TESTBANK FOR Gestational Age and Development
Chapter 29: High-Risk Newborn: Complications Associated
with
Gestational Age and Development
Which is most helpful in preventing premature birth?
a. High socioeconomic status
b. Adequate prenatal care
c. Aid to Families with Dependent Children
d. Women, Infants, and Children (WIC) nutritional program
ANS: B
Prenatal care is vital for identifying possible problems. People with higher
socioeconomic status are more likely to seek adequate prenatal care, which is the
most helpful for prevention. Lower socioeconomic groups do not seek out health
care, and that puts them at risk for preterm labor. Aid to Families with Dependent
Children and WIC aid in the nutritional status of the pregnant woman, but the most
helpful aid for the prevention of premature births is adequate prenatal care.
PTS: 1 DIF: Cognitive Level: Understanding REF: 623
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion
and Maintenance
2. In comparison with the term infant, the preterm infant has:
a. More subcutaneous fat.
b. Well-developed flexor muscles.
c. Few blood vessels visible through the skin.
d. Greater surface area in proportion to weight.
ANS: D
Preterm infants have greater surface area in proportion to their weight. More
subcutaneous fat, well-developed flexor muscles, and few blood vessels visible
,TESTBANK FOR Gestational Age and Development
through the skin are more characteristic of a term infant.
PTS: 1 DIF: Cognitive Level: Analysis REF: 623
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic
Integrity
3. Decreased surfactant production in the preterm lung is a problem because:
a. Surfactant keeps the alveoli open during expiration.
b. Surfactant causes increased permeability of the alveoli.
c. Surfactant dilates the bronchioles, decreasing airway resistance.
d. Surfactant provides transportation for oxygen to enter the blood supply.
ANS: A
Surfactant prevents the alveoli from collapsing each time the infant exhales, thus
reducing the work of breathing. It does not affect the bronchioles. By keeping the
alveoli open, it permits better oxygen exchange, but that is not its main purpose.
PTS: 1 DIF: Cognitive Level: Understanding REF: 623
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic
Integrity
4. A preterm infant is on a respirator, with intravenous lines and much equipment. When
the parents come to visit for the first time, which is an important response by the
nurse?
a. Encourage the parents to touch their infant.
b. Reassure the parents that the infant is progressing well.
c. Discuss the care they will give their infant when the infant goes home.
d. Suggest that the parents visit for only a short time to reduce their anxiety.
ANS: A
Touching the infant will increase the development of attachment. It is important to
keep the parents informed about the infant’s progress, but the nurse needs to be
,TESTBANK FOR Gestational Age and Development
honest with the explanations. Discussing home care is an important part of parent
teaching but is not the most important priority during the first visit. Bonding needs to
occur, and this can be fostered by encouraging the parents to spend time with the
infant.
PTS: 1 DIF: Cognitive Level: Application REF: 641
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Psychosocial Integrity
5. Which preterm infant should receive gavage feedings instead of bottle feedings?
a. Sucks on a pacifier during gavage feedings
b. Sometimes gags when a feeding tube is inserted
c. Has a sustained respiratory rate of 70 breaths/min
d. Has an axillary temperature of 98.4° F, an apical pulse of 149 beats/min,
and respirations of 54 breaths/min
ANS: C
Infants less than 34 weeks of gestation or those who weigh less than 1500 g
generally have difficulty with bottle feeding. Gavage feedings should be initiated if the
respiratory rate is above 60 breaths/min. Providing a pacifier during gavage feedings
gives positive oral stimulation and helps the infant associate the comfortable feeling
of fullness with sucking. The presence of the gag reflex is important before initiating
bottle feeding. Axillary temperature of 98.4° F, an apical pulse of 149 beats/min, and
respirations of 54 breaths/min are within expected limits and an indication that the
infant is not having respiratory problems at that time.
PTS: 1 DIF: Cognitive Level: Analysis REF: 631
OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Physiologic Integrity
6. Overstimulation may cause increased oxygen use in a preterm infant. Which nursing
intervention helps to avoid this problem?
a. Group all care activities together to provide long periods of rest.
, TESTBANK FOR Gestational Age and Development
b. Keep charts on top of the incubator so the nurses can write on them there.
c. While giving a report to the next nurse, stand in front of the incubator and
talk softly about how the infant responds to stimulation.
d. Teach the parents signs of overstimulation, such as turning the face away
or stiffening and extending the extremities and fingers.
ANS: D
Parents should be taught the signs of overstimulation so they will learn to adapt their
care to the needs of their infant. Grouping care activities may understimulate the
infant during those long periods and overtire the infant during the procedures.
Keeping charts on the incubator and giving the report in front of the incubator may
cause overstimulation.
PTS: 1 DIF: Cognitive Level: Application REF: 640
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Health Promotion and Maintenance
7. A characteristic of a post-term infant who weighs 7 lb, 12 oz, and who lost weight in
utero, is:
a. Soft and supple skin.
b. A hematocrit level of 55%.
c. Lack of subcutaneous fat.
d. An abundance of vernix caseosa.
ANS: C
This post-term infant actually lost weight in utero, which is seen as loss of
subcutaneous fat. The skin is normally wrinkled, cracked, and peeling. A hematocrit
of 55% is within the expected range of all newborns. There is no vernix caseosa in a
post-term infant.
