Test Bank For Pediatric Nursing Caring For Children And Their Families 3rd Edition by Nicki L. Potts

CHAPTER 7: GROWTH AND DEVELOPMENT OF THE NEWBORN

MULTIPLE CHOICE

1.The neonatal or newborn period of life is defined as the first:

a. 24 hours c. 7 days

b. 48 hours d. 28 days

ANS: D

Feedback

A Incorrect. The neonatal or newborn period of life is not defined as the first 24 hours.

B Incorrect. The neonatal or newborn period of life is not defined as the first 48 hours.

C Incorrect. The neonatal or newborn period of life is not defined as the first 7 days.

D Correct. The neonatal or newborn period of life is not defined as the first 28 days.

PTS: 1 REF: p. 192 – Growth and Development of the Newborn

OBJ: Cognitive Level: Knowledge

2.In fetal circulation, most blood will bypass the fetal lungs via the:

a. inferior vena cava c. foramen ovale

b. ductus venosus d. ductus arteriosus

ANS: C

Feedback

A Incorrect. In fetal circulation, most blood will not bypass the fetal lungs via the inferior vena cava, instead most of the blood from the placenta enters the inferior vena cava on the way directly to the heart, thus bypassing the lungs.

B Incorrect. In fetal circulation, most blood will not bypass the fetal lungs via the ductus venosus; 60% of the blood from the placenta passes through the ductus venosus directly into the inferior vena cava.

C Correct. In fetal circulation, most blood will bypass the fetal lungs via the foramen ovale, an opening between the right and left atria of the fetal heart.

D Incorrect. In fetal circulation, most blood will not bypass the fetal lungs via the ductus arteriosus, however, a large amount of blood from the placenta travels through the ductus arteriosus (channel between the main pulmonary artery and the aorta).

PTS: 1 REF: p. 192 – Growth and Development of the Newborn

OBJ: Cognitive Level: Knowledge

3.When the fetus makes the transition to becoming a newborn and extrauterine life begins, there occurs a series of changes, including decreased pulmonary vascular resistance, increased pulmonary blood flow, increased pressure of the left atrium, decreased pressure of the right atrium, and closure of which of the following structures?

a. foramen ovale c. inferior vena cava

b. ductus venosus d. superior vena cava

ANS: A

Feedback

A Correct. The transition to extrauterine life requires the lungs to initiate respirations and the PaO2 levels increase. The opening between the left and right atria, the foramen ovale, closes shortly after birth.

B Incorrect. The ductus venosus closes more gradually, usually within 2 weeks of birth.

C Incorrect. The inferior vena cava must remain open for life to persist.

D Incorrect. The superior vena cava must remain open for life to persist.

PTS: 1 REF: p. 192 – Growth and Development of the Newborn

OBJ: Cognitive Level: Knowledge

4.After a long labor, the mother is concerned about the swelling of her baby’s scalp. The newborn is 24 hours old. The nurse palpates the scalp and finds swelling that extends across the suture lines. In addition to explaining the probable cause of the swelling and the time of resolution, the nurse explains that the term for this condition is:

a. cephalhematoma c. molding

b. caput succedaneum d. crepitation

ANS: B

Feedback

A Incorrect. Cephalhematoma will usually develop after 24 hours, indicates rupture of blood vessels and bleeding, but does not extend across the suture lines.

B Correct. Caput succedaneum is often evident after long labor, is swelling of the soft tissues of the scalp. The edema extends across the suture lines, and presents within the first 24 hours following birth.

C Incorrect. Molding describes the misshapen appearance of the head following live birth.

D Incorrect. Crepitation is the noisy discharge of gas from the intestine through the anus.

PTS: 1 REF: p. 193 – Extrauterine Transition OBJ: Cognitive Level: Knowledge

5.The umbilical cord, which connects the fetus to the placenta, contains:

a. one vein and one artery c. one artery and two veins

b. two veins and two arteries d. two arteries and one vein

ANS: D

Feedback

A Incorrect. The umbilical cord, which connects the fetus to the placenta, does not contain one vein and one artery.

B Incorrect. The umbilical cord, which connects the fetus to the placenta, does not contain two veins and two arteries.

