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NCC Low Risk Neonatal Nursing
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A term neonate is born with a cleft lip and palate. Which of the following nursing interventions is important for the management of a neonate with cleft lip and palate?
Assisting with surgical repair immediately after birth
romoting adequate nutrition and feeding techniques wer: C
anation: Promoting adequate nutrition and feeding techniques is an rtant nursing intervention for the management of a neonate with cleft alate. Cleft lip and palate are congenital malformations that can affec ate's ability to feed properly. Special feeding techniques, such as usin alized nipples or feeding devices, may be necessary to ensure adequat tion. Surgical repair of the cleft lip and palate is typically performed a tage, after the neonate has grown and developed further. Antibiotics dministered if there is an associated infection but are not routinely nistered prophylactically.
m neonate is diagnosed with congenital hypothyroidism. Which of th wing interventions is a standard part of the management for this condi
Administering antibiotics prophylactically
P
Ans Expl
impo lip
and p t a
neon g
speci e
nutri t a
later s may
be a admi
A ter e
follo tion?
Surgical correction of the thyroid gland
Administration of corticosteroids
Initiation of thyroid hormone replacement therapy
eterm neonate is being transitioned from parenteral nutrition to enteral Which of the following complications is commonly associated with
al feeding in preterm neonates?
ypertrophic pyloric stenosis (HPS) atent ductus arteriosus (PDA) ecrotizing enterocolitis (NEC)
wer: C
anation: Enteral feeding in preterm neonates is commonly associated w isk of developing necrotizing enterocolitis (NEC). NEC is a gastrointe ition characterized by inflammation and necrosis of the intestinal muc rm neonates have an immature gastrointestinal tract, making them mo eptible to NEC. The introduction of enteral feeds, especially if done ra
Explanation: Initiation of thyroid hormone replacement therapy is a standard part of the management for neonates diagnosed with congenital hypothyroidism. Congenital hypothyroidism is a condition characterized by an inadequate production of thyroid hormones. Replacement therapy with thyroxine (T4) is necessary to maintain normal growth and development. Corticosteroids are not routinely used in the management of congenital hypothyroidism. Surgical correction of the thyroid gland is not typically indicated in this condition.
A pr feeds. enter
H
P
N
Ans
Expl ith
the r stinal
cond osa.
Prete re
susc pidly
or in large volumes, can further increase the risk of developing NEC. Close monitoring and careful advancement of enteral feeds are important to minimize the risk of this serious complication.
A newborn is diagnosed with necrotizing enterocolitis (NEC). Which of the following interventions is a common approach in the management of NEC?
Surgical repair of the affected bowel segment
Administration of broad-spectrum antibiotics
Initiation of enteral feeds
wer: B
anation: Administration of broad-spectrum antibiotics is a common oach in the management of necrotizing enterocolitis (NEC) in a newb is a serious gastrointestinal condition characterized by inflammation osis of the intestinal mucosa. The administration of antibiotics helps c nfection and prevent its progression. In severe cases, surgical interven
e necessary for the repair of the affected bowel segment. Initiation o al feeds is generally delayed or temporarily withheld in the managem
wborn requires resuscitation at birth due to poor respiratory effort and ontaneous crying. Which of the following is the most appropriate initi n resuscitation?
dministering chest compressions
Ans Expl
appr orn.
NEC and
necr ontrol
the i tion
may b f
enter ent of
NEC.
A ne lack
of sp al
step i
A
Providing positive-pressure ventilation
Drying and warming the newborn Answer: C
Explanation: The most appropriate initial step in resuscitating a newborn with poor respiratory effort and lack of spontaneous crying is to dry and warm the
newborn. Drying the newborn removes any wetness from the skin, which can help prevent heat loss. Warming the newborn helps maintain a stable body temperature, which is important for normal physiologic functioning. If the newborn's respiratory effort and crying do not improve after drying and warming, further steps of resuscitation, such as providing positive-pressure ventilation, may be necessary.
m neonate is noted to have cyanosis, poor feeding, and respiratory dis ly after birth. On examination, the neonate has a continuous machiner urmur. What is the most likely diagnosis?
ransposition of the great arteries oarctation of the aorta
atent ductus arteriosus wer: C
anation: The symptoms described, including cyanosis, poor feeding, ratory distress, and a continuous machinery-like murmur, are suggesti nt ductus arteriosus (PDA) in a term neonate. PDA is a congenital hea ct characterized by the failure of the ductus arteriosus, a blood vessel t ects the pulmonary artery to the aorta, to close after birth. This results rmal blood flow between these two vessels, leading to symptoms such osis and respiratory distress. The continuous machinery-like murmur i
A ter tress
short y-
like m
T
C
P
Ans Expl
respi ve of
pate rt
defe hat
conn in
abno as
cyan s a
characteristic finding in PDA.
A preterm neonate is diagnosed with patent ductus arteriosus (PDA). Which of the following medications is commonly used for pharmacological closure of PDA?
Naloxone
Epinephrine
Indomethacin Answer: C
nt ductus arteriosus (PDA) in preterm neonates. Indomethacin is a teroidal anti-inflammatory drug (NSAID) that helps constrict the duct iosus, leading to its closure. Other medications, such as ibuprofen, ma e used for this purpose. Surgical ligation is an alternative treatment o DA if pharmacological closure is ineffective.
eterm neonate is diagnosed with necrotizing enterocolitis (NEC). Whi ollowing findings is associated with advanced stages of NEC?
loody stools
bdominal distension and tenderness ypothermia
wer: B
Explanation: Indomethacin is commonly used for pharmacological closure of a pate
nons us
arter y
also b ption
for P
A pr ch of
the f
B
A
H
Ans
Explanation: Advanced stages of necrotizing enterocolitis (NEC) in a preterm neonate are characterized by abdominal distension and tenderness. NEC is a serious gastrointestinal condition that primarily affects premature infants and is characterized by inflammation and necrosis of the intestinal mucosa. In advanced stages, the affected neonate may develop abdominal distension due to gas accumulation, and the abdomen may appear tender on palpation. Other symptoms can include bloody stools, which are associated with bowel necrosis,
and signs of systemic illness such as hypothermia.
A newborn presents with decreased movement of the left arm and asymmetrical Moro reflex. On examination, there is limited range of motion and asymmetry of the shoulder. The most likely diagnosis is:
rachial plexus injury ongenital hip dysplasia steogenesis imperfecta
wer: A
anation: The symptoms described, including decreased movement of t rm, asymmetrical Moro reflex, limited range of motion, and asymmet houlder, are suggestive of a brachial plexus injury in a newborn. The hial plexus is a network of nerves that controls movement and sensati rm and hand. Injury to the brachial plexus can occur during childbirth cularly in cases of shoulder dystocia or difficult deliveries. This can re rying degrees of weakness or paralysis in the affected arm. Further uation and management, including physical therapy and possible surgi vention, may be necessary.
B
C
O
Ans
Expl he
left a ry of
the s
brac on in
the a ,
parti sult
in va
eval cal
inter
A preterm neonate is diagnosed with hypoglycemia. Which of the following signs or symptoms is commonly associated with hypoglycemia in a neonate?
Hypertonia
Bradycardia
Jitteriness
Answer: C
onate is diagnosed with hyperbilirubinemia. Which of the following ventions is commonly used in the management of neonatal rbilirubinemia?
hototherapy
dministration of bronchodilators itiation of antiviral therapy
wer: A
anation: Phototherapy is a commonly used intervention in the manage onatal hyperbilirubinemia. Hyperbilirubinemia refers to elevated leve ubin in the blood, resulting in jaundice. Phototherapy involves exposin ate to special lights that help convert the bilirubin into a form that can
Explanation: Jitteriness is a common sign associated with hypoglycemia in a neonate. Hypoglycemia is defined as a low blood glucose level and can occur in both term and preterm neonates. Other signs and symptoms of hypoglycemia may include poor feeding, lethargy, cyanosis, apnea, and seizures. Bradycardia and hypertonia are not typically specific signs of hypoglycemia.
A ne inter hype
P
A
In
Ans
Expl ment
of ne ls of
bilir g the
neon be
excreted from the body more easily. This reduces the severity of jaundice and prevents potential complications. Administration of bronchodilators is not indicated for hyperbilirubinemia, and antiviral therapy is not relevant unless there is an associated viral infection.
A neonate presents with poor weight gain, constipation, and a protruding abdomen. On physical examination, the neonate has a palpable olive-shaped mass in the right upper quadrant. The most likely diagnosis is:
Hypertrophic pyloric stenosis
Intussusception
wer: A
anation: The symptoms described, including poor weight gain, tipation, a protruding abdomen, and a palpable olive-shaped mass in t upper quadrant, are characteristic of hypertrophic pyloric stenosis (H eonate. HPS is a condition in which the muscle of the pylorus, the ing between the stomach and the small intestine, becomes thickened,
ng to partial or complete obstruction. The palpable olive-shaped mass sents the hypertrophied pylorus. HPS typically presents in the first fe ks of life and requires surgical intervention.
eterm neonate is diagnosed with persistent pulmonary hypertension of born (PPHN). Which of the following interventions is commonly used
anagement of PPHN?
