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PRACTICE TEST 2: High Risk Newborn

1. The nurse conducts a physical 9. To check the sucking reflex in the
assessment of the neonate as the initial bath newborn, the nurse would implement which
is given several hours after birth. In of the following actions?
assessing the baby’s skin, which of the A. Lightly touch either corner of the baby’s
following observations most likely require mouth
special attention? B. Stroke the lateral aspect of the sole
A. Cyanosis of the hands and feet upward across the ball of the foot
B. Vernix caseosa C. Rotate the head to one side and then the
C. Harlequin sign other
D. Jaundice D. Exert pressure on the palm at the base of
the digits
2. In comparing the newborn’s head and
chest measurements, which of the following 10. To elicit Moro’s reflex, the nurse would
observations would the nurse expect to find? implement which of the following actions?
A. The chest circumference is approximately A. Shake the infant rapidly from head to toe
1 inch smaller than the head circumference B. Hold the infant in both hands and lower
B. The chest circumference is approximately both hands rapidly about an inch
1 inch larger than the head circumference C. Place the infant in the prone position and
C. The head and chest circumference are observe posture
equal D. Turn the infant’s head to one side while
D. The chest circumference is approximately he or she is in a supine position
3 inches smaller than the head
circumference 11. When examining the inside of a
newborn’s mouth, the nurse notices a small,
3. The nurse assesses a 1-hour-old raised white bump on the palate; it does not
newborn’s eyes. Which condition, if found, come off nor does it bleed when touched.
would most likely require additional Which of the following is the most likely
assessment? diagnosis?
A. Transient strabismus A. Milia C. Thrush
B. Subconjunctival hemorrhage B. Epstein’s pearls D. Milk curd
C. Lack of tears when crying
D. Opacity of a pupil 12. Neonates often “spit up” small
quantities following feedings. Which of the
4. The nurse assessing a neonate’s trunk following conditions offers the best
shortly after birth makes the following explanation for this behavior?
observations. Which one would alert the A. Immature cardiac sphincter
nurse to the need for further assessment? B. Overfeeding
A. Breast engorgement C. Activity of the infant during feeding
B. Audible bowel sounds D. Inadequate concentration of enzymes
C. Palpable liver and kidneys
D. Umbilical cord with one artery and one 13. In examining the newborn’s head during
vein the initial physical assessment, the nurse
palpates the posterior fontanel. The nurse
5. Which of the following assessments knows that this fontanel is formed by which
would the nurse report to the physician of the following bones?
concerning a 1-hour old infant’s ears? A. Frontal and parietal C. Temporal
A. The upper parts of the ears are on a plane and frontal
with the angle of the eyes. B. Parietal and occipital D. Frontal and
B. The upper parts of the ears are well occipital
below a line extending through the inner and
outer canthi of the eyes 14. While assessing a 2-hour-old neonate,
C. There is incurving of the pinna and the nurse observes the neonate to have
instant recoil acrocyanosis. Which of the following actions
D. The infant responds to sound with a should be performed initially?
startle or blink A. Activate the code blue or emergency
6. The parents of a newborn ask the nurse B. Do nothing because acrocyanosis is
how much their new baby can see. The normal in the neonate
nurse’s response is based on the knowledge C. Immediately take the neonate’s
that the newborn’s visual capacity shortly temperature
after birth is primarily D. Notify the physician of the need for a
A. Long-distance vision C. Convergence cardiac consult
of the eyes
B. Short-distance fixation D. Coordinated 15. When performing a neurologic
peripheral vision assessment, which sign is considered a
normal finding in a neonate?
7. To check the grasp reflex in the A. Doll eyes C. Positive
newborn, the nurse would implement which Babinski’s sign
of the following actions? B. “Sunset” eyes D. Pupils that
A. Lightly touch either corner of the baby’s don’t react to light
B. Stroke the lateral aspect of the sole 16. A mother of a term neonate asks what
upward across the ball of the foot the thick, white, cheesy coating is on his
C. Rotate the head to one side and then the skin. Which correctly describes this finding?
other A. Lanugo C. Nevus
D. Exert pressure on the palm at the base of flammeus
the digits B. Milia D. Vernix

