse in sepsis is to identify early signs, notify the physician, coordinate treatment, observe
for change, and support the family.
Why are idms more likely to develop macrosomia? - CORRECT ANSWER Macrosomia occurs
in idms because of excessive transfer of glucose, amino acids, and fatty acids from the mother to the
fetus. This results in fetal production of insulin and excessive growth in the fetus.
Why are idms at risk for hypoglycemia after birth? - CORRECT ANSWER idms may develop
hypoglycemia after birth because they have high levels of insulin even though they no longer receive
glucose from the mother. Infants may need early feeding as a result.
How can the nurse deal with the inability to rest in infants with prenatal exposure to drugs? -
CORRECT ANSWER The nurse can help the drug-exposed infant to rest by minimizing
stimulation, swaddling in a flexed position, organizing care to avoid interruptions, and providing a
pacifier.
How can the nurse promote bonding when there has been prenatal drug abuse? - CORRECT
ANSWER The nurse can promote bonding when there has been prenatal drug abuse by helping
the mother feel welcome, encouraging her to participate in infant care, teaching her how to respond to
the infant's behavior and about the infant's care, and modeling parenting behaviors.
Asphyxia: effects - CORRECT ANSWER Asphyxia before or during birth may cause apnea,
acidosis, pulmonary hypertension, and possible death. Neonatal resuscitation must be initiated
immediately.
NI'S for asphyxia - CORRECT ANSWER Nurses must identify conditions that increase the risk
of asphyxia, begin resuscitation promptly, and assist other members of the team during treatment.
Continued follow-up of the infant and parental support are important.
Transient tachypnea - CORRECT ANSWER In transient tachypnea of the newborn, respiratory
difficulty in infants is caused by failure of fetal lung fluid to be absorbed completely. It usually
resolves spontaneously with supportive care.
, Meconium aspiration syndrome - CORRECT ANSWER In meconium aspiration syndrome,
meconium in amniotic fluid enters the lungs before birth during gasping movements or is drawn in
during the first breaths after birth, causing obstruction, air trapping, and inflammation.
The nurse's role in meconium aspiration - CORRECT ANSWER The nurse's role in meconium
aspiration is to notify caregivers when meconium is discovered, prepare equipment, assist with
intubation if necessary, and observe for further respiratory difficulty, infection, and other problems.
Nonphysiologic jaundice - CORRECT ANSWER Nonphysiologic jaundice appears in the first
24 hours of life; bilirubin levels rise faster and to higher levels than those found in physiologic
jaundice. If untreated it may result in injury to the brain.
The nurse's role in phototherapy - CORRECT ANSWER The nurse's role in phototherapy is to
decrease situations such as cold stress or hypoglycemia that might further elevate bilirubin levels,
ensure that lights are used properly, protect the eyes, observe for excessive fluid loss or skin
impairment, ensure adequate oral intake, and teach parents.
Infection can be transmitted to the neonate from the mother during what time? - CORRECT
ANSWER Infection can be transmitted to the neonate from the mother during pregnancy or
birth or from the mother, family members, visitors, or agency staff after birth.
Infection in neonates is a problem because... - CORRECT ANSWER Infection in neonates is a
problem because their immune system is immature, infection spreads easily, and the blood-brain
barrier is less effective.
The infant of a diabetic mother (IDM) may have ... - CORRECT ANSWER The infant of a
diabetic mother (IDM) may have congenital anomalies, may be large (macrosomia) or small for
gestational age, and may suffer from respiratory distress syndrome, hypoglycemia, hypocalcemia, and
polycythemia.
Nursing responsibilities in caring for the IDM include... - CORRECT ANSWER Nursing
responsibilities in caring for the IDM include early identification and follow-up of complications,
monitoring of blood glucose levels, ensuring early and adequate feedings, and support of parents.
Infants with prenatal exposure to drugs may have... - CORRECT ANSWER Infants with
prenatal exposure to drugs may have behavioral and feeding abnormalities. They may have difficulty
relating to others and fail to gain weight.