C Incorrect. The umbilical cord, which connects the fetus to the placenta, does not contain one artery and two veins.

D Correct. The umbilical cord, which connects the fetus to the placenta, does contains two arteries and one vein.

PTS: 1 REF: p. 206 – Cognitive Development OBJ: Cognitive Level: Knowledge

6.The nurse instructing the mother on how to care for the umbilical cord of the newborn would direct the mother to:

a. wash the cord only with warm water and gently dry it

b. apply 70% isopropyl alcohol or hydrogen peroxide to the base next to the skin and to the cord with each diaper change

c. use a solution of baby shampoo and water on the cord, rinse, and dry carefully

d. wash the cord with a solution of Ivory soap and water, dry, air for 30 minutes, and apply triple antibiotic ointment after baths and diaper changes

ANS: B

Feedback

A Incorrect. The nurse instructing the mother on how to care for the umbilical cord of the newborn would not direct the mother to wash the cord only with warm water and gently dry it; will not protect against infection.

B Correct. The nurse instructing the mother on how to care for the umbilical cord of the newborn would direct the mother to apply 70% isopropyl alcohol or hydrogen peroxide to the base next to the skin and to the cord with each diaper change.

C Incorrect. The nurse instructing the mother on how to care for the umbilical cord of the newborn would not direct the mother to use a solution of baby shampoo and water on the cord, rinse, and dry carefully.

D Incorrect. The nurse instructing the mother on how to care for the umbilical cord of the newborn would not direct the mother to wash the cord with a solution of Ivory soap and water, dry, air for 30 minutes, and apply triple antibiotic ointment after baths and diaper changes.

PTS:1REF:p. 194 – Physiological Development

OBJ: Cognitive Level: Comprehension

7.The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is to:

a. allow visualization at all times c. remind the caregivers to do cord care

b. keep the diaper from rubbing the cord d. provide air circulation for the cord

ANS: D

Feedback

A Incorrect. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is not to allow visualization at all times.

B Incorrect. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is not to keep the diaper from rubbing the cord.

C Incorrect. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is not to remind the caregivers to do cord care.

D Correct. The nurse instructs the caregivers of a newborn to notch the diapers or fold them in such a way as to expose the cord. The major purpose of exposing the cord is to provide air circulation for the cord.

PTS:1REF:p. 195 – Physiological Development

OBJ: Cognitive Level: Knowledge

8.The nurse is assessing neonatal reflexes. As the nurse moves the neonate’s head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is called:

a. cat’s eye c. doll’s eye

b. head lag reflex d. eye delay

ANS: C

Feedback

A Incorrect. As the nurse moves the neonate’s head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is not called cat’s eye.

B Incorrect. As the nurse moves the neonate’s head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is not called head lag reflex.

C Correct. As the nurse moves the neonate’s head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is called doll’s eye.

D Incorrect. As the nurse moves the neonate’s head slowly to the right or left, the eyes move more slowly than the head and do not immediately adjust to the position of the head. This reflex is not called eye delay.

PTS:1REF:p. 197 – Physiological Development

OBJ: Cognitive Level: Knowledge

9.The rooting reflex of an infant disappears at approximately how many months of age?

a. 1 c. 4

b. 2 d. 6

ANS: C

Feedback

A Incorrect. The rooting reflex of an infant does not disappear at approximately 1 month of age.

B Incorrect. The rooting reflex of an infant does not disappear at approximately 2 months of age.

C Correct. The rooting reflex of an infant does disappear at approximately 4 months of age.

D Incorrect. The rooting reflex of an infant does not disappear at approximately 6 months of age.

PTS:1REF:p. 197 – Physiological Development

OBJ: Cognitive Level: Knowledge

10.The stomach capacity of the newborn is approximately how many mL?

a. 30 c. 60

b. 40 d. 80

ANS: C

Feedback

A Incorrect. The stomach capacity of the newborn is not approximately 30 mL?

B Incorrect. The stomach capacity of the newborn is not approximately 40 mL?

C Correct. The stomach capacity of the newborn is approximately 60 mL?

D Incorrect. The stomach capacity of the newborn is not approximately 80 mL?