8. To check the Babinski reflex in the 17. Which of the following fetal circulatory
newborn, the nurse would implement which structures close and become nonfunctioning
of the following actions? after birth?
A. Lightly touch either corner of the baby’s A. Ductus arteriosus, umbilical arteries,
mouth pulmonary artery, and hypogastric arteries
B. Stroke the lateral aspect of the sole B. Ductus venosus, foramen ovale, portal
upward across the ball of the foot vein, and ductus arteriosus
C. Rotate the head to one side and then the C. Foramen ovale, pulmonary artery, ductus
other venosus, and umbilical vein
D. Exert pressure on the palm at the base of D. Umbilical vein, foramen ovale, ductus
the digits venosus, and ductus arteriosus

18. A neonate has been diagnosed with 27. The nurse is assigned to care for a
caput succedaneum. Which statement is newly delivered primiparous client and her
correct about caput succedaneum? term neonate 1 hour after a vaginal delivery.
A. It usually resolves in 3-6 weeks The nurse observes that the neonate’s Apgar
B. It doesn’t cross the cranial suture line score at 5 minutes was 9. The nurse
C. It is a collection of blood between the interprets this as indicating which of the
skull and the periosteum following about the neonate?
D. It involves swelling of the tissue over the A. Vigorous resuscitation was needed
presenting part of the fetal head B. The neonate was cyanotic at birth
C. Oxygen administration was necessary at
19. The nurse is teaching a postpartum birth
client about the normal stooling pattern of a D. The neonate is in stable condition
neonate. Which color and consistency best
describes the typical appearance of 28. One minute after birth, a neonate has a
meconium? heart rate of 60 beats/minute. Five minutes
A. Soft, pale yellow C. Sticky after birth, his heart rate is 80 beats/minute.
green, black Which Apgar heart rate score should he
B. Hard, pale brown D. Loose, receive?
golden yellow A. 0 C. 2
B. 1 D. 3
20. A nurse is assessing a neonate. Which
of the following findings is considered General Care
common in the healthy neonate? 29. Terramycin or erythromycin ointment is
A. Simian crease administered to the neonate’s eyes shortly
B. Conjunctival hemorrhages after birth to prevent which disorder?
C. Cystic hygroma A. Cataract C.
D. Bulging fontanelle Ophthalmia neonatorum
B. Diabetic retinopathy D.
21. When assessing a neonate’s skin, the Strabismus
nurse observes small, white papules
surrounded by erythematous dermatitis. 30. The neonate is vulnerable to heat loss
This finding is characteristic of which because of which anatomic characteristic?
condition? A. Immature liver
A. Cutis marmorata C. Erythema B. Immature brain
toxicum C. Large skin surface area to body weight
B. Epstein’s pearls D. Mongolian ratio
spots D. More brown fat (adipose tissue) than an
22. A postpartum client asks the nurse,
“Why does my baby have those red areas on 31. During the transition period, a neonate
his eyelids?” Which response is appropriate? can lose heat in many different ways. A
A. “They’re called milia. They’re clogged oil neonate who isn’t completely dried
glands, which are normal in a neonate.” immediately after birth or a bath loses heat
B. “They’re called telangiectasia or stork through which of the following methods?
bites. They usually disappear within 1 year.” A. Conduction C.
C. “ We’ll watch them closely. They could Evaporation
indicate a bleeding disorder.” B. Convection D. Radiation
D. “ They’re nothing to worry about. The
physician will order topical cream to help 32. Maintaining thermoregulation in the
them go away.” neonate is an important nursing intervention
because cold stress in the neonate can lead
23. When performing an assessment on a to which condition?
neonate, which assessment finding is most A. Anemia
suggestive of hypothermia? B. Hyperlgycemia