AND CORRECT ANSWERS
Asphyxia - CORRECT ANSWER Insufficient oxygen and excess carbon dioxide in the blood
and tissues.
Bilirubin encephalopathy - CORRECT ANSWER Acute manifestation of bilirubin toxicity
occurring in the first weeks after birth.
Erythroblastosis fetalis - CORRECT ANSWER Agglutination and hemolysis of fetal
erythrocytes caused by incompatibility between the maternal and fetal blood types, such as when the
fetus is Rh-positive and the mother is Rh-negative.
Esophageal atresia - CORRECT ANSWER Condition in which the esophagus is separated from
the stomach and ends in a blind pouch.
Gastroschisis - CORRECT ANSWER Protrusion of the intestines through a defect in the
abdominal wall. The intestines are not covered by a peritoneal sac or skin.
Hydrops fetalis - CORRECT ANSWER Heart failure and generalized edema in the fetus
secondary to severe anemia resulting from destruction of erythrocytes.
Kernicterus - CORRECT ANSWER Chronic and permanent result of bilirubin toxicity.
Meningocele - CORRECT ANSWER Protrusion of the meninges through a defect in the
vertebrae; a form of neural tube defect.
Myelomeningocele - CORRECT ANSWER Protrusion of the meninges and spinal cord through
a defect in the vertebrae; a form of neural tube defect.
Neonatal abstinence syndrome - CORRECT ANSWER A cluster of physical signs exhibited by
newborns exposed in utero to maternal use of substances such as heroin.
,Omphalocele - CORRECT ANSWER Protrusion of the intestines into the base of the umbilical
cord. The intestines are covered by a peritoneal sac.
Persistent pulmonary hypertension - CORRECT ANSWER Vasoconstriction of the infant's
pulmonary vessels after birth; may result in right-to-left shunting of blood flow through the ductus
arteriosus, the foramen ovale, or both.
Spina bifida - CORRECT ANSWER Defective closure of the bony spine that encloses the
spinal cord; a type of neural tube defect.
Tracheoesophageal fistula - CORRECT ANSWER Abnormal connection between the
esophagus and trachea.
Transient tachypnea of the newborn - CORRECT ANSWER Condition of rapid respirations
caused by inadequate absorption of fetal lung fluid.
How is TTN different from RDS? - CORRECT ANSWER Transient tachypnea of the newborn
is thought to be caused by failure of fetal lung fluid to be absorbed completely in late preterm, full-
term, or preterm infants. Respiratory distress syndrome (RDS) occurs in preterm infants as a result of
inadequate surfactant. It is less serious than RDS but is the most common respiratory cause of NICU
admission.
Why is there resistance of blood flow into the lungs in PPHN? - CORRECT ANSWER Infants
with PPHN have constriction of the pulmonary blood vessels from inadequate oxygen levels. This
increases resistance to blood flow into the lungs and causes blood to flow through the foramen ovale
and patent ductus arteriosus.
How can kernicterus be prevented? - CORRECT ANSWER Kernicterus can be prevented by
identifying women whose infants are at risk for blood incompatibilities, giving Rh-negative mothers
Rh immune globulin, recognizing infants with bilirubin levels that are not normal, and instituting
phototherapy when it is needed.
How can the nurse help reduce bilirubin levels in infants receiving phototherapy? - CORRECT
ANSWER Nurses can help reduce bilirubin level in an infant receiving phototherapy by
ensuring that the lights or blankets are functioning and positioned properly; reducing the infant's time
out of phototherapy; ensuring adequate intake to increase removal of bilirubin by frequent stools;
,preventing cold stress or hypoglycemia, which would decrease albumin-binding sites for bilirubin;
and turning the infant frequently to expose all areas to the lights.
What is the role of the nurse in caring for the infant with sepsis? - CORRECT ANSWER The
role of the nurse in sepsis is to identify early signs, notify the physician, coordinate treatment, observe
for change, and support the family.
