Download NNP Practice Exam (CCPR 2024) Questions with Complete Solutions | Verified Indication of and more Exams Nursing in PDF only on Docsity!
NNP Practice Exam (CCPR 2024) Questions
with Complete Solutions | Verified
Indication of a plugged endotracheal tube is
a. condensation in the endotracheal tube
b. sudden decrease in chest wall movement
c. tachycardia - Answer ✔️ ✔️ -b. sudden decrease in chest wall movement
A neonate has a low T4 and elevated TSH. The appropriate next step would be
a. begin thyroid hormone replacement therapy
b. monitor the infant for lethargy, hypotonia and feeding difficulties
c. recheck T4 and TSH levels at two months of age - Answer ✔️ ✔️ -a. begin thyroid hormone replacement therapy
A 32 week gestational age male neonate has a 4 cm nontender mass in the right testicle. Differential diagnosis can be faciliated by
a. palpation
b. transillumination
c. ultrasound evaluation - Answer ✔️ ✔️ -b. transillumination
A neonate who has been in the NICU for two weeks is demonstrating habituation in response to environmental stimuli. Habituation is best defined as
a. decreasing responsivity to external stimuli
b. increasing attention to a new stimulus
c. reacting vigorously to repeated stimuli - Answer ✔️ ✔️ -a. decreasing responsivity to external stimuli
Which sense becomes the neurodevelopmental interface between the infant and the world at birth?
a. Auditory
b. Tactile
c. Visual - Answer ✔️ ✔️ -b. Tactile
A newborn with respiratory distress has a chest x-ray that reveals unilateral or bilateral streaky densities and confluent mottled, opacified areas. The nurse should anticipate that initial intervention should be
a. initiation of antibiotics
b. sepsis workup
c. surfactant administration - Answer ✔️ ✔️ -b. sepsis workup
A neonate born to a mother given Demerol three hours prior to delivery is apneic and cyanotic with heart rate of 74 at one hour after birth. The initial intervention should be
a. administration of naloxone 0.1mg/kg
b. bag and mask ventilation
c. placement of endotracheal tube - Answer ✔️ ✔️ -b. bag and mask ventilation
The best recommendation for treatment of intraventricular hemorrhage is
a. management of ensuing problems
b. fluid restriction
c. Dopamine for blood pressure support - Answer ✔️ ✔️ -a. management of ensuing problems
Which congenital heart defect is suspected when a systolic murmur is heard at the location noted on the diagram?
c. surgical repair - Answer ✔️ ✔️ -b. physical therapy
On physical examination of a 4100 gm male neonate, a firm scrotal mass is palpated. The next step in the evaluation is
a. transillumination
b. ultrasound
c. x-ray - Answer ✔️ ✔️ -a. transillumination
The absence of which reflex distinguishes total brachial plexus palsy from Erb's palsy?
a. Grasp
b. Moro
c. Radical - Answer ✔️ ✔️ -a. Grasp
A Neuromuscular development characteristic of prematurity includes increased
a. heel to ear resistance
b. hip flexion and adduction
c. popliteal angle - Answer ✔️ ✔️ -c. popliteal angle
An infant is noted to have vertebral anomalies, a single umbilical artery, and a tracheoesophageal fistula. What studies should you consider obtaining?
a. echocardiogram
b. eye exam
c. renal ultrasound - Answer ✔️ ✔️ -c. renal ultrasound
The decreased ability of the preterm neonate to produce heat to maintain normal body temperature is most related to
a. decreased thermal receptors in the skin
b. large surface skin area relative to body mass
c. limited subcutaneous tissue and brown fat stores - Answer ✔️ ✔️ -c. limited subcutaneous tissue and brown fat stores
The nurse should recognize that the auditory sounds of the NICU can compromise a neonate's neurobehavioral development and that most noise is produced by
a. equipment
b. exogenous sources
c. staff - Answer ✔️ ✔️ -c. staff
Pro-coagulation factors II, VII, IX and X are activated by
a. fibrinogen maturation
b. prothrombin
c. vitamin K - Answer ✔️ ✔️ -c. vitamin K
The skin barrier function in the 25 week gestation neonate may take up to how many weeks to mature?
