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killexams.com Nursing ACCNS-N
AACN Clinical Nurse Specialist - Wellness through Acute Care (Neonatal)
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A neonate is at risk for airway obstruction due to a congenital abnormality. Which of the following nursing interventions is appropriate for preventing airway compromise in this patient?
Positioning the neonate in a prone position
uctioning the airway frequently
onitoring for signs of respiratory distress wer: D
anation: When a neonate is at risk for airway obstruction due to a enital abnormality, monitoring for signs of respiratory distress is an opriate nursing intervention. Early recognition of respiratory distress a rompt intervention and prevention of airway.
wborn is diagnosed with patent ductus arteriosus (PDA). Which cation is commonly used to promote closure of the PDA in this patien
itroglycerin opamine
Administering bronchodilators regularly
S
M
Ans Expl
cong
appr llows
for p
A ne
medi t?
N
D
Ibuprofen
Furosemide
Answer: C
Explanation: Ibuprofen is a commonly used medication to promote closure of
the patent ductus arteriosus (PDA) in newborns. It belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen works by inhibiting the production of prostaglandins, which play a role in maintaining the openness of the ductus arteriosus. By promoting closure of the PDA, ibuprofen helps improve the newborn's cardiac function and oxygenation. Dopamine, nitroglycerin, and furosemide are medications used for different purposes and do not directly influence the closure of the PDA.
wborn is diagnosed with a pneumothorax. Which of the following cli festations should the clinical nurse specialist (CNS) anticipate in this nt?
bdominal distension and decreased bowel sounds yanosis and hypercapnia
radycardia and hypotension
ncreased respiratory rate and diminished breath sounds on the affected wer: D
anation: In a newborn with a pneumothorax, the clinical manifestation nclude an increased respiratory rate and diminished breath sounds on ted side. A pneumothorax occurs when air accumulates in the pleural e, leading to lung collapse and impaired gas exchange. The increased ratory rate is a compensatory response to maintain adequate oxygenat
A ne nical
mani patie
A
C
B
I side
Ans
Expl s
may i the
affec spac
respi ion.
Diminished breath sounds on the affected side are due to reduced lung expansion. Cyanosis and hypercapnia may occur if the pneumothorax is severe and compromises gas exchange, but they are not the initial manifestations. Bradycardia and hypotension are not commonly associated with a pneumothorax. Abdominal distension and decreased bowel sounds are not specific to this condition.
An infant who has been receiving enteral feedings, TPN, and lipids is made NPO due to feeding intolerance. In addition to discontinuing the enteral feedings, the CNS should ensure the infant is prescribed which of the following?
crease the rate of the TPN to maintain total fluids. dd a D10W infusion to maintain total fluids.
iscontinue the TPN and lipids and administer isotonic IV fluids.
wer: C
anation: When an infant is made NPO due to feeding intolerance, it is rtant to ensure that the infant receives adequate fluids to maintain ation. Adding a D10W (10% dextrose in water) infusion helps maintai luids and provides a source of glucose for the infant. TPN and lipids scontinued temporarily until enteral feedings can be resumed, but it is al to provide fluid support in the meantime. Increasing the rate of TP nistering isotonic IV fluids alone may not adequately meet the infant' needs.
Maintain the TPN and lipids at their current infusion rates.
In
A
D
Ans Expl
impo
hydr n
total f may
be di
cruci N or
admi s
fluid
A neonate is diagnosed with persistent pulmonary hypertension of the newborn (PPHN). Which of the following interventions is a nursing priority for this patient?
Administering supplemental oxygen
Providing mechanical ventilation
Initiating chest compressions
Administering prostaglandin E1
Answer: B
efore, the nursing priority for this patient is to initiate mechanical lation. Mechanical ventilation helps improve oxygenation and reduce load on the pulmonary circulation. Administering supplemental oxyg may not be sufficient, as PPHN is characterized by persistent hypox ating chest compressions is not indicated unless the patient experience ac arrest. Prostaglandin E1 may be used to maintain the patency of th us arteriosus in certain cases but does not directly address the pulmon rtension.
onate is diagnosed with meconium aspiration. Which of the following ventions should the clinical nurse specialist (CNS) recommend for thi nt?
dministering surfactant replacement therapy itiating chest physiotherapy
roviding supplemental oxygen via a high-flow nasal cannula
Explanation: In a neonate with persistent pulmonary hypertension of the newborn (PPHN), providing adequate oxygenation and ventilation is crucial.
