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Neonatal Examination Test: Key Concepts and Answers, Exams of Nursing

A comprehensive overview of key concepts and answers related to neonatal examination. It covers a wide range of topics, including fetal fibronectin, placental α-microglobulin-1, fetal heart rate variability, biophysical profile, late and variable decelerations, maternal serum α-fetoprotein, target preductal saturations, arterial cord blood gas, and various genetic syndromes. The document also includes information on neonatal complications, such as respiratory distress syndrome, tetralogy of fallot, and congenital hypothyroidism, along with their respective treatments and management strategies. This resource is valuable for students and professionals in the field of neonatal care, offering a concise and informative guide to essential concepts and clinical practices.

Typology: Exams

2024/2025

Available from 11/22/2024

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CCRN neonatal examination test with verified questions
and answers
Fetal fibronectin - Correct Answer biochemical marker useful for predicting preterm birth
within 2 weeks
placental α-microglobulin-1 (PAMG-1) protein - Correct Answer presence indicates
rupture of membranes
Fetal heart rate variability - Correct Answer best indicator of fetal oxygenation status
(absence of metabolic acidemia)
Biophysical profile - Correct Answer -fetal tone
-fetal breathing
-fetal movement
-nonstress test
-amniotic fluid volume
Late decelerations - Correct Answer transient response to hypoxemia during contractions
Variable decelerations - Correct Answer cord compression
-tx: amnioinfusion, intrauterine pressure catheter
Maternal serum α-fetoprotein - Correct Answer -Elevated: neural tube defect, abdominal
wall defect, EA/duodenal atresia
-Decreased: Down syndrome
Target preductal sat after birth - Correct Answer -1 minute 60-65%
-2 minutes 65-70%
-3 minutes 70-75%
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CCRN neonatal examination test with verified questions

and answers

Fetal fibronectin - Correct Answer biochemical marker useful for predicting preterm birth within 2 weeks placental α-microglobulin- 1 (PAMG-1) protein - Correct Answer presence indicates rupture of membranes Fetal heart rate variability - Correct Answer best indicator of fetal oxygenation status (absence of metabolic acidemia) Biophysical profile - Correct Answer - fetal tone

  • fetal breathing
  • fetal movement
  • nonstress test
  • amniotic fluid volume Late decelerations - Correct Answer transient response to hypoxemia during contractions Variable decelerations - Correct Answer cord compression
  • tx: amnioinfusion, intrauterine pressure catheter Maternal serum α-fetoprotein - Correct Answer - Elevated: neural tube defect, abdominal wall defect, EA/duodenal atresia
  • Decreased: Down syndrome Target preductal sat after birth - Correct Answer - 1 minute 60 - 65%
  • 2 minutes 65 - 70%
  • 3 minutes 70 - 75%
  • 4 minutes 75 - 80%
  • 5 minutes 80 - 85%
  • 10 minutes 85 - 90% Arterial cord blood gas - Correct Answer reveals the metabolic status of the fetus before delivery and strongly correlates with perinatal asphyxia Turner syndrome - Correct Answer - SGA with a broad chest
  • widely spaced nipples
  • edema of the extremities
  • short webbed neck Trisomy 13 - Correct Answer - cutis aplasia
  • overlapping digits
  • low-set ears, cleft palate
  • microcephaly
  • microphthalmia
  • polydactyly
  • rocker bottom feet
  • numerous organ abnormalities (including cardiac) Trisomy 18 - Correct Answer - low birth weight
  • ears that are low set and/or of abnormal shape
  • micrognathia
  • microstomia
  • rocker-bottom feet
  • clenched hand with flexed fingers
  • flexion contraction of the middle two fingers Trisomy 21 - Correct Answer - brachycephaly with flattened occiput
  • low-set and malformed ears
  • generalized hypotonia

Neonatal lupus erythematous - Correct Answer - congenital heart block (ECHO at birth)

  • cutaneous lupus rash
  • pancytopenia Congenital hypothyroidism - Correct Answer - large fontanel
  • umbilical hernia
  • coarse facial features
  • thick skin
  • delayed bone age
  • poor perfusion
  • hypothermia
  • poor feeding Essential fatty acid deficiency - Correct Answer - poor weight gain
  • scaling rash
  • sparse hair growth
  • thrombocytopenia
  • decreased platelet aggregation Iodine deficiency - Correct Answer - hypothyroidism
  • thyroid enlargement
  • cretinism
  • poor growth Copper deficiency - Correct Answer - poor growth
  • osteopenia
  • neutropenia
  • ironresistant anemia
  • pallor
  • edema
  • hypotonia
  • seborrheic dermatitis