a. 2 weeks
b. 4 weeks
c. 8 weeks - Answer ✔️ ✔️ -c. 8 weeks
Which of the following is a true statement regarding neonatal hyperbilirubinemia?
a. Conjugated bilirubin is reabsorbed in the intestine
b. Newborn infants produce more bilirubin per day than adults
c. In VLBW infants, albumin has an increased affinity for bilirubin - Answer ✔️ ✔️ -b. Newborn infants produce more bilirubin per day than adults
Neonates born to mothers with uncontrolled phenylketonuria (PKU) are at increased risk for
a. cardiac defects
c. pulmonary vascular resistance - Answer ✔️ ✔️ -b. oxygen tension
The primary therapy for disseminated intravascular coagulation consists of
a. heparin administration
b. infusion of fresh frozen plasma
c. treatment of the underlying disorder - Answer ✔️ ✔️ -c. treatment of the underlying disorder
Intrauterine growth restricted infants are at risk for decreased glycogen stores because of
a. altered regulation of insulin secretion in pancreatic beta cells
b. hypoxia-induced increased catecholamine secretions
c. inhibition of gluconeogenesis secondary to high insulin concentrations - Answer ✔️ ✔️ -b. hypoxia-induced increased catecholamine secretions
The immunoglobulin that is secreted in breastmilk is
a. IgA
b. IgG
c. IgM - Answer ✔️ ✔️ -a. IgA
Language development delays are most likely noted in neonates exposed to maternal use of
a. alcohol
b. cocaine
c. nicotine - Answer ✔️ ✔️ -> a. alcohol
The Pierre Robin sequence may be a part of a syndrome such as
a. Smith-Lemli-Opitz Syndrome
b. Stickler Syndrome
c. VACTERL - Answer ✔️ ✔️ -b. Stickler Syndrome
The majority of hypertension in infants can be accounted for as a result of
a. endocrine disorders
b. intrinsic renal disease
c. umbilical artery catheter complications - Answer ✔️ ✔️ -b. intrinsic renal disease
An increase in cerebral blood flow can be expected in association with
a. decreased PCO₂
b. decreased PaO₂
c. decreased Kt level - Answer ✔️ ✔️ -b. decreased PaO₂
Physiologic jaundice is due to a combination of increased bilirubin load to the liver and
a. decreased excretion of bilirubin
b. defective conjugation due to increased glucuronyl transferase
c. increased hepatic uptake - Answer ✔️ ✔️ -a. decreased excretion of bilirubin
When placing a neonate on an oxygen saturation monitor, the nurse should recognize that a primary factor in obtaining an accurate reading is
a. adequate warming of the electrode
b. calibration of the monitor
c. perfusion status of the infant - Answer ✔️ ✔️ -c. perfusion status of the infant
Anemia of prematurity is characterized by a low reticulocyte count and
a. abnormal erythroid maturation
b. compromised bone marrow production
c. inadequate response to erythropoietin - Answer ✔️ ✔️ -inadequate response to erythropoietin
Limiting factors when deciding whether a LBW infant should be immunized per the CDC immunization schedule include
b. hyperglycemia
c. seizures - Answer ✔️ ✔️ -c. seizures
The best predictor of bilirubin toxicity is
a. bilirubin-albumin ratio
b. hearing impairment
c. total serum bilirubin concentration - Answer ✔️ ✔️ -hearing impairment
An infant who refers twice on an Auditory Brainstem Response test (ABR) should have a full scale auditory diagnostic evaluation by
a. 2 months of age
b. 3 months of age
c. 4 months of age - Answer ✔️ ✔️ -b. 3 months of age
The optimal time to perform a gestational age assessment for the neonate born at 26 weeks gestation is
a. 48-72 hours of age
b. after 72 hours of age
c. within 12 hours of age - Answer ✔️ ✔️ -c. within 12 hours of age
Lower fluid administration rates are associated with lower incidence of morbidity in neonates with
a. enterostomies
b. necrotizing enterocolitis
c. omphalocele - Answer ✔️ ✔️ -necrotizing enterocolitis
A preterm neonate who required resuscitation at birth is admitted to the neonatal intensive care nursery in stable condition. Care of this infant should include
a. a chest x-ray to rule out pneumothorax
b. insertion of urinary catheter to monitor output
c. oral feeding to prevent hypoglycemia - Answer ✔️ ✔️ -a. a chest x-ray to rule out pneumothorax
A preterm infant of a diabetic mother has experienced several seizures. The initial action that needs to be taken with this neonate is to