A. Bradycardia C. Metabolic C. Metabolic alkalosis
alkalosis D. Increased oxygen consumption
B. Hyperglycemia D. Shivering
33. When teaching umbilical cord care to a
24. An initial assessment of a female new mother, the nurse would include which
neonate shows pink-streaked vaginal information?
discharge. Which factor is the probable A. Apply peroxide to the cord with each
cause? diaper change
A. Cystitis B. Cover the cord with petroleum jelly after
B. Birth trauma bathing
C. Neonatal candidiasis C. Keep the cord dry and open to air
D. Withdrawal of maternal hormones D. Wash the cord with soap and water each
day during a tub bath
25. While performing an initial assessment
on a term neonate with an Asian mother, a 34. When assessing a male neonate, the
bluish marking is observed across the nurse notices that the urinary meatus is
neonate’s lower back. What is the located on the ventral surface of the penis.
significance of this finding? How should the nurse document this finding?
A. It’s probably a sigh of birth trauma A. As the normal location for the urinary
B. It’s probably a telangiectatic hemangioma meatus
C. It’s probably a typical marking in dark- B. As epispadias
skinned races C. As hypospadias
D. It probably indicates that D. As cryptorchidism
hyperbilirubinemia may follow
35. A home health nurse assesses a
26. The mother of a newborn asks the neonate who is 48 hours old and was
nurse why the neonate’s head is cone- discharged from the hospital 24 hours ago.
shaped. Which response is accurate? Which assessment finding indicates a
A. “It results from caput succedaneum. The potential problem?
difficult labor caused bruising and swelling of A. The neonate cries but no tears appear
the neonate’s head.” B. Small papules appear all over the
B. “It results from molding. Overriding of neonate’s skin
the cranial sutures allows the neonate’s head C. The neonate doesn’t turn his head in the
to pass through the birth canal.” direction that his cheek is stroked
C. “It results from cephalhematoma. Some D. The neonate produces a greenish, tarry
blood has collected between the skull bone stool
and periosteum.”
D. “It results from hydrocephalus. Either too
much cerebrospinal fluid is being formed or
too little is being absorbed.”
36. A nurse is performing an admission 45. A woman delivers a 3,250g neonate at
assessment on a small for gestational age 42 weeks’ gestation. Which physical finding
term infant. The nurse observes tachypnea, is expected during an examination of this
grunting, retractions, and nasal flaring. The neonate?
nurse interprets that these symptoms are A. Noticeable veins
likely the result of: B. Absence of sole creases
A. Hypoglycemia C. Breast bud of 1-2 mm in diameter
B. Meconium aspiration syndrome D. Leathery, cracked and wrinkled skin
C. Respiratory distress syndrome
D. Transient tachypnea of the newborn 46. A 34-week-gestation neonate in an
Isolette experiences sudden apnea. The
37. The small-for-gestation neonate is at nurse would first
increased risk during the transitional period A. Administer oxygen with positive pressure
for which complication? B. Call the pediatrician
A. Anemia probably due to chronic fetal C. Increase the humidity in the incubator
hypoxia D. Gently stimulate the infant
B. Hyperthermia due to decreased glycogen
stores 47. Which action best explains the main
C. Hyperglycemia due to decreased role of surfactant in the neonate?
glycogen stores A. Assists with ciliary body maturation in the
D. Polycythemia probably due to chronic upper airways
fetal hypoxia B. Helps maintain a rhythmic breathing
LGA C. Promotes clearing mucus from the
38. A nurse is teaching a mother with respiratory tract
diabetes mellitus who delivered a large for D. Helps the lung remain expanded after the
gestational age male infant about the care of initiation of breathing
