ADVANCED PEDIATRIC NURSING TEST 1 (BURNS) QUESTIONS
WITH ACCURATE SOLUTIONS.
1) Which interventions are recommendations suggested as preventive services for
neonates? -- Answer ✔✔ - Breastfeeding
- Screening neonates for sickle hemoglobinopathies
- Newborns screened for phenylketonuria (PKU) before being 24 hours old
should be rescreened by 2 weeks old.
- Screening for developmental hip dysplasia
2) When providing post delivery information regarding her infant, the nurse will
confirm to the mother that which fetal cardiac structures have no function after
her child is born? -- Answer ✔✔ - Foramen ovale
- Ductus arteriosus
- Explanation: The foramen ovale and ductus arteriosus are no longer
necessary and close.
3) The nurse will contribute which neonate characteristics noted in the first period
of reactivity to sympathetic system changes? -- Answer ✔✔ - Transient rales
, - Tachycardia
- Alertness
- Explanation: The first period of reactivity includes sympathetic system
changes, such as tachycardia, rapid respirations, transient rales, grunting,
flaring and retractions, a falling body temperature, hypertonus, and alertness.
Parasympathetic system changes during the first period of reactivity include
the initiation of bowel sounds and the production of oral mucus. After an
interval of sleep, the newborn enters the second period of reactivity. During
this time, the oral mucus production again becomes evident, the heart rate
becomes labile, the newborn becomes more responsive to endogenous and
exogenous stimuli, and meconium is often passed.
4) Which assessment factors are included in a 5-minute APGAR score? -- Answer
✔✔ - Heart rate
- Respiratory Rate
- Skin Color
- Muscle tone
- Explanation: Heart and respiratory rates, skin color and muscle tone are
assessed at both the 1 and 5 minute APGAR scoring. While crying has a
positive affect on respirations, crying is not a focus of the assessment
5) Which assessment findings suggest that the neonate is demonstrating stabilization
of physiological functions? -- Answer ✔✔ Temperature: 97.7° F
- Explanation: Temperature is considered stable when between (97.7° to
99.3° F [36.5° to 37.4° C]) in open crib after birth. Heart rate is normally
100 to 190 bpm. Systolic blood pressures greater than 96 mm Hg are
considered significant hypertension in the newborn. Unlabored respirations
at a rate of 30 to 60 breaths/minute is considered normal.
6) During an assessment of a 4-week-old infant, the primary care pediatric nurse
practitioner learns that a breastfed infant nurses every 2 hours during the day but
, is able to sleep for a 4-hour period during the night. The infant has gained 20
grams per day in the interval since last seen in the clinic. What will the nurse
practitioner recommend? -- Answer ✔✔ Continuing to nurse the infant using the
current pattern
- Explanation: Infants who are encouraged to breastfeed every 2 to 3 hours
may have one longer stretch of 4 hours at night. This infant is gaining
between 0.5 and 1 gram per day, which is appropriate. It is not necessary to
alter the pattern of nursing or to supplement with formula.
7) The primary care pediatric nurse practitioner is performing a well baby
examination on a 2-month-old infant who has gained 25 grams per day in the last
interval. The mother is nursing and tells the nurse practitioner that her infant
seems fussy and wants to nurse more often. What will the nurse practitioner tell
her? -- Answer ✔✔ The infant may be going through an expected growth spurt.
- Explanation: Infants may have a growth spurt at 6 to 8 weeks, and mothers
who are breastfeeding may be concerned that they are not making enough
milk when they notice that the infant is fussy and wanting to nurse more
often. The PNP should reassure the mother that this is expected. It is not
necessary, since the infant is gaining weight appropriately, for the mother to
keep a log. The mother should follow the infant's cues for feeding since the
extra suckling will increase the milk supply to meet the growing infant's
needs.
8) The mother of a 6-week-old breastfeeding infant tells the primary care pediatric
nurse practitioner that her baby, who previously had bowel movements with each
feeding, now has a bowel movement once every second day. What will the nurse
practitioner tell her? -- Answer ✔✔ This may be normal for breastfed babies.
- Explanation: Infants begin to have fewer bowel movements and may have
bowel movements ranging from once or twice daily to once every other day
when breastfed. Unless there are other signs, the baby is probably not
constipated. The mother does not need to change her intake of foods or
water, unless constipation is present.
