NICU Exam Questions and Answers 100% Pass

NICU Exam Questions and Answers 100% Pass Wide Pulse Pressure - Answer- Wide pulse pressure is defined as a difference between systolic and diastolic blood pressures of 30 mm Hg in a term infant and 25 mm Hg in the preterm infant. Wide pulse pressure in the infant with a PDA is caused by the increased stroke volume (from the increase in return of blood to the left ventricle), combined with a diversion of blood from the aorta to the pulmonary artery. Hydrocele - Answer- presence of peritoneal fluid in the scrotum; scrotum is nontender but swollen; testes can be palpated in scrotum A large anterior fontenelle is a finding with what congenital disease - Answer- Congenital hypothyroidism Low platelet count clinical presentation - Answer- diffuse petechial rash Sturge Webber Syndrome has a port wine stain over the infant's - Answer- eyes and nose Rocker bottom feet and overlapping clenched fingers - Answer- Trisomy 18 Scarf sign - Answer- position the infant supine; take the infant's hand and pull it across the infant's chest and around the neck as far posterior as possible toward the opposite shoulder, and observe the elbow position in relation to the midline of the infant's body Correct way to assess arm recoil - Answer- supine; flex arm for 5 seconds, then fully extend arms by pulling the hands downward , then release Signs of hyperthermia in the preemie - Answer- Tachypnea, tachycardia, dehydration, dehydration, irritability, hypernatremia Normal birth weight preemies lose - Answer- 10-15% hypocalcemia - Answer- jittery, high pitched cry, seizure activity Glucose infusion rate - Answer- 4-6 mg/kg/minute Subgaleal hemorrhage - Answer- large amount of blood collects in the connective tissue at the back of the head and in the neck; common after assisted vag; fluctuant mass at the back of the head that increases in size after delivery facial edema Cephalohematoma - Answer- bleeding under the periosteal lining of the skull; increases in size after birth but is bounded by suture lines and feels firm to the touch Subdural hematoma - Answer- intracranial bleed that presents with seizures, decreased LOC., and asymmetry of motor function Down's assessment - Answer- Brushfield spots, small ears, simian creases, excess skin on the neck, hypotonia, large tongue, murmur Turner assessement - Answer- SGA, broad chest, widely spaced nipples, edema of extremities, short neck horseshoe kidney (large U shaped) Klinefelter syndrome - Answer- long limbs, elbow dysplasia, clinodactyly involving fifth finger, hyposadias, hypogonadism Parvovirus infection - Answer- Leads to hydrops because it causes hemolysis of fetal red cells leading to capillary leak and edema presents with RDS, hazy lung fields, ascites, and pleural effusions harlequin sign - Answer- color change resulting from imbalance in the autonomic nervous system that disrupts blood flow to the cutaneous vasculature; occurs on the dependent side of the body and is rarely seen after 10 days of life; usually benign; change infant position line of demarcation down the infant's midline; infant appears pale on one half and red on the other Talipes equinovarus - Answer- medial turning and inversion of the sole of the foot with deformity of the hindfoot; clubfoot Erb palsy - Answer- from brachial plexus injury the arm is adducted and internally rotated; moro reflex absent on affected side; seen with shoulder dystocia Correct position of the ears - Answer- the insertion of the ear is above a line drawn from the inner to the outer canthus of the eye Preterm infant initial weight loss - Answer- expected to lose 10-15% of total body weight Hypocalcemia assessment findings - Answer- jitteriness, seizure activity, high-pitched cry, stridor, poor feeding, vomiting, abd distension Parity - Answer- term - preterm - abortions - living children PAPP-A - Answer- -protein produced by the placenta in early pregnancy -lower levels associated with increased risk for adverse pregnancy outcomes including fetal loss, preterm birth, and IUGR free beta hCG - Answer- -hormone produced by the placenta in early pregnancy -abnormal levels associated with increased risk for chromosome abnormality Nuchal translucency (NT) - Answer- measurement of midsagittal plane with the neck in neutral position; elevated measurements associated with Trisomy 21 cell free fetal DNA - Answer- noninvasive test uses mother's blood to screen for increased amounts of material from chromosomes 21, 13, 18 -can be as early as 10 weeks for women at risk due to age, family history -not recommended for low risk or multiple gestation Alpha-fetoprotein screen (AFP) - Answer- -protein normally produced by the fetal liver, present in amniotic fluid and crosses placenta -open neural tube defects -chromosomal abnormalities (21) -abdominal wall defects -twins Maternal serum screen - Answer- -also called quad screen or triple test -look at AFP, hCG, unconjugated estriol -for chromosomal and NTDs Chorionic villus sampling - Answer- -Invasive (need informed consent) -performed if risk for chromosomal -10-13 weeks -needle inserted through cervix or abd to remove cells from placenta Amniocentesis - Answer- -Invasive -15-20 weeks -chromosomal and NTDs -sample amniotic fluid and cells from sac surrounding fetus Fetal assessments begin at - Answer- 30 weeks -fetal movement -non-stress testing -BPP -contraction stress tests -amniotic fluid volume Non-stress test - Answer- most common method of antepartum fetal surveillance screening -after 28 wks; fetal movement and HR Biophysical profile (BPP) - Answer- includes US and non-stress test (fetal APGAR) -fetal breathing -movement -fetal HR reactivity -tone -amniotic fluid volume Fetal lung maturity testing - Answer- -Lamellar body count: PREFERRED! -rapid and sensitive to all populations -Lecithin/sphingomyelin (L/S) ratio of 2:1 indicates maturity -Phosphatidylglycerol (PG): highly predictive in IDM (insulin inhibits surfactant production) Second stage of labor - Answer- 2 hours without epidural 3 hours with epidural Preeclampsia and eclampsia - Answer- -elevated BP after 20 wks with proteinuria (140/90) -edema, HA, visual changes, epigastric pain, irritabilit