Maternal Newborn Nursing Test Newborn Pharmacology and Procedures 2 — Questions and Answers
Question 1: Which finding would indicate a complication following a heel stick blood collection on a newborn?
- Calcified nodule or scar formation at the puncture site from repeated sticks (Correct answer)
- A small drop of blood at the puncture site
- Brief crying during the procedure
- Minimal bruising resolving within 24 hours
Correct answer: Calcified nodule or scar formation at the puncture site from repeated sticks
Repeated heel sticks in the same area can cause calcified nodules (calcinosis cutis) or scarring; sites should be rotated and the lateral aspects of the heel used to prevent this complication.
Question 2: A nurse is preparing to perform a circumcision care assessment. Which finding at the circumcision site requires provider notification?
- Purulent yellow discharge, peri-wound erythema spreading beyond the glans, and fever (Correct answer)
- A thin yellow exudate forming over the glans at 24–48 hours
- Slight swelling and redness immediately after the procedure
- A small amount of bleeding controlled with gentle pressure
Correct answer: Purulent yellow discharge, peri-wound erythema spreading beyond the glans, and fever
A thin yellow pseudomembrane forming over the glans is normal healing; spreading erythema, purulent discharge, and fever indicate infection requiring provider evaluation.
Question 3: Which pain management intervention is evidence-based for use during painful newborn procedures such as heel sticks?
- Oral sucrose solution given 2 minutes before the procedure (Correct answer)
- Topical EMLA cream applied 60 minutes before
- IV morphine administration
- No intervention is needed as newborns do not feel pain
Correct answer: Oral sucrose solution given 2 minutes before the procedure
Oral sucrose (24% solution, 0.5–2 mL) administered 2 minutes before painful procedures activates endogenous opioid pathways and reduces behavioral pain responses in newborns.
Question 4: A nurse is caring for a premature newborn at 30 weeks gestation who requires surfactant therapy. Which condition is this treatment intended to address?
- Respiratory distress syndrome (RDS) caused by insufficient surfactant production (Correct answer)
- Meconium aspiration syndrome
- Transient tachypnea of the newborn (TTN)
- Bronchopulmonary dysplasia
Correct answer: Respiratory distress syndrome (RDS) caused by insufficient surfactant production
Preterm infants lack sufficient surfactant, leading to alveolar collapse and RDS; exogenous surfactant therapy reduces surface tension, improves lung compliance, and decreases mortality.
Question 5: A newborn is ordered to receive ampicillin and gentamicin for suspected sepsis. Which nursing assessment is essential before administering gentamicin?
- Serum creatinine and BUN to assess renal function, and urine output (Correct answer)
- Liver function tests
- Blood glucose level
- Head circumference measurement
Correct answer: Serum creatinine and BUN to assess renal function, and urine output
Gentamicin is nephrotoxic and ototoxic; renal function (creatinine, BUN, urine output) must be assessed before each dose, and peak/trough levels monitored to prevent toxicity.
Question 6: When performing umbilical cord care, what should the nurse teach parents?
- Keep the cord dry, fold diapers below the cord, and allow it to dry and fall off naturally in 7–14 days (Correct answer)
- Clean the cord with alcohol swabs with each diaper change
- Cover the cord with petroleum jelly to prevent drying
- Bandage the cord stump to protect it from air exposure
Correct answer: Keep the cord dry, fold diapers below the cord, and allow it to dry and fall off naturally in 7–14 days
Current evidence supports dry cord care (keeping the cord clean and dry without antiseptic); the diaper should be folded below the cord to prevent urine contamination, and the cord naturally separates in 7–14 days.