the infant. Which statement, if made by the
mother, indicates further teaching is 48. The physician orders betamethasone
necessary? (Celestone) for a 34-year old multigravid
A. “I will talk to my baby when he is in a client at 32 weeks’ gestation who is
quiet alert state.” experiencing preterm labor. The nurse
B. “I will watch my baby closely, because I explains that this drug is given for which of
know he may not be as mature in motor the following reasons?
development.” A. Enhance fetal lung maturity
C. “I will breastfeed my baby every 2 1/2 to B. To counter the effects of tocolytic therapy
3 hours, and will implement arousing C. To treat chorioamnionitis
techniques.” D. To decrease neonatal production of
D. “I will allow my baby to sleep throughout surfactant
the night, because he needs his rest.”
39. Which of the following characteristics is 49. Which symptom would indicate the
most commonly associated with a large for neonate was adapting appropriately to
gestational age newborn? extrauterine life without difficulty?
A. Weight under 4000g C. Risk for birth A. Nasal flaring
injury B. Light audible grunting
B. Dysmorphic features D. Hypothermia C. Respiratory rate 40-60 breaths/minute
D. Respiratory rate 60-80 breaths/minute
40. Neonates of mothers with diabetes are 50. Which condition or treatment best
at risk for which complication following birth? ensures lung maturity in a neonate?
A. Atelectasis C. A. Meconium in the amniotic fluid
Microcephaly B. Glucocorticoid treatment just before
B. Pneumothorax D. Macrosomia delivery
C. Lecithin to sphingomyelin ration more
41. Which of the following infants would be than 2:1
at lowest risk for hypoglycemia? D. Absence of phosphatidylglycerol in
A. A 2-hour old, full-term neonate whose amniotic fluid
mother’s blood glucose level was 350mg/dl
during labor 51. After reviewing the client’s maternal
B. A large for gestational age neonate 10 history of magnesium sulfate during labor,
hours after birth whose hemogluco test which condition would the nurse anticipate
shows a reading of 60mg/dl as a potential problem in the neonate?
C. A 32-week-gestation neonate 5 hours A. Hypoglycemia C.
after birth Respiratory depression
D. A small-for-gestational age neonate, 12 B. Jitteriness D.
hours after birth, who is NPO because of Tachycardia
respiratory distress
52. Which circumstance of delivery would
42. Which of the following orders would be predispose a neonate to respiratory distress
included when planning care for an infant of syndrome?
a diabetic mother? A. Premature birth C. First born
A. Provide extra stimulation of twins
B. Use oil on the body after bathing B. Vaginal delivery D. Post date
C. Give early feeding of glucose and water pregnancy
D. Start early infusion of insulin
53. Which assessment finding would be the
43. When caring for an infant of a mother most unlikely risk factor for respiratory
with diabetes, which physiological finding is distress syndrome?
most indicative of a hypoglycemic episode? A. Second born of twins
A. Hyperalert state B. Neonate of a diabetic mother
B. Jitteriness C. Neonate born at 34 weeks
C. Positive Babinski reflex D. Chronic maternal hypertension
D. Serum glucose level of 60mg/dl
54. A nurse is monitoring a newborn infant
PRETERM/POSTERM for signs of respiratory distress syndrome.
44. A nurse is performing an assessment on The nurse monitors the infant for
a postmature neonate. Which physical A. Cyanosis, tachypnea, retractions,
characteristic would the nurse expect to grunting respirations, and nasal flaring
observe? B. Acrocyanosis, apnea, pneumothorax, and
A. Vernix that covers the body in a thick grunting
layer C. Barrel-shaped chest, hypotension, and
B. Desquamation over the body bradycardia
C. Smooth soles without creases D. Acrocyanosis, emphysema, and
D. Lanugo covering the entire body interstitial edema