PTS: 1 DIF: Cognitive Level: Understanding REF: 646
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic
Chapter 29: High-Risk Newborn: Complications Associated
with
Gestational Age and Development
Which is most helpful in preventing premature birth?
a. High socioeconomic status
b. Adequate prenatal care
c. Aid to Families with Dependent Children
d. Women, Infants, and Children (WIC) nutritional program
ANS: B
Prenatal care is vital for identifying possible problems. People with higher
socioeconomic status are more likely to seek adequate prenatal care, which is the
most helpful for prevention. Lower socioeconomic groups do not seek out health
care, and that puts them at risk for preterm labor. Aid to Families with Dependent
Children and WIC aid in the nutritional status of the pregnant woman, but the most
helpful aid for the prevention of premature births is adequate prenatal care.
PTS: 1 DIF: Cognitive Level: Understanding REF: 623
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion
and Maintenance
2. In comparison with the term infant, the preterm infant has:
a. More subcutaneous fat.
b. Well-developed flexor muscles.
c. Few blood vessels visible through the skin.
d. Greater surface area in proportion to weight.
ANS: D
Preterm infants have greater surface area in proportion to their weight. More
subcutaneous fat, well-developed flexor muscles, and few blood vessels visible
,TESTBANK FOR Gestational Age and Development
through the skin are more characteristic of a term infant.
PTS: 1 DIF: Cognitive Level: Analysis REF: 623
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic
Integrity
3. Decreased surfactant production in the preterm lung is a problem because:
a. Surfactant keeps the alveoli open during expiration.
b. Surfactant causes increased permeability of the alveoli.
c. Surfactant dilates the bronchioles, decreasing airway resistance.
d. Surfactant provides transportation for oxygen to enter the blood supply.
ANS: A
Surfactant prevents the alveoli from collapsing each time the infant exhales, thus
reducing the work of breathing. It does not affect the bronchioles. By keeping the
alveoli open, it permits better oxygen exchange, but that is not its main purpose.
PTS: 1 DIF: Cognitive Level: Understanding REF: 623
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic
Integrity
4. A preterm infant is on a respirator, with intravenous lines and much equipment. When
the parents come to visit for the first time, which is an important response by the
nurse?
a. Encourage the parents to touch their infant.
b. Reassure the parents that the infant is progressing well.
c. Discuss the care they will give their infant when the infant goes home.
d. Suggest that the parents visit for only a short time to reduce their anxiety.
ANS: A
Touching the infant will increase the development of attachment. It is important to
keep the parents informed about the infant’s progress, but the nurse needs to be
,TESTBANK FOR Gestational Age and Development
honest with the explanations. Discussing home care is an important part of parent
teaching but is not the most important priority during the first visit. Bonding needs to
occur, and this can be fostered by encouraging the parents to spend time with the
infant.
PTS: 1 DIF: Cognitive Level: Application REF: 641
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Psychosocial Integrity
5. Which preterm infant should receive gavage feedings instead of bottle feedings?
a. Sucks on a pacifier during gavage feedings
b. Sometimes gags when a feeding tube is inserted
c. Has a sustained respiratory rate of 70 breaths/min
d. Has an axillary temperature of 98.4° F, an apical pulse of 149 beats/min,
and respirations of 54 breaths/min
ANS: C
Infants less than 34 weeks of gestation or those who weigh less than 1500 g
generally have difficulty with bottle feeding. Gavage feedings should be initiated if the
respiratory rate is above 60 breaths/min. Providing a pacifier during gavage feedings
gives positive oral stimulation and helps the infant associate the comfortable feeling
of fullness with sucking. The presence of the gag reflex is important before initiating
bottle feeding. Axillary temperature of 98.4° F, an apical pulse of 149 beats/min, and
respirations of 54 breaths/min are within expected limits and an indication that the
infant is not having respiratory problems at that time.
PTS: 1 DIF: Cognitive Level: Analysis REF: 631
OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Physiologic Integrity
6. Overstimulation may cause increased oxygen use in a preterm infant. Which nursing
intervention helps to avoid this problem?
a. Group all care activities together to provide long periods of rest.
, TESTBANK FOR Gestational Age and Development
b. Keep charts on top of the incubator so the nurses can write on them there.
c. While giving a report to the next nurse, stand in front of the incubator and
talk softly about how the infant responds to stimulation.
d. Teach the parents signs of overstimulation, such as turning the face away
or stiffening and extending the extremities and fingers.
ANS: D
Parents should be taught the signs of overstimulation so they will learn to adapt their
care to the needs of their infant. Grouping care activities may understimulate the
infant during those long periods and overtire the infant during the procedures.
Keeping charts on the incubator and giving the report in front of the incubator may
cause overstimulation.
PTS: 1 DIF: Cognitive Level: Application REF: 640
OBJ: Nursing Process Step: Implementation
MSC: Client Needs: Health Promotion and Maintenance
7. A characteristic of a post-term infant who weighs 7 lb, 12 oz, and who lost weight in
utero, is:
a. Soft and supple skin.
b. A hematocrit level of 55%.
c. Lack of subcutaneous fat.
d. An abundance of vernix caseosa.
ANS: C
This post-term infant actually lost weight in utero, which is seen as loss of
subcutaneous fat. The skin is normally wrinkled, cracked, and peeling. A hematocrit
of 55% is within the expected range of all newborns. There is no vernix caseosa in a
post-term infant.
PTS: 1 DIF: Cognitive Level: Understanding REF: 646
OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic
