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1. A newborn with severe meconium aspiration syndrome (MAS) is not responding to
conventional treatment. Which measure would the nurse anticipate as possibly
necessary for this newborn?
A) extracorporeal membrane oxygenation (ECMO) abirb.com/test
B) respiratory support with a ventilator
C) insertion of a laryngoscope for deep suctioning
D) replacement of an endotracheal tube via X-ray abirb.com/test

2. When assessing an infant born at 32 weeks' gestation, which finding would lead the
nurse to suspect to suspect that the newborn has a patentabirb.com/test
ductus arteriosus (PDA)?
A) Weak, thready pulse
B) Decreased pulse rate
C) High diastolic arterial pressure abirb.com/test
D) Continuous murmur on auscultation

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3. Which type of nutrition would the nurse expect to administer to a preterm infant who
was born at 34 weeks' gestation and has developed necrotizing enterocolitis (NEC)?
A) Total parenteral nutrition (TPN)
B) Gavage feeding method abirb.com/test
C) Trophic feeding technique
D) Oral breastfeeding
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4. A preterm infant is born at risk for normochromic, normocytic anemia. Which nursing
action reduces the risk of the infant developing this condition? (Select all that apply.)
A) Coordinate blood draws so that they are as few as possible
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B) Delay cord clamping at birth
C) Perform phototherapy
D) Use caution when administering IV therapy
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E) Administer indomethacin
F) Perform a cranial ultrasound

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5. The nurse is visiting the parents of a newborn diagnosed with periventricular
leukomalacia. Which statement indicates that the parents understand the newborn's
health problem?
A) "Once the infection clears up, the baby will be fine."abirb.com/test
B) "We will need to plan for special care to help with learning disabilities."
C) "In a few months, more brain tissue will grow to fill in the hollow areas in the
brain." abirb.com/test
D) "In a few months, the baby will need to have physical therapy to train muscles to
work."
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6. Which intervention should a nurse implement to promote thermal regulation in a
preterm newborn?
A) Assess the newborn’s temperature every 8 hours until stable.
B) Set the temperature of the radiant warmer at a fixedabirb.com/test
level.
C) Observe for clinical signs of cold stress such as weak cry.
D) Check the blood pressure of the infant every 2 hours.
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7. The nurse needs to conduct a procedure on a preterm newborn. Which measures would
be most effective in reducing pain? Select all that apply.
A) swaddling the newborn closely abirb.com/test

B) offering a pacifier prior to a procedure

C) encouraging kangaroo care during procedures
D) removing tape quickly from the skin abirb.com/test
E) increasing the volume on device alarms

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8. A nurse is assessing a preterm newborn for possible sepsis. The nurse suspects an early
onset infection based on which risk factors? Select all that apply.
A) preterm labor
B) prolonged rupture of membranes abirb.com/test
C) immaturity of the immune system
D) decreased gastric acid
E) maternal fever
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9. A jaundiced neonate must have heel sticks to assess bilirubin levels. Which assessment
findings would indicate that the neonate is in pain? Select all that apply.
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A) There is flaccid muscle tone of the affected limb.
B) Respiration rate is 52 breaths per minute.
C) Heart rate is 180 beats per minutes.
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D) Oxygen saturation level is 88%.
E) The infant has facial grimacing and quivering chin.

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10. A perinatal nurse is providing care for a large for gestational age neonate admitted to the
observational unit after a complicated vaginal birth resulting in shoulder dystocia.
Which assessment would be a priority for the nurse to perform?
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A) Ballard assessment
B) Moro assessment
C) Dubowitz assessment
D) suck assessment abirb.com/test

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11. A preterm infant with enteral tube feedings is being monitored for weight gain. What
would be priorities for the nurse to include in the infant's plan of care? Select all that
apply.
A) Weigh daily. abirb.com/test
B) Measure daily intake and output.
C) Monitor weight weekly.
D) Assess serum electrolytes. abirb.com/test
E) Monitor Coombs results.
F) Assess for dehydration.
G) Measure abdominal girth AC.
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12. The nurse is caring for a small-for-gestational-age infant at 1 hour old, after a difficult
birth, with a glucose level of 40 mg/dL (2.5 mmol/L). Which nursing action would be
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the priority?
A) Initiate early oral feedings.
B) Ensure feedings are on demand.
C) Initiate daily newborn weights. abirb.com/test

D) Monitor the infant at feedings.

