Maternal Newborn Nursing Test Neonatal Complications and High-Risk Newborn 2 — Questions and Answers
Question 1: A newborn is diagnosed with hypoxic-ischemic encephalopathy (HIE). Which therapeutic intervention has been shown to improve neurological outcomes?
- Systemic corticosteroid administration
- Therapeutic hypothermia (cooling therapy) (Correct answer)
- High-frequency ventilation
- Early gavage feeding
Correct answer: Therapeutic hypothermia (cooling therapy)
Therapeutic hypothermia (cooling to 33–34°C for 72 hours) initiated within 6 hours of birth reduces neuronal apoptosis and improves neurological outcomes in term infants with moderate-to-severe HIE.
Question 2: A preterm neonate has a patent ductus arteriosus (PDA). Which sign would the nurse observe during assessment?
- Quiet precordium with no murmur
- Continuous machinery-like murmur at the left upper sternal border (Correct answer)
- Diastolic murmur at the right sternal border
- Friction rub heard over the apex
Correct answer: Continuous machinery-like murmur at the left upper sternal border
A PDA produces a characteristic continuous machinery-like murmur heard best at the left infraclavicular area due to continuous shunting of blood from the aorta to pulmonary artery.
Question 3: A nurse is caring for a neonate with intraventricular hemorrhage (IVH). Which behavior change would the nurse most likely observe?
- Excessive activity and crying
- Bulging anterior fontanel, apnea, and seizures (Correct answer)
- Hyperglycemia and polyuria
- Decreased oxygen requirements
Correct answer: Bulging anterior fontanel, apnea, and seizures
IVH in preterm infants presents with bulging fontanel due to increased intracranial pressure, along with apneic episodes and seizure activity reflecting neurological compromise.
Question 4: A 26-week preterm infant in the NICU has retinopathy of prematurity (ROP). What is the primary cause of this condition?
- Insufficient oxygen delivery to the retina
- Immature retinal blood vessel development disrupted by supplemental oxygen (Correct answer)
- Congenital infection of the optic nerve
- Genetic deficiency of retinal pigmentation
Correct answer: Immature retinal blood vessel development disrupted by supplemental oxygen
ROP occurs when immature retinal vasculature is disrupted by hyperoxia and fluctuating oxygen levels, leading to abnormal angiogenesis that can cause retinal detachment and blindness.
Question 5: A newborn is diagnosed with congenital hypothyroidism on newborn screen. Without treatment, which outcome is most likely?
- Precocious puberty
- Intellectual disability and growth retardation (Correct answer)
- Neonatal seizure disorder
- Congenital heart disease progression
Correct answer: Intellectual disability and growth retardation
Untreated congenital hypothyroidism causes cretinism — severe intellectual disability and stunted growth — because thyroid hormone is essential for early brain development.
Question 6: Which intervention is the most important in preventing infection in the NICU for high-risk neonates?
- Administering prophylactic broad-spectrum antibiotics to all preterm infants
- Strict hand hygiene by all personnel and family members (Correct answer)
- Keeping all infants in strict isolation rooms
- Using sterile gloves for all routine assessments
Correct answer: Strict hand hygiene by all personnel and family members
Consistent and proper hand hygiene by healthcare workers and visitors is the single most effective intervention for preventing healthcare-associated infections in vulnerable NICU patients.