WITH ACCURATE SOLUTIONS.
1) Which interventions are recommendations suggested as preventive services for
neonates? -- Answer ✔✔ - Breastfeeding
- Screening neonates for sickle hemoglobinopathies
- Newborns screened for phenylketonuria (PKU) before being 24 hours old
should be rescreened by 2 weeks old.
- Screening for developmental hip dysplasia
2) When providing post delivery information regarding her infant, the nurse will
confirm to the mother that which fetal cardiac structures have no function after
her child is born? -- Answer ✔✔ - Foramen ovale
- Ductus arteriosus
- Explanation: The foramen ovale and ductus arteriosus are no longer
necessary and close.
3) The nurse will contribute which neonate characteristics noted in the first period
of reactivity to sympathetic system changes? -- Answer ✔✔ - Transient rales
, - Tachycardia
- Alertness
- Explanation: The first period of reactivity includes sympathetic system
changes, such as tachycardia, rapid respirations, transient rales, grunting,
flaring and retractions, a falling body temperature, hypertonus, and alertness.
Parasympathetic system changes during the first period of reactivity include
the initiation of bowel sounds and the production of oral mucus. After an
interval of sleep, the newborn enters the second period of reactivity. During
this time, the oral mucus production again becomes evident, the heart rate
becomes labile, the newborn becomes more responsive to endogenous and
exogenous stimuli, and meconium is often passed.
4) Which assessment factors are included in a 5-minute APGAR score? -- Answer
✔✔ - Heart rate
- Respiratory Rate
- Skin Color
- Muscle tone
- Explanation: Heart and respiratory rates, skin color and muscle tone are
assessed at both the 1 and 5 minute APGAR scoring. While crying has a
positive affect on respirations, crying is not a focus of the assessment
5) Which assessment findings suggest that the neonate is demonstrating stabilization
of physiological functions? -- Answer ✔✔ Temperature: 97.7° F
- Explanation: Temperature is considered stable when between (97.7° to
99.3° F [36.5° to 37.4° C]) in open crib after birth. Heart rate is normally
100 to 190 bpm. Systolic blood pressures greater than 96 mm Hg are
considered significant hypertension in the newborn. Unlabored respirations
at a rate of 30 to 60 breaths/minute is considered normal.
6) During an assessment of a 4-week-old infant, the primary care pediatric nurse
practitioner learns that a breastfed infant nurses every 2 hours during the day but
, is able to sleep for a 4-hour period during the night. The infant has gained 20
grams per day in the interval since last seen in the clinic. What will the nurse
practitioner recommend? -- Answer ✔✔ Continuing to nurse the infant using the
current pattern
- Explanation: Infants who are encouraged to breastfeed every 2 to 3 hours
may have one longer stretch of 4 hours at night. This infant is gaining
between 0.5 and 1 gram per day, which is appropriate. It is not necessary to
alter the pattern of nursing or to supplement with formula.
7) The primary care pediatric nurse practitioner is performing a well baby
examination on a 2-month-old infant who has gained 25 grams per day in the last
interval. The mother is nursing and tells the nurse practitioner that her infant
seems fussy and wants to nurse more often. What will the nurse practitioner tell
her? -- Answer ✔✔ The infant may be going through an expected growth spurt.
- Explanation: Infants may have a growth spurt at 6 to 8 weeks, and mothers
who are breastfeeding may be concerned that they are not making enough
milk when they notice that the infant is fussy and wanting to nurse more
often. The PNP should reassure the mother that this is expected. It is not
necessary, since the infant is gaining weight appropriately, for the mother to
keep a log. The mother should follow the infant's cues for feeding since the
extra suckling will increase the milk supply to meet the growing infant's
needs.
8) The mother of a 6-week-old breastfeeding infant tells the primary care pediatric
nurse practitioner that her baby, who previously had bowel movements with each
feeding, now has a bowel movement once every second day. What will the nurse
practitioner tell her? -- Answer ✔✔ This may be normal for breastfed babies.
- Explanation: Infants begin to have fewer bowel movements and may have
bowel movements ranging from once or twice daily to once every other day
when breastfed. Unless there are other signs, the baby is probably not
constipated. The mother does not need to change her intake of foods or
water, unless constipation is present.
