Chapter 08: Health Problems of the Newborn Test Bank for Wong's Nursing Care of Infants And Children 11th Edition by Hockenberry

TEST BANK FOR WONG'S NURSING CARE OF INFANTS AND CHILDREN 11TH EDITION BY HOCKENBERRY Chapter 08: Health Problems of the Newborn MULTIPLE CHOICE 1. Which term is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery? a. Hydrocephalus b. Cephalhematoma c. Caput succedaneum d. Subdural hematoma ANS: C Caput succedaneum is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery. The swelling consists of serum or blood (or both) accumulated in the tissues above the bone, and it may extend beyond the bone margin. Hydrocephalus is caused by an imbalance in production and absorption of cerebrospinal fluid. When production exceeds absorption, fluid accumulates within the ventricular system, causing dilation of the ventricles. A cephalhematoma has sharply demarcated boundaries that do not extend beyond the limits of the (bone) suture line. A subdural hematoma is located between the dura and the cerebrum. It should not be visible on the scalp. DIF: Cognitive Level: Remembering TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 2. Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture? a. Positive scarf sign b. Asymmetric Moro reflex c. Swelling of fingers on affected side d. Paralysis of affected extremity and muscles ANS: B A newborn with a broken clavicle may have no signs. The Moro reflex, which results in sudden extension and abduction of the extremities followed by flexion and adduction of the extremities, will most likely be asymmetric. The scarf sign that is used to determine gestational age should not be performed if a broken clavicle is suspected. Swelling of the fingers on the affected side and paralysis of the affected extremity and muscles are not signs of a fractured clavicle. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 3. The parents of a newborn ask the nurse what caused the babys facial nerve paralysis. The nurses response is based on remembering that this is caused by what? a. Birth injury b. Genetic defect c. Spinal cord injury d. Inborn error of metabolism ANS: A Pressure on the facial nerve (cranial nerve VII) during delivery may result in injury to the nerve. Genetic defects, spinal cord injuries, and inborn errors of metabolism did not cause the facial nerve paralysis. The paralysis usually disappears in a few days but may take as long as several months. DIF: Cognitive Level: Understanding TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 4. A mother is upset because her newborn has erythema toxicum neonatorum. The nurse should reassure her that this is what? a. Easily treated b. Benign and transient c. Usually not contagious d. Usually not disfiguring ANS: B Erythema toxicum neonatorum, or newborn rash, is a benign, self-limiting eruption of unknown cause that usually appears within the first 2 days of life. The rash usually lasts about 5 to 7 days. No treatment is indicated. Erythema toxicum neonatorum is not contagious. Successive crops of lesions heal without pigmentation. DIF: Cognitive Level: Applying TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Health Promotion and Maintenance 5. What should nursing care of an infant with oral candidiasis (thrush) include? a. Avoid use of a pacifier. b. Continue medication for the prescribed number of days. c. Remove the characteristic white patches with a soft cloth. d. Apply medication to the oral mucosa, being careful that none is ingested. ANS: B The medication must be continued for the prescribed number of days. To prevent relapse, therapy should continue for at least 2 days after the lesions disappear. Pacifiers can be used. The pacifier should be replaced with a new one or boiled for 20 minutes once daily. One of the characteristics of thrush is that the white patches cannot be removed. The medication is applied to the oral mucosa and then swallowed to treat Candida albicansinfection in the gastrointestinal tract. DIF: Cognitive Level: Applying MSC: Client Needs: Physiological Integrity 6. A mother brings her 6-week-old infant in with complaints of poor feeding, lethargy, fever, irritability, and a vesicular rash. What does the nurse suspect? a. Impetigo b. Candidiasis c. Neonatal herpes d. Congenital syphilis ANS: C Neonatal herpes is one of the most serious viral infections in newborns, with a mortality rate of up to 60% in infants with disseminated disease. Bullous impetigo is an infectious superficial skin condition most often caused byStaphylococcus aureus infection. It is characterized by bullous vesicular lesions on previously untraumatized skin. Candidiasis is characterized by white adherent patches on the tongue, palate, and inner aspects of the cheeks. Congenital syphilis has multisystem manifestations, including hepatosplenomegaly, lymphadenopathy, hemolytic anemia, and thrombocytopenia. DIF: Cognitive Level: Analyzing TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity 7. Which is a bright red, rubbery nodule with a rough surface and a well-defined margin that may be present at birth? a. Port-wine stain b. Juvenile melanoma c. Cavernous hemangioma d. Strawberry hemangioma ANS: D Strawberry hemangiomas (or capillary hemangiomas) are benign cutaneous tumors that involve only capillaries. They are bright red, rubbery nodules with rough surfaces and well-defined margins. They may or may not be apparent at birth but enlarge during the first year of life and tend to resolve spontaneously by ages 2 to 3 years. A port-wine stain is a vascular stain that is a permanent lesion and is present at birth. Initially, it is a pink; red; or, rarely, purple stain of the skin that is flat at birth; it thickens, darkens, and proportionately enlarges as the infant grows. Melanoma is not differentiated into juvenile and adult forms. A cavernous hemangioma involves deeper vessels in the dermis and has a bluish red color and poorly defined margins. DIF: Cognitive Level: Understanding TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 8. What is an infant with severe jaundice at risk for developing?