Maternal Newborn Nursing Test Neonatal Complications and High-Risk Newborn 1 — Questions and Answers
Question 1: A preterm infant at 28 weeks gestation is placed on a mechanical ventilator for respiratory distress syndrome (RDS). Which medication is typically administered to promote lung maturity before preterm birth?
- Surfactant via endotracheal tube
- Betamethasone (corticosteroid) to the mother (Correct answer)
- Magnesium sulfate IV to the neonate
- Indomethacin to the infant
Correct answer: Betamethasone (corticosteroid) to the mother
Antenatal corticosteroids (betamethasone or dexamethasone) given to the mother 24–48 hours before preterm birth stimulate fetal surfactant production and significantly reduce RDS severity.
Question 2: A 30-week preterm infant develops abdominal distension, blood in the stool, and feeding intolerance. Which condition should the nurse suspect?
- Hirschsprung disease
- Necrotizing enterocolitis (NEC) (Correct answer)
- Pyloric stenosis
- Intussusception
Correct answer: Necrotizing enterocolitis (NEC)
Necrotizing enterocolitis is an acute intestinal inflammatory emergency in preterm infants presenting with abdominal distension, bloody stools, and feeding intolerance.
Question 3: A nurse is caring for a 32-week gestation newborn with respiratory distress syndrome. Surfactant replacement therapy is ordered. Via which route is surfactant administered?
- Intravenously
- Intramuscularly
- Endotracheally (Correct answer)
- Subcutaneously
Correct answer: Endotracheally
Exogenous surfactant is administered directly into the lungs via an endotracheal tube to replace deficient surfactant and improve alveolar stability in preterm infants.
Question 4: A newborn is born to a mother with insulin-dependent diabetes. Which complication is the newborn at HIGHEST risk for in the first hours of life?
- Hyperglycemia
- Hypocalcemia
- Hypoglycemia (Correct answer)
- Hypernatremia
Correct answer: Hypoglycemia
Infants of diabetic mothers have pancreatic beta-cell hyperplasia from chronic in utero hyperglycemia; after delivery they lose maternal glucose but continue producing excess insulin, causing hypoglycemia.
Question 5: A full-term newborn is diagnosed with transient tachypnea of the newborn (TTN). Which delivery method puts a newborn at higher risk for TTN?
- Vaginal delivery with prolonged labor
- Elective cesarean section without labor (Correct answer)
- Vacuum-assisted vaginal delivery
- Forceps-assisted vaginal delivery
Correct answer: Elective cesarean section without labor
TTN occurs when fetal lung fluid is not adequately expelled; labor contractions and passage through the birth canal compress the chest and help clear lung fluid — skipped in elective cesarean.
Question 6: A neonate is showing signs of neonatal abstinence syndrome (NAS). Which set of findings is consistent with this diagnosis?
- Hypotonia, lethargy, bradycardia, hypothermia
- High-pitched cry, tremors, poor feeding, diarrhea (Correct answer)
- Hypoglycemia, central cyanosis, weak suck
- Jaundice, hepatomegaly, petechiae
Correct answer: High-pitched cry, tremors, poor feeding, diarrhea
NAS results from opioid or other substance withdrawal and is characterized by high-pitched cry, irritability, tremors, poor feeding, and GI disturbances such as diarrhea.
