A 2-day-old infant with a patent ductus arteriosus (PDA) is receiving IV indomethacin. Which assessment finding would indicate a potential adverse effect requiring immediate intervention?
Ccrn Neonatal Cardiovascular
Question · Medium
An infant with hypoplastic left heart syndrome (HLHS) becomes irritable, diaphoretic, and tachypneic shortly after feeding. The nurse notes that the preductal SpO2 was 85% but is now 72%. What is the priority nursing intervention?
Question · Hard
Introduction and Exam Overview
1.1 Current Exam Facts
Study guide
Which of the following ECG findings would be most concerning in a neonate receiving digoxin for supraventricular tachycardia?
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A preterm infant with respiratory distress syndrome (RDS) on bubble CPAP at 6 cm H2O develops increasing respiratory distress. The nurse notes increased work of breathing with nasal flaring and seesaw respirations. The SpO2 is 88% on 35% oxygen. What is the most appropriate initial action?
Ccrn Neonatal Respiratory
An infant born at 28 weeks gestation develops pulmonary interstitial emphysema (PIE) following mechanical ventilation. Which ventilator strategy is most appropriate?
Which arterial blood gas result would be most consistent with a diagnosis of persistent pulmonary hypertension of the newborn (PPHN)?
1.2 Eligibility, Retakes, and Renewal
An infant with meconium aspiration syndrome (MAS) is receiving mechanical ventilation. The nurse notes sudden deterioration with bradycardia, decreased breath sounds on the right, and shifting of the cardiac apex beat. What is the priority intervention?
A premature infant with bronchopulmonary dysplasia (BPD) is being weaned from mechanical ventilation. Which finding best indicates readiness for extubation to nasal CPAP?
Which nursing intervention is most appropriate for an infant with congenital diaphragmatic hernia (CDH) immediately post-surgery?
An infant with apnea of prematurity is being started on caffeine citrate therapy. Which statement by the nurse indicates correct understanding of this medication?
Question · Easy
1.3 Synergy Model, Blueprint Weights, and NICU Foundations
The nurse is caring for an infant with suspected surfactant protein deficiency. Which finding would be most supportive of this diagnosis?
What is the primary mechanism of action for inhaled nitric oxide (iNO) in treating PPHN?
An infant with RDS is receiving volume-targeted ventilation. The set tidal volume is 4.5 mL/kg, but the ventilator shows actual delivered volumes of 6-7 mL/kg. What should the nurse do first?
A premature infant born at 32 weeks gestation has a total bilirubin of 12 mg/dL at 24 hours of age. The infant is receiving phototherapy. Which intervention is most important for the nurse to implement?
Ccrn Neonatal Endocrine Hematology Gi Renal Integ
Cardiovascular: Transition and Congenital Disease
2.1 Fetal Circulation, PDA, PFO, and Transitional Physiology
An infant with hemolytic disease of the newborn secondary to Rh incompatibility requires an exchange transfusion. Which laboratory value would be most important to monitor immediately following the procedure?
A 3-day-old preterm infant has a platelet count of 45,000/mm³. The infant appears well with no petechiae or bleeding. What is the most appropriate initial nursing action?
An infant born at 26 weeks gestation develops abdominal distension, gastric residuals, and bloody stools. The abdomen appears discolored. Which intervention should the nurse anticipate?
An infant with congenital adrenal hyperplasia (CAH) presents with ambiguous genitalia, vomiting, and lethargy. Which laboratory finding would be most consistent with this diagnosis?
2.2 Congenital Heart Defects
A preterm infant has serum glucose of 22 mg/dL. The infant is jittery and lethargic. What is the most appropriate initial treatment?
Which assessment finding in a neonate receiving total parenteral nutrition (TPN) requires immediate intervention?
An infant with omphalocele is born. The sac is intact. Which nursing intervention has the highest priority?
A preterm infant has an elevated blood urea nitrogen (BUN) of 35 mg/dL and creatinine of 1.5 mg/dL. Urine output is 0.8 mL/kg/hr. Which factor most likely contributes to these findings?
2.3 Neonatal Cardiac Surgery and Postoperative Care
Which infant is at highest risk for developing hypoglycemia?
An infant with Hirschsprung disease presents with abdominal distension and failure to pass meconium within 48 hours. Which diagnostic test is most definitive?
Which finding in an infant with polycythemia (hematocrit >65%) requires immediate intervention?
A nurse is caring for an infant with epidermolysis bullosa. Which nursing intervention is most appropriate?
Cardiovascular: Instability and Rhythm
3.1 Hemodynamic Instability, Monitoring, and Vascular Access
An infant is receiving phototherapy with fiberoptic blanket. The bilirubin level has decreased from 18 mg/dL to 12 mg/dL over 24 hours. What is the most appropriate nursing action?
An infant born at 32 weeks gestation has an intraventricular hemorrhage (IVH) diagnosed by cranial ultrasound. Which position should the nurse maintain to minimize risk of hemorrhage extension?
Ccrn Neonatal Neuro Musculoskeletal Psychosocial
An infant with myelomeningocele is born. The sac is leaking CSF. What is the priority nursing intervention?
An infant with hypoxic-ischemic encephalopathy (HIE) is receiving therapeutic hypothermia. Which parameter requires the most frequent monitoring?
3.2 Heart Failure, Tamponade, and Acquired Cardiac Conditions
Which finding in a neonate is most suggestive of a brachial plexus injury (Erb palsy)?
A mother of a premature infant in the NICU expresses feelings of guilt and states, "I must have done something wrong to make my baby come early." What is the most appropriate nursing response?
An infant with a suspected inborn error of metabolism presents with lethargy, poor feeding, and seizures. Which laboratory finding would be most concerning?
An infant develops tachycardia, hypotension, poor perfusion, and metabolic acidosis 24 hours after initiation of central line TPN. Which complication should the nurse suspect?
Ccrn Neonatal Multisystem
3.3 Neonatal Dysrhythmias and Cardioversion
Which infant meets criteria for early-onset sepsis requiring empiric antibiotic therapy?
An infant develops tachypnea, grunting, and hypoxemia 2 hours after receiving a blood transfusion. The chest x-ray shows diffuse pulmonary infiltrates. What is the most likely diagnosis?
An infant with suspected sepsis has the following arterial blood gas: pH 7.18, PaCO2 28, HCO3 10, base excess -18. Which acid-base disorder is present?
Which assessment finding best indicates adequate tissue perfusion in a neonate with septic shock?
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