55. A nurse is assessing a 3-day-old 64. A nurse is caring for a term newborn.
neonate with a diagnosis of respiratory Which assessment finding would alert the
distress syndrome. Which assessment nurse to suspect the occurrence of jaundice
finding indicates that the neonate’s in this newborn?
respiratory status is improving? A. A negative result to a direct Coomb’s test
A. Presence of systolic murmur B. Birth weight of 8lb 6oz
B. Respiratory rate between 60 and 70 C. Presence of a cephalhematoma
breaths/min D. Infant blood type of O negative
C. Edema of the hands and feet
D. Urine output of 1-3ml/kg/hr 65. A client with group AB blood whose
husband has group O blood has just given
56. Which complication is common in birth. The major sign of ABO blood
neonates who receive prolonged mechanical incompatibility in the neonate is which
ventilation at birth? complication or test result?
A. Bronchopulmonary dysplasia A. Negative Coomb’s test
B. Esophageal atresia B. Bleeding from nose or ear
C. Hydrocephalus C. Jaundice after the first 24 hours of life
D. Renal failure D. Jaundice within the first 24 hours of life

MAS 66. Which clinical finding is most suggestive

57. When a neonate is delivered with of physiologic hyperbilirubinemia in a
meconium staining in the amniotic fluid, neonate?
which sequence of events will most A. Clinical jaundice before 36 hours of age
effectively decrease the risk of meconium B. Clinical jaundice lasting beyond 14 days
aspiration? C. Bilirubin levels of 12 mg/dl by 3 days of
A. Deliver the thorax, then suction the life
mouth D. Serum bilirubin level increasing by more
B. Clamp the umbilical cord, then suction than 5mg/dl/day
the neonate’s mouth
C. Deliver the head and then suction the 67. On the second day of life, a neonate
mouth and then the nose develops hyperbilirubinemia and is placed
D. Deliver the thorax, then suction the nose under phototherapy. Which of the following
then the mouth would be included in the nurse’s care plan
for this infant?
58. Which of the following positions is A. Keep the infant swaddled in a blanket
recommended for placing an infant to sleep? B. Record the type and amount of stools
A. Prone position C. Maintain continuous eye patches
B. Supine position D. Limit fluid intake
C. Side-lying position
D. With head of bed elevated 30 degrees 68. A 3-day-old neonate needs
phototherapy for hyperbilirubinemia.
59. Which of the following definitions best Nursery care of a neonate receiving
describes the etiology of sudden infant death phototherapy would include which nursing
syndrome? intervention?
A. Cardiac arrhythmias A. Tube feedings
B. Apnea of prematurity B. Feeding the neonate under phototherapy
C. Unexplained death of an infant lights
D. Apparent life-threatening event C. Mask over the eyes to prevent retinal
60. Which of the following children has an D Temperature monitored every 6 hours
increased risk of sudden infant death during phototherapy
A. Premature infant with low birth weight 69. On the first postpartum day, a neonate
B. A healthy 1 year old diagnosed with an ABO incompatibility has a
C. Infant hospitalized for fever bilirubin level of 10 mg/dl. After teaching the
D. First born child parents about this condition, which of the
following statements by the parents about
61. Sudden infant death syndrome is the neonate indicates the need for additional
confirmed by which of the following teaching?
procedures? A. “Phototherapy causes the baby’s stools to
A. Autopsy C. Skeletal be bright green.”
survey B. “Breastfeeding may need to be stopped
B. Chest X-ray D. Laboratory temporarily.”
analysis C. “The baby will need an exchange
transfusion with type A blood.”
62. Which of the following reactions are D. “The baby may become anemic over the
usually exhibited by the family of an infant next 2 weeks.”
who has died from sudden infant death
syndrome? 70. A postpartum mother who is Rh
A. Feelings of blame or guilt negative is to receive RhoGAM after the
B. Acceptance of the diagnosis delivery of an Rh positive baby. Before
C. Requests for the infant’s belongings receiving the medication, she asks the nurse
D. Questions regarding the etiology of the how the drug works. Which fo the following
diagnosis best describes how RhoGAM acts in the
expectant mother’s body?
Hyperbilirubinemia/Isoimmunization A. RhoGAM attaches to maternal anti-Rh
63. Which statement is the best explanation antibodies and directly destroys them
for physiologic hyperbilirubinemia? B. RhoGAM suppresses the production of
A. The neonate usually also has a medical maternal antibodies
problem C. RhoGAM destroys fetal Rh positive red
B. In term neonates, it usually appears after blood cells in the maternal circulation before
24 hours sensitization occurs
C. It is caused by elevated conjugated D. RhoGAM prevents fetal-maternal bleeding
bilirubin levels episodes from occurring at the former
D. It is usually progressive from the placenta site
neonate’s feet to his head

