Chapter 4 Physical Assessment
1. When beginning the assessment of a newborn infant, which of the following should be performed last?
2. Prior to delivery, a mother received a number of doses of magnesium sulfate to treat her preeclampsia. Which of the following would be an expected finding in her newborn infant?
3. A full-term male infant is born by vaginal delivery with vacuum extraction. His Apgar score is 7 at 1 minute and 8 at 5 minutes. He is pink and active. The nurse notices that he has a fluctuant swelling over the back of the head. Bruising around the ears is also noted. The most likely cause is:
4. A newborn infant born at 37 weeks’ gestation is at the 5th percentile for weight and the 30th percentile for length and head circumference. The infant is at an increased risk of:
5. A female infant is born by cesarean section without difficulty. She is admitted to the NICU with a weight of 1.5 kg at 34 weeks’ gestation. On examination the nurse notes that the head and length are proportional to the body weight. These findings are most likely associated with:
6. A 4.2-kg, 41-week-gestation infant is admitted to the NICU because of tachypnea, grunting, and cyanosis. He was delivered vaginally with forceps, and his Apgar score was 4 at 1 minute and 7 at 5 minutes. On admission he requires an inspired oxygen fraction (Fio2) of 0.50 to achieve an oxygen saturation of 94%. Despite attempts to wean to room air, the infant has an increasing oxygen requirement. A chest radiograph is ordered that reveals patchy infiltrates with expansion of the chest to the tenth rib. This infant most likely has:
7. When examining a term infant of appropriate size for gestational age, the nurse finds several anomalies that include heart murmur, malformed ears, a short neck with excessive skin, Brushfield spots, a large tongue, and simian creases. The nurse also notices that the infant is hypotonic when the Ballard assessment is performed. These findings are most likely related to:
8. A term male infant is born by vaginal delivery to a 35-year-old primigravida mother. Following delivery, the infant is noted to have dramatic cyanosis and severe respiratory distress. He is transferred to the NICU for further evaluation. Physical findings include poor perfusion, diminished breath sounds, sunken abdomen, and loud heart sounds on the right side of the chest. The most likely diagnosis is:
9. An infant born at 34 weeks’ gestation is noted to have respiratory distress. A radiograph shows hazy lung fields, ascites, and pleural effusions. A review of the history is most likely to reveal maternal:
10. Cyanosis at birth is most likely to be present in an infant with:
11. During the initial physical examination of a newborn infant, the nurse palpates the pulses while assessing cardiac function. The nurse compares both brachial pulses for timing and intensity, and then compares both femoral pulses. A significant difference is noted when the brachial and femoral pulses are compared. What is the most likely diagnosis for this infant?
12. An infant is noted to have a moist erythematous rash in the groin area. Small white pustules are present. The most likely diagnosis is:
13. Dermal sinuses are most commonly found on which area of the spinal cord?
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