ntravenous fluid administration
Hirschsprung's disease Ans
Expl
cons he
right PS)
in a n open leadi
repre w
wee
A pr the
new in
the m
I
Inhaled nitric oxide (iNO) therapy
Exchange transfusion
Answer: B
in the management of persistent pulmonary hypertension of the newborn (PPHN). PPHN is a condition characterized by abnormal pulmonary vasoreactivity and decreased oxygenation. Inhaled nitric oxide helps dilate the pulmonary blood vessels, improving blood flow and oxygenation. Intravenous fluid administration is a routine practice in neonatal care but is not specific to PPHN. Exchange transfusion may be indicated in certain cases, such as severe neonatal jaundice, but is not a primary intervention for PPHN.
m neonate is diagnosed with meconium aspiration syndrome (MAS). ch of the following interventions is a common management approach ondition?
ontinuous positive airway pressure (CPAP) therapy acement of a chest tube
dministration of surfactant wer: A
anation: Continuous positive airway pressure (CPAP) therapy is a co agement approach for meconium aspiration syndrome (MAS) in a ter ate. MAS occurs when the neonate inhales meconium-stained amnioti into the lungs, leading to respiratory distress and potential airway uction. CPAP therapy helps maintain positive pressure in the airways, enting collapse and facilitating better oxygenation. It is often used as a
A ter
Whi for
this c
C
Pl
A
Ans
Expl mmon
man m
neon c
fluid obstr prev
first-line intervention for respiratory support in neonates with MAS. Surfactant administration may be considered in severe cases, and placement of a chest tube is not typically indicated for MAS.
cry. Laboratory investigations reveal an elevated thyroid-stimulating hormone (TSH) level and low levels of thyroid hormones (T3 and T4). The most likely diagnosis is:
Congenital hypothyroidism
Down syndrome
wer: A
anation: The symptoms described, including dysmorphic facial featur tonia, hoarse cry, elevated TSH level, and low levels of thyroid horm nd T4), are consistent with congenital hypothyroidism in a newborn. genital hypothyroidism is a condition characterized by insufficient uction of thyroid hormones, which are essential for normal growth an lopment. The dysmorphic facial features, such as a large tongue and a ned nasal bridge, can be seen in infants with congenital hypothyroidis
diagnosis and prompt treatment with thyroid hormone replacement a al to prevent long-term developmental impairments.
m neonate presents with pallor, poor feeding, and petechiae on physic mination. Laboratory investigations reveal a low hemoglobin level and mbocytopenia. The most likely diagnosis is:
Turner syndrome
Ans
Expl es,
hypo ones
(T3 a
Con
prod d
deve
flatte m.
Early re
cruci
A ter al
exa thro
Hemolytic disease of the newborn
Neonatal sepsis
Disseminated intravascular coagulation (DIC) Answer: C
atal sepsis or hemolytic disease of the newborn.
wborn is noted to have a single umbilical artery on examination. Whi ollowing congenital anomalies is commonly associated with this findi
ardiac anomalies enal anomalies
astrointestinal anomalies
wer: B
anation: The finding of a single umbilical artery in a newborn is com ciated with renal anomalies. Normally, the umbilical cord contains tw ies and one vein. However, in some cases, one of the arteries may be nt or underdeveloped, resulting in a single umbilical artery. This findi
Explanation: The symptoms described, including pallor, poor feeding, petechiae, low hemoglobin level, and thrombocytopenia, are suggestive of disseminated intravascular coagulation (DIC) in a term neonate. DIC is a serious condition characterized by widespread activation of the clotting cascade, leading to both excessive clot formation and depletion of clotting factors and platelets. This can result in bleeding manifestations such as petechiae and laboratory abnormalities including low hemoglobin and platelet count. DIC can be secondary to various underlying conditions, including neon
A ne ch of
the f ng?
C
R
G
Ans
Expl monly
asso o
arter
abse ng is
often seen in association with renal anomalies, such as renal agenesis or renal dysplasia. Therefore, further evaluation of the newborn's renal system is warranted.
A neonate requires resuscitation at birth. Which of the following is an essential
component of effective neonatal resuscitation?
Administration of anticoagulant medications
Intravenous administration of glucose
anation: The use of positive pressure ventilation is an essential compo fective neonatal resuscitation. Positive pressure ventilation involves th ery of breaths to the newborn's lungs using a bag-mask device or a alized ventilator. This helps establish adequate oxygenation and
lation in a neonate who is not breathing or breathing ineffectively at b inistration of anticoagulant medications and intravenous administratio ose are not primary interventions during neonatal resuscitation.
Use of positive pressure ventilation Answer: C
Expl nent
of ef e
deliv speci
venti irth.
Adm n of
gluc