71. Rh isoimmunization in a pregnant client 81. A nurse is teaching parents about

develops during which of the following tricuspid atresia. Which of the following
conditions? statements indicates the parents
A. Rh-positive maternal blood crosses into understand?
fetal blood, stimulating fetal antibodies A. “There’s a narrowing at the aortic outflow
B. Rh-positive fetal blood crosses into tract.”
maternal blood, stimulating maternal B. “The pulmonary veins don’t return to the
antibodies left atrium.”
C. Rh-negative fetal blood crosses into C. “There’s a narrowing at the entrance of
maternal blood, stimulating maternal the pulmonary artery.”
antibodies D. “There’s no communication between the
D. Rh-negative maternal blood crosses into right atrium and right ventricle.”
fetal blood, stimulating fetal antibodies
82. Which of the fallowing statements best
Hemolytic Disease of the Newborn describes transposition of the great arteries?
72. A postpartum client asks why her A. The body receives only saturated blood
newborn is getting an injection of vitamin K. B. It is classified as an acyanotic defect with
Which statement best explains why this drug increased pulmonary blood flow
is given to neonates? C. The pulmonary artery leaves the left
A. Vitamin K assists with coagulation ventricle, and the aorta exits from the right
B. Vitamin K assists with the gut to mature ventricle
C. Vitamin K initiates the immunization D. It is a condition in which the right atrium
process and the left atrium empty into one
D. Vitamin K protects the brain from excess ventricular chamber
fluid production
83. Which of the following cardiovascular
Cardiovascular disorders is considered acyanotic?
73. Which is the most common cause of A. Patent ductus arteriosus C.
heart failure in children? Tricuspid atresia
A. Myocarditis C. Severe B. Tetralogy of Fallot D. Truncus
hypoxia arteriosus
B. Complete heart block D. Congenital
heart disease NEC
84. A nurse assessing a client with
74. Which of the following factors indicating necrotizing enterocolitis would expect which
a cardiac defect might be found when of the following findings?
assessing a 1-month-old infant? A. Abdominal distention and gastric
A. Weight gain C. Poor retention
nutritional intake B. Gastric retention and Guaiac-negative
B. Hyperactivity D. Pink stools
mucous membranes C. Metabolic alkalosis and abdominal
75. Which of the following signs may be D. Guaiac-negative stools and metabolic
seen in a child with ventricular septal defect? alkalosis
A. Cyanosis of the nailbeds Maternal Infection
B. Above average height on a growth chart 85. The most common neonatal sepsis and
C. Above average weight gain on growth meningitis infections seen within 24 hours
chart after birth are caused by which organism?
D. Pink nailbeds with capillary refill less than A. Candida albicans
2 seconds B. Chlamydia trachomatis
C. Escherichia coli
76. Which of the following conditions best D. Group B beta-hemolytic streptococcus
describes ventricular septal defect?
A. Narrowing of the aortic arch 86. A pregnant woman, 36 weeks’
B. Failure of a septum to develop completely gestation, learns that she is HIV positive.
between the atria She asks the clinic nurse how this will affect
C. Narrowing of the valves at the entrance her unborn baby. The nurse responds
of the pulmonary artery A. “A cesarean delivery will prevent your
D. Failure of a septum to develop completely baby from being infected.”
between the ventricles B. “There is about 50% chance that your
baby will be infected.”
77. Which of the following conditions best C. “Because your pregnancy is past the first
describes coarctation of the aorta? trimester, the baby will not be infected.”
A. Absent tricuspid valve D. “If you are symptom-free, your baby will
B. Narrowing in the area of the aortic valve not be infected.”
C. Localized constriction or narrowing of the
aortic wall 87. A nurse is developing a teaching plan
D. Narrowing at some location along the for the mother of a newborn infant who is
right ventricular outflow tract human immunodeficiency virus-positive.
Which specific instruction should be included
78. Which of the following assessments is in the teaching plan?
expected when assessing a child with A. Instruct the mother to provide meticulous
tetralogy of Fallot? skin care of the newborn infant and to
A. Machine-like murmur change the infant’s diaper after each voiding
B. Normal blood pressure or stool
C. Increasing cyanosis with crying or activity B. Instruct the mother to feed the newborn
D. Higher pressures in the upper extremities infant in an upright position with the head
than with the lower extremities and chest tilted slightly back to avoid
79. A child with tetralogy of Fallot has C. Instruct the mother to feed the newborn
clubbing of fingers and toes, a finding related infant with a special nipple and bubble the
to which of the following conditions? infant frequently to decrease the tendency to
A. Polycythemia C. Pansystolic swallow air
murmur D. Instruct the mother to check the anterior
B. Chronic hypoxia D. Abnormal growth fontanel for bulging and sutures for widening
and development each day

