A newborn is delivered at 38 weeks gestation. The mother has a history of type 1 diabetes with poor glycemic control during pregnancy. Which newborn complication is most likely?
Lrn General Assessment
Question · Medium
The ROME trick for blood gases
Short
What does a Category III fetal heart rate tracing tell the team preparing for a birth?
General Assessment
Flashcard
A mother with a first-episode primary genital herpes simplex virus (HSV) infection has active lesions and delivers vaginally. What is the most appropriate management of the asymptomatic newborn?
Question · Hard
Chapter 1: Exam Overview & Maternal-Fetal Risk Assessment
1.1 RNC-LRN Exam Structure, Eligibility & Test Blueprint
Study guide
A newborn is assessed using the New Ballard Score. Which finding indicates a post-term infant (42+ weeks)?
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Why does maternal chorioamnionitis change the newborn's admission plan?
Using the New Ballard Score, a newborn has a popliteal angle of 180 degrees (score -1), and the scarf sign and heel-to-ear maneuver also score -1. Which gestational age do these neuromuscular findings suggest?
During a newborn assessment, the nurse notes a systolic murmur at the left lower sternal border that is louder when the infant is crying. The infant is pink with normal vital signs. What is the most likely cause?
How are late preterm, early term, full term, and post-term births defined by gestational week?
A nurse is assessing a 4-hour-old newborn and notes a soft, cystic swelling over the right parietal-occipital area that crosses the suture line. What is this finding called?
Question · Easy
1.2 Maternal Health Conditions & Prenatal Risk Factors
A nurse is performing the Neonatal Behavioral Assessment Scale (NBAS) on a 3-day-old infant. Which reflex, if absent, would be most concerning for neurologic integrity?
Symmetric versus asymmetric intrauterine growth restriction: what does each pattern suggest about timing and cause?
A term newborn has a venous hematocrit of 68% at 2 hours of age. The infant is plethoric but feeds well, with normal respiratory effort, normal tone and no neurologic signs. What is the priority nursing intervention?
A premature infant born at 32 weeks develops grunting, nasal flaring, and retractions at 2 hours of age. Chest x-ray shows a "ground glass" appearance with air bronchograms. What is the most likely diagnosis?
Lrn Pathophysiology
How do you tell caput succedaneum from a cephalohematoma at the bedside?
A term infant delivered by cesarean section develops tachypnea (RR 80) shortly after birth. The infant is pink with mild retractions. Chest x-ray shows fluid in the fissures and prominent perihilar markings. What is the most appropriate management?
1.3 Intrapartum Events & Fetal Surveillance Interpretation
A 36-week gestation infant has progressive respiratory distress and requires intubation. Chest x-ray shows diffuse, patchy infiltrates with hyperinflation. The mother had prolonged rupture of membranes with maternal fever. What is the most likely diagnosis?
What does an asymmetric Moro reflex tell you?
An infant with meconium aspiration syndrome is receiving mechanical ventilation. The nurse notes sudden deterioration with cyanosis, decreased breath sounds on the left, and shifted heart sounds. What complication has likely occurred?
A preterm infant with RDS on nasal CPAP has increasing oxygen requirements and respiratory distress. The infant is 12 hours old. Which intervention is most appropriate?
Which cord blood vessel reflects the newborn's own acid-base status, and what values define significant metabolic acidemia?
A term infant at 12 hours of age has a preductal (right hand) oxygen saturation of 95% and a postductal (foot) saturation of 84%. The infant is tachypneic and the chest radiograph shows clear lung fields. What does this differential cyanosis indicate?
1.4 Antepartum Fetal Surveillance, Labor Progression & Perinatal Screening
A newborn becomes cyanotic with feeding and crying. The cyanosis improves when the infant is calm and in knee-chest position. Which cardiac defect is most likely?
Which bedside findings suggest a hemodynamically significant patent ductus arteriosus?
Assessment and Management of Pathophysiologic Conditions
A term infant develops severe cyanosis within hours of birth that does not improve with supplemental oxygen (hyperoxia test shows PaO2 <100 mmHg on 100% FiO2). Chest x-ray shows a "egg on a string" cardiac silhouette. What is the diagnosis?
A newborn has weak or absent femoral pulses with upper extremity hypertension. Four-extremity blood pressures show a 25 mmHg gradient between arms and legs. What is the most likely diagnosis?
Which pulse and blood pressure pattern points to coarctation of the aorta?
A term infant born by vacuum-assisted delivery develops a cephalhematoma and becomes lethargic with poor feeding at 24 hours. The anterior fontanelle is bulging. What is the priority diagnostic test?
Chapter 2: Comprehensive Neonatal Assessment & Gestational Age
2.1 Physical Assessment & Normal Variations vs. Abnormalities
An infant born at 29 weeks gestation is now 48 hours old and develops apnea with bradycardia. The episodes are more frequent after feeding. What is the most likely cause?
Which cyanotic heart lesion barely improves when the infant is given 100% oxygen?
A 3-hour-old term infant of a mother with poorly controlled diabetes has seizure activity with horizontal eye deviation, blinking and swimming movements of the arms. The infant is afebrile and the bedside glucose is 18 mg/dL (1.0 mmol/L). What is the most likely etiology?
A preterm infant at 30 weeks gestation has a head ultrasound showing blood in the germinal matrix without ventricular dilation. Using the Papile classification, what grade is this hemorrhage?
How do respiratory distress syndrome and transient tachypnea of the newborn differ?
A term infant has not passed meconium within 48 hours of birth. The abdomen is distended and vomiting is noted. Rectal examination causes explosive passage of stool and flatus. What is the most likely diagnosis?
2.2 Gestational Age Assessment: New Ballard Score & Maturity Classification
A newborn is found to have an imperforate anus during the initial physical examination. Which associated pattern of anomalies should be investigated?
Why does congenital diaphragmatic hernia cause such severe respiratory failure, and what is the ventilation priority?
A premature infant at 32 weeks gestation, now 10 days old, develops feeding intolerance, abdominal distension, and bloody stools. Abdominal x-ray shows pneumatosis intestinalis. What is the diagnosis?
A male newborn has bilaterally undescended testes at 38 weeks gestation. What is the most appropriate nursing action?
Which measurement supports a diagnosis of persistent pulmonary hypertension of the newborn?
A newborn with ABO incompatibility (mother O+, baby A+) develops jaundice at 12 hours of age. The bilirubin is rising rapidly. Which complication is most concerning?
2.3 Neurobehavioral Assessment & Primitive Reflexes
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