a. assess for metabolic imbalances
b. obtain ultrasound
c. perform lumbar puncture - Answer ✔️ ✔️ -a. assess for metabolic imbalances
Diagnosis of hypertelorism or hypotelorism is primarily based on the measurement represented by point
a. A
b. B
c. C - Answer ✔️ ✔️ -A
Preterm infants should receive the influenza vaccine at
a. 3 months of age
b. 6 months of age
c. 12 months of age - Answer ✔️ ✔️ -b. 6 months of age
Phototherapy is contraindicated with the following condition
a. breast milk jaundice
b. congenital erythropoietic porphyria
c. hemophilla - Answer ✔️ ✔️ -congenital erythropoietic porphyria
A woman on methadone wants to breastfeed. She should be advised that
a. supervised methadone use is considered safe
c. the infant's association of touch with pain - Answer ✔️ ✔️ -the infant's association of touch with pain
A neonate is oliguric. A 10-20 mL/kg body weight test dose of isotonic solution is given IV over 1 hour. If the problem is prerenal, the urine output should
a. decrease
b. increase
c. remain unchanged - Answer ✔️ ✔️ -b. increase
Validity as applied to a research instrument demonstrates
a. ability of the instrument to measure in a consistent manner
b. degree to which the instrument measures what it was purported to measure
c. how the instrument was able to correlate data it to the hypotheses - Answer ✔️ ✔️ -degree to which the instrument measures what it was purported to measure
T lymphocytes develop and differentiate in the
a. bone marrow
b. lymph nodes
c. thymus - Answer ✔️ ✔️ -thymus
In the newborn a tense fontalle is a/an
a. early sign of meninigitis
b. late sign of meningitis
c. sign of a subgaleal hemmorage - Answer ✔️ ✔️ -b. late sign of meningitis
The mandatory diagnostic test for infants suspected of having congenital syphilis is
a. CSF VDRL
b. fluorescent treponemal antibody absorption
c. serum VDRL - Answer ✔️ ✔️ -a. CSF VDRL
There is an increased risk of hypochloremia in neonates who
a. are asphyxiated at birth
b. had prolonged diarrhea
c. have been over-treated with diuretics - Answer ✔️ ✔️ -c. have been over-treated with diuretics
Compared to indomethacin, ibuprofen reduces the incidence of side effects in which system?
a. Gastrointestinal
b. Hepatic
c. Renal - Answer ✔️ ✔️ -c. Renal
The American Academy of Pediatrics recommends discharge of the late preterm infant after
a. 24 hours
b. 48 hours
c. 72 hours - Answer ✔️ ✔️ -b. 48 hours
When meconium aspiration syndrome is suspected, x-ray findings that would be confirmatory for the condition are
a. hyperexpansion
b. peripherial air bronchograms
c. reticulogranular pattern - Answer ✔️ ✔️ -hyperexpansion
Prior to administration of sodium bicarbonate for resuscitation, the following should be established
a. adequate ventilation
b. correction of hypovolemic shock
c. documentation of respiratory acidosis - Answer ✔️ ✔️ -a. adequate ventilation
c. herpes - Answer ✔️ ✔️ -gonorrhea
Absence of the ileocecal valve in the neonate with short bowel syndrome can lead to
a. bacterial overgrowth in the small bowel
b. nutritional deficiencies and cholestasis
c. watery or fatty diarrhea - Answer ✔️ ✔️ -bacterial overgrowth in the small bowel
Hirschsprung's disease occurs due to
a. abnormal gut motility
b. enzyme deficiency
c. ganglion cell deficiency - Answer ✔️ ✔️ -ganglion cell deficiency
Neonatal hypocalcemia is most likely to occur with
a. perinatal asphyxia
b. placental insufficiency
c. postmaturity - Answer ✔️ ✔️ -a. perinatal asphyxia
A provider asks a nurse to obtain a signature on informed consent for surgery. The nurse's responsibility in this situation is to
a. determine if patient was advised of the reasons, risks and benefits of the surgery
b. clarify any last minute questions for the patient about the surgery
c. insure at least two unbiased witnesses are present when the patient signs the form - Answer ✔️ ✔️ - a. determine if patient was advised of the reasons, risks and benefits of the surgery
On physical examination, a neonate is suspected to have transient pustular melanosis. It is anticipated that aspirating the contents of the pustules will reveal a variable number of
a. eosinophils
b. neutrophils
c. staphylococcus - Answer ✔️ ✔️ -neutrophils
Which milk protein is most difficult to digest?