Why are idms more likely to develop macrosomia? - CORRECT ANSWER Macrosomia occurs
in idms because of excessive transfer of glucose, amino acids, and fatty acids from the mother to the
fetus. This results in fetal production of insulin and excessive growth in the fetus.
Why are idms at risk for hypoglycemia after birth? - CORRECT ANSWER idms may develop
hypoglycemia after birth because they have high levels of insulin even though they no longer receive
glucose from the mother. Infants may need early feeding as a result.
How can the nurse deal with the inability to rest in infants with prenatal exposure to drugs? -
CORRECT ANSWER The nurse can help the drug-exposed infant to rest by minimizing
stimulation, swaddling in a flexed position, organizing care to avoid interruptions, and providing a
pacifier.
How can the nurse promote bonding when there has been prenatal drug abuse? - CORRECT
ANSWER The nurse can promote bonding when there has been prenatal drug abuse by helping
the mother feel welcome, encouraging her to participate in infant care, teaching her how to respond to
the infant's behavior and about the infant's care, and modeling parenting behaviors.
Asphyxia: effects - CORRECT ANSWER Asphyxia before or during birth may cause apnea,
acidosis, pulmonary hypertension, and possible death. Neonatal resuscitation must be initiated
immediately.
NI'S for asphyxia - CORRECT ANSWER Nurses must identify conditions that increase the risk
of asphyxia, begin resuscitation promptly, and assist other members of the team during treatment.
Continued follow-up of the infant and parental support are important.
Transient tachypnea - CORRECT ANSWER In transient tachypnea of the newborn, respiratory
difficulty in infants is caused by failure of fetal lung fluid to be absorbed completely. It usually
resolves spontaneously with supportive care.
, Meconium aspiration syndrome - CORRECT ANSWER In meconium aspiration syndrome,
meconium in amniotic fluid enters the lungs before birth during gasping movements or is drawn in
during the first breaths after birth, causing obstruction, air trapping, and inflammation.
The nurse's role in meconium aspiration - CORRECT ANSWER The nurse's role in meconium
aspiration is to notify caregivers when meconium is discovered, prepare equipment, assist with
intubation if necessary, and observe for further respiratory difficulty, infection, and other problems.
Nonphysiologic jaundice - CORRECT ANSWER Nonphysiologic jaundice appears in the first
24 hours of life; bilirubin levels rise faster and to higher levels than those found in physiologic
jaundice. If untreated it may result in injury to the brain.
The nurse's role in phototherapy - CORRECT ANSWER The nurse's role in phototherapy is to
decrease situations such as cold stress or hypoglycemia that might further elevate bilirubin levels,
ensure that lights are used properly, protect the eyes, observe for excessive fluid loss or skin
impairment, ensure adequate oral intake, and teach parents.
Infection can be transmitted to the neonate from the mother during what time? - CORRECT
ANSWER Infection can be transmitted to the neonate from the mother during pregnancy or
birth or from the mother, family members, visitors, or agency staff after birth.
Infection in neonates is a problem because... - CORRECT ANSWER Infection in neonates is a
problem because their immune system is immature, infection spreads easily, and the blood-brain
barrier is less effective.
The infant of a diabetic mother (IDM) may have ... - CORRECT ANSWER The infant of a
diabetic mother (IDM) may have congenital anomalies, may be large (macrosomia) or small for
gestational age, and may suffer from respiratory distress syndrome, hypoglycemia, hypocalcemia, and
polycythemia.
Nursing responsibilities in caring for the IDM include... - CORRECT ANSWER Nursing
responsibilities in caring for the IDM include early identification and follow-up of complications,
monitoring of blood glucose levels, ensuring early and adequate feedings, and support of parents.
Infants with prenatal exposure to drugs may have... - CORRECT ANSWER Infants with
prenatal exposure to drugs may have behavioral and feeding abnormalities. They may have difficulty
relating to others and fail to gain weight.