80. A child with tetralogy of Fallot may 88. Which of the following best indicates
assume which position of comfort during that a neonate may have an infection?
exercise? A. Respiratory rate of 65 at rest
A. Prone C. Semi- B. Weight increase of 1 lb on 2 successive
Fowler days
B. Side-lying D. Squat C. Axillary temperature of 37 degrees C
D. Hemoglobin of 20 g/dl of blood
Drug Addiction/FAS
89. With heroin addiction in the newborn, 93. A 36-week neonate born weighing
signs of withdrawal are most likely to 1,800g has microcephaly and
A. Appear within the first 4 hours after birth microophthalmia. Based on these findings,
B. Occur 1-2 days after delivery which risk factor might be expected in the
C. Be delayed up to 5 days postnatally maternal history?
D. Be eliminated or greatly reduced if the A. Use of alcohol C. Gestational
newborn receives a narcotic antagonist such diabetes
as naloxone immediately after delivery B. Use of marijuana D. Positive
group B streptococci
90. Which intervention is helpful for the
neonate experiencing drug withdrawal? 94. Which neonatal behavior is most
A. Place the isolette in a quiet area of the commonly associated with fetal alcohol
nursery syndrome?
B. Withhold all medication to improve the A. Hypoactivity C. Poor wake
liver’s metabolization of drugs and sleep patterns
C. Dress the neonate in loose clothing so he B. High birth weight D. High
won’t feel restricted threshold of stimulation
D. Place the isolette near the nurse’s station
for frequent contact with health care workers

91. When attempting to interact with a

neonate experiencing drug withdrawal,
which behavior would indicate that the
neonate is willing to interact?
A. Gaze aversion C. Quiet alert
B. Hiccups D. Yawning

92. A nurse explains to a mother that her

newborn is being admitted to the neonatal
intensive care unit with a probable diagnosis
of fetal alcohol syndrome. The nurse
explains the expected effects of FAS to the
mother. The nurse evaluates the
effectiveness of the explanation when the
mother states:
A. “Withdrawal symptoms will occur after 3
B. “Mental retardation is unlikely to
C. “Withdrawal symptoms are tremors,
crying, seizures, and reflexes that aren’t
D. “The reason the child is so large is
because of the fetal alcohol syndrome