Pediatric Nursing Education Practice Test (NLE/PRC 5-10)

Pediatric Nursing Education Practice Test

5. When caring for preterm infants, the precautions that should be taken against retinopathy of prematurity (retrolental fibroplasias) include:

a. Carefully controlling temperature and humidity.
b. Using phototherapy to prevent jaundice and retinopathy.
c. Keeping oxygen at reduced concentrations and discontinuing it as soon as feasible.
d. Maintaining a high concentration of oxygen (above 75%) together with high humidity.

6. As part of Pediatric Nursing Education of a nursing student, he was asked to identify which of the following neonates is at greatest risk for developing respiratory distress syndrome:

a. A neonate with history of intrauterine growth retardation.
b. A neonate born at less than 35 weeks’ gestation.
c. A neonate whose mother experienced prolonged rupture of membranes.
d. A neonate born at 38 weeks’ gestation.

7. The client is admitted to the hospital in preterm labor. To halt her uterine contractions, the nurse expects to administer.

a. Magnesium sulfate
b. Dinoprosterone
c. Ergonovine maleate
d. Tertbutaline

8. A nurse is aware that Isolettes are used for preterm infants to maintain body temperature at a constant level, because the heat-regulation mechanism of preterm babies is one of the least developed functions. This is related to the fact given by books about Pediatric Nursing Education that these babies:

a. Have a smaller surface area than full-term newborns.
b. Perspire a great deal, thus losing heat almost constantly.
c. Lack subcutaneous fat, which furnish some insulation.
d. Have a limited ability to produce antibodies against infections.

9. When assessing a newly delivered neonate, the nurse notes the following findings; arms and legs slightly flexed; abundant lanugo on the back; skin smooth and transparent; slow recoil of pinna; and few sole creases. In the light of these findings, the care plan for this neonate should include nursing orders to monitor for:

a. Polycythemia
b. Hyperglycemia
c. Postmaturity syndrome
d. Respiratory distress syndrome

10. While caring for a 30 weeks’ gestation infant, the nurse explains to the mother the need for gavage feeding at this time instead of the mother’s plan for bottle feeding. Which of the following would the nurse include as the rationale for this:

a. The neonate has difficulty coordinating sucking, swallowing, and breathing.
b. A high-caloric formula presently needed at this time is more easily delivered via gavage.
c. Gavage feeding can minimize the neonate’s increased risk for development of hypoglycemia.
d. This type of feeding easily given in the Isolette, decrease the neonate’s increased risk for cold stress.



Pediatric Nursing Education
ANSWERS AND RATIONALE

5) C
- Prolonged oxygen administration at relatively high concentrations in a premature infant whose retina is incompletely differentiated and/or vascularized may result in retinopathy of prematurity (retrolental fibroplasias); when oxygen therapy is discontinued, capillary overgrowth in the retina and vitreous body may result and include capillary hemorrhage, fibrosis, and retinal detachment
A- Though true, temperature and humidity not factors in the development of retinopathy of prematurity.
B- Phototherapy is used to decrease hyperbilirubinemia; it is unrelated to retrolental fibroplasias; however eyes are covered to prevent injury for all infants receiving phototherapy.
D- High oxygen concentration is dangerous and a factor in the development of retinopathy of prematurity.

6) B
- Respiratory distress syndrome is predominately seen in premature infants; the more premature the infant, the more severe the disease - according to Pediatric Nursing Education Books.
A & C- Intrauterine growth retardation and prolonged rupture of membrane are unlikely associated with development of respiratory distress syndrome.
D - A 38- week gestation neonate usually has more mature lungs and isn’t at risk for respiratory distress syndrome.

7) D
- Tertbutaline, a beta2- receptor agonist, is used to inhibit preterm uterine contractions.
A- Magnesium sulfate is used to treat pregnancy-induced hypertension.
B- Dinoprosterone is used to induce fetal expulsion and promotes cervical dilatation and softening.
C- It is used to stop uterine blood flow, for example, in hemorrhage.

8) C
- Pediatric Nursing Education teaches that much of a full-term infant’s birth weight is gained during the last month of pregnancy (almost a third), and most of this final spurt is subcutaneous fat, which serves as insulation; the preterm infant has not has the time to grow in the uterus and has little of this insulating layer.
A- There is relatively larger surface area per body weight.
B- There is an extremely limited shivering and sweating response in the preterm infant.
D- This is unrelated to the maintenance of body temperature.

9) D
- The assessment findings are indicative of a preterm infant; therefore the nurse should closely monitor the infant for signs of respiratory distress syndrome; this occurs commonly in preterm infants because their lungs are immature.
A- Preterm AGA infants do not develop polycythemia; preterm LGA infants may develop polycythemia, but there are no data to indicate the infant is LGA.
B- Preterm AGA infants may become hypoglycemic.
C- The neonate is preterm, not post-term.

10) A
- Before 32 weeks’ gestation, the majority of neonates have difficulty coordinating sucking and swallowing reflexes along with breathing. Increased respiratory distress may occur with bottle feeding. Bottle feeding can be given once the neonate shows sucking and swallowing behaviors.
B- high-caloric formulas can be given by bottle or by gavage feeding.
C- Although frequent feeding prevents hypoglycemia, it does not have to be given via gavage tube.
D- Although neonates can be stressed by cold, they can be kept warm with blankets while bottle feeding or fed while in the warm Isolette environment.


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