Zinc deficiency - Correct Answer - stunted growth

  • erythematous skin rash
  • increased risk for infections Calcium:phosphorus ratio - Correct Answer 2: Recommended noise levels - Correct Answer 45 db Pupillary reflex - Correct Answer Not developed fully until 35 weeks First sensory system to develop - Correct Answer Tactile Centralized bowel gas pattern on x-ray - Correct Answer Ascites (possibly from hydrops) Double bubble pattern on abdominal x-ray - Correct Answer Duodenal atresia
  • air in the stomach presents as the first bubble and the dilated duodenum filled with air is the second bubble Proper placement of ETT - Correct Answer midway between the thoracic inlet and the carina UAC placement - Correct Answer T6- 9 Digoxin - Correct Answer - inhibits sodium-potassium-adenosine triphosphatase; this results in calcium influx into the myocardial cells, which enhances contractility (inotropy)
  • higher risk for toxicity with hypokalemia RDS in IDM babies - Correct Answer Delayed lung maturation (surfactant production) = higher rates of RDS TET - Correct Answer Severity of symptoms dependent on RV outflow obstruction Indomethacin - Correct Answer Closely monitor UOP - can decrease renal blood flow BP cuff selection - Correct Answer 25% greater than the width of the extremity

Tetralogy of fallot - Correct Answer 1. VSD

  1. Pulmonary valve stenosis
  2. RV hypertrophy
  3. Overriding aorta Dobutamine - Correct Answer - inotropic vasopressor and increases myocardial contractility
  • decreases systemic and pulmonary vascular resistance
  • only slightly increases heart rate sharp edge sign - Correct Answer - cardiac border and the diaphragm are seen in sharp contrast
  • radiographic finding of a pneumothorax Sail sign - Correct Answer - results from free air lifting the thymus
  • radiographic sign of pneumomediastinum Subglottic stenosis - Correct Answer Can result from prolonged intubation Ventilation perfusion mismatch - Correct Answer - Va/Qc ratio expresses the interaction between pulmonary ventilation and perfusion
  • Matching ventilation and perfusion is required for efficient gas exchange
  • Mismatching is the most common cause of hypoxia Targeted preductal sats at delivery - Correct Answer - 1 minute: 60 - 65%
  • 2 minutes: 65 - 70%
  • 4 minutes: 75 - 80%
  • 10 minutes: 85 - 95% Intermittent mandatory ventilation - Correct Answer delivers breaths at a predetermined rate, irrespective of where the patient's spontaneous breath is in the respiratory cycle

DIC - Correct Answer - low platelet count

  • prolonged prothrombin time
  • partial thromboplastin time (although they may initially be normal)
  • increased level of fibrin split products
  • low fibrinogen level
  • increased level of D-dimer (the marker for DIC) Cryoprecipitate - Correct Answer greatest concentration of fibrinogen for DIC Kleihauer-Betke test - Correct Answer Test for prenatal hemorrhage by looking for fetal hemoglobin in maternal blood Hemophilia A - Correct Answer - Factor VIII deficiency
  • normal or prolonged partial thromboplastin time
  • normal prothrombin time
  • normal platelet count ABO incompatibility - Correct Answer - mothers have blood group O and the babies have blood group A or B
  • more common than Rh incompatibility, but less severe Neonatal alloimmune thrombocytopenia - Correct Answer - leading cause of severe thrombocytopenia in the newborn
  • occurs when maternal platelets come into contact with fetal platelets containing an antigen lacking in the mother
  • baby will have widespread petichiae, oozing, possible IVH w/ normal clotting factors (mom has normal plt level excluding autoimmune thrombocytopenia in both)
  • Maternal antibodies cross the placenta and coat the fetal platelets
  • Treatment includes giving the baby washed maternal platelets, which are free of the platelet antigen Grades of IVH - Correct Answer 1. bleeding confined to the germinal matrix
  1. blood within the ventricle and no associated dilatation of the ventricle

Cord gas - Correct Answer - pH > 7.25: WNL

  • pH 7.2-7.25: potential acidosis/depression at delivery
  • pH < 7.2: fetal compromise Decelerations - Correct Answer Early: head compression, normal Variable: cord compression, can indicate compromise with bradycardia/frequent decels Late: uteroplacental insufficiency