a. casein
b. lysozyme
c. whey - Answer ✔️ ✔️ -a. casein
The most prominent and sensitive skin thermal receptors are in the
a. abdomen
b. crown of head
c. trigeminal area of the face - Answer ✔️ ✔️ -c. trigeminal area of the face
An important point to remember in the interpretation of cord blood gas sample is
a. oxygen levels are higher in the umbilical artery
b. oxygen levels are higher in the umbilical vein
c. oxygen levels are equal in the umbilical vein and artery - Answer ✔️ ✔️ -oxygen levels are higher in the umbilical vein
In determining the Apgar score of a neonate, the following findings are noted: One minute Color: Pale; Heart rate: 40 bpm; Reflexes: No response; Tone: Limp; Respirations: Weak and irregular. Five minutes Color: Pink/blue extremities; Heart rate: 90 bpm; Reflexes: Grimace; Tone: Limp; Respirations: Weak and irregular. The Apgar scores are
a. 2 at one minute and 4 at 5 minutes
b. 2 at one minute and 5 at 5 minutes
c. 3 at one minute and 6 at 5 minutes - Answer ✔️ ✔️ -a. 2 at one minute and 4 at 5 minutes
An asymptomatic mother's hepatitis screen reveals that she is HBsAg positive. This neonate
a. is not at risk since the mother is asymptomatic
b. damage to periventricular white matter
c. dilation of germinal matrix - Answer ✔️ ✔️ -damage to periventricular white matter
When comparing theophylline and caffeine for treatment of prematurity, the nurse should know that
a. caffeine has a more reliable enteral absorption than theophylline
b. caffeine is a more potent vasodilator
c. the half-life of theophylline is approximately two times that of caffeine - Answer ✔️ ✔️ -a. caffeine has a more reliable enteral absorption than theophylline
The nurse can facilitate parental adaption to their new role by
a. being a good listener
b. discussing the problems the medical staff deem important
c. providing parents indepth information on their first visit - Answer ✔️ ✔️ -a. being a good listener
Transporting a neonate from a regional hospital to a community hospital causes a decrease in parental
a. bonding
b. social support
c. trust - Answer ✔️ ✔️ -trust
In research, groups that bear the burden for research participation should be the group that will ultimately benefit from the results exemplifies the ethical principle of
a. autonomy
b. beneficence
c. justice - Answer ✔️ ✔️ -justice
Rib fractures are noted on routine chest x-ray on a 3 month old premature infant. The most likely cause of this finding is
a. congenital hypoparathyroidism
b. inadequate calcium and phosphorus intake
c. vitamin D deficiency due to malabsorption - Answer ✔️ ✔️ -inadequate calcium and phosphorus intake
Which of the following statements describes a practice fundamental to the implementation of an interdisciplinary developmental care team?
a. Care is delivered at regular timely intervals allowing adequate rest time.
b. Infants are prepared for care with hand containment prior to care procedure.
c. Minimize caloric expenditure by limiting movement of extremities with blanket rolls and other positioning aids. - Answer ✔️ ✔️ -Infants are prepared for care with hand containment prior to care procedure.
An increased incidence of low serum calcium levels occurs in neonates who
a. are dehydrated
b. have a history of asphyxia
c. have adrenal insufficiency - Answer ✔️ ✔️ -b. have a history of asphyxia
A factor that usually differentiates the pathophysiology between meconium ileus and meconium plug syndrome is
a. bilious vomiting
b. enzymatic deficiency
c. intestinal obstruction - Answer ✔️ ✔️ -enzymatic deficiency
A reliable indication of hydration status in the extremely low birth weight infant is
a. body weight