Ther
venti s the
work en
alone emia.
Initi s
cardi e
duct ary
hype
A ne
inter s
patie
A
In
P
Intubating and suctioning the endotracheal tube Answer: D
Explanation: In a neonate diagnosed with meconium aspiration, the clinical nurse specialist (CNS) should recommend intubating and suctioning the endotracheal tube. Meconium aspiration occurs when the fetus passes
eterm infant is experiencing apnea of prematurity. Which of the follo ventions should the clinical nurse specialist (CNS) recommend as the
management for this condition?
dministering caffeine citrate itiating bag-mask ventilation
acing the infant in a supine position dministering oxygen via nasal cannula
wer: A
anation: The initial management for apnea of prematurity in a preterm is administering caffeine citrate. Caffeine citrate is a respiratory
ulant that helps stimulate the central nervous system and promotes reg
meconium (the first stool) before or during delivery, and the meconium is aspirated into the airways. Intubation and suctioning help clear the airway of meconium and prevent further aspiration. Administering surfactant replacement therapy may be indicated if there is evidence of surfactant deficiency or respiratory distress syndrome. Chest physiotherapy may be beneficial in certain cases but is not the primary intervention for meconium aspiration. Providing supplemental oxygen via a high-flow nasal cannula may be necessary, but it does not address the underlying meconium aspiration.
A pr wing
inter initial
A
In
Pl
A
Ans Expl
infant
stim ular
breathing patterns. It is commonly used in the management of apnea of prematurity. Initiating bag-mask ventilation may be necessary if the apnea is severe and accompanied by bradycardia or cyanosis. Placing the infant in a supine position is a routine practice to prevent sudden infant death syndrome (SIDS) but is not the primary intervention for apnea of prematurity. Administering oxygen via nasal cannula may be needed if the infant is hypoxic but does not directly address the underlying apnea.
A newborn is diagnosed with bronchopulmonary dysplasia (BPD). Which of the following interventions should the clinical nurse specialist (CNS) recommend to manage this condition?
roviding supplemental oxygen to maintain oxygen saturation itiating chest physiotherapy to improve lung function dministering antiviral medications to treat pulmonary infections
wer: B
anation: In managing bronchopulmonary dysplasia (BPD), providing lemental oxygen to maintain adequate oxygen saturation is a key vention. BPD is a chronic lung disease that often develops in prematu ts who required mechanical ventilation and oxygen therapy for a onged period. Supplemental oxygen helps alleviate hypoxemia and ens uate oxygen delivery to the tissues. Administering diuretics may be idered if the patient has signs of pulmonary edema, but it is not the pri vention for BPD. Chest physiotherapy may be beneficial in certain cas
not a definitive treatment for BPD. Antiviral medications are not nely used to treat pulmonary infections associated with BPD.
Administering diuretics to reduce pulmonary edema
P
In
A
Ans Expl
supp
inter re
infan
prol ures
adeq
cons mary
inter es
but is routi
A newborn presents with severe respiratory distress shortly after birth. Chest X- ray reveals a "ground glass" appearance and decreased lung volumes. These findings are consistent with which of the following conditions?
Transient tachypnea of the newborn (TTN)
Bronchopulmonary dysplasia (BPD)
Respiratory distress syndrome (RDS)
Pulmonary edema
Answer: C
istent with respiratory distress syndrome (RDS). RDS, also known as ctant deficiency, commonly occurs in preterm infants due to insuffici uction of surfactant in the lungs. The "ground glass" appearance on ch is indicative of diffuse bilateral lung opacities. Decreased lung volu result of poor expansion due to surfactant deficiency. Bronchopulmo lasia (BPD) is characterized by chronic lung disease in premature infa as different radiographic findings. Transient tachypnea of the newbor
N) is a self-limiting condition characterized by rapid breathing shortly and its radiographic findings differ from those described. Pulmonary
ma typically presents with increased lung opacities and signs of fluid mulation in the lungs.
Explanation: The described clinical presentation and radiographic findings are cons
surfa ent
prod est
X-ray mes
are a nary
dysp nts
and h n
(TT after
birth, ede accu