PTS:1REF:p. 199 – Physiological Development

OBJ: Cognitive Level: Knowledge

11.The newborn is less capable of absorbing fat than older children and adults because of:

a. natural allergies to fat

b. lack of stomach acid

c. shorter large and small intestines with shorter emptying time

d. reduced bile salt secretion and less efficient pancreas

ANS: D

Feedback

A Incorrect. The newborn is less capable of absorbing fat than older children and adults not because of natural allergies to fat.

B Incorrect. The newborn is less capable of absorbing fat than older children and adults not because of lack of stomach acid.

C Incorrect. The newborn is less capable of absorbing fat than older children and adults not because of shorter large and small intestines with shorter emptying time.

D Correct. The newborn is less capable of absorbing fat than older children and adults because of reduced bile salt secretion from the liver and less efficient pancreas.

PTS:1REF:p. 200 – Physiological Development

OBJ: Cognitive Level: Knowledge

12.The nurse is working with a newborn who has elevated bilirubin levels that are fast approaching the toxic level. The nurse is most concerned about which of the following conditions?

a. ketolysis c. kernicterus

b. bilharziasis d. biliverdin

ANS: C

Feedback

A Incorrect. Elevated bilirubin levels approaching toxicity is not ketolysis.

B Incorrect. Bilharziasis, more commonly known as schistosomiasis, is a parasitic infection second only to malaria in the number of people affected.

C Correct. Kernicterus is the chronic and permanent accumulation of bilirubin in central nervous system tissues.

D Incorrect. Biliverdin is the green bile pigment that becomes bilirubin.

PTS:1REF:p. 200 – Physiological Development

OBJ: Cognitive Level: Comprehension

13.Which of the following statements best describes the purpose of phototherapy?

a. reducing serum bilirubin level and preventing brain damage

b. raising the body temperature of a neonate with a subnormal temperature

c. producing X-rays of the internal organs of the body

d. reducing pain in the muscles and joints of the body

ANS: A

Feedback

A Correct. Phototherapy is the use of special high-intensity fluorescent lights as a method of reducing serum bilirubin level and preventing brain damage.

B Incorrect. Raising the body temperature of a neonate with a subnormal temperature does not best describe the purpose of phototherapy.

C Incorrect. Producing X-rays of the internal organs of the body does not best describe the purpose of phototherapy.

D Incorrect. Reducing pain in the muscles and joints of the body does not best describe the purpose of phototherapy.

PTS:1REF:p. 200 – Physiological Development

OBJ: Cognitive Level: Knowledge

14.The nurse administering phototherapy ordered by the primary care provider must take special safety precautions and:

a. check the baby’s blood glucose before therapy

b. cover the baby with a sheet during therapy

c. shield the baby’s eyes and protect the gonads

d. apply a special sunscreen prior to the treatment

ANS: C

Feedback

A Incorrect. Special safety precautions when administering phototherapy is not to check the baby’s blood glucose before therapy.

B Incorrect. Special safety precautions when administering phototherapy is not to cover the baby with a sheet during therapy.

C Correct. Special safety precautions when administering phototherapy requires the nurse to shield the baby’s eyes (prevent retinal damage) and protect the gonads since maximum exposure is accomplished when the newborn is unclothed.

D Incorrect. Special safety precautions when administering phototherapy is not to apply a special sunscreen prior to the treatment.

PTS:1REF:p. 200 – Physiological Development

OBJ: Cognitive Level: Comprehension

15.To best assess the effectiveness of the phototherapy treatment, the nurse will monitor which of the following?

a. skin color of the newborn c. serial serum bilirubin levels

b. pulse oximetry d. activity level of the baby

ANS: C

Feedback

A Incorrect. To best assess the effectiveness of the phototherapy treatment, the nurse will not rely upon the skin color of the newborn.

B Incorrect. To best assess the effectiveness of the phototherapy treatment, the nurse will not rely upon the oxygen level in the blood.

C Correct. To best assess the effectiveness of the phototherapy treatment, the nurse will rely upon serial serum bilirubin levels.

D Incorrect. To best assess the effectiveness of the phototherapy treatment, the nurse will not rely upon the activity level of the baby.

PTS:1REF:p. 200 – Physiological Development

OBJ: Cognitive Level: Application