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13. The nurse is teaching nursing students about the risks that late preterm infants may
experience. The nurse feels confident learning has taken place when the students make
which statement?
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A) "Late preterm infant complications are considered minor compared to the preterm
newborn."
B) "The late preterm infant is more mature and able to cope as well as a full-term
infant." abirb.com/test
C) "Late preterm newborns have fewer clinical problems leading to shorter hospital
stays."
D) "A late preterm newborn may have more clinical problems compared with
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full-term newborns."

14. Which factors in a maternal birth record are risks for fetal growth restriction?
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A) premature rupture of membranes, gestational diabetes, or multiparity
B) twin pregnancy, gestational diabetes, or essential hypertension
C) renal disease, maternal age over 35, or congenital malformations
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D) congenital malformations, infections, or placental insufficiency

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15. An infant has a grade 3 intraventricular hemorrhage (IVH). The nurse monitors the
infant for which complication?
A) hydrocephalus
B) encephalitis abirb.com/test
C) meningitis
D) intraparenchymal hemorrhage
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16. A neonate receiving oxygen at concentrations greater than 70% is at risk for developing
which complication? Select all that apply.
A) retinopathy of prematurity abirb.com/test

B) pulmonary edema
C) intraventricular hemorrhage
D) pulmonary hypoplasia abirb.com/test
E) cerebral palsy

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17. Which nursing interventions promote healthy development of the preterm neonate?
Select all that apply.
A) nesting
B) nonnutritive sucking abirb.com/test
C) quiet hours
D) covering the incubator
E) supine sleep position
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18. At birth, an infant is below average in weight, length, and head circumference and has a
high hematocrit level. Which problem would the nurse assess for in this infant? Select
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all that apply.
A) low glucose level
B) high bilirubin level
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C) prolonged acrocyanosis
D) cold stress
E) caput succedaneum
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19. The administration of caffeine has become common in NICU infants with apnea of
prematurity. The NICU nurse explains the advantages of this medication to the parents
and knows the parents understood when they make which statements? Select all that
apply. abirb.com/test
A) Caffeine stimulates the breathing center of the preterm infant's brain.
B) Caffeine has a superior safety profile with fewer side effects than theophylline.
C) Caffeine improves the rate of recovery when used inabirb.com/test
conjunction with CPAP
therapy.
D) The neonate can be discharged home while taking caffeine, as it can be given
orally.
E) Caffeine can be given to neonates as either caffeineabirb.com/test
citrate or caffeine sodium
benzoate.

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20. The NICU nurse is caring for a preterm neonate with respiratory distress syndrome on
mechanical ventilation. Which assessment data would alert the nurse that a
pneumothorax might have developed? Select all that apply.
A) Neonate's blood pressure is 80/50. abirb.com/test

B) The neonate's respiratory rate is 68.

C) Oxygen saturation is 92% and heart rate is 130.
D) Neonate is exhibiting nasal flaring and grunting. abirb.com/test
E) Chest radiography reveals low lung volume and a ground glass appearance .
F) The neonate's chest is asymmetrical. with decreased breath sounds on one side.
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Answer Key
1. A
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2. D
3. A
4. A, B
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6. C
7. A, B, C
8. A, B, E
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9. C, D, E
10. B
11. A, B, D, F, G
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13. D
14. D
15. A
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16. A, B
17. A, B, C, D
18. A, B, C, D
19. A, B, C, D abirb.com/test
20. B, D, F

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